How Mediterranean diet and exercise can help with body composition


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Experts say a Mediterranean diet has numerous health benefits, especially for older adults. miodrag ignjatovic/Getty Images
  • Researchers report that older adults who followed a lower calorie Mediterranean diet and increased their physical activity had improvements to body composition.
  • When people age, their body composition changes with an increase in total fat and a reduction in lean muscle mass.
  • Experts say the Mediterranean diet has numerous health benefits.

A lower calorie Mediterranean diet coupled with physical activity may reduce body fat and prevent muscle loss in older adults.

That’s according to new research published in the journal JAMA Network Open.

In their study, researchers reported that study participants who followed the Mediterranean diet and increased their aerobic physical activity had an improvement in body composition.

“A 3-year weight-loss intervention based on an energy-reduced Mediterranean diet and physical activity, compared with advice to follow the Mediterranean diet without weight-loss goals, resulted in significant improvements in body composition in middle-aged and older adults with chronic health conditions. In particular, we found that this multifactorial lifestyle intervention was effective in reducing total body fat and visceral fat,” the study authors wrote.

“Excess visceral fat and loss of muscle mass, which occurs with increasing age, have been associated with a higher risk for a broad spectrum of health outcomes including cardiovascular disease and type 2 diabetes,” the researchers added. “Thus, effective strategies targeting specific body composition components beyond weight management are warranted to improve health in the long term.”

The study involved 1,521 men and women aged between 55 and 75 without a history of cardiovascular events. The subjects were either classified as overweight or had obesity.

The participants were split into two groups.

Those who were placed in the Mediterranean diet group were given a nutrition and behavioral program that involved reducing their calorie intake by 30% and limiting their consumptions of foods such as processed meat, cream, butter, margarine, added sugar, biscuits, bread, and refined cereal.

Those in this group were also asked to steadily increase their aerobic physical activity, eventually reaching a 45-minute walk or equivalent six times a week. They were also asked to do exercises that improved their flexibility, strength, and balance.

This group received contact with a dietitian three times every month in the first year of the program.

The second group was given general advice about following the Mediterranean diet without any specific physical activity requirements.

The researchers reported those in the group following a lower calorie Mediterranean diet with exercise had significant reductions in total body fat mass as well as an increase in total lean mass. The other group had negligible changes.

“These changes are likely of public health and clinical relevance. Given the metabolic relevance of specific body components, especially visceral fat and lean mass, the benefits of this lifestyle intervention could be very promising. However, continued follow-up is warranted to confirm the long-term consequences of these changes on health,” the study authors said.

Having a high amount of body fat can lead to health problems, including increased risk of death from all causes, type 2 diabetes, stroke, high blood pressure, and coronary heart disease.

Fat that is stored around the midsection of the body, also known as visceral fat, has a strong association with cardiometabolic risk. In North America, visceral obesity is increasing at a greater rate than generalized obesity.

When a person ages, their body composition often changes. This can mean an increase in body fat and a reduction in lean mass and bone density.

Lauri Wright, PhD, the president of the Academy of Nutrition and Dietetics who was not involved in the study, says these changes can be challenging to preserve muscle mass while losing body fat.

“If someone is overweight or obese, they carry too much fat as well. But it’s really the composition of the weight that is more indicative of health risks. So when somebody is over fat, we really want to get the fat off,” she told Medical News Today.

“As we age, it’s even more difficult to preserve protein because it’s kind of a natural progression that we can more easily lose our muscle mass. And losing that muscle mass as we age is associated with more falls or hospitalization and less functional abilities. We can potentially help them achieve a healthier body composition and preserve muscle mass by following the Mediterranean lifestyle,” Wright added.

The Mediterranean diet emphasizes plant-based foods, fresh fruits and vegetables, whole grains, nuts, legumes, fish, and some lean meat such as chicken. Healthy fats like olive oil are also encouraged.

Processed foods, red meat, white bread, butter, and margarine are limited on a Mediterranean diet.

Experts say this way of eating has numerous health benefits and the findings of the JAMA study make sense.

“It’s anti-inflammatory and sufficient in proteins. I do recommend it. It’s a great place to start! It also relies mostly on unprocessed foods. Another great place to start,” said Dana Hunnes, PhD, a senior clinical dietitian at the UCLA Medical Center in Los Angeles who was not involved in the study.

“I’m not at all surprised by their findings,” she told Medical News Today. “A reduction in energy intake plus physical activity that promotes lean mass is bound to lead to the results they got. I’m glad to see the corroboration. Diet can impact body composition because when we eat more calories than our body needs for daily functioning, the excess gets stored as fat. If we also are not physically active, we will also lose more muscle mass with age. So, when we eat a healthy diet, with the appropriate amount of calories, we deposit less fat and maybe even use up our fat stores (thereby having less fat) and we increase our muscle mass and/or lessen the amount of muscle mass we lose with age. Muscle is also more metabolically active than most fat-mass.”

In the United States, the majority of people do not eat a healthy diet.

In fact, it’s reported that 9 in 10 Americans consume too much sodium and fewer than 1 in 10 people eat enough fruits and vegetables.

Wright advises people to take small steps when moving toward a Mediterranean way of eating. She suggests increasing fruits and vegetables at every meal and limiting meats to lean meats that only account for about a quarter of a plate at each meal.

“I always recommend that, especially if individuals have some health issues or health concerns. I really highly encourage them to see a registered dietician because a registered dietitian can work with them to individualize an eating pattern that will help them achieve those health goals,” she added.


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