Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Current Diabetes Reports
Erschienen in: Current Diabetes Reports 10/2014

01.10.2014 | Lifestyle Management to Reduce Diabetes/Cardiovascular Risk (EM Venditti, Section Editor)

Weight Loss and Physical Activity for Disease Prevention in Obese Older Adults: an Important Role for Lifestyle Management

verfasst von: Willy Marcos Valencia, Mark Stoutenberg, Hermes Florez

Erschienen in: Current Diabetes Reports | Ausgabe 10/2014

Einloggen, um Zugang zu erhalten

Abstract

Weight loss in older adults has been a controversial topic for more than a decade. An obesity paradox has been previously described and the issue of weight status on health outcomes remains a highly debated topic. However, there is little doubt that physical activity (PA) has a myriad of benefits in older adults, especially in obese individuals who are inactive and have a poor cardiometabolic profile. In this review, we offer a critical view to clarify misunderstandings regarding the obesity paradox, particularly as it relates to obese older adults. We also review the evidence on PA and lifestyle interventions for the improvement of cardiorespiratory fitness, which can prevent disease and provide benefits to obese older adults, independent of weight changes.
Literatur
1.
2.
3.•
TOS Obesity Writing Group, Allison DB, Downey M, Atkinson RL, et al. Obesity as a disease: a white paper on evidence and arguments commissioned by the council of The Obesity Society. Obesity. 2008;16:1161–77. This article, ahead of its time, allows the reader not only to better understand the definition and implications of defining obesity and disease, but also to incorporate language and concepts that will be extremely useful when discussing with patients about the definition of obesity as a disease.PubMedCrossRef
4.
AACE Position Statement, Mechanick JI, Garber AJ, Handelsman Y, Garvey WT. American association of clinical endocrinologists’ position statement on obesity and obesity medicine. Endocr Pract. 2012;18:642–8.PubMedCrossRef
5.
6.
7.
8.
Loef M, Walach H. Midlife obesity and dementia: meta-analysis and adjusted forecast of dementia prevalence in the United States and China. Obesity. 2013;21:E51–5.PubMedCrossRef
9.
Darmon P. Intentional weight loss in older adults: useful or wasting disease generating strategy. Curr Opin Clin Nutr Metab Care. 2013;16:284–9.PubMedCrossRef
10.
Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS obesity guideline. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and The Obesity Society. Circulation 2013; 00:000–000.
11.
12.
Reed JL, Chaput J-P, Tremblay A, Doucet E. The maintenance of energy balance is compromised after weight loss. Can J Diabetes. 2013;37:121–7.PubMedCrossRef
13.
DeFronzo RA, Abdul-Ghani MA. Preservation of β-cell function: the key to diabetes prevention. J Clin Endocrinol Metab. 2011;96:2354–66.PubMedCrossRef
14.
Kirkman S, Briscoe VJ, Clark N, et al. Diabetes in older adults: a consensus report. J Am Geriatr Soc. 2012;60:2342–56.CrossRef
15.
Alpert MA, Omran J, Mehra A, Ardhanari S. Impact of obesity and weight loss on cardiac performance and morphology in adults. Prog Cardiovasc Dis. 2014;56:391–400.PubMedCrossRef
16.
Chrostowska M, Szyndler A, Hoffmann M, Narkiewicz K. Impact of obesity on cardiovascular health. Best Pract Res Clin Endocrinol Metab. 2013;27:147–56.PubMedCrossRef
17.
Bastien M, Poirier P, Lemieux I, Després J-P. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis. 2014;56:369–81.PubMedCrossRef
18.
Kannel WB, Wilson PW, Nam BH, D’Agostino RB. Risk stratification of obesity as a coronary risk factor. Am J Cardiol. 2002;90:687–701.CrossRef
19.
McClain J, Hsu F, Brown E, et al. Pericardial adipose tissue and coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA). Obesity. 2013;21:1056–63.PubMedCrossRefPubMedCentral
20.
21.
Wassel CL, Laughlin GA, Araneta MR, et al. Associations of pericardial and intrathoracic fat with coronary calcium presence and progression in a multiethnic study. Obesity. 2013;21:1704–12.PubMedCrossRefPubMedCentral
22.
Grabowski DC, Ellis JE. High body mass index does not predict mortality in older people: analysis of the longitudinal study of aging. JA GS. 2001;49:968–79.
23.
Gruberg L, Weissman NJ, Waksman R, et al. The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: the obesity paradox? J Am Coll Cardiol. 2002;39:578–84.PubMedCrossRef
24.
25.
Carnethon MR, De Chavez PJD, Biggs ML, et al. Association of weight status with mortality in adults with incident diabetes. JAMA. 2012;308:581–90.PubMedPubMedCentral
26.
Florez H, Castillo-Florez S. Beyond the obesity paradox in diabetes. Fitness, fatness and mortality. Editorial. JAMA. 2012;308:619–20.PubMedCrossRef
27.
28.••
Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories. A systematic review and meta-analysis. JAMA. 2013;309:71–82. This meta-analysis confirms the expected association between obesity and increased risk for all-cause mortality. The data was stronger in older adults, which is the focus of this review.PubMedCrossRef
29.
De Schutter A, Lavie CJ, Milani RV. The impact of obesity on risk factors and prevalence and prognosis of coronary heart disease—the obesity paradox. Prog Cardiovasc Dis. 2014;56:401–8.PubMedCrossRef
30.
Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol. 2014;63:1345–54.PubMedCrossRef
31.
Lavie CJ, Alpert MA, Arena R, Mehra MR, Milani RV, Ventura HO. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure. J Am Coll Cardiol HF. 2013;1:93–102.
32.
McAuley PA, Beavers KM. Contribution of cardiorespiratory fitness to the obesity paradox. Prog Cardiovasc Dis. 2014;56:434–40.PubMedCrossRef
33.
Barry VW, Baruth M, Beets MW, Durstine JL, Liu J. Blair SN. Fitness vs fatness on all-cause mortality: a meta-analysis. Prog Cardiovasc Dis. 2014;56:382–90.PubMedCrossRef
34.
Banack HR, Kaufman JS. The obesity paradox: understanding the effect of obesity on mortality among individuals with cardiovascular disease. Prev Med. 2014;62:96–102.PubMedCrossRef
35.
Preston SH, Stokes A. Obesity paradox. Conditioning on disease enhances biases in estimating the mortality risks of obesity. Epidemiol. 2014;25:454–61.CrossRef
36.
Zheng H, Tumin D, Qian Z. Obesity and mortality risk: new findings from body mass index trajectories. Am J Epidemiol. 2013;178:1591–9.PubMedCrossRef
37.
Wildman RP, Muntner P, Reynolds K, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering. Prevalence and correlates of 2 phenotypes among the US populations (NHANES 1999–2004). Arch Intern Med. 2008;168:1617–24.PubMedCrossRef
38.
Hamer M, Stamatakis E. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. J Clin Endocrinol Metab. 2012;97:2482–8.PubMedCrossRefPubMedCentral
39.
Hinnouho G-M, Czernichow S, Dugravot A, Batty GD, Kivimaki M, Singh-Manoux A. Metabolically healthy obesity and risk of mortality. Does the definition of metabolic health matter? Diabetes Care. 2013;36:2294–300.PubMedCrossRefPubMedCentral
40.•
Kramer CK, Zinman B, Retnakaran R. Are metabolically healthy overweight and obesity benign conditions? A systematic review and meta-analysis. Ann Intern Med. 2013;159:758–69. This systematic review offers a great insight to the suggested concept of healthy obesity, with results consistent with the prevalent need to address and manage obesity.PubMedCrossRef
41.
Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky S, Ferrucci L. Sarcopenic obesity—definition, etiology and consequences. Curr Opin Clin Nutr Metab Care. 2008;11:693–700.PubMedCrossRefPubMedCentral
42.
Jensen GL, Hsiao PY. Obesity in older adults: relationship to functional limitation. Curr Opin Clin Nutr Metab Care. 2010;13:46–51.PubMedCrossRef
43.•
Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol 2014; Mar 6 [Epub ahead of print]. This review offers a great insight to the pathophysiology of sarcopenic obesity and the metabolic and endocrinologic issues of sarcopenia, age-related or disease-related.
44.
Chung J-Y, Kang H-T, Lee D-K, Lee H-R, Lee Y-J. Body composition and its association with cardiometabolic risk factors in the elderly: a focus on sarcopenic obesity. Arch Gerontol Geriatr. 2013;56:270–8.PubMedCrossRef
45.
46.
Visser M. Symposium 2: exercise and protein nutrition. Obesity, sarcopenia and their functional consequences in old age. Proc Nutr Soc. 2011;70:114–8.PubMedCrossRef
47.
Espeland MA, Rejeski WJ, West DS, et al. Intensive weight loss intervention in older individuals: results from the action for health in diabetes type 2 diabetes mellitus trial. J Am Geriatr Soc. 2013;61:912–22.PubMedCrossRefPubMedCentral
48.
Gaesser GA, Angadi SS, Sawyer BJ. Exercise and diet, independent of weight loss, improve cardiometabolic risk profile in overweight and obese individuals. Phys Sports Med. 2011;39:87–97.CrossRef
49.
50.
51.
Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343–50.PubMedCrossRef
52.
Knowler WC, Barrett-Connor E, Flowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle interventions or metformin. N Engl J Med. 2002;346:393–403.PubMedCrossRef
53.
Wing RR, Hamman RF, Bray GA, et al. Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res. 2004;12:1426–34.PubMedCrossRef
54.
Crandall J, Schade D, Ma Y, et al. The influence of age on the effects of lifestyle modification and metformin in prevention of diabetes. J Gerontol: Med Sci. 2006;61A:1075–81.
55.
Davis N, Ma Y, Delahanty LM, et al. Predictors of sustained reduction in energy and fat intake in the Diabetes Prevention Program Outcomes Study intensive lifestyle intervention. J Acad Nutr Diet. 2013;113:1455–64.PubMedCrossRef
56.
Delahanty LM, Peyrot M, Shrader PJ, et al. Pretreatment, psychological, and behavioral predictors of weight outcomes among lifestyle intervention participants in the Diabetes Prevention Program (DPP). Diabetes Care. 2013;36:34–40.PubMedCrossRefPubMedCentral
57.
Kowall B, Rathmann W, Heier M, et al. Impact of weight and weight change on normalization of prediabetes and on persistence of normal glucose tolerance in an older population: the KORA S4/F4 study. Int J Obes. 2012;36:826–33.CrossRef
58.
Church TS, LaMonte MJ, Barlow CE, Blair SN. Cardiorespiratory fitness and body mass index as predictors of cardiovascular disease mortality among men with diabetes. Arch Intern Med. 2005;165:2114–20.PubMedCrossRef
59.
Jakicic JM, Jaramillo SA, Balasubramanyam A, et al. Effect of a lifestyle intervention on change in cardiorespiratory fitness in adults with type 2 diabetes: results from the Look AHEAD study. Int J Obes. 2009;33:305–16.CrossRef
60.
61.
Clark AL, Fonarow GC, Horwich TB. Obesity and the obesity paradox in heart failure. Prog Cardiovasc Dis. 2014;56:409–14.PubMedCrossRef
62.
Atkins JL, Whincup PH, Morris RW, Lennon LT, Papacosta O, Wannamethee SG. Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men. J Am Geriatr Soc. 2014;62:253–60.
63.
Brown CJ, Flood KL. Mobility limitation in the older patient. A clinical review. JAMA. 2013;310:1168–77.PubMedCrossRef
64.
Bouchonville MF, Villareal DT. Sarcopenic obesity: how do we treat it? Curr Opin Endocrinol Diabetes Obes. 2013;20:412–9.PubMedCrossRef
65.
Pahor M, Guralnik JM, Ambrosius WT, et al. Effect of structured physical activity on prevention of major mobility disability in older adults. The LIFE study randomized clinical trial. JAMA. 2014;311:2387–96.
66.
Delahanty LM. The Look AHEAD study: implications for clinical practice go beyond the headlines. J Acad Nutr Diet. 2014;114:537–42.PubMedCrossRef
67.
Florez H, Pan Q, Ackerman RT, et al. Impact of lifestyle intervention and metformin on health-related quality of life: the Diabetes Prevention Program randomized trial. J Gen Intern Med. 2012;27:1594–601.PubMedCrossRefPubMedCentral
68.
Ali MK, Echouffo-Tcheugui JB, Williamson DF. How effective were lifestyle interventions in real-world settings that were modeled on the Diabetes Prevention Program? Health Aff. 2012;31:67–75.CrossRef
69.
Harwell TS, Vanderwood KK, Hall TO, Butcher MK, Helgerson SD. The Montana Cardiovascular Disease and Diabetes Prevention Workgroup. Factors associated with achieving a weight loss goal among participants in an adapted Diabetes Prevention Program. Prim Care Diabetes. 2011;5:125–9.PubMedCrossRef
70.
West DS, Bursac Z, Cornell CE, et al. Lay health educators translate a weight-loss intervention in senior centers: a randomized controlled trial. Am J Prev Med. 2011;41:385–91.PubMedCrossRef
71.
Johnson JA, McIlroy WE, Papaioannou A, Thabane L, Giangregorio L. Feasibility study of walking for exercise in individuals living in assisted living settings. J Geriatr Phys Ther. 2013;36:175–81.PubMedCrossRef
72.
73.
74.
75.
76.
Villareal DT, Banks M, Siener C, Sinacore DR, Klein S. Physical frailty and body composition in obese elderly men and women. Obes Res. 2004;12:913–20.PubMedCrossRef
77.
Waters DL, Ward AL, Villareal DT. Weight loss in obese adults 65 years and older: a review of the controversy. Exp Gerontol. 2013;48:1054–61.PubMedCrossRef
78.
Blüher S, Markert J, Hergert S, et al. Who should we target for diabetes prevention and diabetes risk reduction? Curr Diabetes Rep. 2012;12:147–56.CrossRef
79.
Basu S, Seligman H, Winkleby M. A metabolic-epidemiological microsimulation model to estimate the changes in energy intake and physical activity necessary to meet the Health People 2020 obesity objective. Am J Public Health. 2014;104:1209–16.PubMedCrossRefPubMedCentral
80.
Avenell A, Broom J, Brown TJ, et al. A systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technol Assess. 2004;8:1–182.
81.
Herman WH, Edelstein SL, Ratner R, et al. Effectiveness and cost-effectiveness of diabetes prevention among adherent participants. Am J Manag Care. 2013;19:194–202.PubMedPubMedCentral
82.
Krukowski RA, Lensing S, Love S, et al. Training of lay health educators to implement an evidence-based behavioral weight loss intervention in rural senior centers. The Gerontologist. 2012;53:162–71.PubMedCrossRef
83.
Krukowski RA, Pope RA, Love S, et al. Examination of costs for a lay health educator-delivered translation of the Diabetes Prevention Program in senior centers. Prev Med. 2013;57:400–2.PubMedCrossRef
84.
Prohaska T, Belansky E, Belza B, et al. Physical activity, public health, and aging: critical issues and research priorities. J Gerontol: Soc Sci. 2006;61:S267–73.CrossRef
85.
Barnes PM, Schoenborn CA. Physical activity among adults: United States, 2000: advance data from vital and health statistics. CDC Natl Cent Health Stat. 2003;333:15.
86.
Wang F, McDonald T, Reffitt B, Edington DW. BMI, physical activity, and health care utilization/costs among medicare retirees. Obes Res. 2005;13:1450–7.PubMedCrossRef
87.
Biedenweg K, Meischke H, Bohl A, et al. Understanding older adults’ motivators and barriers to participating in organized programs supporting exercise behaviors. J Prim Prev. 2014;35:1–11.PubMedCrossRef
88.
Michael YL, Nagel CL, Gold R, Hillier TA. Does change in the neighborhood environment prevent obesity in older women? Soc Sci Med. 2014;102:129–37.PubMedCrossRef
89.
Chrysant SG, Chrysant GS. New insights into the true nature of the obesity paradox and the lower cardiovascular risk. J Am Soc Hypertens. 2013;7:85–94.PubMedCrossRef
90.
Swift DL, Johannsen NM, Lavie CJ, Earnest CP, Church TS. The role of exercise and physical activity in weight loss and maintenance. Prog Cardiovasc Dis. 2014;56:441–7.PubMedCrossRef
Metadaten
Titel
Weight Loss and Physical Activity for Disease Prevention in Obese Older Adults: an Important Role for Lifestyle Management
verfasst von
Willy Marcos Valencia
Mark Stoutenberg
Hermes Florez
Publikationsdatum
01.10.2014
Verlag
Springer US
Erschienen in
Current Diabetes Reports / Ausgabe 10/2014
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-014-0539-4

Weitere Artikel der Ausgabe 10/2014

Current Diabetes Reports 10/2014 Zur Ausgabe

Microvascular Complications—Neuropathy (D Ziegler, Section Editor)

The Role of Sodium Channels in Painful Diabetic and Idiopathic Neuropathy

Psychosocial Aspects (KK Hood, Section Editor)

Executive Function, Adherence, and Glycemic Control in Adolescents with Type 1 Diabetes: a Literature Review

Lifestyle Management to Reduce Diabetes/Cardiovascular Risk (EM Venditti, Section Editor)

Lifestyle Management for Enhancing Outcomes after Bariatric Surgery

Psychosocial Aspects (KK Hood, Section Editor)

Motivational Interviewing to Promote Adherence Behaviors in Pediatric Type 1 Diabetes

Psychosocial Aspects (KK Hood, Section Editor)

Neurocognitive Outcomes in Pediatric Diabetes: a Developmental Perspective

Microvascular Complications—Neuropathy (D Ziegler, Section Editor)

Is There an Association Between Diabetic Neuropathy and Low Vitamin D Levels?

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise