Effect Of Short-term Weight Loss Research Articles

Short-Term Effects of Weight Loss after Bariatric Surgery on Respiratory and Skeletal Muscles’ Strength

Background: Bariatric surgery leads to weight loss and body fat percentage reduction, but patients are prone to lean tissue loss which itself reduces the quality of life, and increases the risk of deatand h. This study evaluated the effects of bariatric surgery and changes in Fat Mass (FM) and Fat-Free Mass (FFM) on the respiratory and skeletal muscles’ strength three months after bariatric surgery.
 Methods: After obtaining demographic information, anthropometric measurements and body composition analysis, including Body Mass Index (BMI), FM, FFM, Percent Body Fat (PBF), handgrip isometric force, respiratory muscle forces and spirometry volumes, were assessed before and three months after bariatric surgery in 50 men and women undergoing this surgery.
 Results: Weight, BMI, FM, PBF and FFM isometric muscle force were decreased significantly. In contrast, respiratory muscle forces and respiratory volumes were increased significantly three months after the surgery. Reduction in FFM 3 months after the surgery did not lead to a change in respiratory muscle strength (p-values≥0.05).
 Conclusion: According to our findings, FM and FFM along with weight and BMI decrease significantly after bariatric surgery. These alternations were accompanied by a significant increase in respiratory muscle strength but were not correlated with handgrip muscle force changes.

Long-term impact of the metabolic status on weight loss-induced health benefits

BackgroundWhile short-term effects of weight loss on quality of life and metabolic aspects appear to be different in metabolically healthy (MHO) and metabolically unhealthy obese (MUO), respective long-term data is still missing. Given the high relevance of long-term changes, we aimed to address these in this post-hoc analysis of the MAINTAIN trial.MethodsWe analyzed 143 overweight/obese subjects (BMI ≥ 27 kg/m2, age ≥ 18 years) before and after a 3-month weight loss program (≥ 8% weight loss), after a 12-month period of a randomized weight maintenance intervention (n = 121), and after another 6 months without intervention (n = 112). Subjects were retrospectively grouped into MHO and MUO by the presence of metabolic syndrome and secondarily by estimates of insulin sensitivity (HOMA-IR and ISIClamp). Quality of life (QoL), blood pressure, lipids, HOMA-IR, and ISIClamp were assessed and evaluated using mixed model analyses.ResultsDespite similar short- and long-term weight loss, weight loss-induced improvement of HOMA-IR was more pronounced in MUO than MHO after 3 months (MHO: 2.4[95%-CI: 1.9–2.9] vs. 1.6[1.1–2.1], p = 0.004; MUO: 3.6[3.2–4.0] vs. 2.0[1.6–2.4], p < 0.001; p = 0.03 for inter-group comparison). After 21 months, the beneficial effect was no longer seen in MHO (2.0[1.5–2.6], p = 1.0), while it remained partially preserved in MUO (2.9[2.4–3.3], p = 0.002). QueryShort-term improvements of lipid parameters were similar in both groups. However, long-term improvements of HDL-cholesterol and triglycerides were only seen in MUO (44.4[41.5–47.4] vs. 49.3[46.2, 52.3] mg/dl, p < 0.001; 176.8[158.9–194.8] vs. 138.8[119.4–158.3] mg/dl, p < 0.001, respectively) but not in MHO. Weight loss-induced improvements in the QoL and particularly the physical health status were maintained in MUO until the end of the trial, while benefits disappeared over time in MHO. Group allocation by HOMA-IR and ISIClamp revealed higher benefits for MUO mainly in parameters of the glucose metabolism and QoL.ConclusionsOur data demonstrates stronger and longer-lasting improvements of metabolism and QoL in MUO after weight loss.Trial registration (ClinicalTrials.gov): NCT00850629. Registered 25 February 2009, https://clinicaltrials.gov/ct2/show/NCT00850629.

Effects of Short-term Weight Loss on Stress Hormone and EEG in Weight Athletes

Effects of Short-term Weight Loss on Stress Hormone and EEG in Weight Athletes

Telomere length increase after weight loss induced by bariatric surgery: results from a 10 year prospective study.

Obesity contributes to telomere attrition. Studies focusing on short-term effects of weight loss have been unable to identify protection of telomere length. This study investigates long-term effects of pronounced weight loss induced by bariatric surgery on telomere length. One hundred forty-two patients were recruited in a prospective, controlled intervention study, follow-up investigations were done after 10.46±1.48 years. A control group of normal weight participants was recruited and followed from 1995 to 2005 in the Bruneck Study. A total of 110 participants from each study was matched by age and sex to compare changes in telomere length. Quantitative PCR was used to determine telomere length. Telomere length increased significantly by 0.024±0.14 (P=0.047) in 142 bariatric patients within 10 years after surgery. The increase was different from telomere attrition in an age- and sex-matched cohort population of the Bruneck Study (-0.057±0.18; β=0.08; P=0.003). Significant changes in telomere length disappeared after adjusting for baseline body mass index (BMI) because of general differences in BMI and telomere length between the two study populations (β=0.07; P=0.06). Age was proportional to telomere length in matched bariatric patients (r=0.188; P=0.049) but inversely correlated with telomere length in participants of the Bruneck Study (r=-0.197; P=0.039). There was no association between percent BMI/excess weight loss and telomere attrition in bariatric patients. Baseline telomere length in bariatric patients was inversely associated with baseline plasma cholesterol and triglyceride concentrations. Telomere shortening was associated with lower high-density lipoprotein cholesterol and higher fasting glucose concentration at baseline in bariatric patients. Increases in relative telomere length were found after bariatric surgery in the long term, presumably due to amelioration of metabolic traits. This may overrule the influence of age and baseline telomere length and facilitate telomere protection in patients experiencing pronounced weight loss.

Effect of short-term weight loss on mental stress-induced cardiovascular and pro-inflammatory responses in women

Epidemiologic evidence links psychosocial stress with obesity but experimental studies examining the mechanisms that mediates the effect of stress on adiposity are scarce. The aim of this study was to investigate whether changes in adiposity following minimal weight loss affect heightened stress responses in women, and examine the role of the adipokine leptin in driving inflammatory responses. Twenty-three overweight or obese, but otherwise healthy, women (M age = 30.41 ± 8.0 years; BMI = 31.9 ± 4.1 kg/m2) completed standardized acute mental stress before and after a 9-week calorie restriction program designed to modify adiposity levels. Cardiovascular (blood pressure and heart rate) and inflammatory cytokines (leptin and interleukin-6; IL-6) responses to mental stress were assessed several times between baseline and a 45-min post-stress recovery period. There were modest changes in adiposity measures while the adipokine leptin was markedly reduced (−27%) after the intervention. Blood pressure reactivity was attenuated (−3.38 ± 1.39 mmHg) and heart rate recovery was improved (2.07 ± 0.96 Bpm) after weight loss. Blood pressure responses were inversely associated with changes in waist to hip ratio post intervention. Decreased levels of circulating leptin following weight loss were inversely associated with the IL-6 inflammatory response to stress (r = −0.47). We offered preliminary evidence suggesting that modest changes in adiposity following a brief caloric restriction program may yield beneficial effect on cardiovascular stress responses. In addition, reductions in basal leptin activity might be important in blunting pro-inflammatory responses. Large randomized trials of the effect of adiposity on autonomic responses are thus warranted.

Short-term weight loss in overweight/obese low-income women improves plasma zinc and metabolic syndrome risk factors

Metabolic syndrome is a group of disorders involving obesity, insulin resistance, dyslipidemia and hypertension. Obesity is the most crucial risk factor of metabolic syndrome, because it is known to precede other risk factors. Obesity is also associated with disturbances in the metabolism of the trace mineral, zinc. The overall purpose of this study was to investigate the effects of short-term weight loss on plasma zinc and metabolic syndrome risk factors. An 8-week weight loss intervention study was conducted with 90 low-income overweight/obese mothers, whose youngest child was 1–3 years old. Plasma levels of zinc, glucose, insulin, leptin, triglycerides, total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol were measured and compared at weeks 0 and 8 of the weight loss program. At pre-study, plasma zinc was low in 39% and, within normal values in 46%, of obese/overweight mothers. By the end of intervention, plasma zinc rose by 22% and only 5% of the mothers continued to exhibit low plasma zinc. At post-study, the metabolic syndrome risk factors of waist circumference, HDL cholesterol, and diastolic blood pressure ( p < 0.05) showed significant improvements. Plasma zinc increased by a greater margin (67%) in women with low zinc, as compared to those with normal zinc (18%); weight reduction was similar in both the groups. Finally, changes in % body fat were related negatively with changes in plasma zinc ( r = − 0.28, p < 0.05). The circulating levels of zinc, as well as the metabolic syndrome components, showed significant improvements in overweight/obese low-income women after weight loss.

Effects of short-term weight loss on stress hormone and immune function in Judo players

Effects of short-term weight loss on stress hormone and immune function in Judo players

Preoperative Weight Loss in the Context of a Comprehensive Lifestyle Intervention

To the Editor Drs. Wiezer, Jansen, and Thorell note that 6 months seem to be an unnecessarily long period of intervention in our study on preparing patients for weight-loss surgery (R01DK077102; PREP Study, ClinicalTrials.gov NCT00623792). In particular, they question whether this duration is necessary if the goal is to reduce surgical complications. This is an excellent question, which we would like to address. Although it is almost certainly true that significant weight loss could occur more quickly with aggressive intervention such as a very low energy diet (VLED), the PREP study is not restricted to the question of whether preoperative weight loss reduces perioperative complications. Rather, we are addressing a broader set of aims including whether a comprehensive lifestyle intervention emphasizing behavioral self-management will confer benefits through 2 years after operation. We hypothesize that patients who participate in the intervention will exhibit better postoperative compliance (e.g., adherence to dietary and exercise guidelines), fewer behavior-related complications (e.g., severe and persistent vomiting, dumping syndrome), and lower healthcare utilization (e.g., surgeryrelated outpatient and emergency room visits), relative to those receiving usual preoperative care. Our approach is adapted from evidence-based lifestyle interventions that have been associated with modest weight losses (5–10% of initial body weight) and concomitant improvements in health among individuals at high risk (e.g., [1, 2]). The 6-month duration of the PREP intervention provides for sufficient time to monitor and address eating behaviors such as overconsumption of high-calorie liquids, frequent snacking, and recurrent loss of control over eating, which have been associated with complications and poor weight control after bariatric surgery. Furthermore, this duration corresponds minimum duration of physiciansupervised dieting most US insurance companies require prior to approval for surgery. In order to facilitate participation among candidates for weight-loss surgery—many of whom have physical limitations on their mobility or travel a significant distance to seek care—the intervention is delivered through a combination of face-to-face and telephone counseling sessions. Multidisciplinary work is needed to establish effects of diet, exercise, and behavior change in this patient population as well as to determine the most appropriate timing and duration of preoperative interventions. We were pleased to learn about the SHOPWEL study to evaluate the effect of short-term weight loss 2 to 3 weeks prior to surgery using VLED. We agree that randomized controlled trials currently underway will yield important information for optimizing surgical care. Melissa A. Kalarchian, Ph.D. Associate Professor of Psychiatry and Psychology Marsha D. Marcus, Ph.D. Professor of Psychiatry and Psychology Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center

Early Decreases in Plasma Lipid Transfer Proteins During Weight Reduction

To determine the effect of short-term weight loss in obese women on concentrations of plasma cholesteryl ester transfer protein (CETP) and phospholipid transfer protein (PLTP), two new risk factors for cardiovascular disease. Plasma CETP and PLTP mass concentrations were measured in 38 obese, non-diabetic women before and after a moderate, 4% weight loss that was obtained by a 1250 kcal/d diet for 4 weeks. Anthropometric and biological parameters were measured before and after weight loss. Plasma CETP concentration decreased substantially after weight loss (2.76 +/- 0.79 before and 2.31 +/- 0.69 mg/L after; p = 0.000), and the same was true for plasma PLTP concentration (9.01 +/- 2.44 mg/L before vs. 8.34 +/- 2.57 after; p = 0.043). The HDL profile shifted toward the small-sized range, with significant decreases in the relative abundance of HDL(2b) and HDL(2a) at the expense of HDL(3b) after weight loss. A significant, positive correlation between CETP and PLTP mass concentrations is reported for the first time in obese patients (r = 0.43, p = 0.004), and weight reduction was accompanied by early, concomitant, and parallel decreases in plasma CETP and PLTP levels (r = 0.47, p = 0.003). The significant relationship between CETP and PLTP levels was lost after the dietary intervention (r = 0.27; p = 0.11). CETP and PLTP correlate positively and significantly in obese patients. The hypocaloric dietary manipulation constitutes a relevant intervention to reduce rapidly and simultaneously plasma levels of CETP and PLTP. The impact of reduced PLTP activity on HDL size appeared to be more prominent than the impact of concomitant reduction in CETP activity.

The Master Female Athlete

The Master Female Athlete

Effects of Weight Loss in Overweight/Obese Individuals and Long-Term Hypertension Outcomes

Many studies have assessed short-term effects of weight loss on blood pressure, whereas little attention has been paid to long-term effects. We conducted a systematic review to evaluate the long-term effects of weight loss on hypertension outcome measures in adults using literature published from 1966 to 2001. All prospective studies and trials, performed on participants with body mass index of > or =28 kg/m2 with a follow-up of >2 years and weight changes recorded, were included. The data from these studies were used to model the long-term effects on blood pressure. Previous reviews on shorter-term studies indicate a 1:1 drop in blood pressure (mm Hg) with weight loss (kilograms). Our findings, based on studies with follow-up of > or =2 years, demonstrate blood pressure decreases less than this after weight loss. The surgical intervention studies exhibited huge weight losses with undramatic blood pressures changes. When surgical interventions are excluded, the models suggest that for 10 kg weight loss, decreases of 4.6 mm Hg and 6.0 mm Hg in diastolic and systolic blood pressure, respectively, may be expected, about half of that predicted from the short-term trials. Initial blood pressure, the length of follow-up, medication changes, and physiological restrictions may contribute to this reduced effect in the long-term studies. Extrapolation of short-term blood pressure changes with weight loss to the longer term is potentially misleading. The weight/hypertension relationship is complex and needs well-conducted studies with long-term follow-up to examine the effects of weight loss on hypertension outcomes.

The Effects Of Short-term Weight Loss And Partial Weight Regain On Systemic Inflammatory Markers

PURPOSE The purpose of the present study was to investigate the effect of short term weight loss, by exercise training and diet, on circulating levels of adipokines and other systemic inflammatory markers. Additionally, we wanted to examine the influence of weight maintenance or partial weight regain with continued exercise training on these parameters. METHODS Nineteen overweight to class I obese (BMI = 25–34.9) individuals participated in this 10 wk, two phase study. In Phase 1, subjects underwent 6 wk of modest energy restriction and aerobic exercise training to induce a 5% reduction in body weight. During Phase 2, subjects were randomized into either a weight maintenance or a partial (50% of initial weight loss) weight regain group for 4 wk. All subjects continued exercise training, while adjusting energy intake to achieve weight goals. Exercise training during both phases consisted of 45 min/d, 5d/wk of walking and/or treadmill jogging at 60% VO2max. Fasting serum samples were collected at three testing sessions (pre-weight loss (baseline), post Phase 1 treatment (wk 6), and post Phase 2 treatment (wk 11)) for the determination adiponectin, tumor necrosis factor-alpha (TNFa), and its soluble receptor (sTNFR2), as well as secretory phospholipase A2 (sPLA2), soluble intracellular adhesion molecule-1 (sICAM-1), and C-reactive protein (CRP). RESULTS Exercise training- and diet-induced weight loss significantly reduced adiponectin and sICAM-1 (p <0.05), significantly elevated sPLA2, but had no effect on TNFa, sTNFR2, or CRP concentrations. Following four additional weeks of exercise in which subjects either maintained or partially regained weight, adiponectin and sPLA2 values returned close to baseline, sICAM-1 remained attenuated, and TNFa, sTNFR2, and CRP remained unchanged. CONCLUSIONS Based on results from the present study, six weeks of exercise training and diet, to induce modest weight loss (5%), had detrimental effects on adiponectin and sPLA2, but significantly reduced the marker for cellular adhesion. In addition, it does not appear that partial weight regain with continued exercise training had a significant impact in those parameters that were significantly altered with weight loss. Supported by NIH T32 AR48523, Elizabeth Hegarty Foundation, and UMC Research Council.

The Effects Of Short-term Weight Loss And Partial Weight Regain On Systemic Inflammatory Markers

The Effects Of Short-term Weight Loss And Partial Weight Regain On Systemic Inflammatory Markers

Short-term effects of weight loss on the cardiovascular risk factors in morbidly obese patients.

To analyze the short-term effects of weight loss on the cardiovascular risk factors in morbidly obese patients. Five metabolic cardiovascular risk factors (blood glucose, blood pressure, total cholesterol, high-density lipoprotein (HDL)-cholesterol, and triglycerides) were determined before and 15.3 +/- 2.1 months after laparoscopic gastric banding in 650 morbidly obese patients. Global cardiovascular risk was calculated according to the Prospective Cardiovascular Münster (PROCAM) scoring system. Mean weight loss was 22.7 +/- 20.4 kg. Normalization of the metabolic alteration was observed in 67.3% of patients with diabetes, 38.3% of patients with hypercholesterolemia, 72.5% of patients with low HDL-cholesterol, 72.3% of patients with hypertriglyceridemia, and 46.7% of patients with hypertension. PROCAM score fell from 31.4 +/- 11.6 to 28.0 +/- 12.0 points (p < 0.001). The modifications of total cholesterol and blood pressure were unrelated to percentage weight loss. Percentage weight loss was significantly related to the reductions of fasting blood glucose, triglyceride level, and the PROCAM score and to the increase of HDL-cholesterol concentrations observed after surgery. However, the strength of these four relationships was generally low. The variations of HDL-cholesterol concentrations and blood pressure levels were more influenced by actual energy balance than by the extent of weight loss. Weight loss observed in the first 12 to 18 months after gastric banding was associated with a significant improvement of single cardiovascular risk factors and global risk. On the other hand, the extent of weight loss was poorly related to the magnitude of improvement in cardiovascular risk.

Circulating leptin is associated with oxidized LDL in postmenopausal women

Recently, leptin has been suggested as a possible cause of atherosclerotic disease. In the present study, we have investigated in postmenopausal women ( n=60; age: 52±13) the relationship between circulating levels of leptin, oxidized LDL (Ox-LDL) and other biochemical and anthropometric variables of atherosclerotic risk. In addition, we have evaluated soluble thrombomodulin (sTM) as a marker of endothelial damage. An additional study was conducted in a subgroup of obese subjects to determine the short-term effects of weight loss on selected variables. Ox-LDL showed a positive correlation with leptin circulating levels ( r=0.65, P<0.0001). A significant association was also found between Ox-LDL and body mass index ( r=0.69, P<0.0001), waist-to-hip ratio ( r=0.50, P<0.0001), insulin levels ( r=0.65, P<0.0001), HOMA index ( r=0.55, P<0.0001) and sTM ( r=0.74, P<0.0001) levels. After multivariate regression analysis leptin was still related to Ox-LDL levels ( P=0.007). In obese women who completed the program of weight reduction, leptin changes persisted as a significant predictor of plasma changes in Ox-LDL levels. These findings suggested a novel link between leptin and Ox-LDL, possibly involved in atherosclerotic disease.

Circulating leptin is associated with oxidized LDL in postmenopausal women

<h2>Abstract</h2> Recently, leptin has been suggested as a possible cause of atherosclerotic disease. In the present study, we have investigated in postmenopausal women (<i>n</i>=60; age: 52±13) the relationship between circulating levels of leptin, oxidized LDL (Ox-LDL) and other biochemical and anthropometric variables of atherosclerotic risk. In addition, we have evaluated soluble thrombomodulin (sTM) as a marker of endothelial damage. An additional study was conducted in a subgroup of obese subjects to determine the short-term effects of weight loss on selected variables. Ox-LDL showed a positive correlation with leptin circulating levels (<i>r</i>=0.65, <i>P</i><0.0001). A significant association was also found between Ox-LDL and body mass index (<i>r</i>=0.69, <i>P</i><0.0001), waist-to-hip ratio (<i>r</i>=0.50, <i>P</i><0.0001), insulin levels (<i>r</i>=0.65, <i>P</i><0.0001), HOMA index (<i>r</i>=0.55, <i>P</i><0.0001) and sTM (<i>r</i>=0.74, <i>P</i><0.0001) levels. After multivariate regression analysis leptin was still related to Ox-LDL levels (<i>P</i>=0.007). In obese women who completed the program of weight reduction, leptin changes persisted as a significant predictor of plasma changes in Ox-LDL levels. These findings suggested a novel link between leptin and Ox-LDL, possibly involved in atherosclerotic disease.

Effect of short-term weight loss on the metabolic syndrome and conduit vascular endothelial function in overweight adults

Impaired vascular endothelial function may be an important mechanism linking obesity to increased cardiovascular risk. We investigated whether short-term weight loss improves conduit artery endothelial dysfunction in overweight adults. Forty-three otherwise healthy overweight patients with a body mass index ≥27 kg/m 2 completed an open-label 3-month trial consisting of a calorie-restricted diet and 120 mg of orlistat taken 3 times daily with meals. Endothelial function and parameters of the metabolic syndrome were measured before and after intervention. Subjects lost 6.6 ± 3.4% of their body weight. Low-density lipoprotein cholesterol, low-density lipoprotein concentration, fasting insulin, and leptin decreased significantly (all p <0.009), and C-reactive protein decreased (p = 0.22). Conduit vascular function did not change as assessed by flow-mediated dilation (3.86 ± 3.54 vs 3.74 ± 3.78%, p = 0.86) and nitroglycerin-mediated dilation (17.18 ± 5.89 vs 18.87 ± 7.11%, p = 0.13) of the brachial artery. A moderate degree of weight reduction over 3 months improved the metabolic syndrome profile but not the vascular dysfunction associated with uncomplicated obesity.

Soluble thrombomodulin and vascular adhesion molecule-1 are associated to leptin plasma levels in obese women

Recent studies have suggested that leptin, a plasma protein secreted by adipocytes, may play a role in artherothrombosis. In this study, we tested the hypothesis that leptin contributes to in vivo endothelial dysfunction in obese subjects. A cross-sectional comparison of plasma leptin, soluble thrombomodulin (sTM) and soluble vascular adhesion molecule-1 (VCAM-1) was carried out in 35 obese women (age 48±13) selected with a body mass index (BMI) ≥30 kg/m 2 and 25 normal weight women (age 50±11, BMI < 25). An additional study was conducted to determine the short-term effects of weight loss induced by caloric restriction. Plasma levels of leptin, sTM and sVCAM-1 were measured before and after weight loss. Obese women had higher levels of leptin (35±22 versus 22±19, P<0.01), sTM (4.8±1.8 versus 1.9±1.5, P<0.001) and sVCAM-1 (726±109 versus 583±50, P<0.001) than non-obese women. sTM and sVCAM-1 concentrations had a positive correlation with BMI (sTM, r=0.70, P<0.001; sVCAM-1, r=0.60, P<0.001), waist circumference (sTM, r=0.66, P<0.001; sVCAM-1, r=0.37, P<0.01) and leptin levels (sTM, r=0.53, P<0.001; sVCAM-1, r=0.42, P<0.005). At multiple regression analysis leptin predicted sTM and sVCAM-1 independently of obesity measures and other covariates. Twenty-nine obese patients who completed the program of weight reduction showed a significant decrease in leptin, sTM, and sVCAM-1 levels. The magnitude of decrease of sTM and sVCAM-1 was related to the magnitude of reduction in leptin levels. Therefore, our results show that obesity is associated with enhanced levels of atherosclerosis markers. These abnormalities are related to abdominal obesity possibly mediated by leptin levels, and are reversible with weight loss.

Short-term effects of weight loss with or without low-intensity exercise training on fat metabolism in obese men

Energy restriction is known to induce a decline in fat oxidation during the postdiet period. Reduced fat oxidation may contribute to weight regain. The present study investigated the effect of the addition of low-intensity exercise training to energy restriction on postdiet fat oxidation and on the contribution of the sympathetic nervous system to fat oxidation. Forty obese men were divided randomly into 2 groups: diet (D) and diet plus exercise (DE). Both groups followed an energy restriction program for 10 wk. Subjects in the DE group also participated in a low-intensity exercise training program [40% maximal oxygen uptake (VO2max)] for 12 wk. Before the intervention and after 12 wk, with subjects at stable body weights, we measured body composition, VO2max, and substrate oxidation at rest, during exercise at 50% VO2max, and during recovery. Measurements were made with and without administration of the beta-adrenergic antagonist propranolol. Both interventions led to significant decreases in body weight, fat mass, and fat-free mass (P < 0.001); these decreases did not differ significantly between the D and DE groups. Neither intervention significantly affected VO2max. The effect of the intervention on the respiratory exchange ratio differed significantly between the D and DE groups [two-way analysis of variance (ANOVA), P < 0.05]. The effect on the beta-adrenergic-mediated respiratory exchange ratio tended to be different between the 2 groups (two-way ANOVA, P = 0.09). Addition of low-intensity exercise training to energy restriction counteracts the decline in fat oxidation during the postdiet period.