# Enhanced Protein Intake During Obesity Reduction in Older Male Veterans: Differences in Physical Function and Muscle Quality Responses by Race

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2022 · —

## Abstract

Project Summary: The negative impact of obesity on physical function in older adults is largely
unrecognized, yet close to 40% of older adults in the U.S. are obese and almost all have reduced physical
function due to excess body fat plus age-related decline in muscle mass/strength (sarcopenia). Obesity is
especially common in older African Americans, who as a result face greater functional decline and higher rates
of Type 2 diabetes than whites. Obesity treatment can improve function and muscle health but it threatens long
term functional outcomes due to concomitant loss of lean mass. Lowering of muscle mass is a concern not only
for future functional status but it could also lead to impaired glucose tolerance. Unless effective interventions
can be found to circumvent these challenges, the older adult physically limited by sarcopenia and excessive
adiposity is likely to become the most common phenotype of geriatric frailty in the near future.
The proposed study concerns a variety of important consequences of late life obesity but its primary focus is on
the detrimental influences of obesity on physical function in older individuals who are at very high risk for
frailty. Recognizing the high prevalence of Type 2 diabetes in older individuals (especially African Americans)
and its links with poor muscle quality, the intervention will target men with prediabetes and assess their
changes in insulin sensitivity, as well as their functional responses, to the interventions. A novel (higher-
protein, balanced by meal) weight loss regimen that has been previously shown to improve physical function in
obese, frail older adults will be tested in obese older white and black Veterans with functional limitations. The
intervention regimen will be culturally tailored to meet the individual preferences of the target population and
adapted to make sure low-income participants are able to afford the healthy foods in their diet plan.
A total of 168 obese (BMI ≥30 kg/m2) male Veterans aged ≥60 yrs, with mild to moderate functional
impairments (Short Physical Performance Battery score of 4 to 10 units) and prediabetes, will be randomized
to a higher-protein weight loss treatment or an RDA-level protein control weight loss treatment. All
participants receive individualized calorie prescriptions calculated to achieve a weight loss of ~1-2 pounds per
week and attend weekly group support sessions designed to enhance diet compliance with goal setting, self-
monitoring, stress management, and daily diet journaling; [they will also attend a weekly low impact, chair
exercise class]. Higher-protein group participants are provided a supply of chilled/frozen high quality protein
foods (lean meats, low fat dairy products, eggs) sufficient to give ≥30 g high quality protein for two of three
meals daily to help assure diet compliance. Treatment responses will be compared for the primary outcome of
functional performance by Short Physical Performance Battery and important secondary...

## Key facts

- **NIH application ID:** 10356071
- **Project number:** 5I01RX002843-04
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** CONNIE W BALES
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10356071

## Citation

> US National Institutes of Health, RePORTER application 10356071, Enhanced Protein Intake During Obesity Reduction in Older Male Veterans: Differences in Physical Function and Muscle Quality Responses by Race (5I01RX002843-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10356071. Licensed CC0.

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