Effect of Nutritional Intervention and Exercise Patterns on the Functionality of Obese Elderly People: A Review
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
DOI: https://doi.org/10.11144/Javeriana.umed62-2.effe
Effect of Nutritional Intervention and
Exercise Patterns on the Functionality of
Obese Elderly People: A Review
Efecto de la intervención nutricional y los patrones de ejercicio en la
funcionalidad de las personas mayores obesas: una revisión
Recibido: 27 Enero 2021 | Aceptado: 13 Marzo 2021
Cristian Curilem Gatica a
Escuela de kinesiología, Facultad de salud, Universidad Santo Tomás, Chile
ORCID: https://orcid.org/0000-0002-3175-4417
Carlos Bahamondes Ávila
Escuela de kinesiología, Facultad de Ciencias, Universidad Mayor, Temuco, Chile
ORCID: https://orcid.org/0000-0003-4616-5663
José Bruneau-Chávez
Faculty of Education, Social Sciences and Humanities, Department of Physical
Education, Universidad de la Frontera, Temuco, Chile
ORCID: https://orcid.org/0000-0003-3786-2678
Francisco José Berral de la Rosa
Universidad Pablo de Olavide, Seville, Spain. Research Group CTS-595, España
ORCID: https://orcid.org/0000-0003-3552-8262
RESUMEN
Las personas mayores son susceptibles de padecer enfermedades
cardiovasculares asociadas con la obesidad, que son factores de riesgo
en ancianos frágiles. E l propósito de este estudio fue determinar los
regímenes de ejercicio y nutrición para los ancianos obesos para mejorar
la funcionalidad. E sta revisión sistemática cumple con la declaración
PRISMA. La estrategia “PICOS” se aplicó en este estudio; población:
mayor, obesidad; intervención: ejercicio, dieta; comparación: grupo de
control; resultado: ancianos frágiles; diseño: prueba controlada aleatoria.
E l análisis se realizó hasta septiembre de 2020 utilizando las siguientes
bases de datos: Pubmed, SciELO, BVSALUD, Medline/PMC, Science
Direct, Sport Discus/EBSCO Host. Se identificaron un total de 1700
artículos aplicando los criterios de selección. Se analizaron un total de
19 estudios, que incluyeron a 1310 participantes con un índice medio de
masa corporal de 33,0 ± 3,8 kg/m². El ejercicio duró de 8 a 78 semanas.
a Corresponding author: c.curilem.g@gmail.com Un total del 57 % de los estudios utilizaron ejercicio multicomponente, y
el 37 % de los estudios utilizaron restricciones calóricas nutricionales. El
ejercicio multicomponente y la restricción calórica se pueden utilizar en
adultos obesos mayores y están relacionados con una mejor funcionalidad.
How to cite: Curilem Gatica C, Bahamondes Ávila Los datos obtenidos son útiles para planificar el ejercicio y los regímenes
C, Bruneau-Chávez J, Berral de la Rosa FJ. Effect of de nutrición en adultos mayores obesos de atención primaria.
nutritional intervention and exercise patterns on the Palabras clave
functionality of obese elderly people: a review. Univ. envejecimiento; ejercicio; sobrepeso; nutrición.
Med. 2021;62(2). https://doi.org/10.11144/Javeriana.
umed62-2.effe
ABSTRACT
E lderly people are susceptible to obesity-associated cardiovascular
diseases, which are risk factors for frail elderly. The purpose of this
study is to determine exercise and nutrition regimens for obese elderly to
improve functionality. This systematic review complies with the PRISMA
statement. The PICOS strategy was applied in this study; population:
major, obesity; intervention: exercise, diet; comparison: control group;
| Universitas Medica |Colombia | V. 62 | No. 2 | Abril-Junio | 2021 | ISSN 0041-9095 |Cristian Curilem Gatica, Carlos Bahamondes Ávila, José Bruneau-Chávez, et al.
result: frail elderly; design: randomized controlled test. entities, with a fat mass more significant than
The analysis was performed until September 2020 using 37% in men or 40% in women (8), which
the following databases: Pubmed, SciELO, BVSALUD,
Medline/PMC, Science Direct Sport Discus/EBSCO Host.
pose a more significant challenge for geriatric
A total of 1700 items were identified by applying the rehabilitation and improved functionality.
selection criteria. A total of 19 studies were analyzed, Older adults’ functional capacity prevents
which included 1,310 participants with an average body cardiovascular, musculoskeletal, and cognitive
mass index of 33.0 ± 3.8 kg/m². The exercise lasted for impairment and improves aging impairment
8–78 weeks. Fifty-seven per cent of studies used multi-
component exercise, and 37% of studies used nutritional
functionality. The programs developed are
caloric restrictions. Multi-component exercise and caloric conservative in intensity, power, volume, and
restriction can be used in older obese adults and are related training (9, 10). Continuous moderate-intensity
to improved functionality. The data obtained are useful for training significantly improves body weight,
planning exercise and nutrition regimens in primary care subcutaneous body fat, fat distribution, lipid
of obese elderly adults.
profile, and glucose control. In older adults,
Keywords
aging; exercise; overweight; nutrition. high-intensity exercises promote increased
cardiovascular capacity, muscle hypertrophy, and
Introduction bone density. In turn, high-intensity interval
training is more effective, faster, and has a more
significant effect (11). To improve body mass
Currently, older adults are susceptible to obesity- index and bone mineral density in older adults,
associated cardiovascular diseases, which are risk researchers recommend performing strength
factors for developing frail elderly and decreasing training exercises for 30 minutes, three times per
their functionality (1). The functionality of week, with three series of 8–10 repetitions, with
older adults is altered in the frail elderly, breaks of 1–2 minutes between series, with a
which decreases their strength, endurance, load of 70% and 85% of 1RM, accompanied by
and physiological functions, causes vulnerability, cardiovascular resistance training three times a
disability falls, long-term care, and mortality. week for 30 minutes at the intensity of 70–89% of
Frail elderly have unintentional weight loss, low the reserve heart rate (12). In addition, resistance
functional capacity, exhaustion, weak gripping training has benefits for cardiovascular health,
force, and slow running speed (2). weight management, prevention of disability and
Functionality promotes a better quality of falls, because the loss of muscle mass and strength
life in older adults and is related to necessary is a determinant of functionality and reduction of
daily life activities such as dressing, using quality of life (7).
instruments (phone, money), and performing In turn, nutrition is a fundamental part of
advanced tasks (travel planning). Better quality treating a patient who is considered fragile.
of life is associated with functional capacity, Malnourished and frail elderly are not the same
normal nutritional status, lower comorbidity entity. With age, there is a decrease in energy
rate, and fewer locomotive or psychological intake, secondary to a decrease in functional
problems (3, 4). Functionality is related to the capacity, along with weight loss, at the expense
quality of life and social participation. Functional of muscle mass and functional deterioration,
capacity and social relations between the elderly which are fundamental points in the concept of
are necessary (5). Functionality decreases with sarcopenia. It is mostly the supply of proteins that
sarcopenia, which is an accelerated loss of allows to reverse malnutrition, in which anabolic
skeletal muscle mass and strength, and is resistance is predominant and accompanied by
associated with multiple adverse outcomes such insulin resistance and endothelial dysfunction.
as falls, multimorbidity, deterioration of quality For muscle synthesis, it is essential to reach
of life, disability, and mortality (6, 7). Similarly, an amount of protein intake of at least 1.2–
obesity with sarcopenia has an increased risk 1.5 g per kilogram of weight per day, with an
in older adults. It is the combination of both adequate proportion of essential amino acids (8).
2 | Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 |Effect of Nutritional Intervention and Exercise Patterns on the Functionality of Obese...
Therefore, this study aimed to “determine the exercises, associated or not with a nutritional
most effective planning of exercise and nutrition regimen, focused on energy or protein ratio,
to improve functionality in older obese adults.” changes in macronutrient profile or proportion of
additional macronutrients (mainly proteins and
Materials and Method amino acids), in the form of whole foods orally.
Figure 1.
This systematic review respects the PRISMA PRISMA search diagram
declaration and Cochrane collaboration. The
PICOS strategy was adopted and delimited
the study’s scope. Population: aged, obese;
intervention: exercise, diet; comparison: control
groups; result: frail elderly; design: a randomized
controlled trial.
The inclusion criteria for the article search
were: 1. Population over 60 years of age with
obesity was assessed by body mass index or fat
mass percentage; 2. Results in functionality; 3.
Clinical trials with a control group; 4. Study with
exercise and nutrition; 5. Language of articles:
Portuguese, Spanish, and English; 6. Publications
until September 2020. The exclusion criteria Results measures: search for differences in
were: 1. Absence of relevant information in the operating averages, physical work, functional
study; 2. Unsuitable design when reading the full independence, geriatric assessment, activity
text; 3. Data duplicated by the same author; 4. rate, cardiorespiratory capacity, running speed,
Displays inadequacy when reading the full text; balance, gripping force, or leg strength (8).
5. Unsuitable intervention when reading the full Evaluation of the quality of the studies: a scale
text; 6. Body mass index or incorrect fat mass of 11 items “Physiotherapy Evidence Database”
percentage. for internal validity of clinical trials and statistical
Search for studies: the research team searched information. Studies with scores equal to or
until September 2020 by tracking summaries greater than five can be considered to be studies
and articles in the databases (Pubmed, SciELO, of high methodological quality and low bias risk.
BVSALUD, Medline/PMC, Science Direct, and Data extraction: the research team reviewed
Sport Discus/EBSCO Host). The following the full text by extracting the data and
combination of terms (MeSH) was used: performing the synthesis. The main result was
Population: aged, obesity; Intervention: exercise, the effect on functionality, including its standard
diet; Results: frail elderly; Design: a randomized deviation, with the descriptive characteristics of
controlled trial. the article (year and sample), the characteristics
Study selection: The research team reviewed of the interventions and the results.
the titles and summaries by applying the inclusion Qualitative analysis of the data: the results of
criteria. Figure 1 shows the grounds for exclusion. the studies were examined, presenting them in a
Participants: older obese adults, verifying summary table, looking for the means with their
ethical compliance with research. Intervention: standard deviation, which presented statistical
structured body movements that increase energy significance, in tests that measure functioning,
expenditure, practiced systematically (frequency, physical work, functional independence, geriatric
intensity, and duration), designed to maintain assessment, activity index, cardiorespiratory
or improve health and supervised by health capacity, running speed, balance, gripping force,
professionals, with cardiorespiratory or strength or leg strength.
| Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 | 3Cristian Curilem Gatica, Carlos Bahamondes Ávila, José Bruneau-Chávez, et al.
Results treating or evaluating, administering the therapy,
and measuring a key outcome.
Characteristics of the studies: 1700 articles were Table 2.
identified by applying the selection criteria. A Evaluation of the quality of the studies
total of 19 studies met the inclusion criteria.
Figure 1 shows the flowchart and the selection of
studies, according to the PRISMA statement (13,
14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26,
27, 28, 29, 30, 31).
Characteristics of the participants: Table 1
presents 19 studies, with a total of 1310
participants. Fifty-seven per cent of the studies
use body mass index to assess the nutritional
status of older adults. The average body mass
index of the elderly involved was 33.0 ± 3.8 kg/
m (2). Notes: 1. Eligibility criteria were specified; 2.
Subjects were randomly allocated to groups (in a
Table 1. crossover study, subjects were randomly allocated
an order in which treatments were received); 3.
Characteristics of the studies Allocation was concealed; 4. The groups were
similar at baseline regarding the most important
prognostic indicators; 5. There was blinding of all
subjects; 6. There was blinding of all therapists
who administered the therapy; 7. There was
blinding of all assessors who measured at least
one key outcome; 8. Measures of at least one
key outcome were obtained from more than 85%
of the subjects initially allocated to groups; 9.
All subjects for whom outcome measures were
available received the treatment or control
condition as allocated or, where this was not
the case, data for at least one key outcome was
analyzed by “intention to treat;” 10. The results
of between-group statistical comparisons are
reported for at least one key outcome; 11. The
Characteristics of the interventions: The study provides both point measures and measures
exercise regimen lasted for 8–78 weeks. Fifty- of variability for at least one key outcome.
seven per cent of the studies use multi- Estimating the effect of exercise and nutrition:
component exercise to intervene with older The 19 studies included in the qualitative
adults (i.e., aerobic exercise, endurance exercise, analysis have different and heterogeneous
balance exercise, and stretching). Thirty-seven results. Therefore, it is not possible to perform
per cent of studies use caloric restriction as statistical analysis with meta-analysis. Therefore,
nutritional intervention. a qualitative analysis of the articles was
Description of the quality of the studies: performed, and the results are presented in a
Table 2 presents the evaluation of the studies, summary table.
presenting a moderate methodological quality
(PEDro 7.1 ± 1.1). The lowest scores on
the PEDro scale in the analyzed research are Discussion
obtained for the method of producing blindness
of researchers concerning the subjects they were This study aimed to determine the most effective
exercise and nutrition planning to improve
4 | Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 |Effect of Nutritional Intervention and Exercise Patterns on the Functionality of Obese... functionality of older obese adults. In our study, functionality such as the strength of the lower owing to an increase in life expectancy, it is limbs or the gripping force of the upper limb (33). necessary to assess older adults’ physical and In turn, frail elderly have a vulnerable situation functional capacities. A decrease in functional that increases the likelihood of adverse health capacity predicts mortality, increased hospital outcomes (34). It is closely related to age income, and decreased quality of life (32). In the and the consequent loss of functional capacity. literature, there are different tests to evaluate Therefore, it is a syndrome that may be present in functional capacity. It is possible to choose those older adults. It is also associated with significant that best fit the population to be evaluated. It health implications because fragile people have may even be necessary to use several of them a high risk of institutionalization, hospitalization, in combination to perform a complete study. disability, and death. SPPB is a validated and Our review describes different results that are standardized test that combines balance, speed related to functionality and recommends to use of travel, and the test of getting up from the the Short Physical Performance Battery (SPPB), chair (35). It is validated for the frail elderly in a test used in geriatrics that allows to evaluate primary care and has high reliability in predicting a greater number of patients with a decrease in disability. A score of 10–12 is non-fragile, 4–9 their functional capacity and who are challenging is fragile, and 0–3 is disabled. We recommend to evaluate with other physical fitness tests (32). using this evaluation in older adults to define The aging process is often associated with exercise-based intervention. Speed of travel is a deterioration in functional capacity, which the most common objective functional limitation can often cause problems in daily activities assessment test. In longitudinal studies, it has and lead to dependence. The help of another demonstrated the ability to predict adverse person is required to perform them. Therefore, events such as hospitalization, frail elderly, falls, we use different measures in our review to dependence, and mortality; it is also a component evaluate the results of interventions in older of the frail elderly phenotype. Running speed adults to assess the change in functionality. greater than 1 m/s is standard, while values Functional ability is a combination of daily, between 0.8 and 0.9 m/s indicate pre-frail raw, instrumental, and advanced activities. Daily elderly, and values less than 0.8 m/s indicate activities may include getting up/lying down, frail elderly. Therefore, SPPB is a valid test maintaining body posture, walking or moving for determining exercise prescription programs inside the house, walking or moving out of with an individualized prescription according to the house, moving in transportation, washing/ the functional capacity and monitoring of the showering, combing/cutting nails, controlling the subject over time; the disadvantage is that its need to urinate (bladder control), controlling realization requires more time and greater patient the need to defecate (bowel control), dressing, collaboration (34). In patients with Alzheimer’s eating, shopping, preparing food, and performing disease, 6 weeks of aerobic, strength, balance household chores. Therefore, these activities are and coordination exercises improve fat mass, essential in a geriatric evaluation and depend on muscle strength, balance, and fall prevention. the older adult’s physical condition related to In our review, 57% of the studies use multi- health, i.e., body composition, cardiorespiratory component exercises and show improvements in capacity, strength, muscle endurance, and the functionality of obese elderly (36). flexibility. Disability problems often start with Nutritional recommendations for older adults instrumental activities, which are more complex are to maintain the calorie balance to reach and require more significant effort and skill to and maintain a healthy weight and to limit the execute. They often end up in those necessary intake of sodium, solid fats, added sugars and activities that are easier to execute but involve refined cereals. In addition, the focus should be a more significant care burden. Therefore, our on consuming nutrient-rich beverages and foods results include different measures to evaluate such as milk and dairy products, lean poultry and | Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 | 5
Cristian Curilem Gatica, Carlos Bahamondes Ávila, José Bruneau-Chávez, et al.
meats, eggs, legumes, nuts, and seeds. Likewise, it the physical and functional performance of older
is necessary to consume vegetables, fruits, whole adults (39).
grains, milk, and dairy products to obtain more The population of Latin American has
potassium, dietary fiber, calcium, and vitamin D. increased. Because functionality is critical to
Similarly, it is essential to consume a wide variety the quality of life, preventing and reversing
of vegetables (e.g., dark green, red, and orange), dependence should be the priority of the public
beans, and peas. At least half of all cereals in the agenda. Therefore, this review outlines exercise
diet should be in the form of whole grains. Thus, and nutrition plans for older obese adults (40).
our review concludes that the consumption of In Colombia, research using SPPB established
these foods, together with caloric restriction and benchmark values for Colombian seniors living
suppression of high energy-power foods, is the in the community. The evaluation of physical
most useful nutritional intervention in older function with SPPB (provides information on
obese adults (37). Nutrition professionals should the functional decline of elderly people). It also
perform these nutritional interventions to avoid allows to evaluate the effect of interventions
health consequences for the obese elderly. on the functional state of the elderly. SPPB
Changes in body weight and composition is calculated based on the time required to
have implications for the health status and complete a 4-meter walk, time to get up from a
functional efficiency in advanced age populations chair five times, and the ability to stand up to
(38). These changes include decreased fat- 10 s in three different ways. This evaluation can
free mass, bone mineral density, and increased detect ≤9 points between vigorous and fragile
fat mass as age progresses. Older people with people. This approach has been validated in
excess fat have an increased risk of knee studies in Brazil and Colombia. In this study, the
osteoarthritis, sarcopenia, physical deterioration, SPPB score was 8.7 (2.0) points and suggests that
reduced quality of life, and present risk factors age, body mass, height, body mass index, and leg
that are commonly associated with coronary perimeter contribute to gait speed (p < 0.001)
heart disease, stroke, and other disorders such after controlling for confusing factors including
as dementia. Cossio et al. have indicated that ethnicity, socioeconomic status and urbanity.
the body mass index is a predictor of fat in Therefore, the diet, health status, race, and
old age, with a variance between 79% and 80% geographical location of Colombian populations,
and a standard estimation error of less than 3%. in general, greatly affect anthropometric and
Therefore, this review used body mass index and physical performance. We encourage the use
fat percentage to assess the nutritional status of of this test in experimental studies with the
older adults (38). elderly to analyze the results. In our study, the
Fitness assessment is essential in promoting evaluation of studies is heterogeneous. Using
functional capacity and health because it can SPPB, the meta-analysis of results provides more
identify people who are at risk for chronic information (35).
diseases and the frail elderly (39). Physical This approach evaluates the effectiveness of
performance decreases with age mainly due to nutrition and exercise on body composition
deterioration of aerobic endurance, flexibility, and strength in older adults with obesity
strength, speed, agility, and balance. Therefore, and sarcopenia. In only two trials with
for older obese adults, we recommend multi- 61 participants, with nutrition of 15 grams
component exercises accompanied by caloric of protein per day (cheese consumption)
restriction, which is reflected in most of the and resistance training with high-speed
results of this review, with interventions ranging circuits, it was determined that exercise
from 8 weeks to 78 weeks. It is necessary to improves muscle strength. In our study,
plan and distribute training loads by following caloric restriction and multi-component exercise
the principles of training in search of improving improved functionality in obese older adults.
However, protein intake needs to be considered
6 | Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 |Effect of Nutritional Intervention and Exercise Patterns on the Functionality of Obese...
to improve muscle protein synthesis in obese sarcopenia are needed to analyze nutritional
older adults to improve functionality. Our review interventions in these patients.
includes a healthy protein intake of 1 g/kg
plus multi-component exercise, improvements Conflict of interest
in cardiorespiratory capacity, high protein
consumption, endurance exercises, and walking
None.
speed improvements (41).
Future research should focus on aging,
frail elderly, cognitive decline, and improving Acknowledgments
functionality, disability, and quality of life, with
multidomain exercise interventions, nutrition, The authors would like to thank the Research
and cognitive training, improving the functional Executive of the Universidad Santo Tomás,
decline and quality of life of older people (42). the Universidad Mayor, the Universidad de la
In addition, the results of our research indicate Frontera, and the Universidad Pablo de Olavide
that inequalities in older adults, between men in Seville, Spain, for their constant support
and women, depending on the economic status, for research. Also to Falcon Scientific Editing
access to public services, family environment, (https://falconediting.com) for proofreading the
and health conditions should be considered English language in this paper.
in Latin America to improve living conditions
and health of aging people because these References
methodologies must be available to all older
adults in public service and primary care (43).
The limitation of our research is the language 1. Ahmed AM, Ahmed D, Alfaris M,
due to the lack of accurate translations that Holmes A, Aljizeeri A, Al-Mallah MH.
allow us to evaluate and analyze other databases. Prevalence and predictors of frailty
Another limitation is that functionality is in a high-income developing country:
a complex variable, and different evaluation A cross-sectional study. Qatar Med J.
methodologies are used. We propose to use SPPB 2020 Jan 23;2019(3):20. https://doi.or
to evaluate functionality in obese older adults, g/10.5339/qmj.2019.20
which would make it easier to perform a meta- 2. Suikkanen S, Soukkio P, Pitkälä K,
analysis to obtain quantitative results. We use Kääriä S, Kautiainen H, Sipilä S, et
qualitative analysis due to the heterogeneity of al. Older persons with signs of frailty
tests used to evaluate functionality in older obese in a home-based physical exercise
adults. intervention: baseline characteristics
of an RCT. Aging Clin Exp Res.
2019;31(10): 1419-1427. https://doi.or
Conclusion
g/10.1007/s40520-019-01180-z
3. Hernández I, Martínez M, Sánchez
Our work allows us to conclude that multi-
A, Reolid R, Tello G, Párraga
component exercises and caloric restriction
I. Análisis de la comorbilidad y
provide benefits for older, obese adults and
calidad de vida de pacientes mayores
improve their functional capacity. We hope that
polimedicados. Rev Clín Méd Fam
these results will help plan and structure exercise
[internet]. 2016;9(2):91-9. Available
for primary care of older adults. In addition, we
from: https://www.redalyc.org/pdf/169
note that caloric restriction is a strategy that
6/169646754005.pdf
can be used in older obese adults. However,
additional studies on older, obese adults with 4. Sánchez-García S, García-Peña
C, Salvà A, Sánchez-Arenas R,
Granados-García V, Cuadros-Moreno
| Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 | 7Cristian Curilem Gatica, Carlos Bahamondes Ávila, José Bruneau-Chávez, et al.
J, Velázquez-Olmedo LB, Cárdenas- is more efficient than moderate
Bahena Á. Frailty in community- continuous training for management
dwelling older adults: association with of body composition lipid profile
adverse outcomes. Clin Interv Aging. and glucose metabolism in the
2017 Jun 26;12:1003-11. https://doi.or diabetic elderly. Int J Morphol.
g/10.2147/CIA.S139860 2020;32(2):392-9. http://dx.doi.org/10
5. Gobbens R, Van Assen M. .4067/S0717-95022020000200392
Associations between 12. Rocha C, Guimarães A,
multidimensional frailty and quality Maia B, Santos C. Effects of
of life among Dutch older a 20-week concurrent training
people. Arch Gerontol Geriatr. 2017 program on bone metabolism in
Nov;73:69-76. https://doi.org/10.1016/ elderly women. Int J Morphol.
j.archger.2017.07.007 2018;36(2):655-60. http://dx.doi.org/1
6. Lu Y, Niti M, Yap KB, Tan 0.4067/S0717-95022018000200655
CTY, Zin Nyunt MS, Feng L, et 13. Anton S, Manini TM, Milsom
al. Assessment of sarcopenia among VA, Dubyak P, Cesari M, Cheng
community-dwelling at-risk frail adults J, et al. Effects of a weight loss
aged 65 years and older who received plus exercise program on physical
multidomain lifestyle interventions. function in overweight, older women: a
JAMA Netw Open. 2019;2(10): randomized controlled trial. Clin Interv
e1913346. https://doi.org/10.1001/jam Aging. 2011;(6):141-9. https://doi.org/
anetworkopen.2019.13346 10.2147/CIA.S17001
7. Giuliano C, Karahalios A, Neil 14. Armamento-Villarreal R, Aguirre
C, Allen J, Levinger I. The effects L, Napoli N, Shah K, Hilton T,
of resistance training on muscle Sinacore DR, et al. Changes in thigh
strength, quality of life and aerobic muscle volume predict bone mineral
capacity in patients with chronic heart density response to lifestyle therapy in
failure: a metanalysis. Int J Cardiol. frail, obese older adults. Osteoporos
2017:413-23. Int. 2014;25(2):551-8. https://doi.org/
8. Abizanda Soler P. Medicina 10.1007/s00198-013-2450-2
geriátrica. Barcelona: Elsevier; 2012. 15. Armamento-Villarreal R, Aguirre
9. Izquierdo M. Prescripción LW, Qualls C, Villareal DT. Effect
de ejercicio físico: el programa of lifestyle intervention on the
Vivifrail como modelo. Nutr Hosp. hormonal profile of frail, obese
2019;36(2):50-6. http://dx.doi.org/10. older men. J Nutr Health Aging.
20960/nh.02680 2016;20(3):334-40. https://doi.org/10.
1007/s12603-016-0698-x
10. Liu J, Kor P, Lee P, Chien W, Siu
P, Hill K. effects of an individualized 16. Arrieta H, Hervás G, Rezola-
exercise program plus behavioral Pardo C, Ruiz-Litago F, Iturburu M,
change enhancement strategies for Yanguas JJ, et al. Serum myostatin
managing fatigue in older people levels are higher in fitter more active,
who are frail: protocol for a cluster and non-frail long-term nursing home
randomized controlled trial. Phys Ther. residents and increase after a physical
2019:1616-27. exercise intervention. Gerontology.
2019;65(3):229-39. https://doi.org/10.
11. Louzada A, Mota J, Furtado
1159/000494137
V, Clodoaldo A. Multimodal HIIT
8 | Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 |Effect of Nutritional Intervention and Exercise Patterns on the Functionality of Obese...
17. Avila J, Gutierres J, Sheehy 2018; 36(14):1564-1571. https://doi.or
M, Lofgren I, Delmonico M. Effect g/10.1080/02640414.2017.1403413
of moderate intensity resistance 23. Irving B, Lanza I, Henderson G,
training during weight loss on body Rao R, Spiegelman B, Sreekumaran
composition and physical performance K. Combined training enhances
in overweight older adults. Eur J Appl skeletal muscle mitochondrial
Physiol. 2010;109(3):517-25. https://d oxidative capacity independent of
oi.org/10.1007/s00421-010-1387-9 age. J Clin Endocrinol Metab.
18. Bouchonville M, Armamento- 2015;100(4):1654-63. https://doi.org/1
Villareal R, Shah K, Napoli N, 0.1210/jc.2014-3081
Sinacore DR, Qualls C, Villareal DT. 24. Marsh A, Miller M, Rejeski
Weight loss, exercise or both and W, Hutton S, Kritchevsky S. Lower
cardiometabolic risk factors in obese extremity muscle function after
older adults: results of a randomized strength or power training in older
controlled trial. Int J Obes (Lond). adults. J Aging Phys Act. 2009;416-43.
2014 Mar;38(3):423-31. https://doi.org
25. Prieto J, Del Valle M, Nistal P,
/10.1038/ijo.2013.122.
Méndez D, Barcala-Furelos R, y C.
19. Cebrià M, Balasch M, Tortosa M, Abelairas. Relevancia de un programa
Balasch S. Effects of resistance training de equilibrio en la calidad de vida
of peripheral muscles versus respiratory relacionada con la salud de mujeres
muscles in older adults with sarcopenia adultas mayores obesas. Nutr Hosp.
who are institutionalized: a randomized 2015;32(6):2800-7. https://doi.org/10.
controlled trial. J Aging Phys Act. 3305/nh.2015.32.6.9713
201826(4):637-46. https://doi.org/10.1
26. Prieto J, Del Valle M, Nistal
123/japa.2017-0268
P, Méndez D, Abelairas C, Barcala
20. Coelho-Júnior HJ, de Oliveira R. Repercusión del ejercicio físico
Gonçalvez I, Sampaio RAC, Sewo en la composición corporal y
Sampaio PY, Cadore EL, Izquierdo M, la capacidad aeróbica de adultos
et al. Periodized and non-periodized mayores con obesidad mediante tres
resistance training programs on body modelos de intervención. Nutr Hosp.
composition and physical function 2015;31(3):1217-24. http://dx.doi.org/
of older women. Exp Gerontol. 10.3305/nh.2015.31.3.8434
2019;121:10-8. https://doi.org/10.1016
27. Stengel S, Kemmler W,
/j.exger.2019.03.001
Engelke K, Kalender W. Effect
21. Colleluori G, Aguirre L, Phadnis of whole-body vibration on
U, Yarasheski K, Qualls C, Villareal neuromuscular performance and body
D. Aerobic plus resistance exercise composition for females 65 years
in obese older adults improves and older: a randomized-controlled
muscle protein synthesis and preserves trial. Scand J Med Sci Sports.
myocellular quality despite weight loss. 2012;22(1):119-27. https://doi.org/10.
Cell Metabolism. 2019:261-73. 1111/j.1600-0838.2010.01126.x
22. Cunha P, Ribeiro AS, Tomeleri 28. Verreijen A, Engberink M,
CM, Schoenfeld BJ, Silva AM, Souza Memelink RG, van der Plas SE, Visser
MF, et al. The effects of resistance M, Weijs P. Effect of a high protein
training volume on osteosarcopenic diet and/or resistance exercise on the
obesity in older women. J Sports Sci. preservation of fat free mass during
weight loss in overweight and obese
| Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 | 9Cristian Curilem Gatica, Carlos Bahamondes Ávila, José Bruneau-Chávez, et al.
older adults: a randomized controlled variables in older Colombian adults.
trial. Nutr J. 2017;16(1):10. https://doi The SABE Study. 2015. Front Med.
.org/10.1186/s12937-017-0229-6 2020;7:52. https://doi.org/10.3389/fme
29. Villareal D, Banks M, Sinacore d.2020.00052
D, Siener C, Klein S. Effect of 36. Pereira-Payo D, Failde-Lintas N,
weight loss and exercise on frailty in Durán-Cano E, Adsuar Sala JC,
obese older adults. Arch Intern Med. Pérez-Gómez J. Seis semanas de
2006;166(8):860-6. https://doi.org/10. ejercicio físico mejoran la capacidad
1001/archinte.166.8.860 funcional y la composición corporal
30. Villareal D, Chode S, Parimi N, en pacientes con Alzheimer. JONNPR.
Sinacore DR, Hilton T, Armamento- 2020;5(2):156-66. http://dx.doi.org/10
Villareal R, et al. Weight loss exercise, .19230/jonnpr.3170
or both and physical function in 37. Kathleen L. Krause dietoterapia.
obese older adults. N Engl J Med. Barcelona: Elsevier; 2013.
2011;364(13):1218-29. https://doi.org/ 38. Cossio Bolaños M, Vidal-Espinoza
10.1056/NEJMoa1008234 R, Campos LF, Sulla-Torres J, Urra
31. Villareal D, Aguirre L, Gurney AB, Albornoz C, Gatica-Mandiola P,
Waters DL, Sinacore DR, Colombo E, et al. Validez de ecuaciones y
et al. Aerobic or resistance exercise, or propuesta de valores referenciales
both, in dieting obese older adults. N para estimar la masa grasa de
Engl J Med. 2017;376(20):1943-55. adultos mayores. Rev Med Chile.
32. Nogueira A, Álvarez G, Russo F, 2020;148(9):1246-53. http://dx.doi.or
San-José B, Sánchez J, Barril G. ¿Es útil g/10.4067/S0034-9887202000090124
el SPPB como método de screening de 6
capacidad funcional en pacientes con 39. Olivares P, Hernández M,
enfermedad renal crónica avanzada? Merellano E, Gusi N, Collado D.
Nefrología. 2019;39(5):489-96. https:/ Análisis de la edad sobre la fiabilidad
/doi.org/10.1016/j.nefro.2019.01.003 de pruebas fitness en mayores. Rev
33. Ayala A, Pujol R, Forjaz M, Int Med Cienc Act Fís Deport.
Abellán A. Comparación de métodos 2019;19(76):627-39. https://doi.org/10
de escalamiento de actividades de .15366/rimcafd2019.76.005
la vida diaria en personas mayores. 40. Leiva AM, Troncoso-Pantoja C,
Gaceta Sanitaria. 2019:511-6. Martínez-Sanguinetti MA, Nazar G,
34. Redín M, Aldaz P, Casas Concha-Cisternas Y, Martorell M, et
A, Gutiérrez M, Martínez N. al. Personas mayores en Chile: el
Heterogeneidad en el cribado nuevo desafío social, económico y
poblacional de la fragilidad. Anales Sist sanitario del siglo XXI. Rev Med Chile.
San Navarra. 2019;42(2):169-78. http: 2020;148(6):799-809. http://dx.doi.or
//dx.doi.org/10.23938/assn.0642 g/10.4067/S0034-9887202000060079
9
35. Ramírez-Vélez R, Pérez-Sousa
MA, Venegas-Sanabria LC, Cano- 41. Theodorakopoulos C, Jones
Gutierrez CA, Hernández-Quiñonez J, Bannermanb E, Greig C.
PA, Rincón-Pabón D, et al. Normative Effectiveness of nutritional and
Values for the Short Physical exercise interventions to improve body
Performance Battery (SPPB) and composition and muscle strength or
their association with anthropometric function in sarcopenic obese older
10 | Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 |Effect of Nutritional Intervention and Exercise Patterns on the Functionality of Obese...
adults: a systematic review. Nutr Res.
2017:3-15.
42. Chacón-Valenzuela E, Morros-
González E, Vargas-Beltrán MP,
Venegas-Sanabria LC, Gómez-Arteaga
RC, Chavarro-Carvajal D, Cano-
Gutiérrez CA. Fragilidad cognitiva:
un desafío en evolución. Univ Med.
2019;60(3). https://doi.org/10.11144/J
averiana.umed60-3.fcde
43. De Santacruz C, Chavarro
D, Venegas L, Gama A, Cano
C. Desigualdades entre mujeres
y hombres mayores y menores
de setenta años. Encuesta Salud
Bienestar y Envejecimiento (SABE)
Colombia 2015. Univ Med.
2019;60(3):20-33. https://doi.org/10.1
1144/javeriana.umed60-3.sabe
| Universitas Medica | V. 62 | No. 2 | Abril-Junio | 2021 | 11You can also read
