HEALTHPLAN MAGAZINE

A recent study published in JAMA Network Open, shows promise for Middle-Aged and Older Adults.

As we age, we become more prone to having belly fat, also known as "visceral fat," which tends to accumulate deep within our abdomens. Additionally, ageing often brings a reduction in muscle mass. These shifts in body composition are associated with various health concerns, including an increased risk of cardiovascular disease and type 2 diabetes, according to the study.

However, this study suggests that there is hope. A combination of an energy-reduced Mediterranean diet and increased physical activity appears to mitigate these effects, potentially helping middle-aged and older adults combat the challenges of ageing and improve their overall health.

The study, published on October 18, 2023, involved middle-aged and older adults with overweight or obesity and metabolic syndrome, a cluster of symptoms that includes obesity, high blood pressure, high blood triglycerides, low HDL ("good") cholesterol, and insulin resistance. The participants in the study experienced a reduction in visceral fat and a greater decrease in the percentage of total body fat during the study. Additionally, they showed delayed loss of lean body mass.

The PREDIMED-Plus Study

The research is part of the ongoing ‘Prevención con Dieta Mediterránea-Plus’ (PREDIMED-Plus) study, a randomised clinical trial designed to assess how the Mediterranean diet can prevent cardiovascular disease. The study includes middle-aged and older individuals, both men and women, who are categorised as having overweight or obesity and metabolic syndrome.

In this specific report, the focus was on a subgroup of 1,521 study participants whose body composition was determined through dual-energy X-ray absorptiometry (DXA scans) at three different points during the study. These participants were randomly divided into two groups.

• The Intervention Group: Participants in this group followed an energy-reduced Mediterranean diet, which involved restricting calorie intake by 30 percent. They also increased their physical activity levels.
• The Control Group: Participants in the control group consumed a Mediterranean diet without any calorie restrictions or increased physical activity.

Upon analysing the data, the researchers discovered "clinically meaningful" changes in body composition in the individuals who reduced their calorie intake and engaged in more physical activity. These individuals were more likely to see significant improvements, with a 5 percent or more reduction in total fat mass, total lean mass, and visceral fat mass, particularly at the one-year mark.

The study's authors conclude that a reduced-energy Mediterranean diet, when combined with increased physical activity, appears to counteract some of the age-related changes in body composition.

Expert Opinion

Dr. David Seres, a Professor of Medicine at the Institute of Human Nutrition at Columbia University Medical Center, not involved in the study, commented on the findings. He highlighted that the study reinforces the idea that a structured program involving a reduced-calorie diet and exercise is more effective for weight loss than casual counselling.

However, he also noted potential issues with the study, particularly the post hoc analysis, which could introduce bias. Dr. Seres suggested repeating the results in new trials to confirm their validity.

What is an Energy-Reduced Mediterranean Diet?

A registered dietitian, Avery Zenker, explained that an energy-reduced Mediterranean diet is essentially a Mediterranean diet with lower calorie intake. This diet, which focuses on calorie reduction, is commonly used for weight loss. The Mediterranean diet is known for its health benefits and has been associated with reduced risks of heart disease and diabetes. It emphasises various foods, including vegetables, fruits, legumes, whole grains, olive oil, fish, nuts, seeds, herbs, and spices.

To make a Mediterranean diet lower in calories, Zenker suggested:

• Reducing portion sizes
• Consuming fewer higher-calorie foods like oils
• Limiting intake of refined sugar
• Eating a balanced plate with a variety of food groups

She also recommended focusing on whole foods and minimising processed or ultra-processed foods, choosing whole fruits over fruit juice, and whole grains over refined grains. Fibre, found in plant foods, should be incorporated as it can enhance satiety and calorie control.

How to Adopt a Mediterranean Diet for Fat Loss

Zenker suggested practical steps for those looking to adapt the Mediterranean diet for fat loss:

• Focus on portion control, especially with higher-calorie foods like nuts, seeds, and olive oil.
• Practise mindful eating to tune into your hunger and satiety cues.
• Use herbs and spices generously for flavour without adding many calories.
• Plan your meals and have "go-to" meals for busy days.
• Stay hydrated, as thirst can sometimes be confused with hunger.
• Plan for setbacks to remain consistent on your journey.

In conclusion, as we age, changes in body composition can pose health risks, but research suggests that a reduced-energy Mediterranean diet coupled with increased physical activity can help mitigate these effects. Adapting the Mediterranean diet for fat loss involves making choices that reduce calorie intake while enjoying a wide range of nutrient-rich foods.

Source: HealthLine