Research Highlight: van de Rest et al. Metabolic effects of a 13-weeks lifestyle intervention in older adults: The Growing Old Together Study. Aging. 2016 Jan;8(1):111-26. https://doi.org/10.18632/aging.100877
Ageing is a complex biological process that has increased clinical relevance resulting from widespread demographic changes. Populations are becoming older, with a substantial proportion of healthcare spending allocated to treatment of age-related illnesses. Observational studies have found that the metabolic health states in older adults is broadly heterogeneous, with this heterogeneity extending to an individual’s different tissues and organs. Chronological age is not necessarily a representative indicator of health state. Many older adults present positive metabolic health when compared to younger adults. The causes of this heterogeneity are thought to be partially genetic, with the results of twin studies estimating genetic contributions to only account for 20-30% of health outcomes later on in life. It is likely then that the majority of age-related conditions observed in the second half of a person’s life course are influenced by environmental factors, such as dietary intake and exercise. In order to investigate ways of stimulating healthily ageing, intervention studies can use metabolic profiling to observe resulting metabolic changes from diet, exercise or medication regimes.
In the Growing Old Together Study, van de Rest and colleagues carried out a 13-week lifestyle intervention program on 164 older adults (mean age=63.2 years), measuring participant metabolic profiles before and after intervention. Additionally, blood pressure, BMI, fasting insulin, glucose and thyroid levels were monitored as further parameters of metabolic health. The lifestyle intervention set a target of 12.5% caloric restriction and a 12.5% increase in energy expenditure resulting from physical activity. These targets were selected as they represent manageable and modest lifestyle changes that participants can realistically achieve without overexertion, potentially establishing a framework for future studies.
Results found that participants presented a mean weight loss of 4.2% and displayed positive improvements in blood pressure, thyroid, glucose and lipid metabolism. NMR metabolic profiling revealed changes in metabolite measures that were similar to previously described associations with low disease risk of type 2 diabetes and cardiovascular disease (CVD). Positive changes, independent of weight loss, were reported in omega-3 fatty acids, very low density lipoprotein (VLDL), low density lipoprotein (LDL) and intermediate density lipoprotein (IDL) cholesterol levels. Profiling also displayed decreases in leucine, tyrosine, glucose, pyruvate, glycerol, total fatty acids, lipid concentrations, 3- hydroxybutyrate, and creatinine.
These findings suggest the effects of metabolic health interventions can be effectively monitored by combining weight, omega-3 fatty acid levels measurements with NMR metabolomics. Despite heterogeneity in response, the Growing Old Together Study demonstrates that metabolic health can be beneficially influenced by lifestyle intervention in older adults.
The Growing Old Together study is an example of Nightingale's NMR metabolomics platform being applied in ageing research. Nightingale's platform has been successfully used in a wide range of research applications and featured in over 100 peer-reviewed studies. Nightingale’s blood analysis service can be utilized to investigate ageing, using metabolic profiling to identify circulating biomarkers as candidate indicators of biological age. In this study, Nightingale’s platform was used to quantify metabolic measures, including detailed lipid and lipoprotein particle profiles, for 164 older adults.