Addressing Obesity in Aging Patients

Elevated levels of ICAM-1 and VCAM-1 are significant risk factors for cardiovascular diseases. Conversely, the regulatory roles of physical activity and omega-3 supplementation in these factors have been reported. The primary aim of the present research was to investigate the impact of an eight-week combined (resistance-endurance) accompanied by omega-3 supplementation on ICAM-1 and VCAM-1 levels in elderly women.

Forty elderly women, averaging 66.7 ± 4.13 years, were randomly assigned to four groups: placebo, omega-3 supplement, training, and training + omega-3. The combined exercise training program was implemented for eight weeks, three sessions per week. Aerobic training included 20 min of running at 60–70% of the reserve heart rate, while resistance training involved exercises at 70% of 1RM with 10 repetitions per exercise for two sets. The omega-3 and training + omega-3 groups consumed 2000 mg of omega-3 daily. Blood samples were collected 48 h after the last combined exercise training or omega-3 consumption, and the measured variables were analyzed using analysis of covariance test and SPSS-24 software.

ICAM-1 and VCAM-1 levels significantly decreased in the training and training + omega-3 groups (p < 0.001). The decrease in ICAM-1 within the training + omega-3 group was also significant compared to the training group (p = 0.024). Additionally, a significant reduction in insulin resistance and body fat percentage was observed in both the training and training + omega-3 groups (p < 0.001).

The present study's results indicate that omega-3 supplementation can enhance the effectiveness of combined training in regulating cardiovascular risk factors.

Age-related functional deterioration in skeletal muscle raises the risk for falls, disability, and mortality in the elderly, particularly in obese people or those with type 2 diabetes mellitus (T2D). However, the response of the skeletal muscle to transitioning from obesity to diabetes remains poorly defined, despite that obesity is classified as a stage of pre-diabetes. We screened and selected spontaneously obese and diabetic rhesus monkeys and examined altered protein expression in skeletal muscle of healthy aging (CON), obesity aging (OB), and type 2 diabetes mellitus aging (T2D) rhesus monkeys using Tandem Mass Tags (TMT)-based quantitative proteomic analysis. In total, we identified 142 differentially expressed proteins. Muscle-nerve communication proteins were firstly suppressed at obese-stage. With the disintegration of skeletal muscle, mitochondrial complex I and other energy homeostasis relate proteins were significantly disordered at T2D stage. Indicating that aging related obesity suppressed muscle-nerve communication and contribute to T2D related functional deterioration of skeletal muscles in elderly rhesus monkeys. Some alterations of muscular functional regulator are detected in both obesity and T2D samples, suggesting some T2D related skeletal muscular hypofunctions are occurring at obesity or pre-obesity stage. Muscle-nerve communication proteins and muscular function related proteins could be potential therapy target or early diagnose marker of for skeletal muscular hypofunctions in aging obesity populations.

La obesidad en los ancianos no solo influye en la morbimortalidad, sino también en su calidad de vida. Este fenómeno ha suscitado una amplia investigación y debate sobre las recomendaciones terapéuticas, debido principalmente a la falta de datos en esta población específica. Cuando se abordan las posibles recomendaciones terapéuticas para adultos mayores con obesidad, es fundamental evaluar ciertos aspectos esenciales, como el estado funcional, la sarcopenia, el estado cognitivo y otros. La pérdida de peso en esta población puede ser tanto eficaz como segura si es intencionada. El mejor plan de pérdida de peso para los ancianos gira en torno a la adopción de unos hábitos de vida saludables, que incluyen seguir una dieta mediterránea y hacer ejercicio físico, especialmente el entrenamiento de fuerza. Además, el uso de medicamentos para adelgazar puede proporcionar una fase de tratamiento adicional, en concreto los agonistas del receptor del péptido glucagonoide-1 y nuevos polipéptidos insulinótropos dependientes de la glucosa/agonistas del receptor del péptido glucagonoide-1. Y en determinados candidatos también se puede plantear la cirugía bariátrica. El objetivo de este documento es proponer un completo algoritmo de recomendaciones para el manejo de la obesidad en las personas de edad avanzada (mayores de 65 años), basado en datos científicos y en la experiencia de los miembros del Grupo de Trabajo de Diabetes, Obesidad y Nutrición de la Sociedad Española de Medicina Interna.

Obesity in the elderly not only impacts morbidity and mortality but their quality of life. This phenomenon has sparked extensive research and debate regarding treatment recommendations, primarly due to the lack evidence in this specific population. When addressing possible treatment recommendations for older adults with obesity, it is crucial to assess certain essential aspects such as functional status, sarcopenia, cognitive status, and others. Intentional weight loss in this population can be both effective and safe. The best weight loss plan for the elderly revolves around adopting a healthy lifestyle, which includes following a Mediterranean diet pattern and engaging in physical exercise, particularly strength training. Additionally, the use of weight loss medications, particularly glucagon-like peptide-1 receptor agonists (GLP-1 RA) and novel glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists, can provide an additional stage of treatment. In selective candidates, bariatric surgery may also be considered. The objective of this document is to propose a comprehensive algorithm of recommendations for the management of obesity in the elderly (above the age of 65), based on scientific evidence and the expertise of members from the Diabetes, Obesity, and Nutrition Workgroup of the Spanish Society of Internal Medicine.

Weight concerns are common among older adults, and it is unclear how they may impact the relationship between seasonality and eating behaviors, which can contribute to various health-related issues.

This study investigated the mediating role of weight concerns in the relationship between seasonality and eating behavior among community-dwelling older adults.

A descriptive correlational analytical design was used on 200 randomly chosen participants who completed the Personal Inventory for Depression and Seasonal Affective Disorder Self-Assessment Version, the Adult Eating Behavior Questionnaire, and the Weight Concern Subscale. A path analysis was conducted to test the hypothesized model.

The study findings indicated that most older adults reported moderate-to-severe seasonal variations, moderate enjoyment of food, emotional overeating, emotional undereating, and food fussiness. Weight concern partially mediated the relationship between seasonality and eating behavior.

By understanding the complex interplay between these factors, weight concerns may play an essential role in mediating the effects of seasonal changes on eating behavior, while seasonal winter symptoms may directly impact eating behavior. These results have potential implications for nurses' efforts to develop interventions to promote healthy eating behaviors and manage weight concerns during seasonal variations, especially in the winter.

To examine the association between dietary diversity (DD) and mortality among Thai older people and to investigate whether age, sex, and nutritional status modify this association.

The national survey conducted from 2013 to 2015 recruited 5631 people aged >60 years. Dietary diversity score (DDS) was assessed for the consumption of eight food groups using food frequency questionnaires. The Vital Statistics System provided the data on mortality in 2021. The association between DDS and mortality was analyzed by Cox proportional hazard model and adjusted for the complex survey design. Interaction terms between DDS and age, sex, and BMI were also tested.

The DDS was inversely associated with mortality (HR_adj 0.98, 95%CI: 0.96–1.00). This association was stronger in people aged >70 years (HR_adj 0.93, 95%CI: 0.90–0.96 for aged 70–79 years, and HR_adj 0.92, 95%CI: 0.88–0.95 for aged >80 years). Inverse association between DDS and mortality was also found in the underweight older population (HR_adj 0.95, 95%CI: 0.90–0.99). A positive association was found between DDS and mortality in the overweight/obese group (HR_adj 1.03, 95%CI: 1.00–1.05). However, the interaction between the DDS with sex to mortality was not statistically significant.

Increasing DD reduces mortality among Thai older people, especially in those above 70, and underweight. In contrast, an increase in DD also meant an increase in mortality among the overweight/obese group. Focus should be placed on the nutritional interventions aimed to improve DD for those 70 and over and underweight to reduce mortality.