Combined versus Individual Effects of Dietary Energy Reduction and Physical Activity on Body Composition in Older Adults with Metabolic Syndrome
Year: 2025
Type: article
Abstract: Background: This study prospectively assessed the combined versus individual effects of reducing energy intake (EI) and increasing physical activity (PA) on body weight and composition in older adults with overweight/obesity and metabolic syndrome. The interaction between both exposures was likewise assessed. Methods: A subsample of 1,110 participants (aged 55-75 years) from the Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) trial was followed for 1 year. The combined effects of 1-year changes in EI and PA on reduction of ≥5% in baseline body weight and total fat, and on ≥5% increments in lean mass were examined using dual-energy X-ray absorptiometry. Multivariate logistic regression models were used to assess the combined association. Multiplicative and additive interactions were tested. Results: Participants who had reduced EI and increased PA over 1 year were significantly more likely to exhibit ≥5% reduction in body weight (odds ratio [OR], 3.24; 95% confidence interval [CI], 1.83 to 5.72) and fat mass (OR, 2.13; 95% CI, 1.23 to 3.69) and ≥5% increase in lean mass (OR, 2.46; 95% CI, 1.24 to 4.87) compared to those who had increased EI and reduced PA. A potential for biological, rather than statistical, interaction between PA and EI was found, with synergy index (>1): 1.08 (95% CI, 0.58 to 1.99) for beneficial changes in body weight, 1.88 (95% CI, 0.41 to 8.65) for fat mass, and 1.44 (95% CI, 0.43 to 4.88) for lean mass. Conclusion: Encouraging an increase in PA with complementary nutritional education to reduce dietary EI may be more effective in managing body composition in older adults with overweight/obesity and metabolic syndrome than focusing on lifestyle behaviors alone.
DOI: 10.7570/jomes25027
Authors: Jadwiga Konieczna, Victor de la O, Miguel Ruiz-Canela, Jordi Salas-Salvadó, Vicente Martín-Sánchez, Ramón Estruch, Josep Vidal, F. Javier Basterra-Gortari, Jesús F. García-Gavilán, Joan Pou Bordoy, Diego Martínez-Urbistondo, José Antonio de Paz, Rosa Casas, Romina Paula Olbeyra, Héctor Vázquez-Lorente, Itziar Abete, Javier Díez Espino, Miguel Fiol, Albert Goday, Dora Romaguera, J. Alfredo Martínez
Institutions: Instituto de Salud Carlos III, Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition, Centro de Investigación Biomédica en Red, Health Research Institute of the Balearic Islands, Hospital Universitario Son Espases, Madrid Institute for Advanced Studies, Navarre Institute of Health Research, Universidad Internacional de La Rioja, IMDEA Food, Universidad de Navarra, Institut de Recerca Biomèdica Catalunya Sud, Universitat Rovira i Virgili, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Universidad de León, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas, Universidad Pública de Navarra (UPNA), Servei de Salut de les Illes Balears, Clinica Universidad de Navarra, Municipal Institute for Medical Research, Hospital del Mar Research Institute, Universidad de Valladolid
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Funders: European Commission, Institució Catalana de Recerca i Estudis Avançats, Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas, National Institutes of Health, Agència de Gestió d'Ajuts Universitaris i de Recerca, Instituto de Salud Carlos III, European Regional Development Fund, Agencia Estatal de Investigación
Awards: G1159337736, G2105682691, G2262748287, PREDIMED-PLUS: Efecto de una dieta mediterránea hipocalórica y promoción de la actividad física en prevención primaria cardiovascular. Estudio piloto sobre marcadores intermedios, G3064436696, G3480869486, G3681454997, G3966099854, G4042783231, G4229835017, G425668148, PREDIMED-PLUS: Efecto de una Dieta Mediterránea Hipocalórica y Promoción de la Actividad Física en Prevención Primaria Cardiovascular. Estudio Piloto sobre Marcadores Intermedios, G4776500066, G5188844167, G5852091828, G5937173505, G6127890710, PREDIMED-PLUS: Efecto de una dieta mediterránea hipocalórica y promoción de la actividad física en prevención primaria cardiovascular. Estudio piloto sobre marcadores intermedios, G6353703441, G6902587947, G7084143925, G7162709665, G8318610523, Lifestyle Interventions, metabolites, microbiome, and diabetes risk, PREDIMED-PLUS: Efecto de una dieta mediterránea hipocalórica y promoción de la actividad física en prevención primaria cardiovascular. Estudio piloto sobre marcadores intermedios, G912047023
OpenAlex ID: W7117709193
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