Obesity (Silver Spring, Md.) · 2026
The Effect of a Very Low-Carbohydrate Diet on Intermuscular Adipose Tissue and Muscle Function in Older Adults With Obesity.
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Drake Carly E, Gower Barbara A, Fontaine Kevin R, Bryan David R, Goss Amy M
Аннотация
OBJECTIVE: Intermuscular adipose tissue (IMAT) is associated with impaired skeletal muscle (SM) quality and declining mobility in older adults with obesity. This secondary analysis examined the effects of a very low-carbohydrate diet (VLCD) versus a low-fat diet (LFD) on changes in IMAT, muscle strength, and physical function in older adults with obesity.
METHODS: Adults (age ≥ 60 years) with obesity were randomized to a weight-maintaining VLCD (< 10% energy from carbohydrates) or LFD (55% energy from carbohydrates) for 8 weeks. Thigh SM and IMAT were measured by MRI. Physical function was assessed via hand grip strength, isometric knee extension, reach score, and six-minute walk tests. Multiple linear regressions examined whether changes in IMAT were associated with changes in physical function outcomes.
RESULTS: The VLCD group showed a significantly greater decrease in IMAT (-24.4% vs. -1.0%, p < 0.01). Across all participants, greater decreases in IMAT were associated with greater improvements in hand grip strength (r2 = 0.95, p < 0.01), isometric knee extension (r2 = 0.88, p < 0.05), and reach score (r2 = 0.75, p < 0.05), after adjusting for changes in thigh SM volume and body weight.
CONCLUSIONS: Dietary interventions that reduce IMAT, such as a VLCD, may help preserve physical function and muscle strength in older adults with obesity.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02760641.
METHODS: Adults (age ≥ 60 years) with obesity were randomized to a weight-maintaining VLCD (< 10% energy from carbohydrates) or LFD (55% energy from carbohydrates) for 8 weeks. Thigh SM and IMAT were measured by MRI. Physical function was assessed via hand grip strength, isometric knee extension, reach score, and six-minute walk tests. Multiple linear regressions examined whether changes in IMAT were associated with changes in physical function outcomes.
RESULTS: The VLCD group showed a significantly greater decrease in IMAT (-24.4% vs. -1.0%, p < 0.01). Across all participants, greater decreases in IMAT were associated with greater improvements in hand grip strength (r2 = 0.95, p < 0.01), isometric knee extension (r2 = 0.88, p < 0.05), and reach score (r2 = 0.75, p < 0.05), after adjusting for changes in thigh SM volume and body weight.
CONCLUSIONS: Dietary interventions that reduce IMAT, such as a VLCD, may help preserve physical function and muscle strength in older adults with obesity.
TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02760641.