Body fat distribution and serum lipids in children and adolescents

Previous studies of normal children have linked body fat but not body fat distribution (BFD), to higher blood pressures, lipids, and insulin resistance (Berenson et al., 1988) BFD is a well-established risk factor for cardiovascular disease in adults (Björntorp, 1988). This study investigates the relation of BFD and serum lipids at baseline in children from Project HeartBeat!, a study of the growth and development of cardiovascular risk factors in 678 children in three cohorts measured initially at ages 8, 11, and 14 years. Initially, two of four indices of BFD were significantly related to the lipids: ratio of upper to lower body skinfolds (ln US:LS) and conicity (C Index). A factor analysis reduced the information in the serum lipids to two vectors: (1) total cholesterol + LDL-cholesterol and (2) HDL-cholesterol − triglycerides, which together accounted for 85% of the lipid variation. Using each serum lipid and vector as separate dependent variables, linear and quadratic regression models were constructed to examine the predictive ability of the two BFD variables, controlling for total body fat, gender, ethnicity (Black, non-Black) and maturation. Linear models provided an acceptable fit. Percent body fat (%BF) was a significant predictor in each and every lipid model, independent of age, maturation, or ethnicity (p ≤ 0.05). No BFD variable entered the equation for total or LDL-cholesterol, although there was a significant maturity by BFD interaction for LDL (ln US:LS was a significant predictor in more mature individuals). Both %BF and BFD (by way of Conicity) were significant predictors of HDL-cholesterol and triglycerides (p ≤ 0.01). All models were statistically significant at a high level (p ≤ 0.01), but adjusted R 2's for all models were low (0.05–0.15). Body fat distribution is a significant predictor of lipids in normal children, but secondarily to %BF, and for LDL-cholesterol in particular, the relation is dependent on maturity status. ^

Physiologic and psychosocial stage-based differences for dietary fat consumption in women with type 2 diabetes

Purpose. This cross-sectional, observational study explored differences among groups staged for intent to decrease dietary fat intake in women with type 2 diabetes in relation to demographic, weight concern, physiological, and psychosocial variables. ^ Methods. A sample of 100 community-dwelling, English-speaking women, who were over age 30 and had type 2 diabetes for at least a year, was accessed through a culturally diverse endocrinology clinic. Subjects completed 7 self-report instruments: demographic sheet, with 11-point weight satisfaction scale; staging algorithm; fat intake (MEDFICTS); depression (CES-D); diabetes-specific dietary knowledge (ADKnowl), social support and self-efficacy scales (SE-Type 2). Physiological variables were abstracted from the medical record (HbA 1c, blood pressure, serum cholesterol and triglycerides). ^ Results. The women's average age was 57.69 years ( SD = 3.07); 50% were married. Subjects were well-educated ( M = 14 years; SD = 3.33), with average diabetes duration of 10.57 years (SD = 9.11), high body mass index (M = 35.72; SD = 8.36), low diabetes-specific dietary knowledge, low weight satisfaction, but in good diabetes control. Racial/ethnic composition was 44% non-Hispanic-White-American, 18% Hispanic-White-American, 15% non-Hispanic-African-American, 16% Hispanic-African-American and 5% other. Fat intake was low and differed by racial/ethnic demographics. The highest fat intake scores were for non-Hispanic-African-Americans (M = 53), followed by Hispanic-White-Americans (M = 51), non-Hispanic-White-Americans (M = 45), and Hispanic-African-Americans (M = 32), who had the lowest fat intake scores. ^ MANOVA analyses revealed no significant differences between stages of behavior change in relation to psychosocial or weight concern variables, age, education, HbA1c, or cholesterol levels. Single women were more likely to be in the three preaction stages (precontemplation, contemplation, and preparation); married women were equally distributed across stages (the preaction stages plus action and maintenance). African-American women (Hispanic and non-Hispanic) were more likely in contemplation and preparation. Triglycerides were higher in women in the action stage than contemplation or preparation. Systolic blood pressure was higher in action than preparation; diastolic blood pressure was higher in action than preaction. ^ Conclusions. Healthcare professionals should consider race, ethnicity, and marital status in client interactions. Dietary intake can vary according to both race and ethnicity; collapsing racial/ethnic groups can alter means and distributions, generating faulty conclusions. Further research is warranted to explore relationships between dietary self-care and marital status, race, ethnicity, and physiological variables. ^

The Association Between Triglyceride and Leptin Levels in Obese Subjects Following a Low-Carbohydrate or Low-Fat Diet

Obesity has been cited as the second leading preventable cause of death in the United States. Studies have determined that at risk overweight and obese individuals have high circulating levels of leptin indicative of leptin resistance as well as elevated levels of plasma triglycerides. Postulates have been formed that link elevated levels of triglycerides with the inhibition of leptin across the blood-brain barrier. If a method of lowering triglycerides is achieved, leptin should be able to cross the blood-brain barrier and reach the ypothalamus, thus regulating body weight through a decrease in appetite and increase in energy expenditure. The primary aim of this study was to compare the effects of both carbohydrate and fat restricted diets on plasma triglycerides and leptin concentrations in overweight and obese subjects with hypertriglyceridemia. Forty subjects were randomly assigned to either the low carbohydrate or low fat diet group for a 12 wk period. Plasma triglyceride and leptin concentrations in the blood were analyzed before and after the 12 wk period to assess diet-induced changes. Both groups had a significant reduction in body weight, though the effect was much greater in the carbohydrate restricted diet group. Fasting and postprandial plasma triglycerides also decreased to a greater extent in the low carbohydrate diet group. Similarly, leptin levels decreased to a greater extent in the carbohydrate restricted diet group. The changes in leptin levels were directly related to the changes in both fasting and postprandial triglyceride levels. The results from this study provide preliminary evidence of diet-induced triglyceride reductions as an underlying mechanism in lowering plasma leptin and improving leptin sensitivity. Further, they provide evidence that an increase in triglyceride levels is at least partially responsible for leptin resistance and reduced leptin sensitivity in obese hypertriglyceridemic individuals. This novel discovery is important as it raises the possibility that other methods of lowering triglycerides may improve the efficiency of leptin transport and ultimately improve fat metabolism in overweight and obese individuals.

The relationship between supermarket nutrient movements and the mortality rates from fat-associated and non-fat-associated cardiovascular disease: Development of an ecologic method for determining community food patterns

Supermarket nutrient movement, a community food consumption measure, aggregated 1,023 high-fat foods, representing 100% of visible fats and approximately 44% of hidden fats in the food supply (FAO, 1980). Fatty acid and cholesterol content of foods shipped from the warehouse to 47 supermarkets located in the Houston area were calculated over a 6 month period. These stores were located in census tracts with over 50% of a given ethnicity: Hispanic, black non-Hispanic, or white non-Hispanic. Categorizing the supermarket census tracts by predominant ethnicity, significant differences were found by ANOVA in the proportion of specific fatty acids and cholesterol content of the foods examined. Using ecological regression, ethnicity, income, and median age predicted supermarket lipid movements while residential stability did not. No associations were found between lipid movements and cardiovascular disease mortality, making further validation necessary for epidemiological application of this method. However, it has been shown to be a non-reactive and cost-effective method appropriate for tracking target foods in populations of groups, and for assessing the impact of mass media nutrition education, legislation, and fortification on community food and nutrient purchase patterns. ^

The heart challenge: The effect of regular aerobic exercise on body fat distribution in third and fourth grade school children: A randomized clinical trial

The pattern of body fat distribution known as "centralized", and characterized by a predominance of subcutaneous fat on the trunk and a "pot belly", has been associated with an increased risk of chronic disease. These patterns of fat distribution, as well as the lifestyle habit variables associated with adult fatness and chronic morbidity clearly begin to develop during childhood, indicating the need for intervention and primary prevention of obesity, particularly the centralized form, during childhood or adolescence. The purpose of this study was to determine whether regular aerobic exercise could beneficially alter the distribution of body fat in 8 and 9 year old children. One hundred and eighty-eight participants were randomized into either a regular aerobic exercise treatment group or a standard physical education program control group. A variety of aerobic activities was used for intervention 5 days per week during physical education class for a period of 12 weeks. Fat distribution was measured by a number of the most commonly used indices, including ratios of body circumferences and skinfolds and indices derived from a principal components analysis. Change over time in average pulse rate was used to determine if intervention actually occurred. Approximately 10% of the students were remeasured, allowing the calculation of intra- and interexaminer measurement reliability estimates for all indices.^ This study group was comparable to the U.S. population, though the study children were slightly larger for certain measures. No effect of the exercise intervention was found. The most likely explanation for this was inadequacy of the intervention, as indicated by the lack of any change in average pulse rate with treatment. The results of the measurement reliability analysis are reported and indicate that body circumference ratios are more precise than skinfold ratios, particularly when multiple observers are used. Reliability estimates for the principal component indices were also high.^ It remains unclear whether the distribution of body fat can be altered with exercise. It is likely that this issue will remain undecided until one highly reliable, valid, and sensitive measure of fat distribution can be found. ^

The effects of omega -3 fatty acid -enriched fish on C -reactive protein levels in postmenopausal women

Coronary heart disease (CHD) is the leading cause of death in women and rates markedly increase among women after 65 years of age. C-reactive protein (CRP) is a new clinical indicator of atherosclerotic-related inflammation with a direct pathogenic role. Studies show lifestyle factors can modulate CRP. Omega-3 fatty acids have anti-inflammatory properties and studies suggest that eating fish high in omega-3 fatty acids may lower CHD risk in women. This study sought to assess the possible role of omega-3 fatty acids in the reduction of CHD-related inflammation by investigating the effect of fish consumption on CRP levels. Methods. Twenty-four healthy postmenopausal women were randomly assigned to a fish group (usual diet plus two servings per week of enriched fish) or control group (usual diet with no fatty fish) for eight weeks. Omega-3 fatty acid-enriched fish developed by the West Virginia University Aquaculture Division was used. Serum CRP, serum interleukin-6 (IL-6), and the fatty acid content of red blood cells (RBC) were measured before and after the study. Women also completed food records. RESULTS: Baseline levels of CRP were low (85% of the fish group had normal levels) and few changes in CRP risk category were observed. Mean IL-6 levels were reduced by 27% and 35% in the fish and control groups, respectively (p for between-group difference = 0.60). Changes in RBC fatty acid composition were not statistically significant. Compared to control women, women in the fish group had greater reductions in mean triglycerides (p = 0.08), total cholesterol (P = 0.04), and LDL cholesterol levels (p = 0.06). Baseline dietary intake of total and monounsaturated fatty acids tended to be positively associated with baseline CRP, while vitamin E intake was inversely related. Saturated fat intake tended to have a positive association with IL-6. Conclusions. Findings regarding the effect of two servings of fish on CRP and IL-6 levels are inconclusive due to low baseline levels of CRP and IL-6. However, results indicate two servings of fatty fish have favorable effects on blood lipids. The relationship of dietary components with CRP and IL-6 is complex and further research is needed to determine the varying roles of diet on the inflammatory process. ^

Comportamiento del perfil de ácidos grasos de aceites y materias grasas hidrogenadas sometidos a calentamiento prolongado

La fritura es un proceso altamente utilizado a nivel industrial y casero, el que considera someter a las grasas a temperaturas cercanas a los 200°C, con lo cual se producen complicados cambios físicos y químicos. En Chile, se utilizan para freír mantecas hidrogenadas las cuales han mostrado alto contenido en ácidos grasos trans (AGT). Este trabajo tiene como objetivo determinar los cambios en el perfil en ácidos grasos, con énfasis en AGT, de diferentes tipos de materias grasas hidrogenadas y aceites vegetales sometidos a calentamiento. Para esto se evaluó y se sometió a un ciclo de calentamiento por 50 h 7 diferentes tipos de materias grasas y como control se consideró a aceite de girasol, se evaluaron los tiempos 0, 10, 20, 30, 40 y 50 h. La composición en ácidos grasos se realizó por cromatografía gas - liquido previa preparación de los ésteres metílicos según Norma española, UNE-EN ISO 5509. Los resultados mostraron que la composición en ácidos grasos de todas las materias grasas estudiadas presentaron modificación durante el tratamiento térmico, observándose una disminución de los ácidos grasos poliinsaturados y un aumento o preservación de los ácidos grasos monoinsaturados y saturados. Los ácidos grasos trans mostraron contenidos importantes en mantecas hidrogenadas (20%), los que se mantuvieron constantes durante todo el calentamiento. El aceite de girasol y el de girasol alto oleico resultaron ser los más adecuados para freír, ya que no mostraron presencia de AGT y se mantuvieron aptos para ser utilizados hasta las 40 h de calentamiento.

The European Hare (Lepus europaeus): A Picky Herbivore Searching for Plant Parts Rich in Fat

European hares of both sexes rely on fat reserves, particularly during the reproduc-tive season. Therefore, hares should select dietary plants rich in fat and energy. However, hares also require essential polyunsaturated fatty acids (PUFA) such as linoleic acid (LA) and alpha-linolenic acid (ALA) to reproduce and survive. Although hares are able to absorb PUFA selectively in their gastrointestinal tract, it is unknown whether this mechanism is sufficient to guarantee PUFA supply. Thus, diet selection may involve a trade-off between a preference for energy versus a preference for crucial nutrients, namely PUFA. We compared plant and nutrient availability and use by hares in an arable landscape in Austria over three years. We found that European hares selected their diet for high energy content (crude fat and crude protein), and avoided crude fibre. There was no evidence of a preference for plants rich in LA and ALA. We conclude that fat is the limiting resource for this herbivorous mammal, whereas levels of LA and ALA in forage are sufficiently high to meet daily requirements, especially since their uptake is enhanced by physiological mechanisms. Animals selected several plant taxa all year round, and preferences did not simply correlate with crude fat content. Hence, European hares might not only select for plant taxa rich in fat, but also for high-fat parts of preferred plant taxa. As hares preferred weeds/grasses and various crop types while avoiding cereals, we suggest that promoting heterogeneous habitats with high crop diversity and set-asides may help stop the decline of European hares throughout Europe.

Production of biodiesel from animal fat using supercritical ethanol

Biodiesel is currently produced from a catalytic transesterification reaction of various types of edible and non-edible oil with methanol. The use of waste animal tallow instead of edible oils opens a route to recycle this waste. This material has the advantage of lower costs but the problem of high content of free fatty acids, becoming necessary a pre-esterification reaction that increases the cost of the catalytic process. The production of biodiesel using supercritical alcohols is appropriate for materials with high acidity and water content, therefore the use of this process with animal fat is a promising alternative. Ethanol has been used because it can be produced from biomass via fermentation resulting in a complete renewable biodiesel, instead of methanol that derives from fossil feedstocks. Two different processes have been studied: first, the direct transesterification of animal fat using supercritical ethanol and second a two-step process where the first step is a hydrolysis of the animal fat and the second step is the esterification of the resulting fatty acids. The temperature, the molar ratio ethanol:fat and the time have been modified in the different reactions to study the effect in the final conversion and the degradation of the unsaturated fatty acid esters, main inconvenient of these high temperature and pressure processes.

A maternal diet high in n − 6 polyunsaturated fats alters mammary gland development, puberty onset, and breast cancer risk among female rat offspring

We hypothesized that feeding pregnant rats with a high-fat diet would increase both circulating 17β-estradiol (E2) levels in the dams and the risk of developing carcinogen-induced mammary tumors among their female offspring. Pregnant rats were fed isocaloric diets containing 12% or 16% (low fat) or 43% or 46% (high fat) of calories from corn oil, which primarily contains the n − 6 polyunsaturated fatty acid (PUFA) linoleic acid, throughout pregnancy. The plasma concentrations of E2 were significantly higher in pregnant females fed a high n − 6 PUFA diet. The female offspring of these rats were fed with a laboratory chow from birth onward, and when exposed to 7,12-dimethylbenz(a)anthracene had a significantly higher mammary tumor incidence (60% vs. 30%) and shorter latency for tumor appearance (11.4 ± 0.5 weeks vs. 14.2 ± 0.6 weeks) than the offspring of the low-fat mothers. The high-fat offspring also had puberty onset at a younger age, and their mammary glands contained significantly higher numbers of the epithelial structures that are the targets for malignant transformation. Comparable changes in puberty onset, mammary gland morphology, and tumor incidence were observed in the offspring of rats treated daily with 20 ng of E2 during pregnancy. These data, if extrapolated to humans, may explain the link among diet, early puberty onset, mammary parenchymal patterns, and breast cancer risk, and indicate that an in utero exposure to a diet high in n − 6 PUFA and/or estrogenic stimuli may be critical for affecting breast cancer risk.

Expression of the CD36 homolog (FAT) in fibroblast cells: effects on fatty acid transport.

An adipocyte membrane glycoprotein, (FAT), homologous to human CD36, has been previously implicated in the binding/transport of long-chain fatty acids. It bound reactive derivatives of long-chain fatty acids and binding was specific and associated with significant inhibition of fatty acid uptake. Tissue distribution of the protein and regulation of its expression were also consistent with its postulated role. In this report, we have examined the effects of FAT expression on rates and properties of fatty acid uptake by Ob17PY fibroblasts lacking the protein. Three clones (P21, P22, and P25) were selected based on FAT mRNA and protein levels. Cell surface labeling could be demonstrated with the anti-CD36 antibody FITC-OKM5. In line with this, the major fraction of immunoreactive FAT was associated with the plasma membrane fraction. Assays of oleate and/or palmitate uptake demonstrated higher rates in the three FAT-expressing clones, compared to cells transfected with the empty vector. Clone P21, which had the highest protein levels on Western blots, exhibited the largest increase in transport rates. Fatty acid uptake in FAT-expressing P21 cells reflected two components, a phloretin-sensitive high-affinity saturable component with a Km of 0.004 microM and a basal phloretin-insensitive component that was a linear function of unbound fatty acid. P21 cells incorporated more exogenous fatty acid into phospholipids, indicating that binding of fatty acids was followed by their transfer into the cell and that both processes were increased by FAT expression. The data support the interpretation that FAT/CD36 functions as a high-affinity membrane receptor/transporter for long-chain fatty acids.

Efeito da suplementação com óleo de canola sobre a qualidade da manteiga e muçarela

A sociedade está cada vez mais exigente com relação à qualidade dos produtos consumidos e se preocupa com os benefícios para a saúde. Neste contexto, objetivou-se avaliar o efeito da inclusão de níveis de óleo de canola na dieta de vacas sobre amanteiga e muçarela, buscando produtos mais saudáveis para o consumo humano. Foram utilizadas 18 vacas Holandesas, em estágio intermediário de lactação, com produção média de 22 (± 4) Kg de leite/ dia, as quais foram distribuídas em dois quadrados latinos 3x3 contemporâneos e receberam as dietas experimentais: T1- Controle (0% de inclusão de óleo); T2- 3% de inclusão de óleo de canola e T3- 6% de inclusão de óleo de canola. O perfil lipídico foi determinado através de cromatografia gasosa, além da avaliação de qualidade nutricional, realizada através de equações utilizando os ácidos graxos obtidos no perfil lipídico, análises físico-químicas determinadas pela metodologia do Instituto Adolfo Lutz e análises microbiológicas. Houveram problemas durante processamento do leite, gerando alterações de tecnologia de fabricação do produto manteiga, obtendo-se outro produto, o creme de leite, ao invés de manteiga, além de prejuízos na qualidade microbiológicas do creme de leite e muçarela. A inclusão de óleo de canola na dieta em lactação reduziu quadraticamente os ácidos graxos de cadeia curta e proporcionou aumento quadrático dos ácidos graxos de cadeia longa, dos ácidos graxos insaturados e ácidos graxos monoinsaturados na muçarela. A relação ácidos graxos saturados/ ácidos graxos insaturados (AGS/ AGI) e a relação ômega-6/ômega-3, assim como os índices de aterogenicidade e trombogenicidade, na muçarela, reduziram linearmente 25,68%, 31,35%; 32,12% e 21,78%, respectivamente, quando comparando T1 e T3. No creme de leite, houve redução linear dos ácidos graxos de cadeia curta e média, bem como, os ácidos graxos saturados e a relação ácidos graxos saturados/ ácidos graxos insaturados (AGS/ AGI) em 41,07%; 23,82%; 15,91% e 35,59%, respectivamente, enquanto os ácidos graxos de cadeia longa, ácidos graxos insaturados e ácidos graxos monoinsaturados aumentaram linearmente 41,40%; 28,24% e 32,07%, nesta ordem, quando comparando T1 com T3. Os índices de aterogenicidade e trombogenicidade reduziram de forma linear, enquanto o índice h/H (razão ácidos graxos hipocolesterolêmicos e hipercolesterolêmicos) aumentou linearmente. A composição físico-química de ambos derivados e o rendimento da muçarela não apresentaram efeito significativo com a inclusão do óleo de canola, exceto a proteína bruta da muçarela que apresentou aumento linear e a gordura do creme de leite que apresentou efeito quadrático. As análises microbiológicas mostram contagens muito elevadas de microrganismos, sugerindo que os produtos não apresentam qualidade microbiológica, decorrente da ausência do processo de pasteurização do creme e da baixa eficiência do tratamento térmico aplicado ao leite destinado a produção da muçarela. Conclui-se que a adição de óleo de canola na dieta de vacas lactantes proporciona muçarela e creme de leite mais saudáveis para o consumo humano, pois apresentaram perfil lipídico mais rico em ácidos graxos insaturados, além da série ômega-3 e ácido oleico, entretanto, devido a problemas de processamento, estes produtos obtidos, não estão aptos ao consumo devido à ausência de qualidade microbiológica.

Indicators of success in the dietary management of overweight and obesity: weight, body fat loss and quality

Concepts: %WL: Percentage of weight loss; %FL: Percentage of fat loss. Objective: evaluate which unit of measurement for weight loss could determine the success or failure of dietary treatment for overweight and obesity. Method: 4,625 consultations carried out on 616 patients in the southeast of Spain from 2006 to 2012. All of the patients were over 25 years of age and suffered from overweight or obesity. The consultations were carried out every fortnight, using the Mediterranean or low-calorie diet. The patients were divided into four groups according to their %WL and %FL. Results: most of the sample consisted of: women; participants between 25-45 years of age; attended consultations for over a month and a half; obese. 80% of the patients obtained a %FL ≥ 5% (15.5 ± 12.8). The groups with a higher %FL obtained significant differences in weight loss (22.6 vs 11.2%, p = 0.000). The multinomial analysis shows significant differences between the groups with the highest %FL and the lowest %WL and %FL: sex (p = 0.006 vs p = 0.005), BMI (p = 0.010 vs p = 0.003) and attendance (p = 0.000 vs p = 0.000). Conclusion: the patients who lost < 5% of fat had higher initial parameters (percentage of weight and fat); most of the sample lost ≥ 5% of fat. This means that the method of personalised dietary treatment results in a high fat loss; fat is an indicator of the quality loss obtained. Recommendations: use the measurement of fat as a complementary unit of measurement to weight loss; establish a limit of 5% to evaluate such loss; and increase this type of research in any method of weight loss.

Significance of frictional heating for effects of high pressure homogenisation on milk

High pressure homogenisation (HPH) is a novel dairy processing tool, which has many effects on enzymes, microbes, fat globules and proteins in milk. The effects of HPH on milk are due to a combination of shear forces and frictional heating of the milk during processing; the relative importance of these different factors is unclear, and was the focus of this study. The effect of milk inlet temperature (in the range 10-50 degrees C) on residual plasmin, alkaline phosphatase, lactoperoxidase and lipase activities in raw whole bovine milk homogenised at 200 MPa was investigated. HPH caused significant heating of the milk; outlet temperature increased in a linear fashion (0(.)5887 degrees C/degrees C, R-2 =0-9994) with increasing inlet temperature. As milk was held for 20 s at the final temperature before cooling, samples of the same milk were heated isothermally in glass capillary tubes for the same time/temperature combinations. Inactivation profiles of alkaline phosphatase in milk were similar for isothermal heating or HPH, indicating that loss of enzyme activity was due to heating alone. Loss of plasmin and lactoperoxidase activity in HPH milk, however, was greater than that in heated milk. Large differences in residual lipase activities in milks subjected to heating or HPH were observed due to the significant increase in lipase activity in homogenised milk. Denaturation of beta-lactoglobulin was more extensive following HPH than the equivalent heat treatment. Inactivation of plasmin was correlated with increasing fat/serum interfacial area but was not correlated with denaturation of beta-lactoglobulin. Thus, while some effects of HPH on milk are due to thermal effects alone, many are induced by the combination of forces and heating to which the milk is exposed during HPH.

Does high intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes

The aim was to investigate whether the addition of supervised high intensity progressive resistance training to a moderate weight loss program (RT+WLoss) could maintain bone mineral density (BMD) and lean mass compared to moderate weight loss (WLoss) alone in older overweight adults with type 2 diabetes. We also investigated whether any benefits derived from a supervised RT program could be sustained through an additional home-based program. This was a 12-month trial in which 36 sedentary, overweight adults aged 60 to 80 years with type 2 diabetes were randomized to either a supervised gymnasium-based RT+WLoss or WLoss program for 6 months (phase 1). Thereafter, all participants completed an additional 6-month home-based training without further dietary modification (phase 2). Total body and regional BMD and bone mineral content (BMC), fat mass (FM) and lean mass (LM) were assessed by DXA every 6 months. Diet, muscle strength (1-RM) and serum total testosterone, estradiol, SHBG, insulin and IGF-1 were measured every 3 months. No between group differences were detected for changes in any of the hormonal parameters at any measurement point. In phase 1, after 6 months of gymnasium-based training, weight and FM decreased similarly in both groups (P < 0.01), but LM tended to increase in the RT+WLoss (n=16) relative to the WLoss (n = 13) group [net difference (95% CI), 1.8% (0.2, 3.5), P < 0.05]. Total body BMD and BMC remained unchanged in the RT+WLoss group, but decreased by 0.9 and 1.5%, respectively, in the WLoss group (interaction, P < 0.05). Similar, though non-significant, changes were detected at the femoral neck and lumbar spine (L2-L4). In phase 2, after a further 6 months of home-based training, weight and FM increased significantly in both the RT+WLoss (n = 14) and WLoss (n = 12) group, but there were no significant changes in LM or total body or regional BMD or BMC in either group from 6 to 12 months. These results indicate that in older, overweight adults with type 2 diabetes, dietary modification should be combined with progressive resistance training to optimize the effects on body composition without having a negative effect on bone health.