Optimizing Adaptive Intensive Behavioral Therapy for Obesity During the Transition to Older Adulthood: A Sequential Multiple Assignment Randomized Trial
University of Alabama at Birmingham
Summary
To test adaptive intensive behavioral therapy strategies comprising dietary patterns with varying amounts of protein and including supplemental protein or resistance exercise training for promoting weight loss and attenuating lean mass loss in adults aged 50-75 with obesity.
Description
This Sequential Multiple Assignment Randomized Trial (SMART) seeks to identify the optimal initial dietary strategy (high vs. standard protein diets) and as-needed augmentation strategy (protein supplementation vs. supervised resistance exercise training) for behavioral weight loss in adults aged 50-75. Augmentation strategies will only be used for participants who do not achieve at least 3% weight loss and/or those who lose more than 1.5 kg of fat free mass (i.e., Non-Responders) after 8 weeks of group-based behavioral obesity treatment. Protein supplements and supervised resistance exercise…
Eligibility
- Age range
- 50–75 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Male or female sex * all racial and ethnic groups * BMI: 30-50 kg/m2 * age 50-75 years * postmenopausal status for ≥1 y if female sex Exclusion Criteria: * \<3 months stable use of other medications affecting body weight or appetite * \>450 pounds (due to weight limitations of the DXA) * indication or previous diagnosis of sarcopenia * existing kidney disease * current binge eating disorder, anorexia, or bulimia * untreated hyper- or hypothyroidism, cancer (except basal cell), gastrointestinal disorders affecting food intake or nutrient absorption; any other medical co…
Interventions
- BehavioralHigh Protein Diet Counceling
16 week group-based weight loss program with counseling to consume a high protein diet. Approximate macronutrient distributions (carbohydrate:protein:fat) will be 32%:40%:28%.
- BehavioralStandard Protein Diet Counceling
16 week group-based weight loss program with counseling to consume a standard protein diet. Approximate macronutrient distributions (carbohydrate:protein:fat) will be 53%:20%:27%.
- BehavioralProtein Supplement
Non-responders from either initial randomized group assigned to this intervention receive twice daily protein supplements.
- BehavioralSupervised Exercise
Non-responders from either initial randomized group assigned to this intervention receive twice weekly small-group supervised resistance exercise training sessions.
Location
- University of Alabama at BirminghamBirmingham, Alabama