Effect of Aerobic Exercise Intensity on Energy Expenditure and Weight Loss in Severe Obesity-A Randomized Controlled Trial

Jarle Berge, Jøran Hjelmesaeth, Jens K Hertel, Espen Gjevestad, Milada Cvancarova Småstuen, Line Kristin Johnson, Catia Martins, Eivind Andersen, Jan Helgerud, Øyvind Støren, Jarle Berge, Jøran Hjelmesaeth, Jens K Hertel, Espen Gjevestad, Milada Cvancarova Småstuen, Line Kristin Johnson, Catia Martins, Eivind Andersen, Jan Helgerud, Øyvind Støren

Abstract

Objective: This study aimed to compare the effects of two aerobic exercise programs of different intensities on energy expenditure.

Methods: This was a single-center randomized controlled trial of patients with severe obesity allocated to a 24-week moderate-intensity continuous training (MICT) program or a combined MICT with high-intensity interval training (HIIT/MICT) program. The primary outcome was energy expenditure during exercise (EEDE). Secondary outcomes included resting metabolic rate, cardiorespiratory fitness, and body composition.

Results: A total of 82 (56% females) patients were screened, and 71 (55% females) patients were allocated to HIIT/MICT (n = 37) or MICT (n = 34). Per-protocol analysis showed that EEDE increased by 10% (95% CI: 3%-17%) in the HIIT/MICT group (n = 16) and 7.5% (95% CI: 4%-10%) in the MICT group (n = 24), with no differences between groups. In the 8- to 16- week per-protocol analysis, the HIIT/MICT group had a significantly larger increase in EEDE compared with the MICT group. Resting metabolic rate remained unchanged in both groups. HIIT/MICT and MICT were associated with significant weight loss of 5 kg and 2 kg, respectively.

Conclusions: Patients completing a 24-week combined HIIT/MICT program did not achieve a higher EEDE compared with those who completed a 24-week MICT program. The HIIT/MICT group experienced, on average, a 3-kg-larger weight loss than the MICT group.

Trial registration: ClinicalTrials.gov NCT02311738.

Conflict of interest statement

The authors declared no conflict of interest.

© 2021 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society (TOS).

Figures

Figure 1
Figure 1
Timeline for visit and training. HIIT, high‐intensity interval training; MICT, moderate‐intensity continuous training.
Figure 2
Figure 2
Flowchart. HIIT, high‐intensity interval training; ITT, intention‐to‐treat principle; MICT, moderate‐intensity continuous training.
Figure 3
Figure 3
Energy expenditure during exercise (kcal * h−1) by exercise group at baseline and at 8‐week, 16‐week, and 24‐week follow‐up. Values are presented as estimated means (95% CI) (per‐protocol). Moderate‐intensity continuous training (MICT) group in red dots and combined high‐intensity interval training and moderate‐intensity continuous training (HIIT/MICT) group in blue squares.
Figure 4
Figure 4
Resting metabolic rate (kcal * d−1) by exercise group at baseline and at 8‐week, 16‐week, and 24‐ week follow‐up. Value are presented as estimated means (95% CI) (per‐protocol). Moderate‐intensity continuous training (MICT) group in red dots and combined high‐intensity interval training and moderate‐intensity continuous training (HIIT/MICT) group in blue squares.
Figure 5
Figure 5
Maximum volume of oxygen consumed (VO2max; L * min−1) by exercise group at baseline and at 8‐week, 16‐week, and 24‐week follow‐up. Values are presented as estimated means (95% CI) (per‐protocol). Moderate‐intensity continuous training (MICT) group in red dots and combined high‐intensity interval training and moderate‐intensity continuous training (HIIT/MICT) group in blue squares.

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