OBJECTIVES: Adherence to lifestyle interventions is crucial for the treatment of obesity. However, there is little research about adherence to lifestyle interventions in persons around retirement age. The objectives of this study are (1) to identify factors associated with the adherence to resistance training and a hypocaloric diet and (2) to describe the association between adherence and changes in body composition outcome parameters. DESIGN: This secondary data analysis included three randomized controlled trials. SETTING & PARTICIPANTS: The inclusion criteria of the participants were an age of 55-75 years, a BMI ≥ 25 kg/m2 and receiving both a hypocaloric diet and resistance training. All participants were residing in the community. MEASUREMENTS: Adherence to hypocaloric diet was measured through the mean dietary intake on the basis of a 3-day dietary record. If the participant consumed at least 600 kcal less than the individual caloric requirements, they were considered adherent. Adherence to resistance training was achieved if ≥67% of the recommended training sessions were attended over the course of the study periods. RESULTS: 232 participants were included, 47.0% female, mean age 64.0 (±5.5) years. 80.2% adhered to resistance training and 51.3% adhered to a hypocaloric diet. Older age (Beta 0.41; 95% CI 0.05, 0.78; p = 0.028) and male sex (Beta 7.7; 95% CI 3.6, 11; p < 0.001) were associated with higher resistance training adherence. A higher BMI at baseline (Beta 6.4; 95% CI 3.6, 9.2; p < 0.001) and male sex (Beta 65; 95% CI 41, 88; p < 0.001) were associated with higher adherence to hypocaloric diet. CONCLUSION: We identified several associated factors (sex, age and BMI at baseline) that should be considered to promote adherence in future lifestyle intervention studies in persons around retirement age. We recommend including behavior change techniques in lifestyle interventions and consider sex-specific interventions to improve the adherence of women.

Amsterdam University of Applied Sciences Faculty of Sports and Nutrition Center of Expertise Urban Vitality Dr Meurerlaan 8 1067 SM Amsterdam Amsterdam The Netherlands

Charles University 1st Faculty of Medicine Department of Geriatric Medicine Katerinska 1660 32 12108 Nove Mesto Praha Czech Republic

Department of Nutrition and Dietetics Amsterdam University Medical Centers Amsterdam Public Health Institute VU University Amsterdam The Netherlands

Faculty of Sports and Nutrition Centre of Expertise Urban Vitality Amsterdam University of Applied Sciences Dr Meurerlaan 8 1067 SM Amsterdam The Netherlands

HAS Green Academy Onderwijsboulevard 221 5223 DE' s Hertogenbosch DE 's Hertogenbosch The Netherlands

Medical University of Graz Institute of Medical Informatics Statistics and Documentation Auenbruggerplatz 2 8010 Graz Graz Austria

Medical University of Graz Institute of Nursing Science Neue Stiftingtalstraße 6 P06 WEST 8010 Graz Graz Austria

University Clermont Auvergne Human Nutrition Unit INRA CRNH Auvergne CHU Clermont Ferrand Clinical Nutrition Department 28 Place Henri Dunant 63001 CLERMONT FERRAND Cedex 1 Clermont Ferrand France

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