Exercise and Protein Effects on Strength and Function with Weight Loss in Older Women

Med Sci Sports Exerc. 2021 Jan;53(1):183-191. doi: 10.1249/MSS.0000000000002429.


Obesity negatively affects lower extremity physical function (LEPF) in older adults. Exercise and a higher protein diet are both known to positively and independently affect body composition, muscle strength, and LEPF during weight loss; however, their potential interactive effects have not been well characterized in older women.

Purpose: The aim of this study was to determine the relative efficacy of a higher protein diet with or without exercise to improve body composition, muscle strength, and LEPF in older inactive overweight/obese women after weight loss.

Methods: Postmenopausal women (body mass index = 31.1 ± 5.1 kg·m, 69.2 ± 3.6 yr) completed a 6-month weight loss program after randomization to three groups (n = 72 randomized; 15% dropout): 1) higher protein diet (PRO, ~30% energy from protein; n = 20), 2) PRO plus exercise (PRO + EX; n = 19), or 3) a conventional protein control diet plus EX (CON + EX, ~18% energy from protein; n = 22). EX was supervised, multicomponent (aerobic, muscle strengthening, balance, and flexibility), and three sessions per week. Body composition was measured via dual-energy x-ray absorptiometry, leg strength by isokinetic dynamometry, and LEPF via 6-min walk, 8-ft up and go, and 30-s chair stand tests.

Results: Changes in weight (-7.5 ± 4.1 kg; -9.2% ± 4.8%), fat mass, and leg lean mass did not differ among groups (all P > 0.50). Despite weight loss, muscle strength improved in the exercise groups (PRO + EX and CON + EX) but it declined in the PRO group (P = 0.008). For all LEPF measures, the PRO group had attenuated improvements compared with both PRO + EX and CON + EX (all P < 0.01).

Conclusion: Exercise during weight loss is critical to preserve strength and enhance LEPF; however, a higher protein diet does not appear to influence body composition, muscle strength, or LEPF changes when combined with multicomponent exercise.

Trial registration: ClinicalTrials.gov NCT01893684.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Fat Distribution
  • Body Mass Index
  • Diet, High-Protein*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Lower Extremity / physiology*
  • Muscle Strength / physiology*
  • Obesity / diet therapy
  • Obesity / therapy*
  • Overweight / diet therapy
  • Overweight / therapy*
  • Patient Compliance
  • Weight Loss / physiology*

Associated data

  • ClinicalTrials.gov/NCT01893684