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Weight Loss, Not Aerobic Exercise, Improves Pulmonary Function in Older Obese Men

^a Department of Medicine, Divisions of Gerontology, University of Maryland at Baltimore, Baltimore Veterans Administration Medical Center, Geriatric Research, Education, and Clinical Center
^b Department of Medicine, Divisions of Pulmonary Medicine, University of Maryland at Baltimore, Baltimore Veterans Administration Medical Center, Geriatric Research, Education, and Clinical Center
^c Department of Kinesiology, University of Maryland, College Park

Andrew P. Goldberg, Baltimore VA Medical Center, GRECC (18), 10 N. Greene Street, Baltimore, MD 21201-1524 E-mail: apgoldbe{at}umaryland.edu.

Decision Editor: William B. Ershler, MD

Background. We evaluated the effect of weight loss (WL) or aerobic exercise (AEX) on pulmonary function in middle-aged and older (46–80 years) obese, sedentary men to determine the effect of reductions in body weight and increases in cardiorespiratory fitness on pulmonary function.

Methods. Subjects were randomly assigned to WL (), AEX (n ), or control (n ) groups. Maximal oxygen uptake (V.O₂max), body composition and anthropometrics, pulmonary function, and arterial blood gases were measured at baseline and after interventions.

Results. The 35 subjects who completed WL decreased weight by 11%, body fat percentage by 21% (p < .001), waist circumference by 8%, waist-hip ratio by 2%, and fat-free mass by 3% (p < .05). This resulted in a 3% increase in forced vital capacity (FVC) (4.08 ± 0.71 L vs 4.21 ± 0.76 L), a 5% increase in total lung capacity (6.62 ± 0.99 L vs 6.94 ± 0.99 L), an 18% increase in functional residual capacity (3.09 ± 0.58 L vs 3.66 ± 0.79 L), and an 8% increase in residual volume (2.20 ± 0.44 L vs 2.37 ± 0.52 L), with no change in forced expiratory volume in one second (FEV₁), FEV₁/FVC ratio, or carbon monoxide diffusing capacity. The change in FVC correlated with change in body weight (, p < .05). The 38 subjects who completed AEX increased V.O₂max by 14%, with no change in pulmonary function. There were no changes in 8 control subjects.

Conclusions. WL changes static lung volumes, not dynamic pulmonary function, in middle-aged and older, moderately obese, sedentary men. Some of the alterations in static lung function associated with aging may be due to the development of obesity and are modifiable by WL.