#Grand Rounds

Diet and/or Exercise Intervention: What Leads to the Greatest Weight Loss in Menopause?

BACKGROUND AND PURPOSE:

Women who are peri- and postmenopausal are at risk for weight gain
Previous studies have reported some benefits with diet and exercise
- However, there was significant heterogeneity between these studies, including age and types of interventions
Cheng et al. (Menopause, 2018) examined the impact of diet and exercise on weight loss and body composition in overweight/obese peri- and postmenopausal women using systematic review

Database search of RCTs and prospective studies of overweight/obese peri- or postmenopausal women
- Overweight, BMI ≥25.0 kg/m2
- Obese, BMI ≥30.0 kg/m2
Patients were exposed to dietary or exercise intervention, alone or combined vs routine care without lifestyle modification
Diet intervention: Multiple interventions, including
- Carbohydrates 50%-60%, fats 30%, and protein 10%-20% | Sweets/snacks limited | Low-fat and low-sugar food sources | Emphasis on vegetable consumption | Reduced portion size | Advised energy intake of 1,200 to 2,000 kcal/d based on baseline weight, or reducing calories by 500 kcal/day
Exercise intervention: Multiple interventions were diverse, including
- Low-intensity resistance exercise or moderate-to-vigorous intensity exercise (began at 50%-60% maximal heart rate and progressing to 85%-95%)
- Aerobic exercise | Bicycling | Stair walking | Treadmill running
- Several studies included resistance training programs
- Requirements ranged from 1 to 1.5 h/d to 45 to 60 min/d, 3-5 times/wk
- At-home and facility records were maintained for all study participants
The primary outcome was percentage reduction in body weight
Primary outcome: Change of body weight (kg) from baseline to after the intervention
Secondary outcomes
- Change of BMI | Waist circumference (WC) | Fat mass (kg) | Lean body mass (kg) from baseline to after the intervention

11 studies were selected
Compared to control groups, both the dietary and  exercise  intervention groups had significantly greater weight loss 
- Diet vs. control: Difference in means was −6.55, 95% CI, −9.51 to −3.59 (P < 0.001)
-  Exercise vs control: Difference in means was −3.49, 95% CI, −6.96 to −0.02 (P = 0.049)
Combined dietary and exercise interventions resulted in greater weight loss than dietary interventions alone
- Diet + exercise vs. diet: Difference in means was −1.22, 95% CI, −2.14 to −0.29 (P = 0.010)
Compared to diet alone, diet plus exercise resulted in
- Greater fat loss: Difference in means was −0.44, 95% CI, −0.67 to −0.20 (P < 0.001)
- Greater lean mass loss: Difference in means was −0.84, 95% CI, −1.13 to −0.55 (P < 0.001)

Both diet and exercise intervention increased weight loss compared to controls
Exercise interventions result in greater reduction in body weight, but not fat mass and lean mass
A combined diet and exercise regimen led to greater weight loss in obese/overweight peri- and postmenopausal women than just diet intervention alone
The authors recommend adding exercise training to calorie-restricted diet

< Previous

Next >