Table 2.
Effect of Diet, Exercise, or Combined on Outcome Variables in Obese Older Adults
| Mean (SD) Value | Difference in Change from Baseline to 12 mo (95% CI) | P Value* | |||
|---|---|---|---|---|---|
| Baseline | Change at 6 mo | Change at 12 mo | |||
| Insulin sensitivity index | |||||
| Control group | 3.3 (2.0) | −0.1 (0.8) | 0.2 (1.4) | - | - |
| Diet group | 2.7 (1.6) | 1.1 (1.2)† | 1.2 (1.6)† | - | - |
| Exercise group | 3.5 (2.6) | 0.1 (1.4) | 0.1 (1.9) | - | - |
| Diet-exercise group | 3.4 (2.4) | 1.2 (1.6)† | 2.4 (2.3)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | 1.0 (0.0 to 1.8) | 0.05 |
| Exercise vs. control | - | - | - | −0.1 (−1.2 to 0.8) | 0.66 |
| Diet-exercise vs. diet | - | - | - | 1.2 (0.2 to 2.1) | 0.02 |
| Diet-exercise vs. exercise | - | - | - | 2.3 (1.4 to 3.4) | <0.001 |
| Other OGTT variables | |||||
| Insulin AUC (× 103 mg.min/dL) | |||||
| Control group | 9.1 (5.1) | 0.9 (3.3) | 0.6 (4.0) | - | - |
| Diet group | 12.9 (7.5) | −3.1 (−5.9)† | −2.9 (6.1)† | - | - |
| Exercise group | 10.7 (6.8) | 0.1 (3.6) | −0.1 (3.6) | - | - |
| Diet-exercise group | 10.8 (5.5) | −2.9 (4.1)† | −2.9 (3.9)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −3.5 (−6.3 to −1.4) | <0.01 |
| Exercise vs. control | - | - | - | −0.5 (−3.0 to 1.9) | 0.78 |
| Diet-exercise vs. diet | - | - | - | 0.0 (−1.8 to 2.9) | 0.67 |
| Diet-exercise vs. exercise | - | - | - | −3.0 (−5.2 to 0.4) | 0.02 |
| Glucose AUC (× 103 mg.min/dL) | |||||
| Control group | 19.0 (2.8) | 0.2 (3.2) | −0.3 (1.9) | - | - |
| Diet group | 18.6 (3.5) | −1.8 (2.3)† | −2.2 (2.7)† | - | - |
| Exercise group | 18.1 (2.8) | 0.3 (2.2) | −0.3 (2.7) | - | - |
| Diet-exercise group | 18.1 (3.6) | −0.9 (2.9)† | −1.4 (2.8)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −2.5 (−3.8 to −0.8) | <0.01 |
| Exercise vs. control | - | - | - | 0.0 (−1.8 to 1.4) | 0.80 |
| Diet-exercise vs. diet | - | - | - | 0.8 (−0.8 to 2.2) | 0.35 |
| Diet-exercise vs. exercise | - | - | - | −1.7 (−2.9 to 0.2) | 0.08 |
| Fasting insulin (μU/mL) | |||||
| Control group | 16.0 (9.9) | 0.1 (7.1) | −2.0 (9.5) | - | - |
| Diet group | 17.5 (9.9) | −5.0 (6.8)† | −4.5 (7.3)† | - | - |
| Exercise group | 16.0 (10.2) | −1.1 (6.3) | −2.1 (6.4) | - | - |
| Diet-exercise group | 17.0 (12.0) | −3.3 (6.3)† | −6.2 (7.1)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −2.5 (−6.7 to 1.2) | 0.12 |
| Exercise vs. control | - | - | - | 0.1 (−4.4 to 3.3) | 0.88 |
| Diet-exercise vs. diet | - | - | - | −1.7 (−5.4 to 2.4) | 0.45 |
| Diet-exercise vs. exercise | - | - | - | −4.1 (−8.4 to −0.6) | 0.02 |
| HOMA-IR | |||||
| Control group | 4.1 (2.9) | 0.3 (2.6) | −0.3 (2.9) | - | - |
| Diet group | 4.2 (2.8) | −1.3 (1.7)† | −1.4 (1.8)† | - | - |
| Exercise group | 4.0 (2.7) | −0.3 (1.7) | −0.7 (1.8) | - | - |
| Diet-exercise group | 4.4 (3.6) | −1.1 (1.4)† | −1.7 (1.9)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −1.1 (−2.0 to 0.2) | 0.12 |
| Exercise vs. control | - | - | - | −0.4 (−1.3 to 1.0) | 0.78 |
| Diet-exercise vs. diet | - | - | - | −0.3 (−1.5 to 0.6) | 0.43 |
| Diet-exercise vs. exercise | - | - | - | −1.0 (−2.3 to −0.1) | 0.04 |
| Body weight and central obesity | |||||
| Body weight (kg) | |||||
| Control group | 101.0 (16.3) | 0.9 (2.8) | −0.1 (3.5) | - | - |
| Diet group | 104.1 (15.3) | −9.0 (5.4)† | −9.7 (5.4)† | - | - |
| Exercise group | 99.2 (17.4) | −0.3 (2.3) | −0.5 (3.6) | - | - |
| Diet-exercise group | 99.1 (16.8) | −7.7 (4.2)† | −8.6 (3.8)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −9.0 (−1.1 to −6.7) | <0.001 |
| Exercise vs. control | - | - | - | −0.4 (−2.7 to 1.8) | 0.72 |
| Diet-exercise vs. diet | - | - | - | 0.3 (−1.9 to 2.6) | 0.78 |
| Trunk fat (kg) | |||||
| Control group | 22.4 (5.6) | −0.3 (1.4) | 0.5 (2.9) | - | - |
| Diet group | 21.8 (4.1) | −3.2 (2.7)† | −3.4 (2.4)† | - | - |
| Exercise group | 21.2 (4.1) | −0.6 (1.1)† | −0.8 (1.3)† | - | - |
| Diet-exercise group | 20.9 (4.8) | −3.4 (1.8)† | −3.3 (1.9)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −3.9 (−5.2 to −2.9) | <0.001 |
| Exercise vs. control | - | - | - | −1.3 (−2.4 to −0.8) | 0.04 |
| Diet-exercise vs. diet | - | - | - | 0.1 (−0.9 to 1.3) | 0.74 |
| Diet-exercise vs. exercise | - | - | - | −2.5 (−3.8 to −1.5) | <.001 |
| Visceral fat (cm3) | |||||
| Control group | 2591 (1539) | - | 15 (589) | - | - |
| Diet group | 2175 (1087) | - | −561 (454)† | - | - |
| Exercise group | 2231 (1183) | - | −115 (244)† | - | - |
| Diet-exercise group | 2086 (1337) | - | −787 (896)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −576 (−866 to −285) | <0.001 |
| Exercise vs. control | - | - | - | −130 (−380 to 120) | 0.39 |
| Diet-exercise vs. diet | - | - | - | −226 (−615 to 163) | 0.19 |
| Diet-exercise vs. exercise | - | - | - | −672 (−1031 to −312) | <0.001 |
| Subcutaneous fat (cm3) | |||||
| Control group | 3805 (1036) | - | 305 (889) | - | - |
| Diet group | 3558 (958) | - | −457 (326)† | - | - |
| Exercise group | 3256 (978) | - | −83 (326) | - | - |
| Diet-exercise group | 3600 (1389) | - | −464 (475)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −762 (−1134 to −389) | <0.001 |
| Exercise vs. control | - | - | - | −388 (−760 to −16) | 0.02 |
| Diet-exercise vs. diet | - | - | - | −7 (−231 to 217) | 0.96 |
| Diet-exercise vs. exercise | - | - | - | −381 (−605 to −156) | 0.03 |
| Lean body mass (kg) | |||||
| Control group | 57.3 (11.5) | −0.7 (2.3) | −0.8 (2.5) | ||
| Diet group | 61.4 (13.0) | −3.5 (2.7)† | −3.2 (2.0)† | ||
| Exercise group | 57.6 (13.7) | 1.1 (2.1)† | 1.3 (1.6)† | ||
| Diet-exercise group | 57.2 (10.3) | −1.7 (1.6)† | −1.8 (1.7)† | ||
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −2.4 (−3.6 to 1.2) | <0.001 |
| Exercise vs. control | - | - | - | 2.1 (0.9 to 3.3) | <0.001 |
| Diet-exercise vs. diet | - | - | - | 1.2 (0.3 to 2.3) | 0.04 |
| Diet-exercise vs. exercise | - | - | - | −3.1 (−4 to −2.2) | <0.001 |
| hs-CRP and adipocytokines | |||||
| hs-CRP (mg/L) | |||||
| Control group | 3.8 (3.9) | 0.7 (3.2) | 2.2 (5.0) | - | - |
| Diet group | 3.5 (3.0) | −1.0 (1.4)† | −1.1 (1.4)† | - | - |
| Exercise group | 4.0 (4.0) | −0.2 (1.7) | 0.7 (2.8) | - | - |
| Diet-exercise group | 4.8 (6.3) | −1.8 (3.7)† | −1.8 (3.4)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −3.3 (−5.2 to −1.6) | <0.001 |
| Exercise vs. control | - | - | - | −2.9 (−4.7 to −1.1) | <0.01 |
| Diet-exercise vs. diet | - | - | - | −0.7 (−2.2 to 1.2) | 0.56 |
| Diet-exercise vs. exercise | - | - | - | −1.1 (−2.7 to 0.7) | 0.23 |
| sTNF R1 (pg/mL) | |||||
| Control group | 167.2 (34.7) | −2.2 (24.7) | 12.3 (20.6)† | - | - |
| Diet group | 155.8 (34.7 | −11.9 (−19.7)† | −12.8 (21.7)† | - | - |
| Exercise group | 166.6 (51.2) | −0.6 (22.4) | 9.6 (20.4) | - | - |
| Diet-exercise group | 177.5 (49.1) | −21.6 (26.1)† | −17.0 (29.2)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −25.1 (−36.7 to −8.7) | <0.01 |
| Exercise vs. control | - | - | - | −2.7 (−15.2 to 12.9) | 0.87 |
| Diet-exercise vs. diet | - | - | - | −4.2 (−18.7 to 8.1) | 0.44 |
| Diet-exercise vs. exercise | - | - | - | −26.6 (−40.3 to −13.5) | <0.001 |
| Adiponectin (ng/mL) | |||||
| Control group | 31.9 (23.3) | −3.2 (10.8) | −4.9 (20.6) | - | - |
| Diet group | 23.3 (12.1) | 2.8 (4.7)† | 4.0 (5.5)† | - | - |
| Exercise group | 20.8 (7.4) | 1.0 (5.9) | 1.6 (5.1) | - | - |
| Diet-exercise group | 24.4 (13.0) | 2.5 (5.7)† | 5.0 (8.4)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | 8.9 (3.5 to 14.8) | <0.01 |
| Exercise vs. control | - | - | - | 6.5 (0.8 12.3) | 0.02 |
| Diet-exercise vs. diet | - | - | - | 1.0 (−4.5 to 6.2) | 0.74 |
| Diet-exercise vs. exercise | - | - | - | 3.4 (−1.9 to 9.0) | 0.21 |
| Metabolic syndrome components | |||||
| Fasting glucose (mg/dL) | |||||
| Control group | 101.7 (10.1) | 2.4 (9.4) | −0.6 (11.8) | - | - |
| Diet group | 96.2 (12.2) | −3.5 (8.7)† | −3.7 (11.5)† | - | - |
| Exercise group | 99.7 (8.4) | 0.9 (8.9) | −1.3 (8.3) | - | - |
| Diet-exercise group | 99.3 (11.3) | −2.4 (7.0)† | −5.4 (9.0)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −3.1 (−8.3 to 2.3) | 0.27 |
| Exercise vs. control | - | - | - | −0.7 (−5.5 to 5.3) | 0.96 |
| Diet-exercise vs. diet | - | - | - | −1.7 (−6.6 to 3.7) | 0.58 |
| Diet-exercise vs. exercise | - | - | - | −4.1 (−9.5 to 0.9) | 0.11 |
| Waist circumference (cm) | |||||
| Control group | 117.5 (12.8) | −1.2 (7.2) | 1.0 (6.1) | - | - |
| Diet group | 118.2 (11.5) | −8.5 (10.5)† | −8.4 (8.6)† | - | - |
| Exercise group | 114.9 (12.7) | −0.1 (8.0) | −4.0 (9.1)† | - | - |
| Diet-exercise group | 116.0 (14.8) | −7.9 (10.0)† | −8.2 (10.3)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −7.4 (−12.3 to −1.3) | 0.02 |
| Exercise vs. control | - | - | - | −3.0 (−8.4 to 2.8) | 0.15 |
| Diet-exercise vs. diet | - | - | - | 0.2 (−5.3 to 5.1) | 0.97 |
| Diet-exercise vs. exercise | - | - | - | 4.2 (−9.4 to 1.3) | 0.13 |
| HDL cholesterol (mg/dL) | |||||
| Control group | 51.7 (13.4) | 0.0 (4.9) | 1.3 (5.5) | - | - |
| Diet group | 53.3 (12.9) | 1.0 (6.1) | 1.6 (5.8) | - | - |
| Exercise group | 53.7 (13.9) | −1.6 (3.1) | −1.5 (3.4) | - | - |
| Diet-exercise group | 55.2 (15.4) | −1.3 (7.9) | 1.1 (8.7) | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | 2.9 (−1.2 to 6.5) | 0.17 |
| Exercise vs. control | - | - | - | −0.2 (−4.3 to 3.4) | 0.82 |
| Diet-exercise vs. diet | - | - | - | −0.5 (−4.1 to 3.1) | 0.79 |
| Diet-exercise vs. exercise | - | - | - | 2.6 (−1.1 to 6.3) | 0.17 |
| Triglyceride (mg/dL) | |||||
| Control group | 123.2 (50.4) | 0.3 (33.2) | 7.1 (29.3) | - | - |
| Diet group | 144.6 (60.1) | −26.2 (39.2)† | −24.3 (33.1)† | - | - |
| Exercise group | 158.4 (73.8) | −4.2 (65.9) | −18.9 (45.6) | - | - |
| Diet-exercise group | 134.7 (65.1) | −18.9 (45.6)† | −30.7 (40.0)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −31.4 (−60.9 to −3.1) | 0.03 |
| Exercise vs. control | - | - | - | −16.1 (−46.7 to 11.9) | 0.24 |
| Diet-exercise vs. diet | - | - | - | −6.7 (−34.0 to 20.8) | 0.63 |
| Diet-exercise vs. exercise | - | - | - | −21.7 (−49.1 to 6.7) | 0.14 |
| Systolic blood pressure (mm Hg) | |||||
| Control group | 133.3 (18.6) | −4.8 (19.8) | −5.9 (23.0) | - | - |
| Diet group | 135.3 (19.1) | −15.9 (13.6)† | −13.1 (15.1)† | - | - |
| Exercise group | 131.2 (11.7) | −0.4 (15.3) | −1.2 (15.5) | - | - |
| Diet-exercise group | 138.6 (23.6) | −13.4 (24.5)† | −15.9 (18.9)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −7.2 (−18.5 to 4.1) | 0.23 |
| Exercise vs. control | - | - | - | 4.7 (−7.4 to 15.5) | 0.49 |
| Diet-exercise vs. diet | - | - | - | −2.8 (−14.1 to 7.8) | 0.49 |
| Diet-exercise vs. exercise | - | - | - | −14.7 (−25.5 to −3.3) | <0.01 |
| Diastolic blood pressure (mm Hg) | |||||
| Control group | 71.5 (10.7) | 0.7 (12.1) | −1.1 (11.2) | - | - |
| Diet group | 75.7 (11.0) | −6.0 (9.6)† | −6.7 (10.3)† | - | - |
| Exercise group | 70.9 (8.3) | −1.4 (11.1) | −2.1 (6.1) | - | - |
| Diet-exercise group | 74.0 (10.1) | −4.5 (10.6)† | −4.9 (9.5)† | - | - |
| Intergroup comparisons | |||||
| Diet vs. control | - | - | - | −5.5 (−11.1 to 0.8) | 0.09 |
| Exercise vs. control | - | - | - | −1.0 (−7.6 to 4.4) | 0.60 |
| Diet-exercise vs. diet | - | - | - | −1.8 (−5.0 to 6.6) | 0.77 |
| Diet-exercise vs. exercise | - | - | - | −2.8 (−8.6 to 3.2) | 0.36 |
Abbreviations: CI, confidence interval; OGTT, oral glucose tolerance test; AUC, area under the curve, HOMA-IR, homeostasis model assessment of insulin resistance, hs-CRP, high sensitivity C-reactive protein; sTNF R1, soluble tumor necrosis factor receptor 1
*
P values, as calculated with the use of mixed-model repeated-measures analyses of variance contrasts
†
P<.0.05 for the comparison of the value from baseline, as calculated with the use of mixed-model repeated-measures analyses of variance