Exercise Dose Effects on Body Fat 12 Months after an Exercise Intervention: Follow-up from a Randomized Controlled Trial

Christine M Friedenreich, Yibing Ruan, Aalo Duha, Kerry S Courneya, Christine M Friedenreich, Yibing Ruan, Aalo Duha, Kerry S Courneya

Abstract

Background: Exercise interventions can result in weight loss, which is associated with reductions in disease risk. It is unknown how the volume of exercise prescribed in a one-time exercise intervention impacts long-term body fatness. We compared 24-month body fat changes among postmenopausal women previously prescribed 300 versus 150 minutes/week of exercise in a year-long exercise intervention trial.

Methods: The Breast Cancer and Exercise Trial in Alberta (BETA) was a two-centred randomized controlled trial in Alberta, Canada. The trial consisted of a 12-month intervention and 12-month observation period. For the intervention, participants were randomized to either a moderate-volume exercise group (150 min/week) or a high-volume exercise group (300 min/week). Participants in this study were 334 inactive postmenopausal women who had been followed-up to 24 months. The primary outcome for this study was 24-month change in total body fat using dual energy X-ray absorptiometry scans. Other measures included weight, waist and hip circumferences, subcutaneous and intra-abdominal fat from computed tomography scans, and lean mass. Researchers were blinded to randomization group when measuring body fat.

Results: Both groups self-reported ∼180 minutes/week moderate-vigorous activity at 24 months. No statistically significant difference was found in total body fat at 24 months between the two groups. Statistically significant effects (comparing high versus moderate groups) were found for BMI (least-square mean change (95% CI): -0.66 (-0.97, -0.36) versus -0.25 (-0.55, 0.05) kg/m2, P=0.04), waist-to-hip ratio (-0.033 (-0.040, -0.026) versus -0.023 (-0.030, -0.016), P=0.05), and subcutaneous abdominal fat area (-32.18 (-39.30, -25.06) versus -22.20 (-29.34, -15.05) cm2, P=0.04).

Conclusion: Prescribing 300 versus 150 minutes/week of exercise to inactive postmenopausal women resulted in some long-term greater decreases in measures of body composition but no overall differences in total body fat loss. This trail is registered with NCT01435005.

Figures

Figure 1
Figure 1
Flow of participants through BETA and the 24-month follow-up study, Alberta, Canada, 2010–2014.
Figure 2
Figure 2
Average fat and lifestyle measurements over time for participants with data at all time points. Sample sizes based on data availability were as follows: n=163 high, n=159 moderate for body fat measures; n=167 high, n=162 moderate for self-reported moderate–vigorous physical activity; n=133 high, n=132 moderate for objectively measured total physical activity (ActiGraph, vertical axis measure); n=123 high, n=120 moderate for objectively measured sedentary time (activPAL™; data not collected at baseline); n=169 high, n=164 moderate for self-reported dietary energy intake.

References

    1. Prospective Studies Collaboration. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–1096. doi: 10.1016/s0140-6736(09)60318-4.
    1. Emerging Risk Factors Collaboration. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet. 2011;377(9771):1085–1095. doi: 10.1016/s0140-6736(11)60105-0.
    1. Renehan A. G., Tyson M., Egger M., Heller R. F., Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. The Lancet. 2008;371(9612):569–578. doi: 10.1016/s0140-6736(08)60269-x.
    1. Neuhouser M. L., Aragaki A. K., Prentice R. L., et al. Overweight, obesity, and postmenopausal invasive breast cancer risk. JAMA Oncology. 2015;1(5):611–621. doi: 10.1001/jamaoncol.2015.1546.
    1. Fabian C. J., Kimler B. F., Donnelly J. E., et al. Favorable modulation of benign breast tissue and serum risk biomarkers is associated with >10% weight loss in postmenopausal women. Breast Cancer Research and Treatment. 2013;142(1):119–132. doi: 10.1007/s10549-013-2730-8.
    1. Toth M. J., Tchernof A., Sites C. K., Poehlman E. T. Menopause-related changes in body fat distribution. Annals of the New York Academy of Sciences. 2000;904(1):502–506. doi: 10.1111/j.1749-6632.2000.tb06506.x.
    1. Zhang M., Hu T., Zhang S., Zhou L. Associations of different adipose tissue depots with insulin resistance: a systematic review and meta-analysis of observational studies. Scientific Reports. 2015;5(1) doi: 10.1038/srep18495.18495
    1. Doyle S. L., Donohoe C. L., Lysaght J., Reynolds J. V. Visceral obesity, metabolic syndrome, insulin resistance and cancer. Proceedings of the Nutrition Society. 2011;71(1):181–189. doi: 10.1017/s002966511100320x.
    1. Greenway F. L. Physiological adaptations to weight loss and factors favouring weight regain. International Journal of Obesity. 2015;39(8):1188–1196. doi: 10.1038/ijo.2015.59.
    1. Ross R., Freeman J. A., Janssen I. Exercise alone is an effective strategy for reducing obesity and related comorbidities. Exercise and Sport Sciences Reviews. 2000;28(4):165–170.
    1. Slentz C. A., Aiken L. B., Houmard J. A., et al. Inactivity, exercise, and visceral fat. STRRIDE: a randomized, controlled study of exercise intensity and amount. Journal of Applied Physiology. 2005;99(4):1613–1618. doi: 10.1152/japplphysiol.00124.2005.
    1. Donnelly J. E., Blair S. N., Jakicic J. M., Manore M. M., Rankin J. W., Smith B. K. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine & Science in Sports & Exercise. 2009;41(2):459–471. doi: 10.1249/mss.0b013e3181949333.
    1. Sims S. T., Larson J. C., Lamonte M. J., et al. Physical activity and body mass. Medicine & Science in Sports & Exercise. 2012;44(1):89–97. doi: 10.1249/mss.0b013e318227f906.
    1. Blanck H. M., McCullough M. L., Patel A. V., et al. Sedentary behavior, recreational physical activity, and 7-year weight gain among postmenopausal U.S. Women∗. Obesity. 2007;15(6):1578–1588. doi: 10.1038/oby.2007.187.
    1. Bea J. W., Cussler E. C., Going S. B., Blew R. M., Metcalfe L. L., Lohman T. G. Resistance training predicts 6-yr body composition change in postmenopausal women. Medicine & Science in Sports & Exercise. 2010;42(7):1286–1295. doi: 10.1249/mss.0b013e3181ca8115.
    1. Wang X., Lyles M. F., You T., Berry M. J., Rejeski W. J., Nicklas B. J. Weight regain is related to decreases in physical activity during weight loss. Medicine & Science in Sports & Exercise. 2008;40(10):1781–1788. doi: 10.1249/mss.0b013e31817d8176.
    1. Mekary R. A., Feskanich D., Hu F. B., Willett W. C., Field A. E. Physical activity in relation to long-term weight maintenance after intentional weight loss in premenopausal women. Obesity. 2012;18(1):167–174. doi: 10.1038/oby.2009.170.
    1. Ross R., de Lannoy L., Stotz P. J. Separate effects of intensity and amount of exercise on interindividual cardiorespiratory fitness response. Mayo Clinic Proceedings. 2015;90(11):1506–1514. doi: 10.1016/j.mayocp.2015.07.024.
    1. Ross R., Hudson R., Stotz P. J., Lam M. Effects of exercise amount and intensity on abdominal obesity and glucose tolerance in obese adults. Annals of Internal Medicine. 2015;162(5):325–334. doi: 10.7326/m14-1189.
    1. Reichkendler M. H., Rosenkilde M., Auerbach P. L., et al. Only minor additional metabolic health benefits of high as opposed to moderate dose physical exercise in young, moderately overweight men. Obesity. 2013;22(5):1220–1232. doi: 10.1002/oby.20226.
    1. Saris W. H. M., Blair S. N., van Baak M. A., et al. How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obesity Reviews. 2003;4(2):101–114. doi: 10.1046/j.1467-789x.2003.00101.x.
    1. World Health Organization. Global Recommendations on Physical Activity for Health. Geneva, Switzerland: World Health Organization; 2011. Recommended population levels of physical activity for health; pp. 15–34.
    1. Friedenreich C. M., Neilson H. K., O’Reilly R., et al. Effects of a high vs moderate volume of aerobic exercise on adiposity outcomes in postmenopausal women. JAMA Oncology. 2015;1(6):766–776. doi: 10.1001/jamaoncol.2015.2239.
    1. Tate D. F., Jeffery R. W., Sherwood N. E., Wing R. R. Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? The American Journal of Clinical Nutrition. 2007;85(4):954–959. doi: 10.1093/ajcn/85.4.954.
    1. Friedenreich C. M., MacLaughlin S., Neilson H. K., et al. Study design and methods for the breast cancer and exercise trial in Alberta (BETA) BMC Cancer. 2014;14(1):p. 919. doi: 10.1186/1471-2407-14-919.
    1. McNeil J., Farris M. S., Ruan Y., et al. Effects of prescribed aerobic exercise volume on physical activity and sedentary time in postmenopausal women: a randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity. 2018;15(1):p. 27. doi: 10.1186/s12966-018-0659-3.
    1. Pollock M. L., Foster C., Schmidt D., Hellman C., Linnerud A. C., Ward A. Comparative analysis of physiologic responses to three different maximal graded exercise test protocols in healthy women. American Heart Journal. 1982;103(3):363–373. doi: 10.1016/0002-8703(82)90275-7.
    1. National Institutes of Health. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obesity Research & Clinical Practice. 1998;6(2):51–209.
    1. Shepherd J. A., Fan B., Lu Y., et al. A multinational study to develop universal standardization of whole-body bone density and composition using GE Healthcare Lunar and Hologic DXA systems. Journal of Bone and Mineral Research. 2012;27(10):2208–2216. doi: 10.1002/jbmr.1654.
    1. Friedenreich C. M., Courneya K. S., Neilson H. K., et al. Reliability and validity of the past year total physical activity questionnaire. American Journal of Epidemiology. 2006;163(10):959–970. doi: 10.1093/aje/kwj112.
    1. Csizmadi I., Kahle L., Ullman R., et al. Adaptation and evaluation of the national cancer institute’s dietary history questionnaire and nutrient database for Canadian populations. Public Health Nutrition. 2007;10(1):88–96. doi: 10.1017/s1368980007184287.
    1. Ainsworth B. E., Haskell W. L., Herrmann S. D., et al. Compendium of Physical Activities: a second update of codes and MET values. Medicine & Science in Sports & Exercise. 2011;43(8):1575–1581. doi: 10.1249/mss.0b013e31821ece12.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Vol. 2. New York, NY, USA: Academic Press; 1988.
    1. Stevens J., Truesdale K. P., McClain J. E., Cai J. The definition of weight maintenance. International Journal of Obesity. 2006;30(3):391–399. doi: 10.1038/sj.ijo.0803175.
    1. Catenacci V. A., Odgen L., Phelan S., et al. Dietary habits and weight maintenance success in high versus low exercisers in the National Weight Control Registry. Journal of Physical Activity and Health. 2014;11(8):1540–1548. doi: 10.1123/jpah.2012-0250.
    1. de Roon M., van Gemert W. A., Peeters P. H., Schuit A. J., Monninkhof E. M. Long-term effects of a weight loss intervention with or without exercise component in postmenopausal women: a randomized trial. Preventive Medicine Reports. 2017;5:118–123. doi: 10.1016/j.pmedr.2016.12.006.
    1. Mora-Rodriguez R., Ortega J. F., Hamouti N., et al. Time-course effects of aerobic interval training and detraining in patients with metabolic syndrome. Nutrition, Metabolism and Cardiovascular Diseases. 2014;24(7):792–798. doi: 10.1016/j.numecd.2014.01.011.
    1. Opdenacker J., Delecluse C., Boen F. A 2-year follow-up of a lifestyle physical activity versus a structured exercise intervention in older adults. Journal of the American Geriatrics Society. 2011;59(9):1602–1611. doi: 10.1111/j.1532-5415.2011.03551.x.
    1. Douda H. T., Kosmidou K. V., Smilios I., Volaklis K. A., Tokmakidis S. P. Community-based training-detraining intervention in older women: a five-year follow-up study. Journal of Aging and Physical Activity. 2015;23(4):496–512. doi: 10.1123/japa.2013-0241.
    1. Delshad M., Ghanbarian A., Mehrabi Y., Sarvghadi F., Ebrahim K. Effect of strength training and short-term detraining on muscle mass in women aged over 50 Years old. International Journal of Preventive Medicine. 2013;4(12):1386–1394.
    1. Koga R., Sakata T., Tanaka M., et al. Daily exercise fluctuations and dietary patterns during training predict visceral fat regain in obese women. American Journal of the Medical Sciences. 2008;336(6):450–457. doi: 10.1097/maj.0b013e31817242a5.
    1. Hunter G. R., Brock D. W., Byrne N. M., et al. Exercise training prevents regain of visceral fat for 1 year following weight loss. Obesity. 2010;18(4):690–695. doi: 10.1038/oby.2009.316.
    1. Jeffery R. W., Wing R. R., Sherwood N. E., Tate D. F. Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? American Journal of Clinical Nutrition. 2003;78(4):684–689. doi: 10.1093/ajcn/78.4.684.

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