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Session: Impact of Food-based Components on Chronic Disease and Older Adults (Oral 26)

(OR26-04-23) Protein Supplementation During Weight Loss and Physical Function and Body Composition in Low Functioning Older Adults With Obesity: A Randomized Controlled Trial

Tuesday, July 25, 2023
10:36 AM – 10:48 AM ET
Location:  Commonwealth
Disclosure(s):
Denise K. Houston, PhD, RDN: Dairy Management, Inc.: Speaker/Speaker's Bureau (Terminated, November 9, 2022)
Objectives: To assess the effect of protein supplementation over a 6-month weight loss intervention and 12-month follow-up on physical function and body composition in low functioning older adults with obesity.

Methods: We conducted an 18-month randomized, double-blind, placebo-controlled trial in 187 low functioning older adults with obesity (mean±SD age, 71.0±4.3 yrs; Short Physical Performance Battery [SPPB] score, 7.8±1.8; BMI, 34.2±4.1 kg/m2; 66% women; 76% white). All participants were enrolled in a 6-month behavioral weight loss intervention followed by 12 months of follow-up and randomized to one of three groups: 50 g/d of supplemental protein (PRO) for 6 (n=62) or 18 (n=63) months or 50 g/d of supplemental carbohydrate (CHO) for 6 months (n=62). Physical performance (SPPB and expanded SPPB), knee extensor strength and body composition by DXA were assessed at baseline, 6 and 18 months and differences in change over 18 months examined using analysis of covariance adjusted for age, sex, race, and baseline measure.

Results: One hundred and fifty-three participants (50-52/group) completed the trial. Protein intake at 18 months was higher in the 18-m PRO group compared to the 6-m PRO and 6-m CHO groups (mean±SD: 1.02±0.39 vs. 0.80±0.30 and 0.80±0.26 g/kg body weight/d, respectively; p< 0.001). Weight loss at 18 months did not differ by intervention group (-5.2±5.6, -4.9±5.4 and -4.3±5.3 kg for 18-m PRO, 6-m PRO and 6-m CHO, respectively). SPPB score (adjusted mean±SE: 0.5±0.3, 0.5±0.3 and 0.3±0.3 for 18-m PRO, 6-m PRO and 6-m CHO, respectively), expanded SPPB score (0.17±0.08, 0.12±0.08 and 0.07±0.08) and knee extensor strength (8.2±4.9, 9.4±5.2 and 9.5±4.5 Nm) improved over 18 months but did not differ by intervention group. There were also no differences by intervention group in 18-month changes in whole body and appendicular lean mass (-1.2±0.5 and -0.6±0.3 kg, -1.4±0.5 and -0.6±0.3 kg, and -1.2±0.5 and -0.7±0.2 kg, respectively, for 18-m PRO, 6-m PRO and 6-m CHO) or fat mass (-2.0±1.0, -2.0±1.0 and -1.9±0.9 kg).

Conclusions: In low functioning older adults with obesity enrolled in a weight loss trial, randomization to protein supplementation for 18 months did not result in greater improvements in physical performance, strength or body composition compared to randomization to protein or CHO supplementation for 6 months.

Funding Sources: National Institute on Aging