Article Text

Effective SLOPE: EffectS of Lifestyle interventions in Older PEople with obesity: a systematic review and network meta-analysis protocol
  1. Gabriel Torbahn1,
  2. Daniel Schoene2,
  3. Lukas Schwingshackl3,
  4. Gerta Rücker4,
  5. Helge Knüttel5,
  6. Wolfgang Kemmler6,
  7. Cornel C Sieber1,7,
  8. John A Batsis8,9,
  9. Dennis T Villareal10,
  10. Nanette Stroebele-Benschop11,
  11. Dorothee Volkert1,
  12. Eva Kiesswetter1
  1. 1Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
  2. 2Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
  3. 3Institute for Evidence in Medicine, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
  4. 4Institute of Medical Biometry and Medical Informatics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
  5. 5University Library, University of Regensburg, Regensburg, Germany
  6. 6Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
  7. 7Department of Medicine, Kantonsspital Winterthur, Winterthur, Zurich, Switzerland
  8. 8Division of Geriatric Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  9. 9Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  10. 10Division of Endocrinology, Diabetes and Metabolism, Baylor College of Medicine, Houston, Texas, USA
  11. 11Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
  1. Correspondence to Mr Gabriel Torbahn; gabriel.torbahn{at}


Introduction Obesity is highly prevalent in older adults aged 65 years or older. Different lifestyle interventions (diet, exercise, self-management) are available but benefits and harms have not been fully quantified comparing all available health promotion interventions. Special consideration must be given to functional outcomes and possible adverse effects (loss of muscle and bone mass, hypoglycaemia) of weight loss interventions in this age group. The objective of this study is to synthesise the evidence regarding the effects of different types and modalities of lifestyle interventions, or their combinations, on physical function and obesity-related outcomes such as body composition in older adults with obesity.

Methods and analyses Six databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Psychinfo and Web of Science) and two trial registries ( and the WHO International Clinical Trials Registry Platform) will be searched for randomised controlled trials of lifestyle interventions in older adults with obesity. Screening (title/abstract and full-text) and data extraction of references as well as assessment of risk of bias and rating of the certainty of evidence (Grading of Recommendations, Assessment, Development and Evaluation for network meta-analyses) will be performed by two reviewers independently. Frequentist random-effects network meta-analyses will be conducted to determine the pooled effects from each intervention.

Ethics and dissemination We will submit our findings to peer-reviewed journals and present at national and international conferences as well as in scientific medical societies. Patient-targeted dissemination will involve local and national advocate groups.

PROSPERO registration number CRD42019147286.

  • geriatric medicine
  • nutrition & dietetics
  • sports medicine

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  • Contributors GT, DS and EK planned and designed this project, drafted the manuscript and approved the final version. LS, GR, HK, WK, CCS, JAB, DTV, NS-B, and DV were involved in the planning and design process of this project, provided critical feedback for the manuscript and approved the final version. EK will be the guarantor of the review.

  • Funding This work was funded by the German Federal Ministry of Education and Research (BMBF) grant number (01KG1903).

  • Competing interests LS is a member of the GRADE working group. JAB is funded by the National Institute on Aging and Office of Dietary Supplements of the National Institutes of Health under Award Number K23AG051681, and the R01 AG067416.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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