Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial

Willemijn A M van Gemert, Job van der Palen, Evelyn M Monninkhof, Anouk Rozeboom, Roelof Peters, Harriet Wittink, Albertine J Schuit, Petra H Peeters, Willemijn A M van Gemert, Job van der Palen, Evelyn M Monninkhof, Anouk Rozeboom, Roelof Peters, Harriet Wittink, Albertine J Schuit, Petra H Peeters

Abstract

Introduction: 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.

Conclusion: 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.

Trial registration: ClinicalTrials.gov NCT01511276.

Conflict of interest statement

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

Figures

Fig 1. Flow-chart of the inclusion, random…
Fig 1. Flow-chart of the inclusion, random assignment, and follow-up of the SHAPE-2 study participants.

References

    1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014.
    1. World Health Organization. Fact sheet on obesity and overweight. 2013. Available: .
    1. Fontaine KR, Barofsky I. Obesity and health-related quality of life. Obes Rev. 2001; 2: 173–182.
    1. Muennig P, Lubetkin E, Jia H, Franks P. Gender and the burden of disease attributable to obesity. Am J Public Health. 2006; 96: 1662–1668.
    1. World Cancer Research Fund, American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC; 2007.
    1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. 2014. Lyon, France: International Agency for Research on Cancer; 2013. Available: .
    1. Jones GL, Sutton A. Quality of life in obese postmenopausal women. Menopause Int. 2008; 14: 26–32. 10.1258/mi.2007.007034
    1. Warkentin LM, Das D, Majumdar SR, Johnson JA, Padwal RS. The effect of weight loss on health-related quality of life: systematic review and meta-analysis of randomized trials. Obes Rev. 2014; 15: 169–182. 10.1111/obr.12113
    1. Maciejewski ML, Patrick DL, Williamson DF. A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. J Clin Epidemiol. 2005; 58: 568–578.
    1. Asbury EA, Chandrruangphen P, Collins P. The importance of continued exercise participation in quality of life and psychological well-being in previously inactive postmenopausal women: a pilot study. Menopause. 2006; 13: 561–567.
    1. Teoman N, Ozcan A, Acar B. The effect of exercise on physical fitness and quality of life in postmenopausal women. Maturitas. 2004; 47: 71–77.
    1. Bowen DJ, Fesinmeyer MD, Yasui Y, Tworoger S, Ulrich CM, Irwin ML et al. Randomized trial of exercise in sedentary middle aged women: effects on quality of life. Int J Behav Nutr Phys Act. 2006; 3: 34
    1. Martin CK, Church TS, Thompson AM, Earnest CP, Blair SN. Exercise dose and quality of life: a randomized controlled trial. Arch Intern Med. 2009; 169: 269–278. 10.1001/archinternmed.2008.545
    1. van Gemert WA, Iestra JI, Schuit AJ, May AM, Takken T, Veldhuis WB et al. Design of the SHAPE-2 study: the effect of physical activity, in addition to weight loss, on biomarkers of postmenopausal breast cancer risk. BMC Cancer. 2013; 13: 395 10.1186/1471-2407-13-395
    1. Health Council of the Netherlands. Guidelines for a healthy diet. 2006. Available:
    1. Roza AM, Shizgal HM. The Harris Benedict equation reevaluated: resting energy requirements and the body cell mass. Am J Clin Nutr. 1984; 40: 168–182.
    1. Armstrong MJ, Mottershead TA, Ronksley PE, Sigal RJ, Campbell TS, Hemmelgarn BR. Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2011; 12: 709–723. 10.1111/j.1467-789X.2011.00892.x
    1. Shaw K, O'Rourke P, Del MC, Kenardy J. Psychological interventions for overweight or obesity. Cochrane Database Syst Rev. 2005; CD003818.
    1. Wendel-Vos GC, Schuit AJ, Saris WH, Kromhout D. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003; 56: 1163–1169.
    1. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide Boston, MA: New England Medical Center, The Health Institute; 1993.
    1. Ware JE, Kosinski M, Keller SD. SF-36 Physical and Mental Health Summary Scales: A User's Manual, in The Health Data Institute of New England Medical Center, Boston, Nimrod: 1994.
    1. VanderZee KI, Sanderman R, Heyink JW, de HH. Psychometric qualities of the RAND 36-Item Health Survey 1.0: a multidimensional measure of general health status. Int J Behav Med. 1996; 3: 104–122.
    1. Lyons RA, Perry HM, Littlepage BN. Evidence for the validity of the Short-form 36 Questionnaire (SF-36) in an elderly population. Age Ageing. 1994; 23: 182–184.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences New York, NY: Lawrence Erlbaum Publishers; 10.1002/bs.3830330104 1988.
    1. Perneger TV, Etter JF, Rougemont. A Prospective versus retrospective measurement of change in health status: a community based study in Geneva, Switzerland. J Epidemiol Community Health. 1997; 51: 320–325.
    1. Ware JE Jr., Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998; 51: 903–912.
    1. Jenkinson CM, Doherty M, Avery AJ, Read A, Taylor MA, Sach TH et al. Effects of dietary intervention and quadriceps strengthening exercises on pain and function in overweight people with knee pain: randomised controlled trial. BMJ. 2009; 339: b3170 10.1136/bmj.b3170
    1. Rejeski WJ, Focht BC, Messier SP, Morgan T, Pahor M, Penninx B. Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Health Psychol. 2002; 21: 419–426.
    1. Imayama I, Alfano CM, Kong A, Foster-Schubert KE, Bain CE, Xiao L et al. Dietary weight loss and exercise interventions effects on quality of life in overweight/obese postmenopausal women: a randomized controlled trial. Int J Behav Nutr Phys Act. 2011; 8: 118 10.1186/1479-5868-8-118
    1. Ross KM, Milsom VA, Rickel KA, Debraganza N, Gibbons LM, Murawski ME et al. The contributions of weight loss and increased physical fitness to improvements in health-related quality of life. Eat Behav. 2009; 10: 84–88. 10.1016/j.eatbeh.2008.12.002
    1. Blissmer B, Riebe D, Dye G, Ruggiero L, Greene G, Caldwell M. Health-related quality of life following a clinical weight loss intervention among overweight and obese adults: intervention and 24 month follow-up effects. Health Qual Life Outcomes. 2006; 4: 43
    1. Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, rmamento-Villareal R et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011; 364: 1218–1229. 10.1056/NEJMoa1008234
    1. Gusi N, Reyes MC, Gonzalez-Guerrero JL, Herrera E, Garcia JM. Cost-utility of a walking programme for moderately depressed, obese, or overweight elderly women in primary care: a randomised controlled trial. BMC Public Health. 2008; 8: 231 10.1186/1471-2458-8-231

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