Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

The comparative and cumulative effects of a dietary restriction and exercise on weight loss

International Journal of Obesity volume 30, pages 112–121 (2006)Cite this article

Abstract

Objective:

To assess the independence of changes made in diet and physical activity for weight loss; and, to examine the comparative and cumulative effects of these behavioral changes on weight loss outcomes.

Design:

The observational study is based on longitudinal data collected from 674 women and 288 men enrolled in a 2-year weight loss program introduced into a managed care setting.

Measurements:

The outcome variable was body mass index (BMI) change from baseline to 2-year follow-up. Primary independent variables were changes in physical activity and dietary fat intake, assessed as continuous measures using the Paffenbarger Physical Activity Questionnaire and Block Fat Screener Questionnaire, respectively. Two-way ANCOVA was used to assess the relative effect on BMI of behavioral changes.

Results:

Study results showed no preference for diet or physical activity change as a weight loss strategy. For both genders, the relationship between the two behaviors was synergistic rather than compensatory. Examination of the comparative benefits of behavioral changes indicated that, for women and men, restricting fat intake was more effective than increasing exercise for weight loss. While fat restrictions alone contributed to weight loss in both genders, exercise alone provided weight loss benefits to men, only. The cumulative effect of weight loss behaviors varied by gender. In women, an interaction was observed. The response of weight to fat restriction was greater among those who increased their exercise moderately or substantially. In men, there was no interaction; exercise increases helped to offset weight gain or provided small weight loss benefits at all levels of dietary fat change.

Conclusion:

Dietary changes appeared to be more effective than increased physical activity for weight loss. For women, the cumulative effect of concomitant changes in diet and exercise on weight loss was more than additive.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Mokdad AH, Bowman BA Ford ES, Vinicor F, Marks JS, Koplan JP . The continuing epidemics of obesity and diabetes in the United States. JAMA 2001; 286: 1195–1200.

    Article  CAS  Google Scholar 

  2. Mokdad AH, Marks JS, Stroup DF, Gerberding JL . Actual causes of death in the United States, 2000. JAMA 2004; 291: 1238–1245.

    Article  Google Scholar 

  3. Hill JO, Melanson EL . Overview of the determinants of overweight and obesity: current evidence and research issues. Med Sci Sports Exerc 1999; 31: 515–521.

    Article  Google Scholar 

  4. Bouchard C, Despres J, Tremblay A . Exercise and obesity. Obes Res 1993; 1: 133–147.

    Article  CAS  Google Scholar 

  5. Grilo CM, Brownell KD, Stunkard AJ . The metabolic and psychological importance of exercise in weight control. In: Stunkard AJ, Wadden TA (eds.), Obesity: Theory and Therapy. New York: Raven Press, 1993, pp 253–273.

    Google Scholar 

  6. Miller WC, Koceja DM, Hamilton EJ . A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord 1997; 21: 941–947.

    Article  CAS  Google Scholar 

  7. Wood PD, Stefanick ML, Dreon DM, Frey-Hewitt B, Garay SC, Williams PT et al. Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with exercise. N Engl J Med 1988; 319: 1173–1179.

    Article  CAS  Google Scholar 

  8. French SA, Jeffery RW, Forster JL, McGovern PG, Kelder SH, Baxter JE . Predictors of weight change over two years among a population of working adults: the Healthy Worker Project. Int J Obes Relat Metab Disord 1994; 18: 145–154.

    CAS  Google Scholar 

  9. Sherwood NE, Jeffery RW, French SA, Hannan PJ, Murray DM . Predictors of weight gain in the Pound of Prevention Study. Int J Obes Relat Metab Disord 2000; 24: 395–403.

    Article  CAS  Google Scholar 

  10. Harris JK, French SA, Jeffery RW, McGovern PG, Wing RR . Dietary and physical activity correlates of long-term weight loss. Obes Res 1994; 2: 307–313.

    Article  CAS  Google Scholar 

  11. Jakicic JM, Wing RR, Winters-Hart C . Relationship of physical activity to eating behaviors and weight loss in women. Med Sci Sports Exerc 2002; 34: 1653–1659.

    Article  CAS  Google Scholar 

  12. Pavlou KN, Krey S, Steffee WP . Exercise as an adjunct to weight loss and maintenance in moderately obese subjects. Am J Clin Nutr 1989; 49: 1115–1123.

    Article  CAS  Google Scholar 

  13. Sikand G, Kondo A, Foreyt JP, Jones PH, Gotto AM . Two-year follow-up of patients treated with a very-low-calorie diet and exercise training. J Am Diet Assoc 1988; 88: 487–488.

    CAS  PubMed  Google Scholar 

  14. Pronk NP, Wing RR . Physical activity and long-term maintenance of weight loss. Obes Res 1994; 2: 587–599.

    Article  CAS  Google Scholar 

  15. Wood PD, Stefanick ML, Williams PT, Haskell WL . The effects on plasma lipoproteins of a prudent weight-reducing diet, with or without exercise, in overweight men and women. N Engl J Med 1991; 325: 461–466.

    Article  CAS  Google Scholar 

  16. Tremblay A, Fontaine E, Poehlman ET, Mitchell D, Perron L, Bouchard C . The effect of exercise training on resting metabolic rate in lean and moderately obese individuals. Int J Obes Relat Metab Disord 1986; 10: 511–517.

    CAS  Google Scholar 

  17. Bielinski R, Schutz Y, Jequier E . Energy expenditure and postprandial thermogenesis in obese women before and after weight loss. Am J Clin Nutr 1985; 42: 69–82.

    Article  CAS  Google Scholar 

  18. Donnelly JE, Hill JO, Jacobsen DJ, Potteiger J, Sullivan DK, Johnson SL et al. Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the Midwest Exercise Trial. Arch Intern Med 2003; 163: 1342–1350.

    Article  Google Scholar 

  19. Westerterp KR, Jeijer GAL, Janssen EME, Saris WHM, ten Hoor F . Long-term effect of physical activity on energy balance and body composition. Br J Nutr 1992; 68: 21–30.

    Article  CAS  Google Scholar 

  20. Despres JP, Tremblay A, Bouchard C . Sex differences in the regulation of body fat mass with exercise-training. In: Bjorntorp P, Rossner S (eds.), Obesity in Europe I. London: John Libbey, 1989, pp 297–304.

    Google Scholar 

  21. Gillman MW, Pinto BM, Tennstedt S, Glanz K, Marcus B, Friedman RH . Relationships of physical activity with dietary behaviors among adults. Prev Med 2001; 32: 295–301.

    Article  CAS  Google Scholar 

  22. Wood PD, Terry RB, Haskell WL . Metabolism of substrates: diet, lipoprotein metabolism and exercise. Fed Proc 1985; 44: 358–363.

    CAS  PubMed  Google Scholar 

  23. Kissileff HR, Pi-Sunyer FX, Segal K, Meltzer S, Foelsch PA . Acute effects of exercise on food intake in obese and nonobese women. Am J Clin Nutr 1990; 52: 240–245.

    Article  CAS  Google Scholar 

  24. Woo R, Garrow JS, Pi-Sunyer FX . Voluntary food intake during prolonged exercise in obese women. Am J Clin Nutr 1982; 36: 478–484.

    Article  CAS  Google Scholar 

  25. Woo R, Garrow JS, PI-Sunyer FX . Effect of exercise on spontaneous calorie intake in obesity. Am J Clin Nutr 1982; 36: 470–477.

    Article  CAS  Google Scholar 

  26. Stubbs RJ, Sepp A, Hughes DA, Johnstone AM, Horgan GW, King N et al. The effect of graded levels of exercise on energy intake and balance in free-living men, consuming their normal diet. Eur J Clin Nutr 2002; 56: 129–140.

    Article  CAS  Google Scholar 

  27. Stubbs RJ, Sepp A, Hughes DA, Johnstone AM, King N, Horgan GW et al. The effect of graded levels of exercise on energy intake and balance in free-living women. Int J Obes Relat Metab Disord 2002; 26: 866–869.

    Article  CAS  Google Scholar 

  28. Westerterp KR, Goran MI . Relationship between physical activity related energy expenditure and body composition: a gender difference. Int J Obes Relat Metab Disord 1997; 21: 184–188.

    Article  CAS  Google Scholar 

  29. Jeffery RW, Sherwood NE, Brelje K, Pronk NP, Boyle R, Boucher JL et al. Mail and phone interventions for weight loss in a managed-care setting: Weight-To-Be one-year outcomes. Int J Obes Relat Metab Disord 2003; 27: 1584–1592.

    Article  CAS  Google Scholar 

  30. Paffenbarger RS, Wing AL, Hyde RT . Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol 1978; 108: 161–175.

    Article  Google Scholar 

  31. Jacobs DR, Ainsworth BE, Hartman TJ, Leon AS . A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 1993; 25: 81–91.

    Article  Google Scholar 

  32. Wing RR, Epstein LH, Patternostro-Bayles M, Kriska A, Nowalk MP, Gooding W . Exercise in a behavioral weight control programme for obese patients with Type 2 (non-insulin-dependent) diabetes. Diabetologia 1988; 31: 902–909.

    Article  CAS  Google Scholar 

  33. Pereira MA, FitzGerald SJ, Gregg EW, Joswiak ML, Ryan WJ, Suminski RR et al. A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc 1997; 29: S1–S05.

    Article  CAS  Google Scholar 

  34. Jeffery RW, Wing RR, Thorson C, Burton LR . Use of personal trainers and financial incentives to increase exercise in a behavioral weight-loss program. J Consult Clin Psychol 1998; 66: 777–783.

    Article  CAS  Google Scholar 

  35. Shah M, McGovern P, French S, Baxter J . Comparison of a low-fat, ad libitum complex-carbohydrate diet with a low-energy diet in moderately obese women. Am J Clin Nutr 1994; 59: 980–984.

    Article  CAS  Google Scholar 

  36. Flatt JP . Dietary fat, carbohydrate balance, and weight maintenance: effects of exercise. Am J Clin Nutr 1987; 45: 296–306.

    Article  CAS  Google Scholar 

  37. Thompson F, Byers T . Dietary assessment resource manual. J Nutr 1994; 124: 2296S.

    Google Scholar 

  38. Caan B, Coates A, Schaffer D . Variations in sensitivity, specificity, and predictive value of dietary fat screener modified from Block et al. J Am Diet Assoc 1995; 95: 564–568.

    Article  CAS  Google Scholar 

  39. Hoaglin DC, Mosteller F, Tukey JW (eds.). Understanding Robust and Exploratory Data Analysis. New York: John Wiley & Sons, Inc., 1983, p 363.

    Google Scholar 

  40. Cohen J, Cohen P . Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Hillsdale, NJ: Erlbaum, 1975, pp 72–73, 413–423.

    Google Scholar 

  41. Snedecor GW, Cochran WG . Statistical Methods 7th edn. Ames: Iowa State University Press, 1980, p 371.

    Google Scholar 

  42. SAS Institute Inc. SAS Users Manual, Version 8.2. Cary, NC: SAS Institute Inc.

  43. Gauvin L, Spence JC . Physical activity and psychological well-being: knowledge base, current issues, and caveats. Nutr Rev 1996; 54 (Part 2): S53–S65.

    CAS  PubMed  Google Scholar 

  44. Reed J, Berg KE, Latin RW, La Voie JP . Affective responses of physical active and sedentary individuals during and after moderate aerobic exercise. J Sports Med Phys Fitness 1998; 38: 272–278.

    CAS  PubMed  Google Scholar 

  45. Steptoe A, Kimball J, Basford P . Exercise and the experience and appraisal of daily stressors: a naturalistic study. J Behav Med 1998; 21: 363–374.

    Article  CAS  Google Scholar 

  46. Yeung RR . The acute effects of exercise on mood state. J Psychosom Res 1996; 40: 123–141.

    Article  CAS  Google Scholar 

  47. Sherwood NE, Jeffery JW . The behavioral determinants of exercise: Implications for physical activity interventions. Annu Rev Nutr 2000; 20: 21–44.

    Article  CAS  Google Scholar 

  48. Brownell KD . Exercise in the treatment of obesity. In: Brownell KD, Fairburn CG (eds.), Eating Disorders and Obesity: A Comprehensive Handbook. New York: Guilford Press, 1995, pp 473–478.

    Google Scholar 

  49. Paul DR, Novotny JA, Rumpler WV . Effects of the interaction of sex and food intake on the relation between energy expenditure and body composition. Am J Clin Nutr 2004; 79: 385–389.

    Article  CAS  Google Scholar 

  50. Despres JP, Tremblay A, Bouchard C . Sex differences in the regulation of body fat mass with exercise-training. In: Bjorntorp P, Rossner S (eds.), Obesity in Europe I. John Libbey: London, 1989, pp 297–304.

    Google Scholar 

  51. Wing RR, Jeffery JW, Burton LR, Thorson C, Kuller LH, Folsom AR . Change in waist-hip ratio with weight loss and its association with change in cardiovascular risk factors. Am J Clin Nutr 1992; 55: 1086–1092.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This research was supported by Grant DK53826 from the National Institute of Diabetes and Digestive and Kidney Diseases.

Author information

Authors and Affiliations

  1. Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    C L Dunn, P J Hannan & R W Jeffery

  2. Health Partners Research Foundation, Minneapolis, MN, USA

    N E Sherwood, N P Pronk & R Boyle

Authors
  1. C L Dunn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P J Hannan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R W Jeffery
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N E Sherwood
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N P Pronk
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R Boyle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C L Dunn.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dunn, C., Hannan, P., Jeffery, R. et al. The comparative and cumulative effects of a dietary restriction and exercise on weight loss. Int J Obes 30, 112–121 (2006). https://doi.org/10.1038/sj.ijo.0803046

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0803046

Keywords

This article is cited by

Search

Advanced search

Quick links