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AgingLIMB-QNCT03329963

Lifestyle Intervention to Improve Bone Quality

A study testing Healthy Lifestyle Intervention and Lifestyle Intervention in people with Aging and Obesity, run by Baylor College of Medicine at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Obese older adults will be randomized to participate in either healthy lifestyle intervention or behavioral diet and exercise intervention for one year. This study aims to determine the effects of Lifestyle intervention on bone microarchitecture, bone strength, bone material properties, and the mechanism behind it. Read more about this study

Who is it for?
Ages 65 to 85 years
Conditions the study is for
Aging, Obesity
What is being tested?
Healthy Lifestyle Intervention and Lifestyle Intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
1 siteUnited States
Study dates
9 Nov 2017to 16 Jan 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 to 85 years
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Age 65 - 85 years • BMI 30 kg/m2 or more• Stable body weight (±2 kg) during the past 6 months • Sedentary (regular exercise <1 h/wk. or <2 x/wk. for the last 6 months) • Willing to provide informed consent

Who cannot join

  • Failure to provide informed consent.
  • Any major chronic diseases, or any condition that would interfere with exercise or dietary restriction, in which exercise or dietary restrictions are contraindicated, or that would interfere with interpretation of results
  • Cardiopulmonary disease (e.g. recent myocardial infarction, unstable angina, stroke) or unstable disease (e.g., New York Heart Class III or IV congestive heart failure, severe pulmonary disease requiring steroid pills or the use of supplemental oxygen ) that would contraindicate exercise or dietary restriction
  • Severe orthopedic (e.g. awaiting joint replacement) and/or neuromuscular (e.g. multiple sclerosis, amyotrophic lateral sclerosis, active rheumatoid arthritis) disease or impairments that would contraindicate participation in exercise
  • Other significant co-morbid disease that would impair ability to participate in the exercise-based intervention (e.g. renal failure on hemodialysis, severe psychiatric disorder [e.g. bipolar, schizophrenia], excess alcohol use [more than14 drinks per week])
  • Severe visual or hearing impairments that would interfere with following directions
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  • Significant cognitive impairment, defined as a known diagnosis of dementia or positive screening test for dementia using the Mini-Mental State Exam score less than 24)
  • Uncontrolled hypertension (BP>160/90 mm Hg)
  • History of malignancy during the past 5 years (except non-melanoma skin cancers)
  • Current use of bone acting drugs (e.g. use of estrogen, or androgen containing compound, raloxifene, calcitonin, parathyroid hormone during the past year or bisphosphonates during the last two years)
  • Osteoporosis (T-score -2.5 and below on hip or spine scan) or history of fragility fractures - Diabetes mellitus requiring insulin for treatment or with a fasting blood glucose of >140 mg/dl, and/or HbA1c >8.5% (Those excluded from the study because of fasting blood glucose of >140 mg/dl or HbA1c>8.5% will be referred to their primary care provider for follow-up and appropriate treatment).
  • Terminal illness with life expectancy less than 12 months, as determined by a physician
  • Use of any drugs or natural products designed to induce weight loss within past three months.
  • Positive exercise stress test for ischemia

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Michael E Debakey VA Medical Center

    Houston, Texas, 77030

Other trials in United States

About this study

Official title: Does Lifestyle Intervention Improve Bone Quality in Obese Older Adults?

Obese older adults will be randomized to participate in either healthy lifestyle intervention or behavioral diet and exercise intervention for one year. This study aims to determine the effects of Lifestyle intervention on bone microarchitecture, bone strength, bone material properties, and the mechanism behind it.

Read the detailed description

Previous studies had suggested that lifestyle therapy (diet plus exercise) resulting in weight loss in elderly population improves physical function, cardio metabolic risk factors, and cognition/quality of life, but a major complication is loss of BMD. The addition of exercise to diet-induced weight loss attenuated but did not eliminate weight-loss-induced reduction of BMD. Moreover, while long-term maintenance of weight loss and physical function was feasible, sustained lifestyle change led to continued loss of hip BMD, which might predict hip fractures. Although similar BMD loss with weight loss has been observed in younger populations, BMD loss in older adults might be of particular concern because of aggravation of age-related bone loss. Moreover, the belief that obesity protects against fractures has now been challenged by studies demonstrating that obesity is associated with poor bone quality and ankle and leg fractures.Because of previous lack of options to assess bone quality in vivo, there has been little or no scientific study of the possibility that lifestyle therapy in obese older adults improves bone quality. This study represents an unprecedented opportunity to prove the hypothesis that lifestyle therapy intervention improves bone quality and thus, may confer a protective rather than adverse effect on bone health. This will be the first randomized controlled trial (RCT) to comprehensively assess bone quality using novel techniques in response to lifestyle therapy in obese older adults, with major ramifications with regards to defining optimal treatment strategies for this increasingly high-risk older population.

Conditions
Aging, Obesity
Being tested
Healthy Lifestyle Intervention, Lifestyle Intervention
Medical subject headings
Obesity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Healthy Lifestyle InterventionBehavioural

    Participants in the this group will receive group educational sessions that focus on diet, exercise, and social support once a month throughout the study. The sessions will provide an opportunity for participants to discuss issues related to living with obesity and aging.Participants will also attend regular scheduled clinic visits for assessment of outcomes.

  • Lifestyle InterventionBehavioural

    The lifestyle modification will be achieved by group behavior therapy sessions designed to have older adults acquire positive weight-control skills/attitudes, and practice weight-maintenance skills.Participants will attend weekly group sessions (10-15 persons), which will last ~75-90 minutes. Visit frequency will be decreased to every 2 wks. from 6 to 12 mos. to prevent "treatment fatigue". A balanced diet will be prescribed to provide a deficit of 500-750 kcal/day from daily energy requirement.

    The exercise sessions are of ~90 min duration (~15 min warm-up of flexibility exercise, followed by ~30 min of aerobic exercise, and after a brief rest period, ~30 min of resistance training, and finally ~15 min balance exercise) conducted three times weekly supervised at our exercise facility for one year. Aerobic exercises consist of treadmill, stationary cycling, and stair climbing.

Study groups in NCT03329963
Study groupRoleWhat they receive
Lifestyle intervention GroupExperimentalBehavioral therapy for weight loss and Exercise Training
Receives: Behavioral: Lifestyle Intervention
Healthy lifestyle intervention GroupActive comparatorGroup education sessions that focus on diet exercise and social support.
Receives: Behavioral: Healthy Lifestyle Intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in cortical thickness

    Assessed by using high-resolution peripheral computed tomography (HR-pQCT)

    Measured: Change from baseline at 12 months

  2. Change in femoral bone strength

    Assessed by using finite element analyses (FEA) of quantitative computed tomography (QCT)

    Measured: Change from baseline at 12 months

Secondary outcomes (41)
  1. Change in bone material strength

    Assessed by using microindentation testing

    Measured: Change from baseline at 12 months

  2. Change in lower extremity strength

    Assessed by using a Biodex dynamometer

    Measured: Change from baseline at 12 months

  3. Change in physical performance test

    assessed by using the objective physical performance test

    Measured: Change from baseline at 12 months

  4. Change in gait speed

    as measured by completing the time to walk a certain distance

    Measured: Change from baseline at 12 months

  5. Change in handgrip strength

    Measured by hydraulic hand dynamometer

    Measured: Change from baseline at 12 months

  6. Change in trabecular thickness

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 months

  7. Change in areal bone mineral density (BMD)

    Assessed by using dual-energy x-ray absorptiometry

    Measured: Change from baseline at 12 months

  8. Change in trabecular number

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 month

  9. Change in total volumetric BMD

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 months

  10. Change in cortical volumetric BMD

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 months

  11. Change in trabecular volumetric BMD

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 months

  12. Change in stiffness

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 months

  13. Change in trabecular separation

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 months

  14. Change in micro-finite element analyses strength

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 months

  15. Change in cortical porosity

    Assessed by using HR-pQCT

    Measured: Change from baseline at 12 months

  16. Change in general quality of life

    Assessed by using the Short Form-36 questionnaire

    Measured: Change from baseline at 12 months

  17. Change in obesity specific quality of life

    Assessed by using the Impact of weight on quality of life short form (IWQOL-Lite) questionnaire

    Measured: Change from baseline at 12 months

  18. Change in mood

    Assessed by using a mood scale questionnaire

    Measured: Change from baseline at 12 months

  19. Change in composite cognitive z-score

    Using cognitive instrument testing

    Measured: Change from baseline at 12 months

  20. Change in cardio metabolic risk factors

    Assessed by measuring metabolic syndrome components

    Measured: Change from baseline at 12 months

  21. Change in word list fluency

    Assessed by using cognitive instrument testing

    Measured: Change from baseline at 12 months

  22. Change in Ray Auditory verbal learning test

    Assessed by using cognitive instrument testing

    Measured: Change from baseline at 12 months

  23. Change in blood pressure

    Assessed by usingSphygmomanometer

    Measured: Change from baseline at 12 months

  24. Change in biochemical marker for bone turnover and bone metabolism

    Assessed by using enzyme linked immunosorbent assay and radioimmunoassay

    Measured: Change from baseline at 12 months

  25. Change in central volumetric BMD

    Assessed by using CT scan at the spine and hip

    Measured: Change from baseline at 12 months

  26. Change in waist circumference

    Assessed by using tape measurement

    Measured: Change from baseline at 12 months

  27. Change in lean mass

    Assessed by using dual-energy x-ray absorptiometry

    Measured: Change from baseline at 12 months

  28. Change in fat mass

    Assessed by using dual-energy x-ray absorptiometry

    Measured: Change from baseline at 12 months

  29. Change in visceral fat

    Assessed by using dual-energy x-ray absorptiometry

    Measured: Change from baseline at 12 months

  30. Change in physical activity using accelerometer

    Assessed by using an accelerometer

    Measured: Change from baseline at 12 months

  31. Change in body weight

    Assessed by using weighing scale

    Measured: Change from baseline at 12 months

  32. Change in sclerostin

    Assessed by using enzyme linked immunoassay

    Measured: Change from baseline at 12 months

  33. Change in wnt signaling pathways

    Assessed by measurements of circulating levels of Wnt 5a and Sfrp5

    Measured: Change from baseline at 12 months

  34. Change in total body mass

    Assessed byusing dual energy x-ray absorptiometry

    Measured: Change from baseline at 12 months

  35. Change in hormones

    Assessed by usingenzyme link immunoassay

    Measured: Change from baseline at 12 months

  36. Change in thigh mass

    Assessed by using CT scan

    Measured: Change from baseline at 12 months

  37. Change in circulating cytokines

    Assessed by using enzyme linked immunoassay

    Measured: Change from baseline at 12 months

  38. Change in adipocytokines

    Assessed by using enzyme linked immunoassay

    Measured: Change from baseline at 12 months

  39. Change in total volumetric BMD

    Assessed by using QCT Pro software

    Measured: Change from baseline at 12 months

  40. Change in cortical trabecular BMD

    Assessed by using QCT Pro software

    Measured: Change from baseline at 12 months

  41. Change in aerobic capacity

    Assessed by using indirect calorimetry during graded treadmill test

    Measured: Change from baseline at 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Nov 2017
  2. Study start9 Nov 2017
  3. Primary completion16 Jan 2023
  4. Study completion16 Jan 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03329963
Sponsor's protocol ID
H-40373
Other IDs
R01DK109950
Acronym
LIMB-Q
Status last verified
May 2025
First submitted
23 Oct 2017
Last updated
6 Jun 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Gregori G, Mediwala S, Liebschner M, Kim D, Bryant MS, Klonis N, Armamento-Villareal R, Qualls C, Villareal DT. Bone quality response to lifestyle intervention in older adults with obesity (LIMB-Q trial): a randomised controlled trial. Lancet Healthy Longev. 2025 Sep;6(9):100761. doi: 10.1016/j.lanhl.2025.100761. Epub 2025 Sep 18.

    PubMed 40976254

Questions about this trial

What is this clinical trial studying?

A study testing Healthy Lifestyle Intervention and Lifestyle Intervention in people with Aging and Obesity, run by Baylor College of Medicine at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in cortical thickness (time frame: Change from baseline at 12 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03329963, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Jun 2025.

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Lifestyle Intervention to Improve Bone Quality | AzTrials