Certain components of body composition appear to be crucial in the emergence of chronic diseases linked to obesity. Specifically, increased age-related loss of muscle mass and extra visceral fat have been linked to an increased risk for several health consequences, such as type 2 diabetes and cardiovascular disease. The findings from a subgroup analysis of the PREDIMED-Plus trial recently published in ‘JAMA Network’ revealed that effective strategies targeting specific body composition components beyond weight management are warranted to improve health in the long-term.

      The ongoing Prevención con Dieta Mediterránea-Plus (PREDIMED-Plus) randomized clinical trial is designed to test the effect of intervention on cardiovascular disease prevention after 8 years of follow-up. The trial is being conducted in 23 Spanish research centers and includes men and women (age 55-75 years) with body mass index between 27 and 40 and metabolic syndrome. Here, in this study, an interim subgroup analysis of the intermediate outcome body composition after 3-year follow-up, was conducted in, a subsample of 1521 individuals, enrolled from centers with access to a dual energy x-ray absorptiometry device, underwent body composition measurements at 3 time points. Participants were randomly assigned to a multifactorial intervention based on an energy-reduced Mediterranean diet (MedDiet) and increased physical activity (PA) or to a control group based on usual care, with advice to follow an ad libitum MedDiet, but no physical activity promotion. The outcomes include 3-year changes in total fat and lean mass (expressed as percentages of body mass) and visceral fat (in grams), tested using multivariable linear mixed-effects models

      The results from the study were quite interesting. In comparison with the control group (n=761), participants in the intervention arm (n=760) showed greater reductions in the percentage of total fat (between group differences after 1-year, −0.94% [95% CI, −1.19 to −0.69]; 3 years, −0.38% [95% CI, −0.64 to −0.12] and visceral fat storage after 1 year, -126 g [95% CI, −179 to −73.3 g]; 3 years, −70.4 g [95% CI, −126 to −15.2 g] and greater increases in the percentage of total lean mass at 1 year, 0.88% [95% CI, 0.63%-1.12%]; 3-years 0.34% [95% CI, 0.09%-0.60%]). According to the researchers, age-related variations in body composition may be mitigated by a combination of low-energy Mediterranean diet and physical activity; long-term health implications will need to be confirmed via further monitoring.