Losing Weight for Middle Age and Older Adults

Successful Weight Loss Tips for Mid-Life & After

 

September 5, 2015

Evelyn Smith

M. S. in Library Science, University of North Texas

Addendum

September 12, 2015

Research has discovered a link between excessive weight at middle age and the earlier onset of Alzheimer’s.

Bakalar, Nicholas. (2015, September 10). Excess weight at age 50 tied to earlier Alzheimer’s onset. Well. Mind.  New York Times.  Retrieved from http://well.blogs.nytimes.com/2015/09/10/excess-weight-at-age-50-linked-to-earlier-alzheimers-onset/?_r=0

Earlier studies have proven that middle-aged spread contributes to an increased risk of Alzheimer’s, and how researchers have determined that it also predicts an earlier onset of Alzheimer’s as well.  After following 1,394 “cognitively healthy” people with the average age 0f 60 for 14 years, 142 developed Alzheimer’s, and after controlling for age, race, level of education, and cardiovascular factors, researchers discovered that each unit increase in body mass index at age 50 corresponded with a 6.7 month decrease in the onset of Alzheimer’s (Bakalar, 2015, September 10, para. 1-4).  The study published in Molecular Psychiatry also correlated a higher BMI with larger deposits of amyloid plaque in the brain (Bakalar, 2015, September 10, para. 5). 

Chuang, Y. F., An, Y., and Bilgel, M., et al. (2015, September).  Midlife adiposity predicts earlier onset of Alzheimer's dementia, neuropathology and presymptomatic cerebral amyloid accumulation. Molecular Psychiatry.  doi: 10.1038/mp.2015.129. [Epub ahead of print].  [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/?term=Molecular+Psychiatry++AND+Alzheimer%27s+BMI++age+50

Analyzing data culled from the Baltimore Longitudinal Study on Aging, researchers analyzing 1,294 “cognitively normal individuals” at baseline for 13.9 years, of which 142 developed Alzheimer’s.  In two subset samples, researchers autopsied 191 participants and performed brain amyloid imaging on 75 non-demented individuals.  When researchers noted all of the participants’ BMI at age 50, they found that each increased unit of BMI accelerated the early onset of Alzheimer’s by 6.7 moths.  They also associated higher midlife BMI with greater Braak neurofibrillary amyloid.  Researchers thus concluded that maintaining a healthy BMI at midlife may delay the onset of Alzheimer’s.

 __________

 
A Prevention article on weight loss in older adults left this researcher wondering what weight loss intervention programs specifically aimed at adults in their 60s and older reveal.  This meant performing a Boolean search using the words “diet” and weight loss” on the Foxfire, Google, and Yahoo search engines as well as searching PubMed for pertinent research studies.  Even though the body changes for both men and women in their 50's, not many meaty articles dealing with diet and weight loss in seniors exist.  But undoubtedly there are more to come since Baby Boomers have already reached that milestone:

7 ways to lose weight when you’re over 60. Prevention. (2015, September 4). Fox News.  Retrieved from http://www.foxnews.com/health/2015/09/04/7-ways-to-lose-weight-when-youre-over-60/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+feedburner%2FMFiX+%28FOXNews.com%29

Before adopting a new exercise regime, schedule a medical checkup because medical problems, like heart disease and metabolic problems, are more common after age 60, oxygen intake may be reduced by 1/3 compared to age 25, and older adults are beginning to felt arthritis pain (para. 9-11).  However, the same tips younger candidates for weight loss follow still work for older adults (7 ways, 2015, September 4, para. 12):

Tip No. 1: Focus on fat loss, not weight loss

Follow this rule: You’re waist size should be no more than half your height (7 ways, 2015, September 4, para. 13).

Tip No. 2: Drink plenty of water

This axiom is especially true for older adults because the hypothalamus (that part of the brain that controls hunger and thirst) ability to discern satiety and thirst is dulled, sometimes mistaking thirst for hunger.  Moreover, older adults often avoid drinking lots of water to keep from constantly heading to the bathroom (7 ways, 2015, September 4, para. 14-16).

Tip No. 3: Add strength training to your routine

At age 50, adults possess 20 percent less muscle mass than they did at age 20, which also equates with a lower metabolism.  However, slowly but methodically beginning a strength-training regime, gradually increasing the weights lifted can make up for this loss Weight lifters know they are lifting the right amount of weights if they barely make it to the end of their reps before needing to rest (7 ways, 2015, September 4, para. (17-20).

Tip No. 4: Load up on protein

 Older adults need more lean protein than younger adults to build muscle tone lost with age.  If craving carbohydrates is a temptation, make sure that at least 30 grams of lean protein are part of each meal (7 ways, 2015, September 4, para. 22-23). 

Note: By way of contrast, most diet experts warn older adults to avoid diets like the paleo diet unless they are frail.

Tip No. 5: Be patient

It takes longer to reach a healthy weight at age 60 than it did at 20.  Even so, concentrating on healthy behaviors can help older adults achieve their final weight loss goal (7 ways, 2015, September 4, para. 24-25).

Tip No. 6: Stretch yourself

The more flexible an older body, the more physical activities an older adult can do without harm.  However, taking a yoga class or adding some stretching exercises to a daily routine can accomplish this task (7 ways, 2015, September 4, para. 26).

Tip No. 7: Change your attitude

Don’t keep singing the same song that that weight gain is part of the aging process, but adopt a new refrain.  This becomes easier when friends exercise together (7 ways, 2015, September 4, para. 27-29).

___________

Contrast Prevention’s advice with U.S. News & World Report’s ranking of various diets for older adults. While both sources emphasize drinking enough water, U.S. News while not limiting protein notes that non-animal sources can provide this need.

Esposito, Lisa. (2015, January 21).  Best diets for seniors. Health.  U.S. News & World Report.  Retrieved from http://health.usnews.com/health-news/health-wellness/articles/2015/01/21/best-diets-for-seniors

Diet experts help older readers select the best diets for healthy weight loss (Esposito, 2015, January 21, para. 1). 

Fewer Calories less Protein

DASH, TLC, and the Mediterranean diet stand out as smart diet choices for older adults since they help them lose weight while controlling diabetes and high blood pressure, according to Amy Campbell, a dietician and diabetes educator (Esposito, 2015, January 21, para. 2).  As adults age, they need less calories, thus older women need between 1,600 to 2,2000  calories daily compared with the 1,800 to 2,200 calories needed by younger women, and older men need  between 2,000 and 2,200 calories compared with the 2,000 to 3,200 calories they needed when they were younger (Esposito, 2015, January 21, para. 3). 

Frailty causes additional health issues since a lack of protein puts the frail elderly at risk for lower immunity and osteoporosis (Esposito, 2015, January 21, para. 4).  However, for the most part, older adults don’t need to follow a special diet; they just need to follow a well-rounded diet with extra protein, including the protein found in lentils, beans, and chickpeas (Esposito, 2015, January 21, para. 5).

Hard to follow diets are out while those that fit with older lifestyles are best (Esposito, 2015, January 21, para. 6-7).

 

Simplicity and Balance

Weight Watchers and other similar plans work well because of their ease of use and long-term wear ability, thus garnering praise from Michael Davidson, the Director of Preventive Cardiology at the University of Chicago Medical Center (Esposito, 2015, January 21, para. 8-9).   Since Davidson also sees iron-deficiency in older adults, he also suggests that paleo-diets might work well for them (Esposito, 2015, January 21, para. 10).

Heart Health and Diabetes

Of all the diets ranked by U.S. News & World Report, the Dash and the Mediterranean diet best manage or prevent diabetes Esposito, 2015, January 21, para. 11). Older adults diagnosed with high cholesterol levels do best with low-saturated fat diets that emphasize low-fat dairy products and lean meat and fish.  Seniors also needs to avoid the trans-fat found in some commercially-prepared bakery goods, so it’s important to read labels (Esposito, 2015, January 21, para. 12).

Doable Diets

Older adults benefit from the advice of trained dieticians, although Weight Watchers, Jenny Craig, and Nutrisystem diets work well on a short-term basis, although the expense of following these commercial plans can be quite hefty (Esposito, 2015, January 21, para. 13-15). 

Fruits and Vegetables

U.S. News ranks the Mediterranean diet and the Flexitarian diet as the best plant-based diets.  It’s also possible to keep these diets on a limited budget, although consumers should read the labels of canned vegetables to avoid excessive sodium intake (Esposito, 2015, January 21, para. 16-17).

Fluid Balance

Drinking enough water is necessary to avoid dehydration.  Campbell suggests adding a slice of lemon to a glass of water.  Davidson concludes that moderate diets programs are best for seniors instead of trying to adhere to carb-restrictive diets (Esposito, 2015, January 21, para. 18-19). 

____________

Felix and West, in turn, back up  U.S. News and World Report’s survey that puts DASH and the Mediterranean diet far above the others since they explain that unbalanced diet can do more harm than good.

Felix, Holly C. and West, Delia S. (2013, January).  Effectiveness of Weight Loss Interventions for Obese Older Adults .  American Journal of Health Promotion. 27(3), 191-199.  doi:  10.4278/ajhp.110617-LIT-259. C.  [Full text].  Retrieved from  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539224/

“Evidence culled from the National Library of Medicine up to the end of 2010 indicates behavioral strategies are effective in producing significant (all p < .05) weight loss without significant risk to obese older adults” (Felix, 2013, January, Abstract, para. 5; para. 25).

Nutrient Intake: Unbalanced, reduced calorie diets can exacerbate age-related decline already possibly accelerated by postmenopausal estrogen reduction and reduced sun exposure (Felix, 2013, January, para. 20).

Bone Density/Fractures:  Low bone density can cause osteoporosis and fractures (Felix, 2013, January, para. 21).  Older women who lose weight, whether intentionally or unintentionally experience “significantly higher” rates of hip bone loss (Felix, 2013, January, para. 22).

Weight loss among older men can result in “significantly greater” lean muscle loss.  However, they lose less lean muscle mass if strength training accompanies a reduction in calories (Felix, 2013, January, para. 23).

Mortality:  Studies indicate that weight loss accompanies mortality risk in community-dwelling older adults.  However, this research doesn’t consider intentional weight loss. Indeed, follow-up data from the Arthritis, Diet, and Activity Promotion Trial (ADAPT) associates a lower mortality rate (Felix, 2013, January, para. 24). 

Benefits of Intentional Weight Loss Among Older Adults: A meta-analysis of obese adults revealed that modest weight doesn’t significantly improve cholesterol levels at one year, but when researchers reviewed adults individually, they discovered that in adults who achieved “significant weight loss” this lowered the risk of cardiovascular “events” and diabetes, and increased function.  Moreover, adults in their 70s who intentionally lost weight possessed higher levels of lean muscle mass and bone density (Felix, 2013, January, para. 25).

At What BMI Level Should Older Adults Be Prescribed Weight Loss, and How Much Should They Lose?  Based on the data received from 11,500 older women, the optimal BMI for the lowest risk of diabetes, hypertension, heart disease, and hospital admissions was 18.5 to 24.9, but most studies indicated that the lowest mortality risk ranged from 27 to 30—overweight but not obese (Felix, 2013, January, para. 27).

Bottom Line:  Weight loss in obese older adults reaps positive health benefits (Felix, 2013, January, para. 29).

___________

Readers can easily determine their Body Mass Index (BMI).

See:

Calculate your body mass index. (n. d.).  National Heart, Lung, and Blood Institute.  Retrieved from http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

___________

After reading more than a few articles and abstracts on seniors and weight loss, the reader comes to the conclusion that starting in middle age, the obese and overweight should diet to improve health and fitness first and then rejoice when they start to lose weight gradually.  Nevertheless, boning up on their findings makes the reader take note of some discrepancies.  For example, when looking at Dr. Mike Moreno’s diet books on Amazon.com, readers will discover that he touts a quick start diet, but the best weight loss plan for seniors seems to be a slow and steady one.

Frey, Malia. (2014, June 1).   Weight loss for seniors: Lose weight and improve your health at any age.   About.Heath. About.com.  Retrieved from http://weightloss.about.com/od/weightloss101/a/Healthy-Weight-Loss-For-Seniors.htm

Because life styles change with aging, older adults need to consider possible medical issues and discuss their weight loss goals with a physician before embarking on a weight loss program (Frey, 2014, June 1, para. 1-3).

After talking to your family physician, San Diego physician Mike Moreno and author of The 17 Day Diet and The 17 Day Plan to Stop Aging, recommends that older adults that need to lose weight need to come up with a plan that they can easily follow to lose weight (Frey, 2014, June 1, para. 4).  Readers, however, should note that most authorities don’t recommend rapid weight loss for older adults.

Healthy Diet Advice for Seniors

Moreno recommends eating smaller and more frequent meals since a sedentary life style comes with age, so it’s harder to stimulate hunger (Frey, 2014, June 1, para. 5).

He also suggests that including a source of lean protein, such as eggs, fish, chicken, and turkey with every meal (Frey, 2014, June 1, para. 6).

Fiber, including raw fruits and vegetables, legumes and whole grains, is also necessary to regulate digestion, prevent constipation, and promote weight loss (Frey, 2014, June 1, para. 7).

Additionally, Moreno provides the following diet and nutrition tips for older adults:

• Stay hydrated:  Drink lots of water:

• If necessary, use supplemental products like Ensure to maintain a regularly scheduled, balanced diet regime.

• Share meals with friends and family: Eating with friends and family helps most older-adults maintain a healthier diet.

• Add [aerobic and strength-training] exercise to a daily routine.

(Frey, 2014, June 1, para. 8-11)

Chores around the yard can also serve as exercise:

Use an old-fashioned mower to cut the grass.

 
 Healthy Exercise Advice for Seniors

Older adults should concentrate on doing those exercises they can do, suggests Dr. Moreno, instead of worrying about what they can’t do; for example, walking on flat ground and swimming, or doing stretching exercises (Frey, 2014, June 1, para. 13-14).

Best Tips to Prevent Aging

Even those adults who don’t quality as senior adults can make some changes in their routine to slow the aging process:

• Maintain a healthy weight and Body Mass Index;

• Drink plenty of water;

• Incorporate physical activity into a daily schedule.

(Frey, 2014, June 1, para. 15-19

___________

Lindsey Getz, a dietician, takes up the now familiar refrain that weight loss for overweight and obese adults middle age and older must be gradual and should be accompanied by daily aerobic and strength-training exercises not only for healthy older adults in their 50’s, 60’s, and 70’s, but for all older adults, even into their 90’s.

Getz, Lindsey. (2013, August).  Older adults and obesity — Is dieting the answer? Today’s Dietitian, 15(8), p. 44. Retrieved from http://www.todaysdietitian.com/newarchives/080113p44.shtml

Losing weight can reduce the risk of chronic disease in obese adults if it occurs “safely and methodically”; however, without taking precautions,  weight loss can lead to lean muscle loss and decreased physical strength (Getz, 2013, August, para. 1-3).  

Growing Prevalence

Obesity in older adults is garnering attention because both aging and obesity contribute to health care spending. Obese older adults are at increased risk for diabetes, hypertension, and heart disease.  Additionally, weight gain can cause joint pain and limit mobility Excess weight becomes a quality of life issue, since the obese have more problems with their hips and knees while walking less makes it more difficult to manage blood glucose (Getz, 2013, August, para. 5-7). 

 

However, losing weight not only reduces the medications that older adults take, it also helps improve mobility” (Getz, 2013, August, para. 8).

Key reasons for weight gain with age increased decreased caloric needs coupled with decreased physical activity, reduced growth hormone and testosterone levels, poor nutrition, medications, hypothyroid disorders, and low metabolic rates.  Hence, weight loss interventions in older adults need to be handled on an individual basis (Getz, 2013, August, para. 9).

Weight-Loss Risks

Obesity in older adults can complicate significant muscle loss and lack of bone density.   Accordingly, older adults, and most particularly older women, are at risk for disability and decreased physical functioning.  But since restrictive diets that help the obese and overweight lose weight too quickly also lead to loss of muscle, planned weight loss must be gradual and targeted.  For example, older adults with hypertension might follow the DASH diet (Getz, 2013, August, para. 10-11).

Moreover, since weight loss might affect dose medications for hypertension, physicians most probably need to readjust how much their patients need to take.  Therefore, diets need not only be nutritionally balance, but also take into account the older obese adult’s current health status when both starting a diet and exercise regime, and as it progresses (Getz, 2013, August, para. 12-13).

Fitting in Fitness

Since weight-resistance exercises, or strength training, minimize muscle loss, older adults trying to lose weight need to schedule two hours of strength training and two and a half hours of moderate aerobic exercise weekly (Getz, 2013, August, para. 14).

Older adults–whether over weight or not—even in their 70's, 80's, and 90's, can use resistance bands and light weight to build muscle mass, which will help their stability and ability to perform activities of daily living (Getz, 2013, August, para. 15).  

Moreover, yoga, using an elliptical machine, and performing water-aerobic exercises are all aerobic workouts that don’t put too much weight on older bones and joints (Getz, 2013, August, para. 16).

Special Dietary Concerns

When planning a weight loss diet for older adults, it’s also crucial to note that some older adults sometimes lose their sense of taste while some other difficulty chewing since both these problems can hamper the amount of lean protein they consume For example, if an older adult has difficult chewing, they can obtain protein from beans, eggs, or peanut butter rather than trying to chew meat.  Limited-income older adults may also need help finding less expensive protein sources while adding herbs and spices to protein dishes may make them more flavorful (Getz, 2013, August, para. 17-19).

Older adults may also be spending money on supplements they don’t really need while they need to concentrate on getting enough calcium and Vitamin D in their diets (Getz, 2013, August, 20-21).

___________

Howell, Nicki. (2015, January 28).  The best weight loss plan for senior women.  Livestrong.  Retrieved from http://www.livestrong.com/article/338863-the-best-weight-loss-plan-for-senior-women/

Post-menopausal women gain weight with hormone changes if they adhere to a high calorie count diet while they decrease physical activity.  In middle age, their weight also shifts from their hips to their waist (Howell, 2015, January 28, para. 1). 

Senior Women Fitness

The Centers for Disease Control suggests getting at least 150 minutes of moderate aerobic activity weekly or 75 minutes of vigorous aerobic activity weekly.  While moderate physical activity easily allows exercisers to carry on a conversation, vigorous exercise doesn’t (Howell, 2015, January 28, para. 2-3).

Strength Training

Older women also need to work in 8 to 12 repetitions of strength training per muscle group at least two times a week (Howell, 2015, January 28, para. 4).

Diet Modification

Since metabolism slows with age, older women should adopt a reduced calorie diet compared with the diet they followed when younger, getting enough fruits, vegetables, whole-grain carbohydrates, and lean protein sources, like nuts and fish, while moderating their fat consumption, getting it primarily from plant-based sources like olive oil (Howell, 2015, January 28, para. 5).

Weight-Loss Promoting Food

Older women can decrease belly fat by consuming monounsaturated fats, like avocados, peanuts, and olive oil since these foods increase the body’s basal metabolism rate (Howell, 2015, January 28, para. 6).

___________

Howell sounds like she is promoting the Mediterranean diet along with offering the now familiar advice that older adults need to exercise daily. Thus, it shouldn’t come as a surprise that the abstract for an article that appeared in the May 2011 issue of the JAMA Internal Medicine summarizes the same advice:

Rejeski, W. Jack, Brubaker, Peter, H, and Goff, David C., et al. (2011, May 23). Translating weight loss and physical activity programs into the community to preserve mobility in older, obese adults in poor cardiovascular health.  JAMA Internal Medicine. 171(10), 880-886. doi:10.1001/archinternmed.2010.522.  [Full-text].  Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=227345

Conclusions:  To improve mobility in older, obese adults with either cardiovascular disease or cardio-metabolic dysfunction, both physical exercise and intentional weight loss must take place. Furthermore, both these tasks can occur in a community setting (Rejeski, 2011, May 23, para. 29).

___________



Rosenberg, et al, have come up with a new twist on exercise, urging older adults to sit less and stand more.  

Rosenberg, D. E., Gell, N. M., and Jones, S.M., et al.  (2015, March 15). The feasibility of reducing sitting time in overweight and obese older adults.  [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25794518

Adults over age 60 with a BMI over 27 kg/mg can benefit from reduce their sedentary time, according to an eight week study that reduced total sitting time and increased sit-to stand transitions.  Inclinometer measured by sitting time decreased 27 minutes per day while standing time increased 25 minutes per day, and all levels of physical activity improved along with gait speed while symptoms of depression decreased.  Researchers thus concluded that reduced sitting time is both a feasible and effective way to improve the health of older adults.

___________

Similarly, the “6 tips” article offers some advice for the oldest of older adults that stress gentle movements and drinking lots of water.

6 tips to lose weight for seniors:  How to gently lose weight.  (2011, July 6).  Hub Pages.  Retrieved from http://ilmdamaily.hubpages.com/hub/6-Tips-to-Lose-Weight-for-Seniors-How-to-Gently-Lose-Weight

All weight loss tips specifically geared toward older adults need to consider possible reduced activity levels and food sensitivities (6 tips, 2011, July 6, para. 1). 

• Try tai chi: it’s slow deliberate movement increases strength and flexibility while combing this venerable exercise with a healthy diet promotes weight loss;

__________

See:

Baum, Josh. (2015, February 18).  Free Tai Chi exercises for seniors.  Livestrong.  Retrieved from http://www.livestrong.com/article/216706-free-tai-chi-exercises-for-seniors/

Baum gives directions for performing three simple Tai Chi exercises that can be performed by most senior adults that aren’t completely bed bound.

Li, Fuzhong, Fisher, John, and Harmer, Peter, et al. (2003).  A simpler eight-form easy Tai-Chi for elderly adults.  Journal of Aging and Physical Activity.  11, 206-211.  [Full text].  Retrieved from http://www.attainmentcompany.com/sites/default/files/pdf/sample/ar-taichiarticle.pdf

Li, et al, present an easy to do Tai Chi program adapted for older adults and individuals with physical impairments that can be performed either sitting or standing (Li, 2003, Abstract, p. 206).

__________

• Water aerobics:  Low-impact, water resistance allows older adults to build strength;

• Herbal teas can help: Stinging nettle tea and lemon tea (hot water with lemon) can help dieters lose weight especially if drunk immediately before bedtime;

• Drink water before a meal: Drinking [a pint of] water [30 minutes] before a meal fills the stomach;

• Keep healthy snacks nearby:  Fill up between meals on healthy, low-calorie snacks;

• Try walking more often:  Regular moderate-impact, aerobic exercise, like brisk walking, can have a beneficial cumulative effect.

(6 tips, 2011, July 6, para. 2-8)

___________

Surprise!  In controlled trials, researchers discovered that obese older adults  were healthy if they adopted a regime that combined both diet and exercise, although dieting alone actually lost slightly more weight.

Villareal, D.T., Chode, S., and Parimi, N, et al. (2011, March 31). Weight loss, exercise, or both and physical function in obese older adults.  New England Journal of Medicine. 364(13), 1218-29. doi: 10.1056/NEJMoa1008234. [Abstract only].  Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21449785

In a year-long, controlled trial, researchers evaluated the weight loss and exercise of 197 obese adults age 65 and older, assigning them randomly to a control group, a weight-management group, an exercise group, and a diet-exercise group.  The obese adults who participated in the diet-exercise group performed better on physical performance tests than either of the groups that confined their efforts to diet or exercise alone. Additionally, their oxygen consumption improved 17 percent versus the diet and exercise groups respectively.  Body weight decrease by 10 percent in the diet group and 9 percent in the diet-exercise group, but didn’t decrease in the exercise group or the control group. Strength, balance, and gait also improved in the study participants who dieted and exercised regularly.   So it isn’t surprising that the finding suggested that weight loss and exercise when coupled together improve physical function better than diet or exercise alone.

___________

The authors of the above study responded to a letter that noted they failed to address cognitive decline in their weight loss study.  The authors reply emphasizes that unintended weight loss serves as a marker for Alzheimer’s as well as other diseases.

Weight Loss and Exercise in Obese Older Adults. (2011, June 23).  New England Journal of Medicine, 364: 2466-2468.  doi: 10.1056/NEJMc1104830. [Full text].  Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMc1104830

To the Editor: Bourke, Liam, Copeland, Robert, and Rosario, Derek.

Villareal, et al, have reported that obese older adults can improve physical function through weight loss and exercise; however, the association between fat loss and cognitive function needs to be assessed, since body-fat mass is thought to be provide protection against cognitive impairment in older women (Correspondence, para. 1). 

The authors reply:  Aziz, N. Ahmad, Pijl, Hanno, and Roos, Raymund, A. C.

No data showing adherence to our study’s weight-loss intervention extends beyond a year, so further trails need to determine if post-intervention follow ups are necessary.  However, this intervention included weight maintenance skills, such as self-monitoring (Correspondence, para. 2).

Unintentional weight loss can be an early marker announcing the onset of dementia.  Additionally, diabetes, hypertension, and cardiovascular disease all correlate with both obesity and cognitive decline while weight loss induced by intentional calorie restriction improves memory possibly because it improves insulin sensitivity and reduces inflammation (Correspondence, para. 3).

___________

Finally, Denise Webb offers older adults some very sensible diet advice that they can follow:

Webb, Denise. (2015). How to choose a weight loss diet for seniors.  How Stuff Works.  Retrieved from http://health.howstuffworks.com/wellness/aging/senior-health-lifestyle/weight-loss-diet-seniors3.htm

Older adults should pick a diet that fits their individual personalities and that they can live with for a long time. It’s also important to pick a diet that is not only healthy and easy to follow but is also inexpensive and includes foods they enjoy (Webb, 2015, p. 1).

How to Lose Weight as a Senior

Putting on excess weight with age is common, but it’s not inevitable.   Nevertheless, beginning in the 20’s, body fat increases while muscle mass decreases from about 45 percent of total body weight to 27 percent of body weight by the time most adults reach age 70.  While a drop in hormones that comes with menopause in women increases female weight gain while decreasing muscle mass. All of which means that adults over 50 burn fewer calories than they did in their 20’s through their 40’s. Consequently, they should downsize their food intake levels while increasing their time spent moderately exercising (Webb, 2015, p. 2).

Questions Seniors Should Ask Before Beginning a Diet

• Determine if the diet requires supplements, strange food combinations, or extremely high levels of protein.  High protein diets promote ketosis, making them hard on the kidneys, lethal to the liver, and deficient in the essential carbohydrates necessary to think clearly

• Diets that limit food choices and that eliminate food groups won’t meet the body’s nutritional needs.

• Don’t fall for diets that make unbelievable claims or require pre-packaged foods or come from questionable sources.

• Avoid diets that promise rapid weight loss since losing weight rapidly means regaining it (and more) just as quickly.  Instead aim at losing a stead one or two pounds per week.

• Diets also need to be practical, allowing for occasional slips on special occasions and eating out and not require a lot of weighing or calorie counting. 

• Diets, however, should include a maintenance plan and require [strength training and aerobic] exercise as part of their regime.

• But even if a diet is nutritional, safe, and effective, each dieters needs to individually assess whether it is right for him or her.

(Webb, 2015, p. 3)

Special Diet Considerations for Seniors

• Cardiovascular Disease:  Avoid diets that require the consumption of a lot of animal protein and make sure the diet includes lots of daily servings of fruits and vegetables.  Additionally, make sure the diet plan provides for enough folate and Vitamins B6 and B12 since high homocysteine levels raise the risk of heart disease.
  

• Breast Cancer:  Women at risk for breast cancer shouldn’t consume soy and soy products.
  

• Constipation:  Stay away from diets that cut carbohydrates, like high fiber whole grains, or limit the intake of fruits and vegetables.

• Diabetes:  Diabetics [and pre-diabetics] shouldn’t emphasize any one food group, although they do need to include heart-healthy fats, like Omega 3 fatty fish, nuts, and lean poultry, and soluble fibers, like beans, peas, lentils, oats, fruits, and vegetables, to control blood sugar and cholesterol levels.

• 
  Gallstones:  Yo-yo dieters put themselves at risk for gallstones.

• High Blood Pressure:  Dieters at risk for high blood pressure need to include low fat dairy foods and plenty of fruits and vegetables in their diet while cutting back on their sodium intake.

 

• Kidney Disease:  Older adults who have kidney disease need to check with their physicians before deciding to diet.  They should also stay clear of plans that emphasize meats, fish, and poultry while drinking lots of fluids.

• Osteoporosis:  Older women need to make sure and include calcium and Vitamin D in their diets and choose plans that don’t over emphasize protein or sodium consumption.

(Webb, 2015, p. 4)

Now, after reading this annotated bibliography, challenge its findings by attempting to lose some weight by following a sensible diet and exercising regularly.  I’d love to hear your results!