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Randomized Controlled Trial
. 2009;4(2):e4515.
doi: 10.1371/journal.pone.0004515. Epub 2009 Feb 18.

Changes in weight, waist circumference and compensatory responses with different doses of exercise among sedentary, overweight postmenopausal women

Timothy S Church  1 , Corby K Martin, Angela M Thompson, Conrad P Earnest, Catherine R Mikus, Steven N Blair
Affiliations
Randomized Controlled Trial

Changes in weight, waist circumference and compensatory responses with different doses of exercise among sedentary, overweight postmenopausal women

Timothy S Church et al. PLoS One. 2009.

Abstract

Background: It has been suggested that exercise training results in compensatory mechanisms that attenuate weight loss. However, this has only been examined with large doses of exercise. The goal of this analysis was to examine actual weight loss compared to predicted weight loss (compensation) across different doses of exercise in a controlled trial of sedentary, overweight or obese postmenopausal women (n = 411).

Methodology/principal findings: Participants were randomized to a non-exercise control (n = 94) or 1 of 3 exercise groups; exercise energy expenditure of 4 (n = 139), 8 (n = 85), or 12 (n = 93) kcal/kg/week (KKW). Training intensity was set at the heart rate associated with 50% of each woman's peak VO(2) and the intervention period was 6 months. All exercise was supervised. The main outcomes were actual weight loss, predicted weight loss (exercise energy expenditure/ 7700 kcal per kg), compensation (actual minus predicted weight loss) and waist circumference. The study sample had a mean (SD) age 57.2 (6.3) years, BMI of 31.7 (3.8) kg/m(2), and was 63.5% Caucasian. The adherence to the intervention was >99% in all exercise groups. The mean (95% CI) weight loss in the 4, 8 and 12 KKW groups was -1.4 (-2.0, -0.8), -2.1 (-2.9, -1.4) and -1.5 (-2.2, -0.8) kg, respectively. In the 4 and 8 KKW groups the actual weight loss closely matched the predicted weight loss of -1.0 and -2.0 kg, respectively, resulting in no significant compensation. In the 12 KKW group the actual weight loss was less than the predicted weight loss (-2.7 kg) resulting in 1.2 (0.5, 1.9) kg of compensation (P<0.05 compared to 4 and 8 KKW groups). All exercise groups had a significant reduction in waist circumference which was independent of changes in weight.

Conclusion: In this study of previously sedentary, overweight or obese, postmenopausal women we observed no difference in the actual and predicted weight loss with 4 and 8 KKW of exercise (72 and 136 minutes respectively), while the 12 KKW (194 minutes) produced only about half of the predicted weight loss. However, all exercise groups had a significant reduction in waist circumference which was independent of changes in weight.

Trial registration: (ClinicalTrials.gov) NCT00011193.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Participant flow diagram.
Figure 2
Figure 2. Distribution of weight loss for each study group.
Figure 3
Figure 3. Actual weight loss (white bars) and predicted weight loss (black bars) for each study group.
Actual weight loss was adjusted for age, baseline weight and ethnicity. Predicted weight loss represents caloric expenditure from supervised exercise divided by 7700 kcal/kg. Error bars represent 95 percent confidence intervals.
Figure 4
Figure 4. The top panel depicts weight compensation (actual weight loss minus predicted weight loss) across exercise groups.
The middle panel depicts the prevalence of compensation across exercise groups and the lower panel presents the percent of predicted weight loss for each exercise group. All values adjusted for age and ethnicity. Error bars in the top panel represent 95 percent confidence intervals.
Figure 5
Figure 5. Predicted weight loss and actual weight loss are presented in the left column while compensation is presented in the right column for each exercise group during weeks 1 through 23 of the intervention period.
This analysis was limited to individuals with at least 19 weeks with recorded weights and for missing values the weight from the previous week was carried forward. This resulted in 132, 84 and 87 participants used in the analysis for the 4, 8 and 12 KKW groups, respectively. It should be noted that exercise during week's 1–4 for the 8 KKW group and weeks 1–8 for the 12 KKW group were not performed at the full dose as these weeks were part of the exercise dose ramping phase. For compensation, statistical deviation from zero for each week was tested using ANOVAs with adjustment for multiple comparisons.
Figure 6
Figure 6. Change in waist circumference for each group with (diagonal striped) and without (open) adjustment for change in weight.
The change in waist circumference was significantly different from control for each exercise groups in both analyses. All values adjusted for age and ethnicity. Error bars in the top panel represent 95 percent confidence intervals.
Figure 7
Figure 7. Changes in waist circumference within stratifications of weight compensation and weight loss with the all data from the exercise groups combined.
The set of bars to the left represent change in waist circumference with categorization by weight compensation (yes/no) and set of bars to the right represent categorization by weight loss (yes/no). All values adjusted for age and ethnicity. Error bars in the top panel represent 95 percent confidence intervals.
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