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A Randomized Controlled Trial

Melinda L. Irwin, PhD, MPH; Yutaka Yasui, PhD; Cornelia M. Ulrich, PhD; Deborah Bowen, PhD; Rebecca E. Rudolph, MD, MPH; Robert S. Schwartz, MD; Michi Yukawa, MD; Erin Aiello, MPH; John D. Potter, MD, PhD; Anne McTiernan, MD, PhD

JAMA. 2003;289:323-330.

Context  The increasing prevalence of obesity is a major public health concern. Physical activity may promote weight and body fat loss.

Objective  To examine the effects of exercise on total and intra-abdominal body fat overall and by level of exercise.

Design  Randomized controlled trial conducted from 1997 to 2001.

Setting and Participants  A total of 173 sedentary, overweight (body mass index 24.0 and >33% body fat), postmenopausal women aged 50 to 75 years who were living in the Seattle, Wash, area.

Intervention  Participants were randomly assigned to an intervention consisting of exercise facility and home-based moderate-intensity exercise (n = 87) or a stretching control group (n = 86).

Main Outcome Measure  Changes in body weight and waist and hip circumferences at 3 and 12 months; total body, intra-abdominal, and subcutaneous abdominal fat at 12 months.

Results  Twelve-month data were available for 168 women. Women in the exercise group participated in moderate-intensity sports/recreational activity for a mean (SD) of 3.5 (1.2) d/wk for 176 (91) min/wk. Walking was the most frequently reported activity. Exercisers showed statistically significant differences from controls in baseline to 12-month changes in body weight (–1.4 kg; 95% confidence interval [CI], –2.5 to –0.3 kg), total body fat (–1.0%; 95% CI, –1.6% to –0.4%), intra-abdominal fat (–8.6 g/cm²; 95% CI, –17.8 to 0.9 g/cm²), and subcutaneous abdominal fat (–28.8 g/cm²; 95% CI, –47.5 to –10.0 g/cm²). A significant dose response for greater body fat loss was observed with increasing duration of exercise.

Conclusions  Regular exercise such as brisk walking results in reduced body weight and body fat among overweight and obese postmenopausal women.

Author Affiliations: Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn (Dr Irwin); Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center (Drs Yasui, Ulrich, Bowen, Rudolph, Potter, and McTiernan and Ms Aiello), and Departments of Epidemiology (Drs Ulrich, Potter, and McTiernan) and Internal Medicine (Drs McTiernan, Rudolph, and Yukawa), University of Washington, Seattle; and Department of Internal Medicine, Division of Geriatric Medicine, University of Colorado Health Sciences Center, Denver (Dr Schwartz).

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