Mixed
In older adults with overweight/obesity and type 2 diabetes, losing weight while simultaneously gaining skeletal muscle mass significantly reduces the risk of adverse cardiovascular events compared to weight gain or weight loss accompanied by muscle loss.
For older adults with excess weight and diabetes, simply losing weight on the scale is not enough to protect the heart. You must preserve or build muscle during weight loss. This likely requires resistance exercise combined with adequate protein intake, rather than dieting alone. Losing weight while losing muscle provides no cardiovascular benefit compared to gaining weight.
The participants gaining SMM along with weight loss achieved the lowest odds of adverse cardiovascular events, whilst those who lost SMM along with weight loss had comparable cardiovascular risk with those gaining weight.
Why this rating
Post-hoc analysis of a large, long-term RCT (Look AHEAD) with robust adjustment for confounders and multiple sensitivity analyses.
Source
Cardiovascular effects of weight loss in old adults with overweight/obesity according to change in skeletal muscle mass
Xiaojie Cai et al. · Journal of Cachexia Sarcopenia and Muscle · 2023
DOI 10.1002/jcsm.13409
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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