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A Randomized Trial

Ross E. Andersen, PhD; Thomas A. Wadden, PhD; Susan J. Bartlett, PhD; Babette Zemel, PhD; Tony J. Verde, PhD; Shawn C. Franckowiak

JAMA. 1999;281:335-340.

Context  Physical inactivity contributes to weight gain, but only 22% of Americans are regularly active.

Objective  To examine short- and long-term changes in weight, body composition, and cardiovascular risk profiles produced by diet combined with either structured aerobic exercise or moderate-intensity lifestyle activity.

Design  Sixteen-week randomized controlled trial with 1-year follow-up, conducted from August 1995 to December 1996.

Participants and Setting  Forty obese women (mean body mass index [weight in kilograms divided by the square of height in meters], 32.9 kg/m²; mean weight, 89.2 kg) with a mean age of 42.9 years (range, 21-60 years) seen in a university-based weight management program.

Interventions  Structured aerobic exercise or moderate lifestyle activity; low-fat diet of about 1200 kcal/d.

Main Outcome Measures  Changes in body weight, body composition, cardiovascular risk profiles, and physical fitness at 16 weeks and at 1 year.

Results  Mean (SD) weight losses during the 16-week treatment program were 8.3 (3.8) kg for the aerobic group and 7.9 (4.2) kg for the lifestyle group (within groups, P<.001; between groups, P = .08). The aerobic group lost significantly less fat-free mass (0.5 [1.3] kg) than the lifestyle group (1.4 [1.3] kg; P = .03). During the 1-year follow-up, the aerobic group regained 1.6 [5.5] kg, while the lifestyle group regained 0.08 (4.6) kg. At week 16, serum triglyceride levels and total cholesterol levels were reduced significantly (P<.001) from baseline (16.3% and 10.1% reductions, respectively) but did not differ significantly between groups and were not different from baseline or between groups at week 68.

Conclusions  A program of diet plus lifestyle activity may offer similar health benefits and be a suitable alternative to diet plus structured aerobic activity for obese women.

Author Affiliations: Division of Geriatric Medicine and Gerontology (Dr Andersen and Mr Franckowiak) and Department of Medicine (Dr Bartlett), Johns Hopkins University School of Medicine, Baltimore, Md; Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia (Dr Wadden); Children's Hospital of Philadelphia (Dr Zemel); and Department of Sports Science, Cabrini College, Radnor, Pa (Dr Verde).

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