{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:52:20Z","timestamp":1791330740699,"version":"4.3.1"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009319","name":"Egg Nutrition Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017553","name":"Nutrition Obesity Research Center, University of Alabama at Birmingham","doi-asserted-by":"publisher","award":["P30DK56336"],"award-info":[{"award-number":["P30DK56336"]}],"id":[{"id":"10.13039\/100017553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Intermuscular adipose tissue (IMAT) is associated with impaired skeletal muscle (SM) quality and declining mobility in older adults with obesity. This secondary analysis examined the effects of a very low\u2010carbohydrate diet (VLCD) versus a low\u2010fat diet (LFD) on changes in IMAT, muscle strength, and physical function in older adults with obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults (age \u2265\u200960 years) with obesity were randomized to a weight\u2010maintaining VLCD (&lt;\u200910% energy from carbohydrates) or LFD (55% energy from carbohydrates) for 8\u2009weeks. Thigh SM and IMAT were measured by MRI. Physical function was assessed via hand grip strength, isometric knee extension, reach score, and six\u2010minute walk tests. Multiple linear regressions examined whether changes in IMAT were associated with changes in physical function outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The VLCD group showed a significantly greater decrease in IMAT (\u221224.4% vs. \u22121.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Across all participants, greater decreases in IMAT were associated with greater improvements in hand grip strength\u00a0(\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), isometric knee extension (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and reach score (\n                      <jats:italic>r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), after adjusting for changes in thigh SM volume and body weight.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dietary interventions that reduce IMAT, such as a VLCD, may help preserve physical function and muscle strength in older adults with obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT02760641<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oby.70316","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:16:01Z","timestamp":1791328561000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of a Very Low\u2010Carbohydrate Diet on Intermuscular Adipose Tissue and Muscle Function in Older Adults With Obesity"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2822-4167","authenticated-orcid":false,"given":"Carly E.","family":"Drake","sequence":"first","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8461-4613","authenticated-orcid":false,"given":"Barbara A.","family":"Gower","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2807-6440","authenticated-orcid":false,"given":"Kevin R.","family":"Fontaine","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, School of Public Health University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Bryan","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Department of Nutrition Sciences, NORC Metabolism Core University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8772-2935","authenticated-orcid":false,"given":"Amy M.","family":"Goss","sequence":"additional","affiliation":[{"name":"Department of Nutrition Sciences University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1038\/ijo.2012.120","article-title":"Obesity in the Elderly: An Emerging Health Issue","volume":"36","author":"Zamboni M.","year":"2012","journal-title":"International Journal of Obesity (Lond)"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1038\/s41569-023-00847-5","article-title":"Obesity and the Risk of Cardiometabolic Diseases","volume":"20","author":"Valenzuela P.","year":"2023","journal-title":"Nature Reviews. Cardiology"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1161\/CIRCRESAHA.119.315896","article-title":"Metabolic Inflammation and Insulin Resistance in Obesity","volume":"126","author":"Wu H.","year":"2020","journal-title":"Circulation Research"},{"issue":"2","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1210\/jc.2013-2832","article-title":"Risk of Developing Diabetes and Cardiovascular Disease in Metabolically Unhealthy Normal\u2010Weight and Metabolically Healthy Obese Individuals","volume":"99","author":"Aung K.","year":"2014","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"e573","DOI":"10.1016\/j.cgh.2021.02.030","article-title":"Estimating Global Prevalence of Metabolic Dysfunction\u2010Associated Fatty Liver Disease in Overweight or Obese Adults","volume":"20","author":"Liu J.","year":"2021","journal-title":"Clinical Gastroenterology and Hepatology"},{"issue":"7","key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"4633","DOI":"10.1016\/j.clnu.2021.06.009","article-title":"Global Prevalence of Sarcopenic Obesity in Older Adults: A Systematic Review and Meta\u2010Analysis","volume":"40","author":"Gao Q.","year":"2021","journal-title":"Clinical Nutrition"},{"issue":"2","key":"e_1_2_8_8_1","article-title":"The Health and Cost Consequences of Obesity Among the Future Elderly","volume":"24","author":"Lakdawalla D.","year":"2005","journal-title":"Health Affairs (Millwood)"},{"key":"e_1_2_8_9_1","volume-title":"Prevalence of Obesity Among Older Adults in the United States, 2007\u20102010","author":"Fakhouri T.","year":"2012"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1007\/s10522-014-9536-x","article-title":"Ageing, Adipose Tissue, Fatty Acids and Inflammation","volume":"16","author":"Pararasa C.","year":"2015","journal-title":"Biogerontology"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/629637"},{"issue":"5","key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1007\/s12603-014-0019-1","article-title":"Intramuscular Fat and Inflammation Differ in Older Adults: The Impact of Frailty and Inactivity","volume":"18","author":"Addison O.","year":"2014","journal-title":"Journal of Nutrition, Health & Aging"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.exger.2016.03.009","article-title":"Calorie Restriction in Overweight Older Adults: Do Benefits Exceed Potential Risks?","volume":"86","author":"Locher J. L.","year":"2016","journal-title":"Experimental Gerontology"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s12986-020-00481-9","article-title":"Effects of Weight Loss During a Very Low Carbohydrate Diet on Specific Adipose Tissue Depots and Insulin Sensitivity in Older Adults With Obesity: A Randomized Clinical Trial","volume":"17","author":"Goss A. M.","year":"2020","journal-title":"Nutrition & Metabolism (London)"},{"issue":"6","key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1519\/JSC.0000000000005089","article-title":"Handgrip Strength Associated With Leg Strength, Power, and Muscle Mass in 18\u201364\u2010Year\u2010Old Males and Females","volume":"39","author":"McBride J. M.","year":"2025","journal-title":"Journal of Strength & Conditioning Research"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","DOI":"10.3390\/app13052946","article-title":"A Sensitive and Practical Evaluation to Detect Lower\u2010Limb Strength Changes in Geriatrics: The Isometric Knee Extension Test","volume":"13","author":"Buend\u00eda\u2010Romero \u00c1.","year":"2023","journal-title":"Applied Sciences"},{"issue":"1","key":"e_1_2_8_17_1","first-page":"1","article-title":"Criterion\u2010Related Validity of Sit\u2010and\u2010Reach Tests for Estimating Hamstring and Lumbar Extensibility: A Meta\u2010Analysis","volume":"13","author":"Mayorga\u2010Vega D.","year":"2014","journal-title":"Journal of Sports Science and Medicine"},{"issue":"3","key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.chest.2019.10.014","article-title":"Six\u2010Minute Walk Test: Clinical Role, Technique, Coding and Reimbursement","volume":"157","author":"Agarwala P.","year":"2020","journal-title":"Chest"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.archger.2018.11.006","article-title":"Inter\u2010Muscular Adipose Tissue Is Associated With Adipose Tissue Inflammation and Poorer Functional Performance in Central Adiposity","volume":"81","author":"Lim J. P.","year":"2019","journal-title":"Archives of Gerontology and Geriatrics"},{"issue":"2","key":"e_1_2_8_20_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/ajcn\/85.2.377","article-title":"Reduced Physical Activity Increases Intermuscular Adipose Tissue in Healthy Young Adults","volume":"85","author":"Manini T.","year":"2007","journal-title":"American Journal of Clinical Nutrition"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.70363","article-title":"Intermuscular Adipose Tissue and Muscle Function in Patients on Maintenance Hemodialysis","volume":"13","author":"Dilaver R.","year":"2025","journal-title":"Physiological Reports"},{"issue":"3","key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"R461","DOI":"10.1152\/ajpregu.00030.2018","article-title":"Relationship Between Intermuscular Adipose Tissue Infiltration and Myostatin Before and After Aerobic Exercise Training","volume":"315","author":"Konopka A.","year":"2018","journal-title":"American Journal of Physiology. Regulatory, Integrative and Comparative Physiology"},{"key":"e_1_2_8_23_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0201789","article-title":"Muscle Mass and Intramuscular Fat of the Quadriceps Are Related to Muscle Strength in Non\u2010Ambulatory Chronic Stroke Survivors: A Cross\u2010Sectional Study","volume":"13","author":"Akazawa N.","year":"2018","journal-title":"PLoS One"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP279595"},{"key":"e_1_2_8_25_1","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.15424","article-title":"Quantifying the Inflammatory Secretome of Human Intermuscular Adipose Tissue","volume":"10","author":"Kahn D.","year":"2022","journal-title":"Physiological Reports"},{"issue":"5","key":"e_1_2_8_26_1","doi-asserted-by":"crossref","first-page":"E866","DOI":"10.1152\/ajpendo.00243.2018","article-title":"Intermuscular Adipose Tissue Directly Modulates Skeletal Muscle Insulin Sensitivity in Humans","volume":"316","author":"Sachs S.","year":"2019","journal-title":"American Journal of Physiology. Endocrinology and Metabolism"},{"key":"e_1_2_8_27_1","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1002\/jcsm.13263","article-title":"Association of Muscle Wasting With Mortality Risk Among Adults: A Systematic Review and Meta\u2010Analysis of Prospective Studies","volume":"14","author":"Zhou H.","year":"2023","journal-title":"Journal of Cachexia, Sarcopenia and Muscle"},{"key":"e_1_2_8_28_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.maturitas.2017.04.007","article-title":"Sarcopenia as a Predictor of All\u2010Cause Mortality Among Community\u2010Dwelling Older People: A Systematic Review and Meta\u2010Analysis","volume":"103","author":"Liu P.","year":"2017","journal-title":"Maturitas"},{"issue":"19","key":"e_1_2_8_29_1","doi-asserted-by":"crossref","DOI":"10.3390\/nu14194192","article-title":"Effect of Ketogenic Diets on Body Composition and Metabolic Parameters of Cancer Patients: A Systematic Review and Meta\u2010Analysis","volume":"14","author":"Zhao H.","year":"2022","journal-title":"Nutrients"},{"key":"e_1_2_8_30_1","doi-asserted-by":"crossref","DOI":"10.1186\/1743-7075-3-9","article-title":"Very\u2010Low\u2010Carbohydrate Diets and Preservation of Muscle Mass","volume":"3","author":"Manninen A. H.","year":"2006","journal-title":"Nutrition & Metabolism (London)"},{"issue":"2","key":"e_1_2_8_31_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1017\/S0954422422000087","article-title":"Low\u2010Carbohydrate and Ketogenic Diets: A Scoping Review of Neurological and Inflammatory Outcomes in Human Studies and Their Relevance to Chronic Pain","volume":"36","author":"Field R.","year":"2023","journal-title":"Nutrition Research Reviews"},{"issue":"1","key":"e_1_2_8_32_1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1093\/pm\/pnz022","article-title":"The Effect of Low\u2010Carbohydrate and Low\u2010Fat Diets on Pain in Individuals With Knee Osteoarthritis","volume":"21","author":"Strath L. J.","year":"2020","journal-title":"Pain Medicine"}],"container-title":["Obesity"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/oby.70316","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/oby.70316","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/oby.70316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:16:05Z","timestamp":1791328565000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/oby.70316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":31,"alternative-id":["10.1002\/oby.70316"],"URL":"https:\/\/doi.org\/10.1002\/oby.70316","archive":["Portico"],"relation":{},"ISSN":["1930-7381","1930-739X"],"issn-type":[{"value":"1930-7381","type":"print"},{"value":"1930-739X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2026-03-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"oby.70316"}}