Cognitive effects of intentional weight @entity28 individuals with XXXX .

@entity1 @entity353 @entity28 @entity2204 @entity303 @entity73 @entity3363 @entity1851
CONTEXT: Obesity in midlife is a risk factor for @entity303 , but it is unknown if caloric restriction-induced @entity353 could prevent @entity73 and therefore @entity303 in elderly @entity1 with @entity73 . OBJECTIVE: To evaluate the cognitive effect of intentional @entity353 in @entity28 elderly @entity1 with @entity73 ( @entity73 ), considering the influence of age, @entity2204 genotype ( @entity2204 ), physical activity, biochemical markers and diet. DESIGN: Single-center, prospective controlled trial. SETTING: Academic medical center @entity1 : Eighty @entity28 @entity1 with @entity73 , aged 60 or older (68.1  4.9 years, body mass index (BMI) 35.5  4.4kg/m(2), 83.7% @entity1 , 26.3% @entity2204 carriers). INTERVENTION: Random allocation to conventional medical care alone (n=40) or together with nutritional counselling (n=40) in group meetings aiming to promote @entity353 through caloric restriction for 12 months. OUTCOME: Measurements: Clinical data, body composition, neuropsychological tests (main outcome), serum biomarkers, @entity2204 genotype, physical performance, dietary recalls. RESULTS: Seventy-five @entity1 completed the follow-up. BMI, on average, decreased 1.7   1.8kg/m(2) (p=0.021), and most of the cognitive tests improved, without difference between the groups. In analysis with linear generalized models, the BMI decrease was associated with improvements in verbal memory, verbal fluency, executive function and global cognition, after adjustment for education, gender, physical activity and baseline tests: this association was strongest in younger seniors (for memory and fluency) and in @entity2204 carriers (for executive function). Changes in HOMA-IR, @entity1851 , leptin and intake of energy, @entity3363 and fats were associated with improvement in cognitive tests. CONCLUSIONS: Intentional @entity353 through diet was associated with cognitive improvement in @entity1 with @entity73 .
