title: Multilevel Approach of a 1-Year Program of Dietary and Exercise Interventions on Bone Mineral Content and Density in Metabolic Syndrome--the RESOLVE Randomized Controlled Trial.
abstract: BACKGROUND
  Weight loss is a public health concern in obesity-related diseases such as metabolic syndrome (MetS). However, restrictive diets might induce bone loss. The nature of exercise and whether exercise with weight loss programs can protect against potential bone mass deficits remains unclear. Moreover, compliance is essential in intervention programs. Thus, we aimed to investigate the effects that modality and exercise compliance have on bone mineral content (BMC) and density (BMD).
  
  
  METHODS
  We investigated 90 individuals with MetS who were recruited for the 1-year RESOLVE trial. Community-dwelling seniors with MetS were randomly assigned into three different modalities of exercise (intensive resistance, intensive endurance, moderate mixed) combined with a restrictive diet. They were compared to 44 healthy controls who did not undergo the intervention.
  
  
  RESULTS
  This intensive lifestyle intervention (15-20 hours of training/week + restrictive diet) resulted in weight loss, body composition changes and health improvements. Baseline BMC and BMD for total body, lumbar spine and femoral neck did not differ between MetS groups and between MetS and controls. Despite changes over time, BMC or BMD did not differ between the three modalities of exercise and when compared with the controls. However, independent of exercise modality, compliant participants increased their BMC and BMD compared with their less compliant peers. Decreases in total body lean mass and negative energy balance significantly and independently contributed to decreases in lumbar spine BMC.
  
  
  CONCLUSIONS
  After the one year intervention, differences relating to exercise modalities were not evident. However, compliance with an intensive exercise program resulted in a significantly higher bone mass during energy restriction than non-compliance. Exercise is therefore beneficial to bone in the context of a weight loss program.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00917917.
authors.affiliation: Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France; Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia; Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Courteix
authors.affiliation: Lusófona University of Humanities and Technologies, Faculty of Physical Education and Sport, Lisbon, Portugal; University of Coimbra, Faculty of Sport Sciences and Physical Education, Research Unit for Sport and Physical Activity (CIDAF), Coimbra, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Valente-dos-Santos
authors.affiliation: Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France; Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Ferry
authors.affiliation: Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France; Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Lac
authors.affiliation: Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France; Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France; Auvergne University, Faculty of Medicine, Geriatric, Clermont-Ferrand, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lesourd
authors.affiliation: Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France; Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Chapier
authors.affiliation: Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Naughton
authors.affiliation: University Hospital of Clermont-Ferrand (CHU), Biochemistry, Clermont-Ferrand, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Marceau
authors.affiliation: University of Coimbra, Faculty of Sport Sciences and Physical Education, Research Unit for Sport and Physical Activity (CIDAF), Coimbra, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: João Coelho-e-Silva
authors.affiliation: Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Vinet
authors.affiliation: Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Walther
authors.affiliation: Laboratory of Pharm-Ecology Cardiovascular (EA4278), University of Avignon, Avignon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Obert
authors.affiliation: Clermont Auvergne University, Blaise Pascal University, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France; Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria, Australia; Research Centre in Human Nutrition (CRNH) Auvergne, Clermont-Ferrand, France; University Hospital of Clermont-Ferrand (CHU), Preventive and Occupational Medicine, Clermont-Ferrand, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dutheil
mesh_terms: D015519:Bone Density; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy* / Q000503:physiopathology*; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data