title: Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women.
abstract: Lifestyle interventions for weight loss are the cornerstone of obesity therapy, yet their optimal design is debated. This is particularly true for postmenopausal women; a population with a high prevalence of obesity yet toward whom fewer studies are targeted. We conducted a year-long, 4-arm randomized trial among 439 overweight-to-obese postmenopausal sedentary women to determine the effects of a calorie-reduced, low-fat diet (D), a moderate-intensity, facility-based aerobic exercise program (E), or the combination of both interventions (D+E), vs. a no-lifestyle-change control (C) on change in body weight and composition. The group-based dietary intervention had a weight-reduction goal of ≥10%, and the exercise intervention consisted of a gradual escalation to 45-min aerobic exercise 5 day/week. Participants were predominantly non-Hispanic whites (85%) with a mean age of 58.0 ± 5.0 years, a mean BMI of 30.9 ± 4.0 kg/m(2) and an average of 47.8 ± 4.4% body fat. Baseline and 12-month weight and adiposity measures were obtained by staff blinded to participants' intervention assignment. Three hundred and ninety nine women completed the trial (91% retention). Using an intention-to-treat analysis, average weight loss at 12 months was -8.5% for the D group (P < 0.0001 vs. C), -2.4% for the E group (P = 0.03 vs. C), and -10.8% for the D+E group (P < 0.0001 vs. C), whereas the C group experienced a nonsignificant -0.8% decrease. BMI, waist circumference, and % body fat were also similarly reduced. Among postmenopausal women, lifestyle-change involving diet, exercise, or both combined over 1 year improves body weight and adiposity, with the greatest change arising from the combined intervention.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Foster-Schubert
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Duggan
authors.forename: Liren
authors.initials: L
authors.lastname: Xiao
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Campbell
authors.forename: Angela
authors.initials: A
authors.lastname: Kong
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Bain
authors.forename: Ching-Yun
authors.initials: CY
authors.lastname: Wang
authors.forename: George L
authors.initials: GL
authors.lastname: Blackburn
authors.forename: Anne
authors.initials: A
authors.lastname: McTiernan
mesh_terms: D000273:Adipose Tissue; D050154:Adiposity; D001823:Body Composition; D015992:Body Mass Index; D031204:Caloric Restriction; D004032:Diet; D018752:Diet, Fat-Restricted; D015444:Exercise; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000628:therapy*; D010352:Patient Dropouts; D017698:Postmenopause; D055105:Waist Circumference; D015431:Weight Loss; D061217:Weight Reduction Programs