Weight loss with energy-reduced Mediterranean Diet and exercise prevent chronic diseases among elderly with obesity

Higher MedDiet adherence improves metabolic marker levels and is also related to healthier body composition due to the reduced levels of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT).

A recent Original Investigation on Nutrition, Obesity, and Exercise published in JAMA Network Open has recently concluded that combining an energy-reduced Mediterranean diet and physical activity mitigates the potential adverse effects of age-dependent changes in body composition.

Evaluating lifestyle interventions in randomized clinical trials for their effects on body composition has been rare. The Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) trial studies the effect of the intervention on cardiovascular disease prevention after eight years of follow-up. It includes individuals with a BMI of 27-40 and metabolic syndrome, ages 55-75. Of 6874 participants, 1521 had body composition measured at three time points. The multifactorial intervention included an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA). 3-year changes in total fat and lean mass and visceral fat tested were the outcomes measured.

Key results of the study are:

There were 1521 individuals with a mean age of 65 years. 52% were men.

The control group had 761 patients.

760 patients in the intervention arm had greater reductions in the percentage of total fat (between-group differences after 1-year and three years were −0.94% and −0.38% and visceral fat storage (after one year and three years, -126 g and −70.4 g)’

In the intervention arm, there were greater increases in the percentage of total lean mass at 1 and 3 years, 0.88% and 0.34%.

The intervention group improved more with absolute risk reduction after one year and three years.

In the intervention group, there were decreased grams of visceral fat mass, while in the control group, the mass of this fat depot was unchanged over time.

They said that weight-loss lifestyle intervention based on an energy-reduced MedDiet and physical activity reduces total and visceral fat and attenuated age-related losses of lean mass in older adults with overweight or obesity and metabolic syndrome.

Study strength includes using repeatedly measured data and determining body composition with precise imaging techniques with standardized measurements. The limitations were limited generalizability, limited access to DXA scanners, loss of follow-up

Further reading:

Konieczna J et al. An Energy-Reduced Mediterranean Diet, Physical Activity, and Body Composition: An Interim Subgroup Analysis of the PREDIMED-Plus Randomized Clinical Trial. JAMA Netw Open. 2023;6(10):e2337994. doi:10.1001/jamanetworkopen.2023.37994