Dose-response effects of aerobic exercise on energy compensation in postmenopausal women: combined results from two randomized controlled trials

Abstract

Background/objectives: Despite the clear health benefits of exercise, exercised-induced weight loss is often less than expected. The term 'exercise energy compensation' is used to define the amount of weight loss below what is expected for the amount of exercise energy expenditure. We examined the dose-response effects of exercise volume on energy compensation in postmenopausal women.

Participants/methods: Data from Alberta Physical Activity and Breast Cancer Prevention (ALPHA) and Breast Cancer and Exercise Trial in Alberta (BETA) were combined for the present analysis. The ALPHA and BETA trials were two-centred, two-armed, 12-month randomized controlled trials. The ALPHA trial included 160 participants randomized to 225 min per week of aerobic exercise, and the BETA trial randomized 200 participants to each 150 and 300 min per week of aerobic exercise. All participants were aged 50-74 years, moderately inactive (<90 min per week of exercise), had no previous cancer diagnosis and a body mass index between 22 and 40 kg m^-2. Energy compensation was based on changes in body composition (dual-energy X-ray absorptiometry scan) and estimated exercise energy expenditure from completed exercise volume. Associations between Δenergy intake, ΔVO_2peak and Δphysical activity time with energy compensation were assessed.

Results: No differences in energy compensation were noted between interventions. However, there were large inter-individual differences in energy compensation between participants; 9.4% experienced body composition changes that were greater than expected based on exercise energy expenditure, 64% experienced some degree of energy compensation and 26.6% experienced weight gain based on exercise energy expenditure. Increases in VO_2peak were associated with reductions in energy compensation (β=-3.44 ml kg^-1 min^-1, 95% confidence interval for β=-4.71 to -2.17 ml kg^-1 min^-1; P=0.0001).

Conclusions: Large inter-individual differences in energy compensation were noted, despite no differences between activity doses. In addition, increases in VO_2peak were associated with lower energy compensation. Future studies are needed to identify behavioral and metabolic factors that may contribute to this large inter-individual variability in energy compensation.

Trial registration: ClinicalTrials.gov NCT00522262 NCT01435005.

Figure 1

Differences in (a) prescribed and (b) completed exercise energy compensation between exercise interventions. Prescribed exercise energy compensation: F (2, 519)=1.79; P=0.17; Completed exercise energy compensation: F (2, 519)=0.11; P=0.90. The values are presented as means±s.e.m.

Figure 2

Distribution of completed exercise energy compensation between participants.

Figure 3

Changes in VO_2peak between completed exercise energy compensation groups. The values are presented as means±s.e.m. Note: Means not sharing the same letter are significantly different from each other (P<0.05).

Figure 4

Inverse association between completed exercise time (min per week) and completed exercise energy compensation (%). Note: participants with a mean completed exercise time <50 min per week were excluded from this Figure.