rbkreider@tamu - Exercise & Sport Nutrition · Effects of a popular exercise and weight loss program on weight loss, body composition, energy expenditure and health in obese women
Richard B Kreider PhD FACSM FASEP FISSN FACN FNAKProfessor amp Executive Director Human Clinical Research Facility
Director Exercise amp Sport Nutrition LabDepartment of Health amp Kinesiology
Texas AampM University
rbkreidertamueduExerciseAndSportNutritionLabcom
hcrftamuedu
Exercise and Nutritional Strategies to Promote Weight Loss
Disclosures Has received funding from industry to conduct exercise and nutrition researchServes as scientific and legal consultant
Historical Perspective of Obesity
bull Obesity has historically been thought to simply be related to an imbalance between energy intake and expenditure
bull Recommendations have focused onndash reducing energy intake ndash maintaining a high CHOlow fat diet ndash Increasing physical activity (eg
walking)
Wilborn et al J Int Soc Sports Nutr 2005 Dec 924-31
Contemporary View of Obesity
bull Genetic physiological and behavioral factors also play a significant role in the etiology of obesity
bull The prevention and management of obesity through implementation of different types of exercise programs macronutrient diets behavioral interventions andor medical interventions are at the forefront of obesity research
bull Seeing a paradigm shift from traditional approaches to personalized diet and exercise strategies
Wilborn et al J Int Soc Sports Nutr 2005 Dec 924-31
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Aerobic Exercise Only
Reference Population Duration (mo) Intervention Weight Change (kg) Body Fat Change ()
Irwin et al (2003) 87 F (ge25 BMI 50-75 yrs)
12 60ndash75 max HR 225 minweek
-13 -12
Nishijima et al (2007) 281 M amp F (ge30 BMI 40-89 yrs)
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Resistance Exercise Only
Reference Population Duration (mo)
Intervention WeightChange (kg)
FFM Change (kg)
Body Fat Change ()
Kirk et al (2009) 22 M amp F (277 BMI 21 yrs)
6 Supervised 3 dwk 1 set x 9 exercises at 85ndash90 1RM
25 15 03
Kerksick et al (2009) 24 CA men (18-22 yrs)25 MA men (35 ndash50 yrs)
2 2 x upper and 2 x lower workoutswk 3ndash6 sets at a 10-RM wks 1-4 8-RM for weeks 5ndash8
0705
0511
04-07
Willis et al (2012) 44 M amp F (25-35 BMI 18-70 yrs)
8 8ndash12 repsset three setsday 3 dwk
08 11 -07
Moghadasi et al (2013)
11 M (327 BMI 462 yrs)
3 8ndash12 repetitions of 65ndash80 1RM 50ndash60 minday 3 daysweek
-03 NR -05
Roberts et al (2013) 28 M (ge 27 BMI 18-35 yrs)
3 Increasing intensityRT to reach 6ndash8 repetitionsset1 hsession threesessionswk
18 27 -10
Body Composition Changes with Resistance Training
-040
-020
000
020
040
060
080
100
Kirk et al (2009) Kerksick et al(2009) - CA
Kerksick et al(2009) - MA
Willis et al (2012) Moghadasi et al(2013)
Roberts et al(2013)
Mean
Chan
ge
Body Composition Changes with Resistance Training
Weight (kgmo) FFM (kgmo) Body Fat (mo))
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Historical Perspective of Obesity
bull Obesity has historically been thought to simply be related to an imbalance between energy intake and expenditure
bull Recommendations have focused onndash reducing energy intake ndash maintaining a high CHOlow fat diet ndash Increasing physical activity (eg
walking)
Wilborn et al J Int Soc Sports Nutr 2005 Dec 924-31
Contemporary View of Obesity
bull Genetic physiological and behavioral factors also play a significant role in the etiology of obesity
bull The prevention and management of obesity through implementation of different types of exercise programs macronutrient diets behavioral interventions andor medical interventions are at the forefront of obesity research
bull Seeing a paradigm shift from traditional approaches to personalized diet and exercise strategies
Wilborn et al J Int Soc Sports Nutr 2005 Dec 924-31
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Aerobic Exercise Only
Reference Population Duration (mo) Intervention Weight Change (kg) Body Fat Change ()
Irwin et al (2003) 87 F (ge25 BMI 50-75 yrs)
12 60ndash75 max HR 225 minweek
-13 -12
Nishijima et al (2007) 281 M amp F (ge30 BMI 40-89 yrs)
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Resistance Exercise Only
Reference Population Duration (mo)
Intervention WeightChange (kg)
FFM Change (kg)
Body Fat Change ()
Kirk et al (2009) 22 M amp F (277 BMI 21 yrs)
6 Supervised 3 dwk 1 set x 9 exercises at 85ndash90 1RM
25 15 03
Kerksick et al (2009) 24 CA men (18-22 yrs)25 MA men (35 ndash50 yrs)
2 2 x upper and 2 x lower workoutswk 3ndash6 sets at a 10-RM wks 1-4 8-RM for weeks 5ndash8
0705
0511
04-07
Willis et al (2012) 44 M amp F (25-35 BMI 18-70 yrs)
8 8ndash12 repsset three setsday 3 dwk
08 11 -07
Moghadasi et al (2013)
11 M (327 BMI 462 yrs)
3 8ndash12 repetitions of 65ndash80 1RM 50ndash60 minday 3 daysweek
-03 NR -05
Roberts et al (2013) 28 M (ge 27 BMI 18-35 yrs)
3 Increasing intensityRT to reach 6ndash8 repetitionsset1 hsession threesessionswk
18 27 -10
Body Composition Changes with Resistance Training
-040
-020
000
020
040
060
080
100
Kirk et al (2009) Kerksick et al(2009) - CA
Kerksick et al(2009) - MA
Willis et al (2012) Moghadasi et al(2013)
Roberts et al(2013)
Mean
Chan
ge
Body Composition Changes with Resistance Training
Weight (kgmo) FFM (kgmo) Body Fat (mo))
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Contemporary View of Obesity
bull Genetic physiological and behavioral factors also play a significant role in the etiology of obesity
bull The prevention and management of obesity through implementation of different types of exercise programs macronutrient diets behavioral interventions andor medical interventions are at the forefront of obesity research
bull Seeing a paradigm shift from traditional approaches to personalized diet and exercise strategies
Wilborn et al J Int Soc Sports Nutr 2005 Dec 924-31
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Aerobic Exercise Only
Reference Population Duration (mo) Intervention Weight Change (kg) Body Fat Change ()
Irwin et al (2003) 87 F (ge25 BMI 50-75 yrs)
12 60ndash75 max HR 225 minweek
-13 -12
Nishijima et al (2007) 281 M amp F (ge30 BMI 40-89 yrs)
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Resistance Exercise Only
Reference Population Duration (mo)
Intervention WeightChange (kg)
FFM Change (kg)
Body Fat Change ()
Kirk et al (2009) 22 M amp F (277 BMI 21 yrs)
6 Supervised 3 dwk 1 set x 9 exercises at 85ndash90 1RM
25 15 03
Kerksick et al (2009) 24 CA men (18-22 yrs)25 MA men (35 ndash50 yrs)
2 2 x upper and 2 x lower workoutswk 3ndash6 sets at a 10-RM wks 1-4 8-RM for weeks 5ndash8
0705
0511
04-07
Willis et al (2012) 44 M amp F (25-35 BMI 18-70 yrs)
8 8ndash12 repsset three setsday 3 dwk
08 11 -07
Moghadasi et al (2013)
11 M (327 BMI 462 yrs)
3 8ndash12 repetitions of 65ndash80 1RM 50ndash60 minday 3 daysweek
-03 NR -05
Roberts et al (2013) 28 M (ge 27 BMI 18-35 yrs)
3 Increasing intensityRT to reach 6ndash8 repetitionsset1 hsession threesessionswk
18 27 -10
Body Composition Changes with Resistance Training
-040
-020
000
020
040
060
080
100
Kirk et al (2009) Kerksick et al(2009) - CA
Kerksick et al(2009) - MA
Willis et al (2012) Moghadasi et al(2013)
Roberts et al(2013)
Mean
Chan
ge
Body Composition Changes with Resistance Training
Weight (kgmo) FFM (kgmo) Body Fat (mo))
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Aerobic Exercise Only
Reference Population Duration (mo) Intervention Weight Change (kg) Body Fat Change ()
Irwin et al (2003) 87 F (ge25 BMI 50-75 yrs)
12 60ndash75 max HR 225 minweek
-13 -12
Nishijima et al (2007) 281 M amp F (ge30 BMI 40-89 yrs)
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Resistance Exercise Only
Reference Population Duration (mo)
Intervention WeightChange (kg)
FFM Change (kg)
Body Fat Change ()
Kirk et al (2009) 22 M amp F (277 BMI 21 yrs)
6 Supervised 3 dwk 1 set x 9 exercises at 85ndash90 1RM
25 15 03
Kerksick et al (2009) 24 CA men (18-22 yrs)25 MA men (35 ndash50 yrs)
2 2 x upper and 2 x lower workoutswk 3ndash6 sets at a 10-RM wks 1-4 8-RM for weeks 5ndash8
0705
0511
04-07
Willis et al (2012) 44 M amp F (25-35 BMI 18-70 yrs)
8 8ndash12 repsset three setsday 3 dwk
08 11 -07
Moghadasi et al (2013)
11 M (327 BMI 462 yrs)
3 8ndash12 repetitions of 65ndash80 1RM 50ndash60 minday 3 daysweek
-03 NR -05
Roberts et al (2013) 28 M (ge 27 BMI 18-35 yrs)
3 Increasing intensityRT to reach 6ndash8 repetitionsset1 hsession threesessionswk
18 27 -10
Body Composition Changes with Resistance Training
-040
-020
000
020
040
060
080
100
Kirk et al (2009) Kerksick et al(2009) - CA
Kerksick et al(2009) - MA
Willis et al (2012) Moghadasi et al(2013)
Roberts et al(2013)
Mean
Chan
ge
Body Composition Changes with Resistance Training
Weight (kgmo) FFM (kgmo) Body Fat (mo))
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Aerobic Exercise Only
Reference Population Duration (mo) Intervention Weight Change (kg) Body Fat Change ()
Irwin et al (2003) 87 F (ge25 BMI 50-75 yrs)
12 60ndash75 max HR 225 minweek
-13 -12
Nishijima et al (2007) 281 M amp F (ge30 BMI 40-89 yrs)
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Resistance Exercise Only
Reference Population Duration (mo)
Intervention WeightChange (kg)
FFM Change (kg)
Body Fat Change ()
Kirk et al (2009) 22 M amp F (277 BMI 21 yrs)
6 Supervised 3 dwk 1 set x 9 exercises at 85ndash90 1RM
25 15 03
Kerksick et al (2009) 24 CA men (18-22 yrs)25 MA men (35 ndash50 yrs)
2 2 x upper and 2 x lower workoutswk 3ndash6 sets at a 10-RM wks 1-4 8-RM for weeks 5ndash8
0705
0511
04-07
Willis et al (2012) 44 M amp F (25-35 BMI 18-70 yrs)
8 8ndash12 repsset three setsday 3 dwk
08 11 -07
Moghadasi et al (2013)
11 M (327 BMI 462 yrs)
3 8ndash12 repetitions of 65ndash80 1RM 50ndash60 minday 3 daysweek
-03 NR -05
Roberts et al (2013) 28 M (ge 27 BMI 18-35 yrs)
3 Increasing intensityRT to reach 6ndash8 repetitionsset1 hsession threesessionswk
18 27 -10
Body Composition Changes with Resistance Training
-040
-020
000
020
040
060
080
100
Kirk et al (2009) Kerksick et al(2009) - CA
Kerksick et al(2009) - MA
Willis et al (2012) Moghadasi et al(2013)
Roberts et al(2013)
Mean
Chan
ge
Body Composition Changes with Resistance Training
Weight (kgmo) FFM (kgmo) Body Fat (mo))
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Body Composition Changes with Aerobic Training
-070
-060
-050
-040
-030
-020
-010
000
Irwin(2003)
Nishijima(2007)
Alves(2009)
Musto(2010)
David(2012)
Willis(2012)
Donnelley(2013) - M
600
Donnelley(2013) - M
400
Donnelley(2013) - F
600
Donnelley(2013) - F
400
Mean
Chan
ge
Body Composition Changes with Aerobic Training
Weight (kgmo) Body Fat (mo))
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Resistance Exercise Only
Reference Population Duration (mo)
Intervention WeightChange (kg)
FFM Change (kg)
Body Fat Change ()
Kirk et al (2009) 22 M amp F (277 BMI 21 yrs)
6 Supervised 3 dwk 1 set x 9 exercises at 85ndash90 1RM
25 15 03
Kerksick et al (2009) 24 CA men (18-22 yrs)25 MA men (35 ndash50 yrs)
2 2 x upper and 2 x lower workoutswk 3ndash6 sets at a 10-RM wks 1-4 8-RM for weeks 5ndash8
0705
0511
04-07
Willis et al (2012) 44 M amp F (25-35 BMI 18-70 yrs)
8 8ndash12 repsset three setsday 3 dwk
08 11 -07
Moghadasi et al (2013)
11 M (327 BMI 462 yrs)
3 8ndash12 repetitions of 65ndash80 1RM 50ndash60 minday 3 daysweek
-03 NR -05
Roberts et al (2013) 28 M (ge 27 BMI 18-35 yrs)
3 Increasing intensityRT to reach 6ndash8 repetitionsset1 hsession threesessionswk
18 27 -10
Body Composition Changes with Resistance Training
-040
-020
000
020
040
060
080
100
Kirk et al (2009) Kerksick et al(2009) - CA
Kerksick et al(2009) - MA
Willis et al (2012) Moghadasi et al(2013)
Roberts et al(2013)
Mean
Chan
ge
Body Composition Changes with Resistance Training
Weight (kgmo) FFM (kgmo) Body Fat (mo))
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Resistance Exercise Only
Reference Population Duration (mo)
Intervention WeightChange (kg)
FFM Change (kg)
Body Fat Change ()
Kirk et al (2009) 22 M amp F (277 BMI 21 yrs)
6 Supervised 3 dwk 1 set x 9 exercises at 85ndash90 1RM
25 15 03
Kerksick et al (2009) 24 CA men (18-22 yrs)25 MA men (35 ndash50 yrs)
2 2 x upper and 2 x lower workoutswk 3ndash6 sets at a 10-RM wks 1-4 8-RM for weeks 5ndash8
0705
0511
04-07
Willis et al (2012) 44 M amp F (25-35 BMI 18-70 yrs)
8 8ndash12 repsset three setsday 3 dwk
08 11 -07
Moghadasi et al (2013)
11 M (327 BMI 462 yrs)
3 8ndash12 repetitions of 65ndash80 1RM 50ndash60 minday 3 daysweek
-03 NR -05
Roberts et al (2013) 28 M (ge 27 BMI 18-35 yrs)
3 Increasing intensityRT to reach 6ndash8 repetitionsset1 hsession threesessionswk
18 27 -10
Body Composition Changes with Resistance Training
-040
-020
000
020
040
060
080
100
Kirk et al (2009) Kerksick et al(2009) - CA
Kerksick et al(2009) - MA
Willis et al (2012) Moghadasi et al(2013)
Roberts et al(2013)
Mean
Chan
ge
Body Composition Changes with Resistance Training
Weight (kgmo) FFM (kgmo) Body Fat (mo))
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Body Composition Changes with Resistance Training
-040
-020
000
020
040
060
080
100
Kirk et al (2009) Kerksick et al(2009) - CA
Kerksick et al(2009) - MA
Willis et al (2012) Moghadasi et al(2013)
Roberts et al(2013)
Mean
Chan
ge
Body Composition Changes with Resistance Training
Weight (kgmo) FFM (kgmo) Body Fat (mo))
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Exercise with Diet InterventionReference Population Duration
(mo)Intervention Weight
Change (kg)Fat Mass
Change (kg)FFM Change
(kg)Body Fat
Change ()
Goodpaster et al (2010)
63 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald)
-82 -59 -21 -17
67 AA M amp F (35-40 BMI 30-55 yrs)
6 DI (1200ndash2100 kcald) + AE (moderate intensity 300 minwk)
-109 -87 -24 -29
Foster-Schubert et al (2012)
118 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI (1200ndash2000 kcalday achieved 10WL in 6 months
-71 -61 -08 -12
117 Asian-Am F (ge 23 BMI 50-75 yrs)
12 AE (70ndash85 max HR 225 minweek)
-20 -21 03 -16
116 Asian-Am F (ge 23 BMI 50-75 yrs)
12 DI+ AE -89 -82 -04 -59
87 Asian-Am F (ge 23 BMI 50-75 yrs)
12 No Diet or Exercise
-07 -04 -01 -02
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Body Composition Changes with Diet andor Exercise
-200
-150
-100
-050
000
050
Diet Diet + Ex Diet Ex Diet + Ex
Goodpaster (2010) Foster-Schubert (2012) Mean
Chan
ge
Body Composition Changes with Diet andor Exercise
Weight (kgmo) Fat Mass (kgmo) FFM (kgmo) BF (mo)
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Rationale
bull Initial weight loss primarily due to diet-induced energy deficit
bull Rapid weight loss associated with reductions in FFM and REE while altering hormonal regulation of appetite and metabolism which makes it difficult to maintain weight loss
bull Goal should be to promote weight loss without loss of FFM or reductions in REE
bull Weight loss programs typically involve caloric restriction and endurance exercise
bull Resistance training can help maintain FFM and REE during weight loss
bull Diet andor nutritional strategies may have differential affects on weight loss
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Established in 2002 to find ways to strengthen women through exercise and diet and provide research-based programs for
Curves members
httpwwwexerciseandsportnutritionlabcomcurves
Health amp Fitness Initiative
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
bull Use of circuit-style resistance-exercise that promotes increases in energy expenditure and maintenance of FFM
bull Online monitoring and weekly coaching follow-up
bull Social interaction and encouragement bull Scientifically tested and validated
programs
httpwwwexerciseandsportnutritionlabcomcurves
Weight Loss Approach
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
bull Resistance exercises includedbull Leg extensioncurlsbull Shoulder PressLat Pullbull Squat PushPullbull Seated bench pressrowsbull Hip AdductionAbductionbull Abdominal CurlBack Extensionbull Leg pressbull Arm curlsextensions
bull Low impact calisthenics or Zumbareg during recovery stations
bull Stretching
Training Approach
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
2 Wk1200 kcald
8 Wk 1600 kcald
4 Wk 2600 kcald
Intermittent2d 1200 kcald
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
n = 161385plusmn85 yrs942plusmn188 kg1642plusmn67 cm349plusmn64 kgm2
438plusmn42 BF
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
-12
-10
-8
-6
-4
-2
0
2
4
6
0 10 14
Cha
nge
(kg)
Weeks
Body Mass
HED ND VLCHPLCMP HCLP CON
n = 161 p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HED ND VLCHPLCMP HCLP CON
p = 0001
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
1 Wk 1200 kcald
9 Wk 1600 kcald
4 Wk 2600 kcald
Diet 2d 1200 kcald only with 3
lb weight gain
14 Weeks of Curves Training
n = 141387plusmn8 yrs350plusmn6 kgbullm-2
448plusmn4 fat
bull At 0 2 10 104 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
-25
-20
-15
-10
-5
0
5
10
0 10 14
Cha
nge
(lbs)
Weeks
Body Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
-8000
-6000
-4000
-2000
0
2000
4000
0 10 14
Cha
nge
(g)
Weeks
Fat Mass
HCD+E LC-VHP+E LC-HP+E
HCHO+E EX Control
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Variable Impact of Curves
Maximal Aerobic Capacity uarr (7)
Maximal Strength (BP amp LP) uarr (10)
Hip amp Waist Circumference darr (15 - 2rdquo)
Resting DBP darr (4)
Total Cholesterol darr (4 during diet)
LDL Cholesterol darr (3 during diet)
Triglycerides darr (12)
Leptin darr (18 during diet 17 overall)
Fasting Insulin darr (19 during diet 15 overall)
Insulin Sensitivity 19 Improvement
Changes in weight loss body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women Kerksick et al Nutri J 959 2010
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
1 Wk1200 kcald
9 Wk1600 kcald
4 Wk2100 kcald
Intermittent2d 1200 kcald
bull At 0 10 amp 14 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)bull 6 Minute Walk Testbull Balance Functional Testing
bull At 0 amp 14 wksbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
14 Weeks of Training
Testing Intervals
Exercise Only HCHO [551530 ] or HP Diets [304030 ]
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Variable Impact of Program
Waist amp Hip darr (2 cm)
Resting HR darr (23cm)
Resting SBP darr (4 mmHg 10 wk)
Resting DBP darr (5 mmHg 10 wk)
1 RM Bench Press uarr (21)
1 RM Leg Press uarr (32)
BP Endurance uarr (29)
LP Endurance uarr (23)
Maximal Oxygen Uptake uarr (12)
6 Minute Walk-Test uarr (6)
Effects of adherence to a higher protein diet on weight loss markers of health and functional capacity in older women participating in a resistance-based exercise program Galbreath et al Nutrients 10(8) 1070 2018
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
1 Wk 1200 kcald
9 Wks 1600 kcald
6 Months 2100 kcald
Intermittent2d 1200 kcald if gain 3 lbs
bull At 0 2 10 14 22 34 Wbull Dietary Records (4-d)bull Psychometric Testsbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 10 14 22 34 W bull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
85 Months of Training
Testing Intervals
CurvesGM Program (HCHO [551530]) vs Special Kreg Weight Loss Program
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 34
lbs
Weeks
Weight Loss
Curves SK
G x T =0001
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
-7
-6
-5
-4
-3
-2
-1
0
0 10 14 22 36
lbs
Weeks
Fat Loss
Curves SK
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
0
50
100
150
200
250
Moderate Vigorous
Min
ute
sW
ee
k
Physical Actvity
Curves SK
0
1
2
3
4
5
6
Moderate Vigorous
Day
sW
ee
k
Physical Activity
Curves SK
A structured diet and exercise program promotes favorable changes in weight loss body composition and weight maintenance Kreider et al J Am Dietetic Assoc 111828-43 2011
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Chart3
Curves
SK
MinutesWeek
Physical Actvity
221485
1493696969697
8429
218181818182
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Sheet3
Curves
SK
DaysWeek
Physical Activity
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Chart4
Curves
SK
DaysWeek
Physical Activity
5125
2803030303
1875
05151515152
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Moderate
Moderate
Vigorous
Vigorous
Sheet1
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
wghtd11
1
0000
00000
37
Curves
0000
-66973
-82595
-89514
-71946
2
0000
00000
40
SK
0000
-35175
-39900
-51025
-48000
Total
0000
00000
77
wghtd61
1
-66973
852117
37
2
-35175
578055
40
Total
-50455
735517
77
wghtd71
1
-82595
986857
37
2
-39900
675687
40
Total
-60416
861219
77
wghtd81
1
-89514
1159889
37
2
-51025
988714
40
Total
-69519
1084607
77
wghtd91
1
-71946
1296521
37
2
-48000
1387179
40
Total
-59506
1340970
77
Sheet1
Curves
SK
Weeks
lbs
Weight Loss
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Sheet1 (2)
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Descriptive Statistics
Descriptive Statistics
group
Mean
Std Deviation
N
0
10
14
22
36
fatlbsd11
1
0000
00000
40
Curves
0000
-51278
-55290
-60641
-54925
2
0000
00000
41
SK
0000
-19819
-22887
-31092
-32005
Total
0000
00000
81
fatlbsd61
1
-51278
795438
40
2
-19819
365784
41
Total
-35354
632771
81
fatlbsd71
1
-55290
693152
40
2
-22887
558066
41
Total
-38888
645380
81
fatlbsd81
1
-60641
876584
40
2
-31092
810028
41
Total
-45684
851332
81
fatlbsd91
1
-54925
775243
40
2
-32005
1044443
41
Total
-43324
922884
81
Sheet1 (2)
Curves
SK
Weeks
lbs
Fat Loss
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Sheet2
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
2 group
Measure
group
Mean
Std Error
95 Confidence Interval
Lower Bound
Upper Bound
DayActLight
1
1830
290
1252
2408
2
2539
319
1903
3176
Moderate
Vigorous
Moderate
Vigorous
PAMinModActivity
1
221485
22519
176583
266387
Curves
221485
84290
Curves
5125
1875
2
149370
24793
99935
198805
SK
149370
21818
SK
2803
515
DaysModAct
1
5125
426
4275
5975
2
2803
469
1868
3738
PAVigorous
1
84290
14095
56186
112394
2
21818
15518
-9123
52760
DaysVigAct
1
1875
234
1408
2342
2
515
258
001
1029
PAMinLight
1
88090
27052
34150
142030
2
215382
29783
155996
274768
Sheet2
Curves
SK
MinutesWeek
Physical Actvity
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Sheet3
Curves
SK
DaysWeek
Physical Activity
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
1 Wk 1200 kcald
3 Wks1500 kcald
bull At 0 4 6 10 12 16 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 16Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
16 Weeks
Testing Intervals
Curves with Zumba (I amp II 304525 III 453025) Weight Watchers Program amp Counseling
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
-12
-10
-8
-6
-4
-2
0
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Weight Loss
C W
MANOVA Body Composition (p=0001)Univariate G x T p=031
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Loss
C W
Univariate G x T p=009
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
-10
-8
-6
-4
-2
0
2
4
6
8
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
g)
Fat Free Mass
C W
Univariate G x T p=001-15
-10
-5
0
5
10
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge(
)
Body Fat
C W
Univariate G x T p=005-2
-1
0
1
2
3
4
Baseline 4 weeks 10 weeks 16 weeks
Chan
ge (k
cals
kgd
)
REE
C W
Univariate G x T p=019
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
0
200
400
600
800
1000
1200
1400
1600
Low PA Mod PA Vig PA Total PA Job PA Trans PA House PA Recreation PA
Physical Activity(MET minswk)
WW C
Comparative effectiveness of two popular weight loss programs in women I body composition and resting energy expenditure Mardock et al JISSN 8(S1) 2011
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
bull At 0 4 8 12 Wbull Dietary Records (4-d)bull Psychometric Testsbull IPAQbull Body CompositionBone Density (DEXA)bull Total Body Water (BIA)bull Hip amp waist measurementbull Resting HR amp BPbull Fasting Blood Samples (12h) bull Resting Energy Expenditure (REE)
bull At 0 amp 12Wbull Maximal Stress Testbull 1RM Bench Pressbull 80 of 1RM on Bench Pressbull 1RM Leg Pressbull 80 of 1RM on Leg Press
bull Side effects were monitored by an RN on a weekly basis
12 Weeks
Testing Intervals
No Diet or Exercise Control Curves Completereg 90-day Challenge (CC) with 304525 CPF Weight Watchersreg Points Plus (WW) Jenny Craigreg (JC) or Nutrisystemreg Advance Selecttrade (NS)
N=12644plusmn12 yr448plusmn5 fat354plusmn6 kgm2
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Control Weight Watchers
Nutrisystem Jenny Craig Curves
Diet No Point Plus Program
Advance Select Online Program
Online Program
Curves Complete
Food Provided No No Yes Yes No
Counseling No Weekly Group Meetings
Online Support Available
Online Support Available
Weekly Individual Progress Checks
ExerciseProgram
No Encouraged but not supervised
Encouraged but not supervised
Encouraged but not supervised
Curves CircuitTraining with Zumba
Cost None ~ $135 ~ $1200 -$1500
~ $1200 -$1500
$199
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
-1200
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Body Mass
CC WW JC NS Con
Overall Body Composition MANOVA (p=0001)Univariate G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-1000
-800
-600
-400
-200
000
200
400
0 4 8 12
Chan
ge (k
g)
Fat Mass
CC WW JC NS Con
WeeksWeeks
G x T p=0001
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (k
g)
Fat Free Mass
CC WW JC NS Con
G x T p=0001
Weeks
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
-700
-600
-500
-400
-300
-200
-100
000
100
200
300
0 4 8 12
Chan
ge (
)
Body Fat
CC WW JC NS ConWeeks
G x T p=0001
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Efficacy of a randomized trial examining commercial weight loss programs on metabolic syndrome in overweight and obese women Baetge et al Appl Physiol Nutri Metabol 1139apnm-0456 2017
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Variability of Body Composition Results
N MeanStd
Deviation Std Error
95 Confidence Interval for Mean
Minimum MaximumLower Bound
Upper Bound
Body Mass HP 373 -428 356 18 -464 -391 -1656 601
HC 293 -343 403 23 -390 -297 -3561 476
Fat Mass HP 373 -323 372 19 -361 -285 -5039 1065
HC 293 -248 302 17 -283 -213 -2397 997
FFM HP 373 -78 203 10 -99 -57 -989 578
HC 293 -60 208 12 -84 -36 -1297 731
Why is there so much variation in weight loss success when women adhere to the same exercise and diet intervention
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
63 obese women had genotype (FABP2rs1799883 PPARG2rs1801282 ADRB3rs4994C3 ADRB2rs1042713 rs1042714) determined
Participants were randomly assigned to follow a moderate- (MC) or lower-carbohydrate (LC) hypo-energetic diet that aligned (A) or did not align (NA) with genotype for 24-weeks while participating in a resistance-trainingwalking program
Participants in the LC group experienced greater improvements (p=0051 ηp2=0025) in percent changes in body composition (weight MC -332 [-14 -52] LC -582 [-41 -76] fat mass MC -725 [-32 -112] LC -1093 [-73 -145] fat-free mass MC -032 [14 -20] LC -148 [07 -30] body fat percentage MC -419 [-16 -68] LC -560 [-33 -79] ) with no significant differences were observed between genotype groups
While individuals following the LC diet experienced greater benefits alignment of these diets to this genetic profile did not promote greater health outcomes
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
bull 221 obese women were prescribed low-fat (30) isoenergeticdiets that consisted of 1200 kcals per day for 1 week and 1600 kcals per day for 9 weeks with HC or HP
bull Diet and training decreased body weight (ndash35 plusmn 3 kg) fat mass (ndash27 plusmn 3 kg) blood glucose (ndash3) total cholesterol (ndash45) LDL (ndash5) TG (ndash59) SBP(ndash26) and waist circumference (ndash37) while increasing peak aerobic capacity (73)
bull Subjects in the HP group experienced greater weight loss (ndash44 plusmn36 kg vs ndash26 plusmn 29 kg) fat loss (ndash34 plusmn 27 kg vs ndash17 plusmn 20 kg) reductions in serum glucose (3 vs 2) and decreases in serum leptin levels (ndash308 vs ndash108) than those in the HC group
bull Participants in the HH (ndash141) and HP-HH (ndash216) groups observed the greatest reduction in serum blood glucose
bull A CHO-restricted diet promoted more favorable changes in weight loss fat loss and markers of health in obese women who initiated an exercise program compared with a diet higher in carbohydrate
bull Obese women with higher HOMA levels experienced greater reductions in blood glucose following an HP diet
A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance Kreider et al Physician and Sportsmedicine 322 May 2011
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
bull We retrospectively analyzed effect of protein-focused (PRO 114thinspgkgday) and carbohydrate-focused (CHO sim22thinspgkgday) diets (sim1600thinspkcals) combined with 10 weeks of circuit exercise training in sedentary overweightobese women (Nthinsp=thinsp661 age 46thinspplusmnthinsp11 years) on metabolic syndrome (MetS)
bull Primary (MetS) secondary (MetS z-scores and individual MetS components) and tertiary outcomes [BMI by WHO cut points] were analyzed using chi-square GLM and McNemars tests
bull Both groups experienced significant weight loss improvements in fitness and reductions in MetSprevalence from baseline to follow-up (PRO 49 to 42 CHO 42 to 36 both Pthinspltthinsp001)
bull MetS z-score improvement (sim665) was similar for both groupsbull No significant differences for waist circumference (-028thinspplusmnthinsp002 vs -028thinspplusmnthinsp0025thinspcm Pthinsp=thinsp097) glucose (-
007thinspplusmnthinsp003 vs -008thinspplusmnthinsp004thinspmM Pthinsp=thinsp087) triglycerides (-016thinspplusmnthinsp004 vs -009thinspplusmnthinsp004thinspmM Pthinsp=thinsp020) high-density lipoprotein cholesterol (-021thinspplusmnthinsp003 vs -019thinspplusmnthinsp004thinspmM Pthinsp=thinsp068) and systolic BP (-016thinspplusmnthinsp04 vs -024thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp026)
bull DBP showed a minor advantage for the PRO group (-014thinspplusmnthinsp005 vs -030thinspplusmnthinsp005thinspmmHg Pthinsp=thinsp002) bull When stratified by BMI those with morbid obesity did not show a significant improvement in MetS
while following a PRO-focused diet bull Low-moderate calorie diet partitioned for CHO and PRO is equally effective when combined with a
structured exercise program for reducing the prevalence of MetS prevalence in overweight women
Retrospective analysis of protein and carbohydrate focused diets combined with exercise on metabolic syndrome prevalence in overweight and obese women Lockard et al Metab Syndr Relat Disord 14(4)228-37 2016
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
bull 8 exercise-training studies performed from 2002ndash2014 (n=663) were examined relative to tertiles of PRO ingestion (Low lt08 gkgd Moderate gt08-12 gkgd High gt12 gkgd)
bull The Primary outcome was clinically significant weight loss (CSWL 5)bull Protein ingestion was Low (n=278 065 gkgd plusmn 012 range 024-080) Moderate (n=225 098 gkgd plusmn 012
range 0891-119) and High (142 (n=142 166 gkgd plusmn 042 range 120-328) bull Weight change was Gained weight (12 101 kg 95 CI 024 178) exhibited non-CSWL (50 -181 kg 95
CI -204 -159) and achieved CSWL (39 -717 kg (95 CI -742 -692) bull High PRO consumers did not gain a significant amount of weight (070 kg 95 CI -042 181) while Low (097
kg 95 CI 030 164) and Moderate PRO consumers did (136 kg 95 CI 084 189) bull 57 of those consuming higher PRO (166 plusmn 042 gkgd) achieved CSWL vs ~33 in low (065 gkgd) and
moderate PRO 098 gkgd plusmn 012) consumers (P-for-trend 0001) bull Low PRO consumers were significantly unlikely to achieve CSWL (adjres= -31) while those ingesting High PRO
were significantly more likely to achieve CSWL (adjres = 49)bull High PRO consumers were significantly more likely to achieve CSWL during a short exercise intervention
consisting of resistance and aerobic training bull Higher PRO consumption may offset the magnitude of weight gain vs lower PRO intakes if weight loss is not
achieved
Retrospective analysis of weight loss relative to protein intake during short-term exercise training in womenEarnest al Med Sci Sports Exerc 49(5S)987 2017
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Determinants of weight loss maintenance a systematic reviewVarkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Strong Predictorsbull Weekly data reports monitoring weight (80)bull Self-monitoring eating (75)bull Increasing physical activity (76)bull Not using meal replacement during weight loss and
maintenance (80)bull Portion control (75)bull Cutting unhealthy food from diet (87)bull Reduction in energy intake energy dense foods (80)bull Not eating fast food or at restaurants (100)bull Increasing fruit amp vegetables (83)bull Reducing sugar-sweetened beverages (80)bull Reduction in fat intake (75)
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
bull Low to moderate intensity exercise provides significant health benefit but marginally affects weight loss in sedentary individuals initiating training
bull Diet intervention serves as the primary means of promoting weight loss in sedentary overweight or obese individuals but greater and more sustained effects are observed when combining diet and exercise
bull Low to moderate intensity aerobic exercise has been the most common form of physical activity in weight loss studies
bull Incorporating resistance exercise and higher protein low fat diets can be an effective way to promote fat loss without loss in FFM or REE
bull This approach is likely safe and effective for healthy men and women individuals at higher risk for chronic disease elderly and individuals with controlled medical conditionshttpwwwexerciseandsportnutritionlabcomcurves
Summary
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
bull Individuals initiating a diet and exercise program with metabolic syndrome or insulin resistance may experience greater benefit particularly in terms of reducing triglycerides and managing blood glucose
bull Maintaining a higher protein diet may help women achieve clinically significant weight loss and be more resistant to gaining weight
bull Maintaining physical activity after weight loss is a primary factor in preventing weight regain
bull Incorporating behavioral factors associated with weight loss or maintenance can improve outcomes
bull More work is needed to understand how genetics andor gene expression influences outcomes as more personalize approaches are developed
httpwwwexerciseandsportnutritionlabcomcurves
Summary
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
1 There is a multitude of diet types and eating styles whereby numerous subtypes fall under each major dietary archetype
2 All body composition assessment methods have strengths and limitations
3 Diets primarily focused on fat loss are driven by a sustained caloric deficit The higher the baseline body fat level the more aggressively the caloric deficit may be imposed Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects
4 Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands The composition and magnitude of the surplus as well as training status of the subjects can influence the nature of the gains
5 A wide range of dietary approaches (low-fat to low-carbohydrateketogenic and all points between) can be similarly effective for improving body composition
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
6 Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition Higher protein intakes (23ndash31 gkg FFM) may be required to maximize muscle retention in lean resistance-trained subjects under hypocaloric conditions Emerging research on very high protein intakes (gt3 gkg) has demonstrated that the known thermic satiating and LM-preserving effects of dietary protein might be amplified in resistance-training subjects
7 The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition
8 The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis
9 There is a paucity of research on women and older populations as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training Behavioral and lifestyle modification strategies are still poorly researched areas of weight management
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
StudentsBaylor University
bull Kristen Beavers PhDbull Jackie Beckham-Dove PhDbull Thomas Buford PhDbull Jen Wismann-Bunn PhDbull Brian Brabham PhDbull Bill Campbell PhDbull Rehka Chandran MDbull Matt Cooke PhD (Post-Doc)bull Julie Culbertson MSbull Terry Magrans-Courtney PhDbull Erika Dieke PhDbull Maria Ferreira PhDbull David Fogt PhD (Post-Doc)bull Melyn Galbreath NP PhDbull Jean Jitomir PhDbull Travis Harvey PhDbull Gregory Hudson PhDbull Mike Iosia PhD (Post-Doc)bull Chad Kerksick PhDbull Paul La Bounty PhDbull Rui Li PhDbull Brandon Marcello PhDbull Jen Moreillon PhDbull Chris Mulligan MSbull Erika Nassar PhDbull Adam Parker PhDbull Mike Roberts MS PhDbull Dan Rhol MSbull Monica Serra PhDbull Kathy Sharp MSbull Brian Shelmadine PhDbull Lem Taylor PhDbull Anthony Vacanti MSbull Colin Wilborn PhD
Texas AampM University
bull Felix Ayadi MSbull Mike Byrd PhDbull Claire Baetge PhD bull Major Nick Barringer RD PhDbull Scott Battley MSbull Jeremy Carter MSbull Minye Cho MSbull Adriana Coletta PhDbull Blaise Collins PhDbull Ryan Dalton PhDbull Elfego Galvin RD PhDbull Chelsea Goodenough BSbull Tyler Grubric PhDbull Andrew Jagim PhDbull Tori Jenkins MSbull Peter Jung PhDbull Deepesh Khanna PhDbull Majid Koozehchian PhDbull Julie Culbetson-Kresta PhDbull Kyle Levers PhDbull Brittanie Lockard PhDbull Major Michelle Mardock PhDbull Jonathan Oliver PhDbull Abigail OConner MSbull Alexander Reeser MS bull Amiee Reyes MS bull Brittany Sanchez PhDbull Sunday Simbo PhDbull Ryan Sowinski BSbull Sammy Springer MSbull Susannah Williamson MS
University of Memphis
bull Darren Bullen MSbull Patty Cowan PhD bull Maria Ferreira MS RDbull Pamela Grindstaff MSbull Shonteh Henderson MS DPTbull Chad Kerksick MSbull Pauline Koh-Banerjee MS DScibull Stacy Lancaster MS PhDbull Jen Lundberg MSbull Charlie Melton MSbull Leigh Ramsey MSbull John Ransom BSbull Chris Rasmussen MSbull Mike Starks MS PhDbull Mike Wilson MSbull Larry Wood MS
Old Dominion University
bull Jen Bozarth PhDbull Eric Burton MSbull Bart Drinkard MS PTbull Tracey Drews MSbull Gary Miller PhD bull Victor Miriel PhDbull Mary Mitchell-Beaton MS bull Sherri Parker PhDbull Debbie Schenck MSbull David Tulis PhD
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Research Network Anthony L Almada MSc (President amp Chief Scientific Officer ImagiNutrition) Diego A Bonilla (Universidad de Coacuterdoba Monteriacutea Colombia amp Universidad Distrital Francisco Joseacute de Caldas Bogotaacute Colombia) Claude Bouchard PhD (Pennington Biomedical Research Center Texas AampM TIAS Faculty Fellow) Patti Cowan PhD RN (College of Nursing University of Tennessee) Stephen Crouse PhD (Director Applied Exercise Science Lab Texas AampM University) Nicholaas Deutz MD PhD (Director Center for Translational Aging and Longevity Texas AampM University) Valter di Salvo PhD (Aspire Academy Qatar) Conrad Earnest PhD (Nutribolt Bryan TX) Jim Fluckey PhD (Muscle Biology Lab Department of Health amp Kinesiology Texas AampM University) Paul Greenhaff PhD (Department of Biomedical Sciences Queens Medical Centre Nottingham ENGLAND) Lori Greenwood PhD ATC LAT (Department of Health amp Kinesiology Texas AampM University) Mike Greenwood PhD FACSM FISSN FNSCA (Department of Health amp Kinesiology Texas AampM University) Roger Harris PhD FISSN (Retired formerly University of Chichester UK) David Huston MD (Director Clinical Science and Translational Research Institute College of Medicine Texas AampM Health Science Center) Gilbert Kaats PhD (Integrative Health Technologies San Antonio TX) Richard Linnehan DVM (NASA - Johnson Space Center - TAMUS) Timothy Lightfoot PhD (Director Huffines Institute for Sports Medicine and Human Performance Texas AampM University) Sarkis Meterissian MD CM (Cedars Breast Centre McGill University Health Center McGill University Quebec CANADA) Peter Murano PhD (Institute for Obesity Research amp Program Evaluation Texas AampM University) Jorge L Petro (Universidad de Coacuterdoba Monteriacutea Colombia) Steven Riechman PhD (Human Countermeasures Lab Department of Health amp Kinesiology Texas AampM University) Catherine Sabiston PhD (Health Behavior amp Emotion Lab Department of Kinesiology amp Physical Education McGill University Quebec CANADA) Lori Sigrist PhD RD CSSD (Center for the Intrepid Brooks Army Medical Center San Antonio TX) Susanne Talcott PhD (Department of Nutrition and Food Science Texas AampM University) Mark Tarnopolsky MD PhD FRCP(C) (Faculty of Health Sciences McMaster University Ontario CANADA) Per Tesch PhD (Mid Sweden University amp Karlinska Institute SWEDEN) Salvador Vargas (University of Maacutelaga Maacutelaga SPAIN) Robert Wolfe PhD (Vice-Chair of Center for Translational Research Professor Department of Geriatrics Reynolds Institute of Aging University of
Arkansas Reynolds Institute on Aging)
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
Students
Research Network
Slide Number 55
Slide Number 1
Slide Number 2
Historical Perspective of Obesity
Contemporary View of Obesity
Effects of Physical Activity on Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 7
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 9
Effects of Diet and Aerobic Exerciseon Weight Loss
Physical activity and obesity what we know and what we need to know Chin et al Obesity Rev 17 1226-44 2016
Slide Number 12
Effects of a High Protein Diet with Resistance-Exercise on Weight Loss
Rationale
Slide Number 15
Slide Number 16
Slide Number 17
Effects of a popular exercise and weight loss program on weight loss body composition energy expenditure and health in obese women Kerksick et al Nutri Metabol 6123 2009
Slide Number 19
Slide Number 20
Slide Number 21
Slide Number 22
Slide Number 23
Slide Number 24
Slide Number 25
Slide Number 26
Slide Number 27
Slide Number 28
Slide Number 29
Slide Number 30
Slide Number 31
Slide Number 32
Slide Number 33
Slide Number 34
Slide Number 35
Slide Number 36
Slide Number 37
Slide Number 38
Slide Number 39
Slide Number 40
Variability of Body Composition Results
Alignment of diet prescription to genotype does not promote greater weight loss success in women with obesity participating in an exercise and weight loss programColetta et al Obesity Sci Pract Epub Oct 16 2018 httpsdoiorg101002osp4305
Slide Number 43
Slide Number 44
Slide Number 45
Behavioral Factors that Contribute to Weight Loss and Maintenance
Determinants of weight loss maintenance a systematic review Varkevisser et al Obesity Reviews Epub ahead of print Oct 16 2018
Slide Number 48
Slide Number 49
Slide Number 50
International Society of Sports Nutrition position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
International Society of Sports Nutrition Position stand diets and body composition Aragon et al J Int Soc Sports Nutri 1416 2017
