{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T07:00:35Z","timestamp":1788332435578,"version":"build-2803163510"},"reference-count":72,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"American Cancer Society of Illinois","award":["261775"],"award-info":[{"award-number":["261775"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AG039374"],"award-info":[{"award-number":["R01AG039374"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>(1) Background: There are currently very few interventions performed within a community setting that compare the effects of physical activity (PA) versus PA plus weight loss on cancer and chronic disease risk in older African Americans. Therefore, we investigated the impact of an 8 week (24 session) PA intervention compared to a PA plus weight loss intervention on fat mass, glucose metabolism, and markers of inflammation in older, overweight and obese African Americans. (2) Methods: Subjects were randomized to a PA (n = 83) or PA plus weight loss (n = 72) intervention that met three times weekly for 8 weeks. At baseline and post-intervention, anthropometrics, body composition, systemic inflammation (high-sensitivity C-reactive protein, tumor necrosis factor-\u03b1, and interleukin 6), fasting glucose, insulin and homeostasis model assessment-insulin resistance (HOMA-IR) were determined. (3) Results: Subjects had a mean age of 67 years (SD = 5.3) and were mostly women (88%). The PA plus weight loss group lost more total and visceral fat than the PA group (\u22124.0% vs. +0.6% and \u22124.1% vs. +3.7%, respectively, p &lt; 0.01 for both). Changes in inflammation and glucose metabolism were similar between groups post-intervention. Within the PA plus weight loss group only, serum insulin and HOMA-IR decreased significantly. (4) Conclusions: PA combined with weight loss can decrease total and visceral fat mass and improve insulin sensitivity, confirming that these cancer- and chronic disease-related risk factors are influenced by relatively modest lifestyle changes in the short term.<\/jats:p>","DOI":"10.3390\/nu12113299","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T11:43:06Z","timestamp":1603885386000},"page":"3299","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Impact of Physical Activity and Weight Loss on Fat Mass, Glucose Metabolism, and Inflammation in Older African Americans with Osteoarthritis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7067-3441","authenticated-orcid":false,"given":"Andrew","family":"McLeod","sequence":"first","affiliation":[{"name":"Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA"},{"name":"Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Schiffer","sequence":"additional","affiliation":[{"name":"Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Castellanos","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3468-7862","authenticated-orcid":false,"given":"Andrew","family":"DeMott","sequence":"additional","affiliation":[{"name":"Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA"},{"name":"Center for Research on Health and Aging, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Olender","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Fitzgibbon","sequence":"additional","affiliation":[{"name":"Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA"},{"name":"Department of Pediatrics, University of Illinois at Chicago, Chicago, IL 60612, USA"},{"name":"University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Hughes","sequence":"additional","affiliation":[{"name":"Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA"},{"name":"Center for Research on Health and Aging, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA"},{"name":"Department of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giamila","family":"Fantuzzi","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Tussing-Humphreys","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA"},{"name":"Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60608, USA"},{"name":"University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21332","article-title":"Cancer Statistics, 2016","volume":"66","author":"Siegel","year":"2016","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1001\/jama.2012.14312","article-title":"Lifetime Risk and Years Lived Free of Total Cardiovascular Disease","volume":"308","author":"Wilkins","year":"2012","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1001\/jama.290.14.1884","article-title":"Lifetime Risk for Diabetes Mellitus in the United States","volume":"290","author":"Narayan","year":"2003","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/j.eururo.2011.07.007","article-title":"Does Physical Activity Reduce the Risk of Prostate Cancer? A Systematic Review and Meta-Analysis","volume":"60","author":"Liu","year":"2011","journal-title":"Eur. Urol."},{"key":"ref_5","unstructured":"Schottenfeld, D., and Fraumeni, J. (2009). Physical Activity. Cancer Epidemiology and Prevention, Oxford University Press."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1038\/oby.2005.66","article-title":"Effects of Exercise on Metabolic Risk Variables in Overweight Postmenopausal Women: A Randomized Clinical Trial","volume":"13","author":"Frank","year":"2005","journal-title":"Obes. Res."},{"key":"ref_7","unstructured":"Mctiernan, A. (2006). Cancer Prevention and Management through Exercise and Weight Control, Taylor & Francis. [1st ed.]."},{"key":"ref_8","first-page":"291546","article-title":"Obesity as a Major Risk Factor for Cancer","volume":"2013","author":"Silvestris","year":"2013","journal-title":"J. Obes."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Oyeyemi, S.O., Braaten, T., Licaj, I., Lund, E., and Benjaminsen Borch, K. (2018). Physical Activity Patterns and the Risk of Colorectal Cancer in the Norwegian Women and Cancer Study: A Population-Based Prospective Study. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-5092-0"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"The Emerging Risk Factors Collaboration (2011). Separate and Combined Associations of Body-Mass Index and Abdominal Adiposity with Cardiovascular Disease: Collaborative Analysis of 58 Prospective Studies. Lancet, 377, 1085\u20131095.","DOI":"10.1016\/S0140-6736(11)60105-0"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.jacc.2010.05.065","article-title":"Screen-Based Entertainment Time, All-Cause Mortality, and Cardiovascular Events: Population-Based Study with Ongoing Mortality and Hospital Events Follow-Up","volume":"57","author":"Stamatakis","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1016\/S0140-6736(17)30058-2","article-title":"Type 2 Diabetes","volume":"389","author":"Chatterjee","year":"2017","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s11606-010-1514-7","article-title":"Racial\/Ethnic Disparities in Exercise and Dietary Behaviors of Middle-Aged and Older Adults","volume":"26","author":"August","year":"2011","journal-title":"J. Gen. Intern. Med."},{"key":"ref_14","unstructured":"Hales, C.M., Carroll, M.D., Fryar, C.D., and Ogden, C.L. (2017). Prevalence of Obesity Among Adults and Youth: United States, 2015\u20132016, NCHS Data Brief, no 288."},{"key":"ref_15","unstructured":"(2016, September 10). SEER, Available online: http:\/\/seer.cancer.gov\/canques\/incidence.html."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.15585\/mmwr.mm6748a1","article-title":"Uterine Cancer Incidence and Mortality\u2014United States, 1999\u20132016","volume":"67","author":"Henley","year":"2018","journal-title":"Morb. Mortal. Wkly. Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"29S","DOI":"10.1177\/1077558707305416","article-title":"Cardiovascular Health Disparities: A Systematic Review of Health Care Interventions","volume":"64","author":"Davis","year":"2007","journal-title":"Med. Care Res. Rev."},{"key":"ref_18","unstructured":"(2016, September 10). National Diabetes Fact Sheet, 2011, Available online: https:\/\/www.cdc.gov\/diabetes\/pubs\/pdf\/methods11.pdf."},{"key":"ref_19","first-page":"48","article-title":"Review Obesity and Cancer: The Oil That Feeds the Flame","volume":"23","author":"Sun","year":"2015","journal-title":"Cell Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1038\/nature05487","article-title":"Mechanisms Linking Obesity with Cardiovascular Disease","volume":"444","author":"Mertens","year":"2006","journal-title":"Nature"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1038\/nature05482","article-title":"Mechanisms Linking Obesity to Insulin Resistance and Type 2 Diabetes","volume":"444","author":"Kahn","year":"2006","journal-title":"Nature"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1038\/nrc2734","article-title":"HHS Public Access","volume":"9","author":"Yu","year":"2016","journal-title":"Nat. Rev. Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.2337\/db06-1656","article-title":"Systemic Inflammation in Obese Humans","volume":"56","author":"Fontana","year":"2007","journal-title":"Diabetes"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/ajcn\/83.2.461S","article-title":"Obesity and the Role of Adipose Tissue in Inflammation and Metabolism","volume":"83","author":"Greenberg","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.cell.2011.02.013","article-title":"Review Hallmarks of Cancer: The Next Generation","volume":"144","author":"Hanahan","year":"2011","journal-title":"Cell"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1146\/annurev.med.080708.082713","article-title":"Biological Mechanisms Linking Obesity and Cancer Risk: New Perspectives","volume":"61","author":"Roberts","year":"2010","journal-title":"Annu. Rev. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3756750","DOI":"10.1155\/2019\/3756750","article-title":"Exercise for Prevention and Relief of Cardiovascular Disease: Prognoses, Mechanisms, and Approaches","volume":"2019","author":"Tian","year":"2019","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1152\/advan.00080.2014","article-title":"Exercise and Type 2 Diabetes: Molecular Mechanisms Regulating Glucose Uptake in Skeletal Muscle","volume":"38","author":"Stanford","year":"2014","journal-title":"Adv. Physiol. Educ."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"161S","DOI":"10.1093\/jn\/137.1.161S","article-title":"Exercise and Biomarkers for Cancer Prevention Studies","volume":"137","author":"Campbell","year":"2007","journal-title":"J. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1038\/sj.ijo.0801373","article-title":"Moderate-Intensity Regular Exercise Decreases Serum Tumor Necrosis Factor-\u03b1 and HbA1c Levels in Healthy Women","volume":"24","author":"Tsukui","year":"2000","journal-title":"Int. J. Obes."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/00001648-200209000-00012","article-title":"Does Exercise Reduce Inflammation? Physical Activity and C-Reactive Protein Among U.S. Adults","volume":"13","author":"Ford","year":"2002","journal-title":"Epidemiology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/JAHA.117.007064","article-title":"Both Light Intensity and Moderate-to-Vigorous Physical Activity Measured by Accelerometry Are Favorably Associated with Cardiometabolic Risk Factors in Older Women: The Objective Physical Activity and Cardiovascular Health (Opach) Study","volume":"6","author":"LaMonte","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1093\/aje\/153.3.242","article-title":"Association between Physical Activity and Markers of Inflammation in a Healthy Elderly Population","volume":"153","author":"Geffken","year":"2001","journal-title":"Am. J. Epidemiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1249\/MSS.0000000000001179","article-title":"Physical Activity and Adiposity-Related Inflammation: The MESA","volume":"49","author":"Vella","year":"2017","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1093\/gerona\/glx203","article-title":"Failed Recovery of Glycemic Control and Myofibrillar Protein Synthesis with 2 Wk of Physical Inactivity in Overweight, Prediabetic Older Adults","volume":"73","author":"McGlory","year":"2018","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2314","DOI":"10.1158\/0008-5472.CAN-11-3092","article-title":"Effects of a Caloric Restriction Weight Loss Diet and Exercise on Inflammatory Biomarkers in Overweight\/Obese Postmenopausal Women: A Randomized Controlled Trial","volume":"72","author":"Imayama","year":"2012","journal-title":"Cancer Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1038\/ijo.2013.122","article-title":"Weight Loss, Exercise or Both and Cardiometabolic Risk Factors in Obese Older Adults: Results of a Randomized Controlled Trial","volume":"38","author":"Bouchonville","year":"2014","journal-title":"Int. J. Obes."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.joca.2014.11.005","article-title":"Effects of Total and Regional Fat Loss on Plasma CRP and IL-6 in Overweight and Obese, Older Adults with Knee Osteoarthritis","volume":"23","author":"Beavers","year":"2015","journal-title":"Osteoarthr. Cartil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1158\/1940-6207.CAPR-11-0369","article-title":"Inflammatory Marker Changes in a Yearlong Randomized Exercise Intervention Trial among Postmenopausal Women","volume":"5","author":"Friedenreich","year":"2012","journal-title":"Cancer Prev. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"523","DOI":"10.2147\/CIA.S157584","article-title":"Hypoglycemic and Antioxidant Effect of Tai Chi Exercise Training in Older Adults with Metabolic Syndrome","volume":"13","year":"2018","journal-title":"Clin. Interv. Aging"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1093\/ajcn\/79.4.544","article-title":"Diet-Induced Weight Loss, Exercise, and Chronic Inflammation in Older, Obese Adults: A Randomized Controlled Clinical Trial","volume":"79","author":"Nicklas","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1093\/gerona\/gln032","article-title":"Effects of Exercise and Caloric Restriction on Insulin Resistance and Cardiometabolic Risk Factors in Older Obese Adults\u2014A Randomized Clinical Trial","volume":"64","author":"Yassine","year":"2009","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1159\/000342084","article-title":"Exercise Training with Weight Loss and Either a High- or Low-Glycemic Index Diet Reduces Metabolic Syndrome Severity in Older Adults","volume":"61","author":"Malin","year":"2012","journal-title":"Ann. Nutr. Metab."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s10900-015-0071-8","article-title":"Community Trial of a Faith-Based Lifestyle Intervention to Prevent Diabetes Among African-Americans","volume":"41","author":"Sattin","year":"2016","journal-title":"J. Community Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/joim.12622","article-title":"Weight Loss and Improved Metabolic Outcomes amongst Rural African American Women in the Deep South: Six-Month Outcomes from a Community-Based Randomized Trial","volume":"282","author":"Ard","year":"2017","journal-title":"J. Intern. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e92","DOI":"10.2196\/mhealth.4478","article-title":"A Behavioral Lifestyle Intervention Enhanced With Multiple-Behavior Self-Monitoring Using Mobile and Connected Tools for Underserved Individuals With Type 2 Diabetes and Comorbid Overweight or Obesity: Pilot Comparative Effectiveness Trial","volume":"6","author":"Wang","year":"2018","journal-title":"JMIR mHealth uHealth"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1001\/jama.2013.277669","article-title":"Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes among Overweight and Obese Adults with Knee Osteoarthritis: The IDEA Randomized Clinical Trial","volume":"310","author":"Messier","year":"2013","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1056\/NEJMoa1008234","article-title":"Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults","volume":"364","author":"Villareal","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1038\/oby.2011.76","article-title":"Effect of Diet and Exercise, Alone or Combined, on Weight and Body Composition in Overweight-to-Obese Postmenopausal Women","volume":"20","author":"Alfano","year":"2012","journal-title":"Obesity"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.exger.2016.09.005","article-title":"Resistance Training Improves Inflammatory Level, Lipid and Glycemic Profiles in Obese Older Women: A Randomized Controlled Trial","volume":"84","author":"Tomeleri","year":"2016","journal-title":"Exp. Gerontol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1093\/gerona\/58.2.M181","article-title":"Lifestyle Intervention of Hypocaloric Dieting and Walking Reduces Abdominal Obesity and Improves Coronary Heart Disease Risk Factors in Obese, Postmenopausal, African-American and Caucasian Women","volume":"58","author":"Nicklas","year":"2003","journal-title":"J. Gerontol. A. Biol. Sci. Med. Sci."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1152\/japplphysiol.00306.2015","article-title":"High-Intensity Interval Training without Weight Loss Improves Exercise but Not Basal or Insulin-Induced Metabolism in Overweight\/Obese African American Women","volume":"119","author":"Arad","year":"2015","journal-title":"J. Appl. Physiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1002\/oby.21877","article-title":"Exercise with Weight Loss Improves Adipose Tissue and Skeletal Muscle Markers of Fatty Acid Metabolism in Postmenopausal Women","volume":"25","author":"Ortmeyer","year":"2017","journal-title":"Obesity (Silver Spring)"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"409","DOI":"10.2337\/diacare.19.5.409","article-title":"Effectiveness of a Behavioral Weight Control Program for Blacks and Whites with NIDDM","volume":"19","author":"Wing","year":"1996","journal-title":"Diabetes Care"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1038\/oby.2011.85","article-title":"Markers of Inflammation and Fat Distribution Following Weight Loss in African-American and White Women","volume":"20","author":"Fisher","year":"2012","journal-title":"Obesity"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1038\/oby.2001.45","article-title":"Modest Lifestyle Intervention and Glucose Tolerance in Obese African Americans","volume":"9","author":"Racette","year":"2001","journal-title":"Obes. Res."},{"key":"ref_57","first-page":"152","article-title":"Resistance Training Differentially Affects Weight Loss and Glucose Metabolism of White and African American Patients with Type 2 Diabetes Mellitus","volume":"18","author":"Winnick","year":"2008","journal-title":"Ethn. Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.cct.2013.11.014","article-title":"Fit and Strong! Plus: Design of a Comparative Effectiveness Evaluation of a Weight Management Program for Older Adults with Osteoarthritis","volume":"37","author":"Fitzgibbon","year":"2014","journal-title":"Contemp. Clin. Trials"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/j.1532-5415.1975.tb00927.x","article-title":"A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients\u2020","volume":"23","author":"Pfeiffer","year":"1975","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1207\/s15324796abm2902s_5","article-title":"Screening, Safety, and Adverse Events in Physical Activity Interventions: Collaborative Experiences from the Behavior Change Consortium","volume":"29","author":"Ory","year":"2005","journal-title":"Ann. Behav. Med."},{"key":"ref_61","unstructured":"Belza, B. (2007). Moving Ahead. Strategies and Tools to Plan, Conduct, and Maintain Effective Community-Based Physical Activity Programs for Older Adults: A Brief Guide."},{"key":"ref_62","unstructured":"Centers for Disease Control and Prevention (CDC), and National Center for Health Statistics (NCHS) (2013). National Health and Nutrition Examination Survey Questionnaire (or Examination Protocol, or Laboratory Protocol)."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.2337\/diacare.27.6.1487","article-title":"Use and Abuse of HOMA Modeling","volume":"27","author":"Wallace","year":"2004","journal-title":"Diabetes Care"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Hardin, J.W., and Hilbe, J.M. (2014). Generalized Estimating Equations: Introduction. Wiley StatsRef: Statistics Reference Online, Wiley Online Library.","DOI":"10.1002\/9781118445112.stat06899"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"633","DOI":"10.2337\/diab.45.5.633","article-title":"Abdominal Fat and Insulin Resistance in Normal and Overweight Women: Direct Measurements Reveal a Strong Relationship in Subjects at Both Low and High Risk of NIDDM","volume":"45","author":"Carey","year":"1996","journal-title":"Diabetes"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3320","DOI":"10.2337\/diacare.26.12.3320","article-title":"Diagnosing Insulin Resistance by Simple Quantitative Methods in Subjects with Normal Glucose Metabolism","volume":"26","author":"Ascaso","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1093\/geront\/gny146","article-title":"Fit & Strong! Plus Trial Outcomes for Obese Older Adults with Osteoarthritis","volume":"60","author":"Hughes","year":"2020","journal-title":"Gerontologist"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1002\/jlb.64.2.135","article-title":"Soluble Receptors in Human Disease","volume":"64","author":"Heaney","year":"1998","journal-title":"J. Leukoc. Biol."},{"key":"ref_69","first-page":"4196","article-title":"Subcutaneous Adipose Tissue Releases Interleukin-6, but Not Tumor Necrosis Factor-Alpha, in Vivo","volume":"82","author":"Goodrick","year":"1997","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"E745","DOI":"10.1152\/ajpendo.2001.280.5.E745","article-title":"Adipose Tissue Tumor Necrosis Factor and Interleukin-6 Expression in Human Obesity and Insulin Resistance","volume":"280","author":"Kern","year":"2001","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.2337\/dc11-2339","article-title":"Defining Insulin Resistance from Hyperinsulinemic-Euglycemic Clamps","volume":"35","author":"Tam","year":"2012","journal-title":"Diabetes Care"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1038\/oby.2010.310","article-title":"Effect of Diet With and Without Exercise Training on Markers of Inflammation and Fat Distribution in Overweight Women","volume":"19","author":"Fisher","year":"2011","journal-title":"Obesity (Silver Spring)"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/11\/3299\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:29:50Z","timestamp":1760178590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/11\/3299"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,28]]},"references-count":72,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["nu12113299"],"URL":"https:\/\/doi.org\/10.3390\/nu12113299","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,28]]}}}