Oral Presentation 33rd ASM of the Australian & New Zealand Bone & Mineral Society 2023

Effects of high-intensity resistance and impact exercise on changes in body composition and metabolic and musculoskeletal health during weight loss in older adults with obesity: A pilot randomised controlled trial (#44)

Jakub Mesinovic 1 2 , Anoohya Gandham 2 3 , Paul Jansons 1 2 , Costas Glavas 1 2 , Michael Braude 2 , Juan P Rodriguez 2 , Barbora De Courten 2 4 , Mavil M Cervo 2 , Belinda Beck 5 6 7 , Peter R Ebeling 2 , David Scott 1 2
  1. Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria
  2. Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria
  3. Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria
  4. School of Health and Biomedical Sciences, RMIT, Melbourne, Victoria
  5. Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland
  6. Exercise Science, School of Health Sciences and Social Work, Griffith University, Gold Coast, Queensland
  7. The Bone Clinic, 26 Turbo Dr, Brisbane, Queensland

Introduction: Weight loss achieved via energy restriction leads to muscle mass and bone mineral density (BMD) loss. High-intensity resistance and impact training (HiRIT) might attenuate weight loss-induced musculoskeletal declines. Our objective was to compare changes in body composition and metabolic and musculoskeletal health in older adults with obesity undertaking weight loss combined with HiRIT or aerobic training (AT).

Methods: Sixty older adults with obesity (aged >60 years; body fat percentage ≥30% in men and ≥40% in women) and a mobility limitation (short physical performance battery score [SPPB] <11) were randomly assigned to either 12 weeks of supervised, centre-based HiRIT, or self-directed, home-based AT, with energy restriction (750-1000kcal reduction in energy intake). Changes in physical function (primary outcome: gait speed), body composition, and metabolic and bone health were compared within and between groups.

Results: Gait speed increased in HiRIT compared with AT, chair stand times decreased in both groups, and handgrip strength and SPPB scores increased in HiRIT, but not AT (Figure). Similar decreases in total body mass (HiRIT: -5.1±4.6kg versus AT: -4.9±4.5kg), fat mass (HiRIT: -3.6±3.7kg versus AT: -3.3±3.6kg), visceral fat (HiRIT: -32.1±41.6cm2 versus AT: -31.4±39.9cm2) and appendicular lean mass (HiRIT: -0.8±1.6kg versus AT: -1.2±1.6kg) were observed. Only HiRIT reduced fasting glucose (HiRIT: -0.4±0.8mmol/L versus AT: -0.2±0.8mmol/L), insulin (HiRIT: -3.3±4.7mU/L versus AT: -1.5±4.7mU/L) and glycated haemoglobin (HiRIT: -0.2±0.4% versus AT: -0.1±0.4%). There were no significant within- or between-group differences in BMD. HiRIT was well-tolerated and accepted with only 7 minor adverse events (AT=5) and 6 participants lost to follow-up (AT=5).

Conclusion: HiRIT appears to be safe and more effective than AT for improving physical performance in older adults with obesity during weight loss. Additional trials with larger sample sizes and longer durations are warranted to explore whether HiRIT can improve metabolic health and attenuate weight loss-induced bone loss.

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