Effect of an energy-restrictive diet, with or without exercise, on lean tissue mass, resting metabolic rate, cardiovascular risk factors, and bone in overweight postmenopausal women

Svendsen, Ole Lander; Hassager, Christian; Christiansen, Cindy L.

doi:10.1016/0002-9343(93)90253-l

Cited by 233 publications

(211 citation statements)

References 30 publications

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“…In agreement with previous studies in overweight premenopausal women (13)(14)(15)49), postmenopausal women (17,50), and men (15,51), in this study, the addition of aerobic or resistance exercise to the energy-restrictive diet did not enhance the changes in the lipid profile. Common to these studies, diet and exercise combined was not associated with an increase in weight loss compared with diet alone.…”

Section: Effects Of Weight Loss On Metabolic Risk Factorssupporting

confidence: 93%

Effects of an Energy-Restrictive Diet With or Without Exercise on Abdominal Fat, Intermuscular Fat, and Metabolic Risk Factors in Obese Women

Janssen

Fortier²,

Hudson³

et al. 2002

Diabetes Care

267

212

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OBJECTIVE -The primary objective was to examine whether the combination of diet and aerobic exercise (DA) or diet and resistance exercise (DR) is associated with greater improvements in metabolic risk factors by comparison to diet only (DO) in obese women. A second objective considered whether reductions in metabolic risk factors are related to concurrent changes in abdominal and/or intermuscular fat distribution. RESEARCH DESIGN AND METHODS-A total of 38 premenopausal obese women were randomly assigned to one of three 16-week treatments: DO (n ϭ 13), DA (n ϭ 11), or DR (n ϭ 14). Plasma glucose, insulin, and lipid levels were measured in a fasting state and after a 75-g oral glucose challenge (oral glucose tolerance test [OGTT]). Total, abdominal subcutaneous, visceral, and intermuscular fat were measured by magnetic resonance imaging.RESULTS -Significant reductions (P Ͻ 0.02) in body weight (ϳ10 kg or 10%) and in total, abdominal subcutaneous, visceral, and intermuscular fat were observed within each group. Fasting and OGTT insulin, total cholesterol, LDL cholesterol, and apolipoprotein B also decreased within each group (P Յ 0.02). The changes in the body fat and metabolic variables were not different across treatment (P Ͼ 0.05). Visceral fat alone was related to the metabolic risk factors both before and after the treatment.CONCLUSIONS -Weight loss was associated with reductions in metabolic risk factors in obese women. The improvement in the metabolic profile was not enhanced by the addition of aerobic or resistance exercise. The findings reinforce the importance of diminished visceral fat in the treatment of insulin resistance. Diabetes Care 25:431-438, 2002T he prevalence of obesity and associated comorbidities is increasing (1,2), which underscores the importance of developing effective strategies for reducing obesity and the risk of metabolic disease in women. Diet-induced weight loss (3-5) as well as aerobic exercise (6 -8) and resistance exercise (7-9) are effective treatments for reducing metabolic risk factors in women. Although these observations suggest that the combination of diet and exercise would have a greater effect on metabolic risk factors than weight loss alone, the influence of diet and exercise combined in women is unclear. Whereas some studies report greater improvements in the plasma lipid profile in response to the combination of diet and exercise than diet alone (10 -12), others report no treatment differences (13-15). It is also reported that the addition of aerobic (16,17) or resistance (16) exercise does not enhance the reductions in plasma insulin and glucose levels in comparison to diet alone in obese women. These observations do not reflect those in a recent report in obese men wherein a twofold greater improvement in insulin action was observed in response to diet combined with aerobic or resistance exercise than diet alone (18). A rationale that explains the equivocal findings is unknown; however, taken together, these observations suggest that the utility of exercise to enha...

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Section: Effects Of Weight Loss On Metabolic Risk Factorssupporting

confidence: 93%

Effects of an Energy-Restrictive Diet With or Without Exercise on Abdominal Fat, Intermuscular Fat, and Metabolic Risk Factors in Obese Women

Janssen

Fortier²,

Hudson³

et al. 2002

Diabetes Care

267

212

View full text Add to dashboard Cite

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“…Generally noted, the positive effect of excess EI, resulting in overweight, on BMD may be due to weight-bearing forces exerted on the skeleton (Harris & Dawson-Hughes, 1996). Likewise, moderate weight loss often results in some bone loss (Svendsen et al, 1993). However, it is much harder to distinguish between the effects of energy per se and that of either increased or decreased weight as a result of over-or under-consumption.…”

Section: Confounding Factorsmentioning

confidence: 99%

Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density

2003

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Objective: Nutrition is an important factor in the prevention and treatment of osteoporosis. Our goal was to examine the relationship between various nutrients and bone mass of several skeletal sites in elderly women, taking into account possible confounding variables. Design/methods: A cross-sectional study in 136 healthy Caucasian, postmenopausal women, free of medications known to affect bone was carried out. Bone mineral density (BMD) and body composition (lean and fat tissue) were measured by dual X-ray absorptiometry using specialized software for different skeletal sites. Parathyroid hormone (PTH) and vitamin D, 25(OH)D, as possible confounders, were determined in serum samples. Dietary intake, including all supplements, was assessed by 3-day dietary record and analyzed using Food Processor 1 . Past physical activity and present walking were examined as well and accounted for as potential confounders. Simple and multiple regression models were created to assess the relationships between nutrients and BMD. To examine the co-linear variables and their possible independent association with bone, subgroup analyses were performed. Results: Showed independent influence of calcium, energy, and protein, examined separately and in multiple regression models on BMD of several skeletal sites. Magnesium, zinc and vitamin C were significantly related to BMD of several skeletal sites in multiple regression models (controlled for age, fat and lean tissue, physical activity and energy intake), each contributing more than 1% of variance. Serum PTH and 25(OH)D did not show significant association with bone mass. Conclusions: Despite the cross-sectional nature of our study we were able to show a significant relationship between BMD and several critical nutrients: energy, protein, calcium, magnesium, zinc and vitamin C. The exact involvement of these nutrients and their clinical significance in bone health need to be further elucidated in humans and conclusions about the effects of a single nutrient on bone mass must be given cautiously, taking into account its interaction and co-linearity with others. Understanding relationships among nutrients, not just limited to calcium and vitamin D, but others that have not been investigated to such extent, is an important step toward identifying preventive measures for bone loss and prevention of osteoporosis.

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“…Of the studies that have investigated changes in bone mass in response to diet-induced weight loss in overweight or obese adults, the results have been highly variable, with increases, (20)(21)(22)(23)(24) decreases, (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) and no change (22,24,26,30,33,(41)(42)(43)(44)(45)(46)(47)(48)(49) in bone mass being reported. Thus, attempting to draw sound conclusions from these mixed results is extremely difficult.…”

Section: Introductionmentioning

confidence: 99%

Does Diet-Induced Weight Loss Lead to Bone Loss in Overweight or Obese Adults? A Systematic Review and Meta-Analysis of Clinical Trials

Zibellini

Seimon

Lee

et al. 2015

Journal of Bone and Mineral Research

113

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Diet-induced weight loss has been suggested to be harmful to bone health. We conducted a systematic review and meta-analysis (using a random-effects model) to quantify the effect of diet-induced weight loss on bone. We included 41 publications involving overweight or obese but otherwise healthy adults who followed a dietary weight-loss intervention. The primary outcomes examined were changes from baseline in total hip, lumbar spine, and total body bone mineral density (BMD), as assessed by dual-energy X-ray absorptiometry (DXA). Secondary outcomes were markers of bone turnover. Diet-induced weight loss was associated with significant decreases of 0.010 to 0.015 g/cm 2 in total hip BMD for interventions of 6, 12, or 24 (but not 3) months' duration (95% confidence intervals [CIs], -0.014 to -0.005, -0.021 to -0.008, and -0.024 to -0.000 g/cm 2 , at 6, 12, and 24 months, respectively). There was, however, no statistically significant effect of diet-induced weight loss on lumbar spine or whole-body BMD for interventions of 3 to 24 months' duration, except for a significant decrease in total body BMD (-0.011 g/cm 2 ; 95% CI, -0.018 to -0.003 g/cm 2 ) after 6 months. Although no statistically significant changes occurred in serum concentrations of N-terminal propeptide of type I procollagen (P1NP), interventions of 2 or 3 months in duration (but not of 6, 12, or 24 months' duration) induced significant increases in serum concentrations of osteocalcin (0.26 nmol/L; 95% CI, 0.13 to 0.39 nmol/L), C-terminal telopeptide of type I collagen (CTX) (4.72 nmol/L; 95% CI, 2.12 to 7.30 nmol/L) or N-terminal telopeptide of type I collagen (NTX) (3.70 nmol/L; 95% CI, 0.90 to 6.50 nmol/L bone collagen equivalents [BCEs]), indicating an early effect of diet-induced weight loss to promote bone breakdown. These data show that in overweight and obese individuals, a single diet-induced weight-loss intervention induces a small decrease in total hip BMD, but not lumbar spine BMD. This decrease is small in comparison to known metabolic benefits of losing excess weight.

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Effect of an energy-restrictive diet, with or without exercise, on lean tissue mass, resting metabolic rate, cardiovascular risk factors, and bone in overweight postmenopausal women

Cited by 233 publications

References 30 publications

Effects of an Energy-Restrictive Diet With or Without Exercise on Abdominal Fat, Intermuscular Fat, and Metabolic Risk Factors in Obese Women

Effects of an Energy-Restrictive Diet With or Without Exercise on Abdominal Fat, Intermuscular Fat, and Metabolic Risk Factors in Obese Women

Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density

Does Diet-Induced Weight Loss Lead to Bone Loss in Overweight or Obese Adults? A Systematic Review and Meta-Analysis of Clinical Trials

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