Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Geriatrics
Published in: BMC Geriatrics 1/2023

Open Access 01-12-2023 | Obesity | Research

Dietary behaviour change intervention for managing sarcopenic obesity among community-dwelling older people: a pilot randomised controlled trial

Authors: Yue-Heng Yin, Justina Yat Wa Liu, Maritta Välimäki

Published in: BMC Geriatrics | Issue 1/2023

Login to get access

Abstract

Background

The effects of dietary intervention in managing sarcopenic obesity are controversial, and behavior change techniques are lacking in previous studies which are important for the success of dietary intervention. This study aimed to evaluate the feasibility and preliminary effects of a dietary behaviour change (DBC) intervention on managing sarcopenic obesity among community-dwelling older people in the community.

Methods

A two-armed, RCT was conducted. Sixty community-dwelling older adults (≥ 60 years old) with sarcopenic obesity were randomised into either the experimental group (n = 30), receiving a 15-week dietary intervention combined with behaviour change techniques guided by the Health Action Process Approach model, or the control group (n = 30), receiving regular health talks. Individual semi-structured interviews were conducted with 21 experimental group participants to determine the barriers and facilitators of dietary behaviour changes after the intervention.

Results

The feasibility of the DBC intervention was confirmed by an acceptable recruitment rate (57.14%) and a good retention rate (83.33%). Compared with the control group, the experimental group significantly reduced their body weight (p = 0.027, d = 1.22) and improved their dietary quality (p < 0.001, d = 1.31). A positive improvement in handgrip strength (from 15.37 ± 1.08 kg to 18.21 ± 1.68 kg), waist circumference (from 99.28 ± 1.32 cm to 98.42 ± 1.39 cm), and gait speed (from 0.91 ± 0.02 m/s to 0.99 ± 0.03 m/s) was observed only in the experimental group. However, the skeletal muscle mass index in the experimental group decreased. The interview indicated that behaviour change techniques enhanced the partcipants’ compliance with their dietary regimen, while cultural contextual factors (e.g., family dining style) led to some barriers.

Conclusion

The DBC intervention could reduce body weight, and has positive trends in managing handgrip strength, gait speed, and waist circumference. Interestingly, the subtle difference between the two groups in the change of muscle mass index warrants futures investigation. This study demonstrated the potential for employing dietary behaviour change interventions in community healthcare.

Trial registration

Registered retrospectively on ClinicalTrailas.gov (31/12/2020, NCT04690985).
Appendix
Available only for authorised users
Literature
1.
Newman AB, Lee JS, Visser M, Goodpaster BH, Kritchevsky SB, Tylavsky FA, et al. Weight change and the conservation of lean mass in old age: the Health, Aging and Body Composition Study. Am J Clin Nutr. 2005;82(4):872–8.PubMed
2.
Roubenoff R. Sarcopenic obesity: the confluence of two epidemics. Obesity. 2004;12(6):887.
3.
Kemmler W, Teschler M, Weissenfels A, Bebenek M, Von Stengel S, Kohl M, et al. Whole-body electromyostimulation to fight sarcopenic obesity in community-dwelling older women at risk. Resultsof the randomized controlled FORMOsA-sarcopenic obesity study. Osteoporos Int. 2016;27(11):3261–70.PubMed
4.
Polyzos SA, Margioris AN. Sarcopenic obesity. Hormones. 2018;17(3):321–31.PubMed
5.
Goisser S, Kemmler W, Porzel S, Volkert D, Sieber CC, Bollheimer LC, et al. Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons–a narrative review. Clin Interv Aging. 2015;10:1267.PubMedPubMedCentral
6.
Kob R, Bollheimer LC, Bertsch T, Fellner C, Djukic M, Sieber CC, et al. Sarcopenic obesity: molecular clues to a better understanding of its pathogenesis? Biogerontology. 2015;16(1):15–29.PubMed
7.
Godziuk K, Prado CM, Woodhouse LJ, Forhan M. The impact of sarcopenic obesity on knee and hip osteoarthritis: a scoping review. BMC Musculoskelet Disord. 2018;19(1):1–10.
8.
Kim TN, Choi KM. The implications of sarcopenia and sarcopenic obesity on cardiometabolic disease. J Cell Biochem. 2015;116(7):1171–8.PubMed
9.
Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky SB, Ferrucci L. Sarcopenic obesity-definition, etiology and consequences. Curr Opin Clin Nutr Metab Care. 2008;11(6):693.PubMedPubMedCentral
10.
Chen MBH, Wang S, Sun W, Li R, Gao ZH, Sun JQ. Prevalence of sarcopenic obesity among the older people in Shanghai. The 17th Symposium of Danone Institute China; Shanghai2014.
11.
Yin Y-H, Liu JYW, Välimäki M. Effectiveness of non-pharmacological interventions on the management of sarcopenic obesity: a systematic review and meta-analysis. Exp Gerontol. 2020;135:110937.PubMed
12.
Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. Aging is associated with diminished accretion of muscle proteins after the ingestion of a small bolus of essential amino acids. Am J Clin Nutr. 2005;82(5):1065–73.PubMed
13.
Paddon-Jones D, Sheffield-Moore M, Katsanos CS, Zhang X-J, Wolfe RR. Differential stimulation of muscle protein synthesis in elderly humans following isocaloric ingestion of amino acids or whey protein. Exp Gerontol. 2006;41(2):215–9.PubMed
14.
Chinese Society of Nutrition. (2016) The Dietary Guidelines for Chinese Residents.
15.
16.
Muscariello E, Nasti G, Siervo M, Di Maro M, Lapi D, D’Addio G, et al. Dietary protein intake in sarcopenic obese older women. Clin Interv Aging. 2016;11:133.PubMedPubMedCentral
17.
Sammarco R, Marra M, Di Guglielmo ML, Naccarato M, Contaldo F, Poggiogalle E, et al. Evaluation of hypocaloric diet with protein supplementation in middle-aged sarcopenic obese women: a pilot study. Obes Facts. 2017;10(3):160–7.PubMedPubMedCentral
18.
Deutz NE, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr. 2014;33(6):929–36.PubMedPubMedCentral
19.
Morley JE, Argiles JM, Evans WJ, Bhasin S, Cella D, Deutz NE, et al. Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc. 2010;11(6):391–6.PubMedPubMedCentral
20.
21.
Kraus WE, Bhapkar M, Huffman KM, Pieper CF, Das SK, Redman LM, et al. 2 years of calorie restriction and cardiometabolic risk (CALERIE): exploratory outcomes of a multicentre, phase 2, randomised controlled trial. The Lancet Diabetes & Endocrinology. 2019;7(9):673–83.
22.
Desroches S, Lapointe A, Ratté S, Gravel K, Légaré F, Turcotte S. (2013) Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. Cochrane Database Syst Rev(2).
23.
Burgess E, Hassmén P, Pumpa KL. Determinants of adherence to lifestyle intervention in adults with obesity: a systematic review. Clin Obes. 2017;7(3):123–35.PubMed
24.
Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Trials. 2010;11(1):1–8.
25.
Chinese Centre for Disease Control. (2006) Guideline for the prevention and control of obesity in Chinese adults. Beijing. p. 44 – 5.
26.
Chen L-K, Woo J, Assantachai P, Auyeung T-W, Chou M-Y, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300–7. e2.PubMed
27.
Thabane L, Ma J, Chu R, Cheng J, Ismaila A, Rios LP, et al. A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol. 2010;10(1):1–10.PubMedPubMedCentral
28.
Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Health. 2008;31(2):180–91.PubMed
29.
Schwarzer R, Luszczynska A. How to overcome health-compromising behaviors: the health action process approach. Eur Psychol. 2008;13(2):141–51.
30.
Chiu CY, Lynch RT, Chan F, Berven NL. The Health action process Approach as a motivational model for physical activity self-management for people with multiple sclerosis: a path analysis. Rehabil Psychol. 2011;56(3):171.PubMed
31.
Schwarzer R, Renner B. Social-cognitive predictors of health behavior: action self-efficacy and coping self-efficacy. Health Psychol. 2000;19(5):487.PubMed
32.
33.
Ioannidis JP, Evans SJ, Gøtzsche PC, O’neill RT, Altman DG, Schulz K, et al. Better reporting of harms in randomized trials: an extension of the CONSORT statement. Ann Intern Med. 2004;141(10):781–8.PubMed
34.
Lee PH, Yu Y, McDowell I, Leung GM, Lam T, Stewart SM. Performance of the international physical activity questionnaire (short form) in subgroups of the Hong Kong chinese population. Int J Behav Nutr Phys Activity. 2011;8(1):1–10.
35.
Schardt C, Adams MB, Owens T, Keitz S, Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007;7(1):1–6.
36.
Neuendorf KA. The content analysis guidebook. Sage; 2017.
37.
Chan ZC, Fung Y-l, Chien W-t. Bracketing in phenomenology: only undertaken in the data collection and analysis process. Qualitative Rep. 2013;18(30):1–9.
38.
Chen HT, Chung YC, Chen YJ, Ho SY, Wu HJ. Effects of different types of exercise on body composition, muscle strength, and IGF-1 in the elderly with sarcopenic obesity. J Am Geriatr Soc. 2017;65(4):827–32.PubMed
39.
Kemmler W, Weissenfels A, Teschler M, Willert S, Bebenek M, Shojaa M et al. (2017) Whole-body electromyostimulation and protein supplementation favorably affect sarcopenic obesity in community-dwelling older men at risk: the randomized controlled FranSO study. Clinical interventions in aging.12:1503.
40.
Meng P, Hu YX, Fan L, Zhang Y, Zhang MX, Sun J, et al. Sarcopenia and sarcopenic obesity among men aged 80 years and older in B eijing: prevalence and its association with functional performance. Geriatr Gerontol Int. 2014;14:29–35.PubMed
41.
Du Y, Wang X, Xie H, Zheng S, Wu X, Zhu X, et al. Sex differences in the prevalence and adverse outcomes of sarcopenia and sarcopenic obesity in community dwelling elderly in East China using the AWGS criteria. BMC Endocr Disord. 2019;19(1):1–11.
42.
Van Achterberg T, Huisman-de Waal GG, Ketelaar NA, Oostendorp RA, Jacobs JE, Wollersheim HC. How to promote healthy behaviours in patients? An overview of evidence for behaviour change techniques. Health Promot Int. 2011;26(2):148–62.PubMed
43.
44.
Fukushima Y, Kurose S, Shinno H, Thu HC, Takao N, Tsutsumi H, et al. Importance of lean muscle maintenance to improve insulin resistance by body weight reduction in female patients with obesity. Diabetes Metab J. 2016;40(2):147.PubMedPubMedCentral
45.
Bosy-Westphal A, Kossel E, Goele K, Later W, Hitze B, Settler U, et al. Contribution of individual organ mass loss to weight loss–associated decline in resting energy expenditure. Am J Clin Nutr. 2009;90(4):993–1001.PubMed
46.
Ross R, Dagnone D, Jones PJ, Smith H, Paddags A, Hudson R, et al. Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men: a randomized, controlled trial. Ann Intern Med. 2000;133(2):92–103.PubMed
47.
Santanasto AJ, Glynn NW, Newman MA, Taylor CA, Brooks MM, Goodpaster BH et al. (2011) Impact of weight loss on physical function with changes in strength, muscle mass, and muscle fat infiltration in overweight to moderately obese older adults: a randomized clinical trial. J Obes.2011.
48.
Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011;364(13):1218–29.PubMedPubMedCentral
49.
Cohen J. Statistical power analysis for the behavioral sciences. Academic press; 2013.
50.
Beavers KM, Nesbit BA, Kiel JR, Sheedy JL, Arterburn LM, Collins AE, et al. Effect of an Energy-Restricted, nutritionally complete, higher protein meal plan on body composition and mobility in older adults with obesity: a Randomized Controlled Trial. The Journals of Gerontology: Series A. 2018;74(6):929–35. https://​doi.​org/​10.​1093/​gerona/​gly146.CrossRef
51.
Subar AF, Crafts J, Zimmerman TP, Wilson M, Mittl B, Islam NG, et al. Assessment of the accuracy of portion size reports using computer-based food photographs aids in the development of an automated self-administered 24-hour recall. J Am Diet Assoc. 2010;110(1):55–64.PubMedPubMedCentral
52.
Pavasini R, Guralnik J, Brown JC, Di Bari M, Cesari M, Landi F, et al. Short physical performance battery and all-cause mortality: systematic review and meta-analysis. BMC Med. 2016;14(1):1–9.
53.
Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr. 2003;133(11):3476–84.PubMed
54.
Research E. (1984) Food Processor® software.
55.
Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med. 2002;18(4):737–57.PubMed
56.
He X-y, Liu X-q. Evaluation of reliability and validity of mini-nutritional assessment and chinese nutrition screen. Nurs J Chin People’s Liberation Army. 2010;27:894–6.
57.
Li L, Wang H, Shen Y. Chinese SF-36 Health Survey: translation, cultural adaptation, validation, and normalisation. J Epidemiol Community Health. 2003;57(4):259–63.PubMedPubMedCentral
Metadata
Title
Dietary behaviour change intervention for managing sarcopenic obesity among community-dwelling older people: a pilot randomised controlled trial
Authors
Yue-Heng Yin
Justina Yat Wa Liu
Maritta Välimäki
Publication date
01-12-2023
Publisher
BioMed Central
Keywords
Obesity
Obesity
Published in
BMC Geriatrics / Issue 1/2023
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-023-04327-w

Other articles of this Issue 1/2023

BMC Geriatrics 1/2023 Go to the issue

Research

Computer-based cognitive tests and cerebral pathology among Japanese older adults

Research

Characterization of patients admitted to specialized geriatric acute care hospital units with the German version of the Standardized Evaluation and Intervention for Seniors at Risk (SEISAR) screening-instrument: a cross-sectional study

Research

Association between positive control in self-perceptions of aging and motoric cognitive risk syndrome among Chinese community-dwelling older adults: a cross-sectional study

Research

A comparison of four dementia palliative care services using the RE-AIM framework

Research

Safer cycling in older age (SiFAr): effects of a multi-component cycle training. a randomized controlled trial

Research

The relationship between self-reported physical frailty and sensor-based physical activity measures in older adults – a multicentric cross-sectional study
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits