Interventions to achieve long-term weight loss in obese older people: a systematic review and meta-analysis

Miles D. Witham, Alison Avenell

    Research output: Contribution to journalArticlepeer-review

    99 Citations (Scopus)

    Abstract

    Design: systematic review and meta-analysis.

    Data sources: thirteen databases were searched, earliest date 1966 to December 2008, including Medline, CINAHL, PsycINFO, the Cochrane database and EMBASE.

    Study selection: we included studies with participants' mean age >= 60 years and mean body mass index >= 30 kg/m(2), with outcomes at a minimum of 1 year. Data were independently extracted by two reviewers and differences resolved by consensus.

    Data extraction: nine eligible trials were included. Study interventions targeted diet, physical activity and mixed approaches. Populations included patients with coronary artery disease, diabetes mellitus and osteoarthritis.

    Results: meta-analysis (seven studies) demonstrated a modest but significant weight loss of 3.0 kg [95% confidence interval (CI) 5.1-0.9] at 1 year. Total cholesterol (four studies) did not show a significant change: -0.36 mmol/l (95% CI -0.75 to 0.04). There was no significant change in high-density lipoprotein, low-density lipoprotein or triglycerides. In one study, recurrence of hypertension or cardiovascular events was significantly reduced (hazard ratio 0.65, 95% CI 0.50-0.85). Six-minute walk test did not significantly change in one study. Health-related quality of life significantly improved in one study but did not improve in a second study.

    Conclusions: although modest weight reductions were observed, there is a lack of high-quality evidence to support the efficacy of weight loss programmes in older people.

    Original languageEnglish
    Pages (from-to)176-184
    Number of pages9
    JournalAge and Ageing
    Volume39
    Issue number2
    DOIs
    Publication statusPublished - Mar 2010

    Keywords

    • obesity
    • older
    • weight loss
    • meta-analysis
    • elderly
    • systematic review
    • RANDOMIZED CONTROLLED-TRIAL
    • POSTMENOPAUSAL WOMEN
    • KNEE OSTEOARTHRITIS
    • CLINICAL-TRIAL
    • ADULTS
    • EXERCISE
    • LIFE
    • OVERWEIGHT
    • MORTALITY
    • RISK

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