(OR07-02-25) Obesity Intervention in Older Men with Prediabetes Has Differential Effects on Body Composition and Function Depending on Race (Black/White): A Pilot Study

Objectives: Obesity rates are escalating in older men, yet weight loss interventions are under-studied in this population, especially regarding potential racial differences. Our objective was to explore a diet/exercise intervention in older male Veterans with obesity and prediabetes, randomized in equal numbers by race (Black/White).

Methods: Changes in body habitus and function were compared by race in 64 men ≥ 60 yrs, with obesity (BMI ≥30 kg/m²) and prediabetes (FBS ≥95 and < 126 mg/dL or HbA1c 5.7-6.4%) who were randomized to either a higher protein (1.4 g/kg/d) or RDA-level protein (0.8 g/kg/d) hypocaloric diet (target 7% weight loss) plus exercise. Diet intervention was facilitated by a weekly support group and measured weights; exercise was facilitated by a weekly in-person class. Outcomes included body weight and composition (BodPod), waist circumference (WC), and function (Short Physical Performance Battery [SPPB], 8-foot up and go [8UG], 6-minute walk time [6MWT]) and handgrip strength. This analysis was a statistical comparison of Black versus White men for change in outcome measures from baseline to 3 and 6 months by unadjusted t-tests, regardless of diet group allocation.

Results: At baseline, mean age was higher (P < 0.03) for Whites (69 ± 6.9 yrs) than Blacks (65 ± 6.9 yrs). BMI and HbA1c were not different by race; total group means were 35.8 ± 4.3 and 6.0 ± 0.3%, respectively. Intervention outcomes by race at 3 months showed that, compared to White men, Black men had lower (p < 0.05) rates of weight loss (-2.7 ± 2.8% versus -5.0 ± 4.0%) but trended towards greater improvements in function by SPPB (p < 0.06) and 8UG (p < 0.07). By 6 months, Black men (-5.6 ± 2.8%) had achieved a similar (NS by group) loss of body weight to White men (-6.9 ± 5.6%) and retained better function outcomes by 8UG (p < 0.04) and SPPB (p < 0.07). Change scores did not differ by racial group at either time point for WC, 6MWT and handgrip.

Conclusions: These findings indicate the impact of diet/exercise interventions on body weight and physical function may differ between Black and White older men with obesity and prediabetes. Indications that responses may differ for both timing and extent suggest further race-specific studies of modality and duration to guide tailoring of lifestyle interventions in this population by race.

Funding Sources: Department of Veterans Affairs, RR&D