title: Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial.
abstract: BACKGROUND
  This study investigates the effect of a modest weight loss either by a calorie restricted diet or mainly by increased physical exercise on health related quality of life (HRQoL) in overweight-to-obese and inactive postmenopausal women. We hypothesize that HRQoL improves with weight loss, and that exercise-induced weight loss is more effective for this than diet-induced weight loss.
  
  
  METHODS
  The SHAPE-2 trial was primarily designed to evaluate any additional effect of weight loss by exercise compared with a comparable amount of weight loss by diet on biomarkers relevant for breast cancer risk. In the present analysis we focus on HRQoL. We randomly assigned 243 eligible women to a diet (n = 97), exercise (n = 98), or control group (n = 48). Both interventions aimed for 5-6 kg weight loss. HRQoL was measured at baseline and after 16 weeks by the SF-36 questionnaire.
  
  
  RESULTS
  Data of 214 women were available for analysis. Weight loss was 4.9 kg (6.1%) and 5.5 kg (6.9%) with diet and exercise, respectively. Scores of the SF-36 domain 'health change' increased significantly by 8.8 points (95% CI 1.6;16.1) with diet, and by 20.5 points (95% CI 13.2;27.7) with exercise when compared with control. Direct comparison of diet and exercise showed a statistically significantly stronger improvement with exercise. Both intervention groups showed a tendency towards improvements in most other domains, which were more pronounced in the exercise group, but not statistically different from control or each other.
  
  
  CONCLUSIONS
  In a randomized trial in overweight-to-obese and inactive postmenopausal women a comparable 6%-7% weight loss was achieved by diet-only or mainly by exercise and showed improvements in physical and mental HRQoL domains, but results were not statistically significant in either the diet or exercise group. However, a modest weight loss does lead to a positive change in self-perceived health status. This effect was significantly larger with exercise-induced weight loss than with comparable diet-induced weight loss.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01511276.
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands.
authors.forename: Willemijn A M
authors.initials: WA
authors.lastname: van Gemert
authors.affiliation: Medisch Spectrum Twente Hospital, Department of Epidemiology, P.O. Box 50000, 7500 KA, Enschede, the Netherlands; University of Twente, Department of Research Methodology, Measurement, and Data Analysis, P.O. Box 217, 7500 AE, Enschede, the Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands.
authors.forename: Evelyn M
authors.initials: EM
authors.lastname: Monninkhof
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands.
authors.forename: Anouk
authors.initials: A
authors.lastname: Rozeboom
authors.affiliation: Utrecht University of Applied Sciences, Research group Lifestyle and Health, Faculty of Health Care, P.O. Box 85182, 3508 AD, Utrecht, the Netherlands.
authors.forename: Roelof
authors.initials: R
authors.lastname: Peters
authors.affiliation: Utrecht University of Applied Sciences, Research group Lifestyle and Health, Faculty of Health Care, P.O. Box 85182, 3508 AD, Utrecht, the Netherlands.
authors.forename: Harriet
authors.initials: H
authors.lastname: Wittink
authors.affiliation: National Institute for Public Health and the Environment, Division of Public Health and Health Care, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands; VU University, Department of Health Sciences and EMGO Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
authors.forename: Albertine J
authors.initials: AJ
authors.lastname: Schuit
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands.
authors.forename: Petra H
authors.initials: PH
authors.lastname: Peeters
mesh_terms: D015415:Biomarkers / Q000097:blood; D004032:Diet; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood*; D050177:Overweight / Q000097:blood*; D017698:Postmenopause; D011788:Quality of Life; D015431:Weight Loss / Q000502:physiology
chemical_list: D015415:Biomarkers