Effect of diet with or without exercise on abdominal fat in postmenopausal women - a randomised trial

Willemijn A van Gemert, Petra H Peeters, Anne M May, Adriaan J H Doornbos, Sjoerd G Elias, Job van der Palen, Wouter Veldhuis, Maaike Stapper, Jantine A Schuit, Evelyn M Monninkhof, Willemijn A van Gemert, Petra H Peeters, Anne M May, Adriaan J H Doornbos, Sjoerd G Elias, Job van der Palen, Wouter Veldhuis, Maaike Stapper, Jantine A Schuit, Evelyn M Monninkhof

Abstract

Background: We assessed the effect of equivalent weight loss with or without exercise on (intra-) abdominal fat in postmenopausal women in the SHAPE-2 study.

Methods: The SHAPE-2 study is a three-armed randomised controlled trial conducted in 2012-2013 in the Netherlands. Postmenopausal overweight women were randomized to a diet (n = 97), exercise plus diet (n = 98) or control group (n = 48). Both intervention groups aimed for equivalent weight loss (6-7%) following a calorie-restricted diet (diet group) or a partly supervised intensive exercise programme (4 h per week) combined with a small caloric restriction (exercise plus diet group). Outcomes after 16 weeks are amount and distribution of abdominal fat, measured by magnetic resonance imaging (MRI) with the use of the three-point IDEAL Dixon method.

Results: The diet and exercise plus diet group lost 6.1 and 6.9% body weight, respectively. Compared to controls, subcutaneous and intra-abdominal fat reduced significantly with both diet (- 12.5% and - 12.0%) and exercise plus diet (- 16.0% and - 14.6%). Direct comparison between both interventions revealed that the reduction in subcutaneous fat was statistically significantly larger in the group that combined exercise with diet: an additional 10.6 cm2 (95%CI -18.7; - 2.4) was lost compared to the diet-only group. Intra-abdominal fat loss was not significantly larger in the exercise plus diet group (- 3.8 cm2, 95%CI -9.0; 1.3).

Conclusions: We conclude that weight loss of 6-7% with diet or with exercise plus diet reduced both subcutaneous and intra-abdominal fat. Only subcutaneous fat statistically significantly reduced to a larger extent when exercise is combined with a small caloric restriction.

Trial register: NCT01511276 (clinicaltrials.gov), prospectively registered.

Keywords: Exercise; Intra-abdominal fat; Subcutaneous fat; Weight loss.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the ethical committee of the University Medical Center Utrecht. All participants provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of the inclusion, random assignment, and follow-up of the SHAPE-2 study participants. Legend: The SHAPE-2 study is a three-armed RCT conducted in 2012–2013 in the Netherlands

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