Abstract
In this secondary analysis of the DiOGenes study, we investigated whether physical activity (PA) contributes to diet-induced weight loss and helps to reduce subsequent regain. We also studied the associations of PA with changes in cardiometabolic variables. Adults with overweight were included and followed an 8-week low-calorie diet (LCD). When successful (>8% weight loss), participants were randomized to different ad libitum diet groups and were advised to maintain their weight loss over the 6-month intervention period. Body weight (BW), body composition, cardiometabolic variables and subjectively-assessed PA were measured at baseline, at the end of weight loss and at the end of the intervention. BW was reduced by the LCD (from 99.8 ± 16.7 to 88.4 ± 14.9 kg; P < 0.001). This reduction was maintained during the weight maintenance period (89.2 ± 16.0 kg). Total PA (sum score of the three subscales of the Baecke questionnaire) increased during the weight loss period (from 8.16 ± 0.83 to 8.39 ± 0.78; P < 0.001) and this increase was subsequently maintained (8.42 ± 0.90). We found no evidence that baseline PA predicted weight loss. However, a higher level of baseline PA predicted a larger weight-loss-induced improvement in total cholesterol, triglycerides, glucose and CRP, and in post-prandial insulin sensitivity (Matsuda index). Subsequent weight and fat mass maintenance were predicted by the post-weight loss level of PA and associated with changes in PA during the weight maintenance phase. In conclusion, despite the fact that higher baseline levels of PA did not predict more weight loss during the LCD, nor that an increase in PA during the LCD was associated with more weight loss, higher PA levels were associated with more improvements in several cardiometabolic variables. The positive effect of higher PA on weight loss maintenance seems in contrast to randomized controlled trials that have not been able to confirm a positive effect of exercise training programmes on weight loss maintenance. This analysis supports the notion that higher self-imposed levels of PA may improve the cardiometabolic risk profile during weight loss and help to maintain weight loss afterwards.
Highlights
The beneficial effects of physical activity (PA) are sufficiently known and include improvements in physical fitness and wellbeing
ANOVA analyses showed that body weight (BW), body fat percentage (%BF) and fat mass (FM) were significantly reduced by the energy-restricted diet (BW from 99.8 ± 16.7 to 88.4 ± 14.9 kg; %BF from 39.8 ± 8.4 to 35.4 ± 14.9 %; FM from 39.8 ± 11.6 to 31.4 ± 10.5 kg; all P < 0.001) and the reductions were maintained during the weight maintenance period (Table 1)
A significant negative association was found for body weight and FM, but not for Fat free mass (FFM). In this secondary analysis of the DiOGenes trial, we found that the level of PA at baseline did not predict weight loss induced by an energy-restricted diet
Summary
The beneficial effects of physical activity (PA) are sufficiently known and include improvements in physical fitness and wellbeing. Many people with overweight or obesity try to lose weight by means of an energy-restricted diet. There is ample evidence from randomized clinical trials (RCTs) that adding an exercise program to a weight loss programme by means of energy restriction will result in extra weight loss [eg., [5,6,7]]. Combined diet and exercise interventions on the long-term have been found to result in more weight loss than diet alone [8, 9]. There is no evidence from RCTs that exercise training programmes help to prevent weight regain after weight loss [7, 10]. Whether self-selected, habitual levels of PA contribute to more weight loss success and may help to prevent weight regain is less well studied
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