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

METHODS: 

• 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

RESULTS: 

• 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)

CONCLUSION: 

• 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

Learn More – Primary Sources: 

Effects of dietary and exercise intervention on weight loss and body composition in obese postmenopausal women: a systematic review and meta-analysis

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North American Menopause Society: Hormone Therapy Statement

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