Abstract
BackgroundIt has been suggested that exercise training results in compensatory mechanisms that attenuate weight loss. However, this has only been examined with large doses of exercise. The goal of this analysis was to examine actual weight loss compared to predicted weight loss (compensation) across different doses of exercise in a controlled trial of sedentary, overweight or obese postmenopausal women (n = 411).Methodology/Principal FindingsParticipants were randomized to a non-exercise control (n = 94) or 1 of 3 exercise groups; exercise energy expenditure of 4 (n = 139), 8 (n = 85), or 12 (n = 93) kcal/kg/week (KKW). Training intensity was set at the heart rate associated with 50% of each woman's peak VO2 and the intervention period was 6 months. All exercise was supervised. The main outcomes were actual weight loss, predicted weight loss (exercise energy expenditure/ 7700 kcal per kg), compensation (actual minus predicted weight loss) and waist circumference. The study sample had a mean (SD) age 57.2 (6.3) years, BMI of 31.7 (3.8) kg/m2, and was 63.5% Caucasian. The adherence to the intervention was >99% in all exercise groups. The mean (95% CI) weight loss in the 4, 8 and 12 KKW groups was −1.4 (−2.0, −0.8), −2.1 (−2.9, −1.4) and −1.5 (−2.2, −0.8) kg, respectively. In the 4 and 8 KKW groups the actual weight loss closely matched the predicted weight loss of −1.0 and −2.0 kg, respectively, resulting in no significant compensation. In the 12 KKW group the actual weight loss was less than the predicted weight loss (−2.7 kg) resulting in 1.2 (0.5, 1.9) kg of compensation (P<0.05 compared to 4 and 8 KKW groups). All exercise groups had a significant reduction in waist circumference which was independent of changes in weight.ConclusionIn this study of previously sedentary, overweight or obese, postmenopausal women we observed no difference in the actual and predicted weight loss with 4 and 8 KKW of exercise (72 and 136 minutes respectively), while the 12 KKW (194 minutes) produced only about half of the predicted weight loss. However, all exercise groups had a significant reduction in waist circumference which was independent of changes in weight.Trial RegistrationClinicalTrials.gov NCT 00011193
Highlights
IntroductionThe increasing prevalence of overweight, obesity and the associated comorbidities of excess weight are well documented and represent a major challenge to public health and the health care systems. [1,2,3,4] Regular exercise is considered a central component of weight loss and there are many organizations that recommend an hour or more per day of exercise to prevent weight gain, promote weight loss and/or prevent weight regain. [1,5,6,7,8] Given the potential for exercise to create a negative energy balance, the relative importance of exercise in promoting weight loss is far more complicated than expected as exercise-based weight loss studies produce considerably less weight loss than predicted
All exercise groups had a significant reduction in waist circumference which was independent of changes in weight
[10] In all previous exercise studies exploring weight compensation, only one dose of exercise was examined and these were typically large doses of exercise prescribed for weight loss. [9,10,11]. This is important because the exercise recommendation for general health is 30 minutes per day on most days of the week, which is considerably less than the weight loss recommendation of 60 minutes per day most days of the week. [1,5,6,7,8,12,13] To our knowledge there are no studies that have examined weight compensation across different doses of exercise
Summary
The increasing prevalence of overweight, obesity and the associated comorbidities of excess weight are well documented and represent a major challenge to public health and the health care systems. [1,2,3,4] Regular exercise is considered a central component of weight loss and there are many organizations that recommend an hour or more per day of exercise to prevent weight gain, promote weight loss and/or prevent weight regain. [1,5,6,7,8] Given the potential for exercise to create a negative energy balance, the relative importance of exercise in promoting weight loss is far more complicated than expected as exercise-based weight loss studies produce considerably less weight loss than predicted. The DoseResponse to Exercise in postmenopausal Women (DREW) study was designed to examine the health benefits of 50%, 100%, and 150% of the NIH Consensus Panel physical activity recommendation in sedentary, overweight or obese, postmenopausal women with elevated blood pressure. [15] the DREW study represents a unique opportunity to examine actual compared to predicted weight loss (compensation) across different doses of exercise. It has been suggested that exercise training results in compensatory mechanisms that attenuate weight loss This has only been examined with large doses of exercise. The goal of this analysis was to examine actual weight loss compared to predicted weight loss (compensation) across different doses of exercise in a controlled trial of sedentary, overweight or obese postmenopausal women (n = 411)
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