title: The effects of exercise training in addition to energy restriction on functional capacities and body composition in obese adults during weight loss: a systematic review.
abstract: BACKGROUND
  Obesity is associated with impairments of physical function, cardiovascular fitness, muscle strength and the capacity to perform activities of daily living. This review examines the specific effects of exercise training in relation to body composition and physical function demonstrated by changes in cardiovascular fitness, and muscle strength when obese adults undergo energy restriction.
  
  
  METHODS
  Electronic databases were searched for randomised controlled trials comparing energy restriction plus exercise training to energy restriction alone. Studies published to May 2013 were included if they used multi-component methods for analysing body composition and assessed measures of fitness in obese adults.
  
  
  RESULTS
  Fourteen RCTs met the inclusion criteria. Heterogeneity of study characteristics prevented meta-analysis. Energy restriction plus exercise training was more effective than energy restriction alone for improving cardiovascular fitness, muscle strength, and increasing fat mass loss and preserving lean body mass, depending on the type of exercise training.
  
  
  CONCLUSIONS
  Adding exercise training to energy restriction for obese middle-aged and older individuals results in favourable changes to fitness and body composition. Whilst weight loss should be encouraged for obese individuals, exercise training should be included in lifestyle interventions as it offers additional benefits.
authors.affiliation: Centre for Exercise and Sports Science, School of Exercise & Nutrition Sciences, Deakin University, Melbourne, Australia.
authors.forename: Clint T
authors.initials: CT
authors.lastname: Miller
authors.affiliation: Centre for Exercise and Sports Science, School of Exercise & Nutrition Sciences, Deakin University, Melbourne, Australia.
authors.forename: Steve F
authors.initials: SF
authors.lastname: Fraser
authors.affiliation: Institute for Sport, Exercise and Active Living (ISEAL), School of Sport and Exercise Science, Victoria University, Melbourne, Australia.
authors.forename: Itamar
authors.initials: I
authors.lastname: Levinger
authors.affiliation: Human Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute, Melbourne, Victoria, Australia.
authors.forename: Nora E
authors.initials: NE
authors.lastname: Straznicky
authors.affiliation: Clinical Obesity Research Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: John B
authors.initials: JB
authors.lastname: Dixon
authors.affiliation: Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Reynolds
authors.affiliation: Centre for Exercise and Sports Science, School of Exercise & Nutrition Sciences, Deakin University, Melbourne, Australia.
authors.forename: Steve E
authors.initials: SE
authors.lastname: Selig
mesh_terms: D000328:Adult; D001823:Body Composition / Q000502:physiology*; D031204:Caloric Restriction; D015444:Exercise / Q000502:physiology*; D006801:Humans; D009765:Obesity / Q000378:metabolism*; D015431:Weight Loss / Q000502:physiology*