University of Georgia
June 2014
Health
Study focuses on healthy weight loss in the elderly

Ellen Evans, co-director of the Obesity and Exercise Team of the Obesity Initiative, is trying to determine how best to treat obesity in older adults.

Study focuses on weight loss in the elderly

Obesity Initiative research tries to find balance between safe weight loss and maintaining bone and muscle strength.

Ellen Evans wants to make a difference in the quality of people’s lives with her teaching and research—particularly, in older women’s lives.

As part of the Obesity Initiative at the University of Georgia, Evans is currently studying how older people can best lose weight, while at the same time preserve bones and muscles.

The notion that obesity for older adults is bad has only been around for the last decade or so. Researchers have focused mainly on obesity in children, young and middle-aged adults, but much less on obesity in older adults, Evans said.

That may be surprising since the highest prevalence of obesity in the U.S. is among older adults. In fact, the prevalence of obesity is highest among women 60 years and older, according to the Centers for Disease Control and Prevention.

Older adults also bear the heaviest burden from obesity in related disorders such as diabetes, heart disease and physical disability. For example, adults who are 65 years and older have a 27 percent prevalence of diabetes and account for 42 percent of cases of diabetes, according to the Centers for Disease Control and Prevention.

In addition, obesity and its related conditions are major factors related to early nursing home admissions. “When a person is obese as an older adult, they typically don’t have the muscle strength to carry their larger body, and they often become more sedentary, leading to an unhealthy cycle,” Evans said. “Family members of older adults then have trouble caring for their loved ones because they may not be able to move them around.”

But changes in physical activity and eating should be tailored to the individual, especially for older adults who often have complications from medications and chronic medical conditions, Evans said.

“As people age, they become frailer. So what is the best approach for safe weight loss in older people? How much do they benefit in terms of improved health outcomes?”

Ellen Evans

Weight loss in older adults can have negative effects on bone health and muscle strength, potentially leading to increased risks for osteoporosis and physical impairments such as decreased mobility.

Ironically, when people lose weight by exercising and eating healthier, they almost always reduce the strength of their bones and muscles, according to Evans.

“As people age, they become frailer. So what is the best approach for safe weight loss in older people? How much do they benefit in terms of improved health outcomes?” Evans asked. “For older adults, we start worrying about them falling and breaking a bone and then being unable to physically take care of themselves. No one wants to lose their independence, have to be taken care of or be placed into a nursing home. So, it becomes very important that we design exercise and nutrition interventions to preserve both bone health and muscles for physical function.”

Evans co-directs the Obesity and Exercise Team of the Obesity Initiative with Mary Ann Johnson, a professor in foods and nutrition in the College of Family and Consumer Sciences, and an adjunct professor of kinesiology in the College of Education.

To further determine how best to treat obesity in older adults and what may be the best diet and exercise regimens for them, Evans and Johnson are studying the effects of a higher-protein weight-loss diet and exercise on body composition, physical function and fatigue in overweight women ages 65 to 80. Higher protein diets include foods such as lean beef, salmon, turkey and chicken.

“The challenge when helping older adults lose weight is to find the diet and exercise program to which they will adhere. However, while gaining health benefits from weight loss such as better blood pressure control and management of diabetes, it is important that other health conditions are not made worse such as osteoporosis and frailty. Ultimately, the goal for all of us is to maintain the ability to live independently until the end of our long lives,” Evans said.

The study focuses on women, because older females have less muscle, are less physically active and live longer, increasing their risk for functional limitations and consequently physical disability, compared to their male counterparts.

Evans is also the director of the UGA Center for Physical Activity and Health, which has recently undergone a transition from being a cardiac rehabilitation facility into a more contemporary fitness center for all populations, particularly faculty and staff on campus.

“(Graduate students) are the future. It’s so fulfilling to watch them develop and grow.”

Ellen Evans

Although she grew up in the Midwest, earned bachelor’s and master’s degrees in Illinois and started her career as a fitness professional at the University of Illinois, she earned her doctorate at UGA under the guidance of Kirk Cureton, professor and head of the department of kinesiology. After post-doctoral training at Washington University School of Medicine in St. Louis, Evans returned to the University of Illinois to begin her academic career where she established a reputation for her research in body composition and exercise over the next several years. However, she enthusiastically pursued the chance to work once again with her mentor and within the department of kinesiology, which is not only a top-ranked department due to its research and academic programs but also has an exceptionally healthy work culture.

Since joining the UGA faculty in 2010, she has secured $1.8 million in new external funding, $1.3 million as a principal investigator.

While research collaborations, such as the one with Johnson, are among the most favorite aspects of her job, mentoring graduate students is the part of her work she says she enjoys most.

“It’s because they are the future. They’re all different and they’re all going different places and their contribution to the field will be different. It’s so fulfilling to watch them develop and grow,” she said.