Abstract
The incidence of obesity is increasing rapidly. Research efforts for effective treatment strategies still focus on diet and exercise programmes, the individual components of which have been investigated in intervention trials in order to determine the most effective recommendations for sustained changes in bodyweight. The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss. Therefore, with respect to long-term effectiveness of weight-loss programmes, the loss of fat mass while maintaining FFM and RMR seems desirable.
Diet intervention studies suggest spontaneous losses in bodyweight following low-fat diets, and current data on a reduction of the carbohydrate-to-protein ratio of the diet show promising outcomes. Exercise training is associated with an increase in energy expenditure, thus promoting changes in body composition and bodyweight while keeping dietary intake constant. The advantages of strength training may have greater implications than initially proposed with respect to decreasing percentage body fat and sustaining FFM. Research to date suggests that the addition of exercise programmes to dietary restriction can promote more favourable changes in body composition than diet or physical activity on its own. Moreover, recent research indicates that the macronutrient content of the energy-restricted diet may influence body compositional alterations following exercise regimens. Protein emerges as an important factor for the maintenance of or increase in FFM induced by exercise training. Changes in RMR can only partly be accounted for by alterations in respiring tissues, and other yet-undefined mechanisms have to be explored. These outcomes provide the scientific rationale to justify further randomised intervention trials on the synergies between diet and exercise approaches to yield favourable modifications in body composition.
Notes
Throughout this article, the terms ‘fat-free mass’ and ‘lean body mass’ are used interchangeably.
References
World Health Organization. The world health report 2002: reducing risks, promoting health life. Geneva: World Health Organization, 2002
World Health Organization. Technical report series (TRS): obesity — preventing and managing the global epidemic; 1997 Jun 3–5; Geneva. Geneva: World Health Organization, 1998. Report no.: 894
Michaud DS, Giovannucci E, Willett WC, et al. Physical activity, obesity, height, and the risk of pancreatic cancer. JAMA 2001; 286 (8): 921–929
Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001; 345 (11): 790–797
Rexrode KM, Hennekens CH, Willett WC, et al. A prospective study of body mass index, weight change, and risk of stroke in women. JAMA 1997; 277 (19): 1539–1545
Pisunyer FX. Medical hazards of obesity. Ann Intern Med 1993; 119 (7): 655–660
March LM, Bagga H. Epidemiology of osteoarthritis in Australia. Med J Aust 2004; 180 (5 Suppl.): S6–S10
Nieters A, Becker N, Linseisen J. Polymorphisms in candidate obesity genes and their interaction with dietary intake of n-6 polyunsaturated fatty acids affect obesity risk in a sub-sample of the EPIC-Heidelberg cohort. Eur J Nutr 2002; 41 (5): 210–221
Bouchard C, Tremblay A. Genetic influences on the response of body fat and fat distribution to positive and negative energy balances in human identical twins. J Nutr 1997; 127: S943–S947
Peters JC, Wyatt HR, Donahoo WT, et al. From instinct to intellect: the challenge of maintaining healthy weight in the modern world. Obes Rev 2002; 3 (2): 69–74
Mazansky H. A review of obesity and its management in 263 cases. S Afr Med J 1975; 49 (47): 1955–1962
Saris WHM, Astrup A, Prentice AM, et al. Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids: the CARMEN study. Int J Obes 2000; 24 (10): 1310–1318
Poppitt SD, Keogh GF, Prentice AM, et al. Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. Am J Clin Nutr 2002; 75 (1): 11–20
Meckling KA, Gauthier M, Grubb R, et al. Effects of a hypocaloric, low-carbohydrate diet on weight loss, blood lipids, blood pressure, glucose tolerance, and body composition in free-living overweight women. Can J Physiol Pharmacol 2002; 80 (11): 1095–1105
Glass JN, Miller WC, Szymanski LM, et al. Physiological responses to weight-loss intervention in inactive obese African-American and Caucasian women. J Sports Med Phys Fitness 2002; 42 (1): 56–64
van Aggel-Leijssen DPC, Saris WHM, Hul GB, et al. Short-term effects of weight loss with or without low-intensity exercise training on fat metabolism in obese men. Am J Clin Nutr 2001; 73 (3): 523–531
Brill JB, Perry AC, Parker L, et al. Dose-response effect of walking exercise on weight loss: how much is enough? Int J Obes 2002; 26 (11): 1484–1493
Utter AC, Nieman DC, Shannonhouse EM, et al. Influence of diet and/or exercise on body composition and cardiorespirato-ry fitness in obese women. Int J Sport Nutr 1998; 8 (3): 213–222
Borg P, Kukkonen-Harjula K, Fogelholm M, et al. Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial. Int J Obes 2002; 26 (5): 676–683
Leslie WS, Lean MEJ, Baillie HM, et al. Weight management: a comparison of existing dietary approaches in a work-site setting. Int J Obes 2002; 26 (11): 1469–1475
Byrne NM, Weinsier RL, Hunter GR, et al. Influence of distribution of lean body mass on resting metabolic rate after weight loss and weight regain: comparison of responses in white and black women. Am J Clin Nutr 2003; 77 (6): 1368–1373
Gorin AA, Phelan S, Wing RR, et al. Promoting long-term weight control: does dieting consistency matter? Int J Obes 2004; 28 (2): 278–281
Leser MS, Yanovski SZ, Yanovski JA. A low-fat intake and greater activity level are associated with lower weight regain 3 years after completing a very-low-calorie diet. J Am Diet Assoc 2002; 102 (9): 1252–1256
Tataranni PA, Harper IT, Snitker S, et al. Body weight gain in free-living Pima Indians: effect of energy intake vs expenditure. Int J Obes 2003; 27 (12): 1578–1583
Ravussin E, Lillioja S, Knowler WC, et al. Reduced rate of energy-expenditure as a risk factor for body-weight gain. N Engl J Med 1988; 318 (8): 467–472
Seidell JC, Muller DC, Sorkin JD, et al. Fasting respiratory exchange ratio and resting metabolic-rate as predictors of weight-gain: the Baltimore Longitudinal study on aging. Int J Obes 1992; 16 (9): 667–674
Muller MJ, Grund A, Krause H, et al. Determinants of fat mass in prepubertal children. Br J Nutr 2002; 88 (5): 545–554
Muller MJ, Bosy-Westphal A, Kutzner D, et al. Metabolically active components of fat-free mass and resting energy expenditure in humans: recent lessons from imaging technologies. Obes Rev 2002; 3 (2): 113–122
Layman DK, Boileau RA, Erickson DJ, et al. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr 2003; 133 (2): 411–417
Farnsworth E, Luscombe ND, Noakes M, et al. Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women. Am J Clin Nutr 2003; 78 (1): 31–39
Tsai AC, Sandretto A, Chung YC. Dieting is more effective in reducing weight but exercise is more effective in reducing fat during the early phase of a weight-reducing program in healthy humans. J Nutr Biochem 2003; 14 (9): 541–549
Belko AZ, Vanloan M, Barbieri TF, et al. Diet, exercise, weight-loss, and energy-expenditure in moderately overweight women. Int J Obes 1987; 11 (2): 93–104
Schwartz RS, Jaeger LF, Veith RC, et al. The effect of diet or exercise on plasma norepinephrine kinetics in moderately obese young men. Int J Obes 1990; 14 (1): 1–11
van Aggel-Leijssen DP, Saris WH, Hul GB, et al. Long-term effects of low-intensity exercise training on fat metabolism in weight-reduced obese men. Metabolism 2002; 51 (8): 1003–1010
Torbay N, Baba NH, Sawaya S, et al. High protein vs high carbohydrate hypoenergetic diet in treatment of obese normoinsulinemic and hyperinsulinemic subjects. Nutr Res 2002; 22 (5): 587–598
Deriaz O, Fournier G, Tremblay A, et al. Lean-body-mass composition and resting energy-expenditure before and after long-term overfeeding. Am J Clin Nutr 1992; 56 (5): 840–847
Bitar A, Fellmann N, Vernet J, et al. Variations and determinants of energy expenditure as measured by whole-body indirect calorimetry during puberty and adolescence. Am J Clin Nutr 1999; 69 (6): 1209–1216
Sparti A, DeLany JP, de la Bretonne JA, et al. Relationship between resting metabolic rate and the composition of the fat-free mass. Metabolsim 1997; 46 (10): 1225–1230
Freake HC, Oppenheimer JH. Thermogenesis and thyroid-function. Annu Rev Nutr 1995; 15: 263–291
Astrup A, Toubro S, Dalgaard LT, et al. Impact of the v/v 55 polymorphism of the uncoupling protein 2 gene on 24-h energy expenditure and substrate oxidation. Int J Obes 1999; 23 (10): 1030–1034
Menozzi R, Bondi M, Baldini A, et al. Resting metabolic rate, fat-free mass and catecholamine excretion during weight loss in female obese patients. Br J Nutr 2000; 84 (4): 515–520
Doucet E, St Pierre S, Almeras N, et al. Changes in energy expenditure and substrate oxidation resulting from weight loss in obese men and women: is there an important contribution of leptin? J Clin Endocrinol Metab 2000; 85 (4): 1550–1556
Harper M-E, Dent R, Monemdjou S, et al. Decreased mitochondrial proton leak and reduced expression of uncoupling protein 3 in skeletal muscle of obese diet-resistant women. Diabetes 2002; 51 (8): 2459–2466
Pelletier C, Doucet E, Imbeault P, et al. Associations between weight loss-induced changes in plasma organochlorine concentrations, serum T3 concentration, and resting metabolic rate. Toxicol Sci 2002; 67 (1): 46–51
Rosenbaum M, Hirsch J, Murphy E, et al. Effects of changes in body weight on carbohydrate metabolism, catecholamine excretion, and thyroid function. Am J Clin Nutr 2000; 71 (6): 1421–1432
Sandoval DA, Davis SN. Leptin: metabolic control and regulation. J Diabetes Complications 2003; 17 (2): 108–113
Filozof CM, Murua C, Sanchez MP, et al. Low plasma leptin concentration and low rates of fat oxidation in weight-stable post-obese subjects. Obes Res 2000; 8 (3): 205–210
Jenkins AB, Markovic TP, Fleury A, et al. Carbohydrate intake and short-term regulation of leptin in humans. Diabetologia 1997; 40 (3): 348–351
Demling RH, DeSanti L. Effect of a hypocaloric diet, increased protein intake and resistance training on lean mass gains and fat mass loss in overweight police officers. Ann Nutr Metab 2000; 44 (1): 21–29
Whitehead JM, McNeill G, Smith JS. The effect of protein intake on 24-h energy expenditure during energy restriction. Int J Obes 1996; 20 (8): 727–732
Sloth B, Krog-Mikkelsen I, Flint A, et al. No difference in body weight decrease between a low-glycemic-index and a high-glycemic-index diet but reduced LDL cholesterol after 10-wk ad libitum intake of the low-glycemic-index diet. Am J Clin Nutr 2004; 80 (2): 337–347
Mueller-Cunningham WM, Quintana R, Kasim-Karakas SE. An ad libitum, very low-fat diet results in weight loss and changes in nutrient intakes in postmenopausal women. J Am Diet Assoc 2003; 103 (12): 1600–1606
Schlundt DG, Hill JO, Popecordle J, et al. Randomized evaluation of a low-fat ab libitum carbohydrate-diet for weight-reduction. Int J Obes 1993; 17 (11): 623–629
Turley ML, Skeaff CM, Mann JI, et al. The effect of a low-fat, high-carbohydrate diet on serum high density lipoprotein cholesterol and triglyceride. Eur J Clin Nutr 1998; 52 (10): 728–732
Brand-Miller JC, Holt SHA, Pawlak DB, et al. Glycemic index and obesity. Am J Clin Nutr 2002; 76 (1): 281S–285S
Brehm BJ, Spang SE, Lattin BL, et al. The role of energy expenditure in the differential weight loss in obese women on low-fat and low-carbohydrate diets. J Clin Endocrinol Metab 2005; 90 (3): 1475–1482
Skov AR, Toubro S, Ronn B, et al. Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes 1999; 23 (5): 528–536
Baba NH, Sawaya S, Torbay N, et al. High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects. Int J Obes 1999; 23 (11): 1202–1206
Luscombe-Marsh ND, Noakes M, Wittert GA, et al. Carbohydrate-restricted diets high in either monounsaturated fat or protein are equally effective at promoting fat loss and improving blood lipids. Am J Clin Nutr 2005; 81 (4): 762–772
Luscombe ND, Clifton PM, Noakes M, et al. Effect of a high-protein, energy-restricted diet on weight loss and energy expenditure after weight stabilization in hyperinsulinemic subjects. Int J Obes 2003; 27 (5): 582–590
McCrory MA, Suen VMM, Roberts SB. Biobehavioral influences on energy intake and adult weight gain. J Nutr 2002; 132 (12): 3830S–3834S
de Jonge L, Bray GA. The thermic effect of food and obesity: a critical review. Obes Res 1997; 5 (6): 622–631
Nair KS, Halliday D, Garrow JS. Thermic response to isoenergetic protein, carbohydrate or fat meals in lean and obese subjects. Clin Sci 1983; 65 (3): 307–312
Jequier E. Pathways to obesity. Int J Obes 2002; 26: S12–S17
Layman DK, Baum JI. Dietary protein impact on glycemic control during weight loss. J Nutr 2004; 134 (4): 968S–973S
McCrory MA, Fuss PJ, Saltzman E, et al. Dietary determinants of energy intake and weight regulation in healthy adults. J Nutr 2000; 130 (2): 276S–279S
Westerterp-Plantenga MS, Rolland V, Wilson SAJ, et al. Satiety related to 24h diet-induced thermogenesis during high protein carbohydrate vs high fat diets measured in a respiration chamber. Eur J Clin Nutr 1999; 53 (6): 495–502
Westerterp-Plantenga MS, Lejeune M, Nijs I, et al. High protein intake sustains weight maintenance after body weight loss in humans. Int J Obes 2004; 28 (1): 57–64
Poppitt SD, McCormack D, Buffenstein R. Short-term effects of macronutrient preloads on appetite and energy intake in lean women. Physiol Behav 1998; 64 (3): 279–285
Latner JD, Schwartz M. The effects of a high-carbohydrate, high-protein or balanced lunch upon later food intake and hunger ratings. Appetite 1999; 33 (1): 119–128
Stubbs RJ, van Wyk MCW, Johnstone AM, et al. Breakfasts high in protein, fat or carbohydrate: effect on within-day appetite and energy balance. Eur J Clin Nutr 1996; 50 (7): 409–417
Raben A, Agerholm-Larsen L, Flint A, et al. Meals with similar energy densities but rich in protein, fat, carbohydrate, or alcohol have different effects on energy expenditure and substrate metabolism but not on appetite and energy intake. Am J Clin Nutr 2003; 77 (1): 91–100
Vozzo R, Wittert G, Cocchiaro C, et al. Similar effects of foods high in protein, carbohydrate and fat on subsequent spontaneous food intake in healthy individuals. Appetite 2003; 40 (2): 101–107
Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 2003; 348 (21): 2082–2090
Samaha FF, Iqbal N, Seshadri P, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med 2003; 348 (21): 2074–2081
Eisenstein J, Roberts SB, Dallal G, et al. High-protein weight-loss diets: are they safe and do they work? A review of the experimental and epidemiologic data. Nutr Rev 2002; 60 (7): 189–200
Kerstetter JE, O’Brien KO, Insogna KL. Dietary protein, calcium metabolism, and skeletal homeostasis revisited. Am J Clin Nutr 2003; 78 (3): 584S–592S
Massey LK. Dietary animal and plant protein and human bone health: a whole foods approach. J Nutr 2003; 133 (3): 862S–865S
Ryan AS. Insulin resistance with aging: effects of diet and exercise. Sports Med 2000; 30 (5): 327–346
Maehlum S, Grandmontagne M, Newsholme EA, et al. Magnitude and duration of excess postexercise oxygen-consumption in healthy-young subjects. Metabolism 1986; 35 (5): 425–429
Borsheim E, Bahr R. Effect of exercise intensity, duration and mode on post-exercise oxygen consumption. Sports Med 2003; 33 (14): 1037–1060
Frey GC, Byrnes WC, Mazzeo RS. Factors influencing excess postexercise oxygen-consumption in trained and untrained women. Metabolism 1993; 42 (7): 822–828
Short KR, Sedlock DA. Excess postexercise oxygen consumption and recovery rate in trained and untrained subjects. J Appl Physiol 1997; 83 (1): 153–159
Sjodin AM, Forslund AH, Westerterp KR, et al. The influence of physical activity on BMR. Med Sci Sports Exerc 1996; 28 (1): 85–91
Melby C, Scholl C, Edwards G, et al. Effect of acute resistance exercise on postexercise energy-expenditure and resting metabolic-rate. J Appl Physiol 1993; 75 (4): 1847–1853
Tonkonogi M, Krook A, Walsh B, et al. Endurance training increases stimulation of uncoupling of skeletal muscle mitochondria in humans by non-esterified fatty acids: an uncou-pling-protein-mediated effect? Biochem J 2000; 351: 805–810
Schrauwen P, Hesselink M. Uncoupling protein 3 and physical activity: the role of uncoupling protein 3 in energy metabolism revisited. Proc Nutr Soc 2003; 62 (3): 635–643
Short KR, Vittone JL, Bigelow ML, et al. Age and aerobic exercise training effects on whole body and muscle protein metabolism. Am J Physiol Endocrinol Metab 2004; 286 (1): E92–E101
Poehlman ET, Gardner AW, Goran MI. Influence of endurance training on energy intake, norepinephrine kinetics, and metabolic rate in older individuals. Metabolism 1992; 41 (9): 941–948
Horton TJ, Drougas HJ, Sharp TA, et al. Energy-balance in endurance-trained female cyclists and untrained controls. J Appl Physiol 1994; 76 (5): 1937–1945
Westerterp KR, Meijer GAL, Schoffelen P, et al. Body-mass, body-composition and sleeping metabolic-rate before, during and after endurance training. Eur J Appl Physiol Occup Physiol 1994; 69 (3): 203–208
Venables MC, Achten J, Jeukendrup AE. Determinants of fat oxidation during exercise in healthy men and women: a cross-sectional study. J Appl Physiol 2005 Jan; 98 (1): 160–167. Epub 2004 Aug 27
Abdel-Hamid TK. Modeling the dynamics of human energy regulation and its implications for obesity treatment. System Dynamics Rev 2002; 18 (4): 431–471
van Aggel-Leijssen DP, Saris WH, Wagenmakers AJ, et al. The effect of low-intensity exercise training on fat metabolism of obese women. Obes Res 2001; 9 (2): 86–96
Wilmore JH, Despres JP, Stanforth PR, et al. Alterations in body weight and composition consequent to 20 wk of endurance training: the HERITAGE Family Study. Am J Clin Nutr 1999; 70 (3): 346–352
Donnelly JE, Hill JO, Jacobsen DJ, et al. Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the midwest excercise trial. Arch Intern Med 2003; 163 (11): 1343–1350
Kirk EP, Jacobsen DJ, Gibson C, et al. Time course for changes in aerobic capacity and body composition in overweight men and women in response to long-term exercise: the Midwest Exercise Trial (MET). Int J Obes 2003; 27 (8): 912–919
Wilmore JH, Stanforth PR, Hudspeth LA, et al. Alterations in resting metabolic rate as a consequence of 20 wk of endurance training: the HERITAGE Family Study. Am J Clin Nutr 1998; 68 (1): 66–71
Grediagin MA, Cody M, Rupp J, et al. Exercise intensity does net effect body-composition change in untrained, moderately overfat women. J Am Diet Assoc 1995; 95 (6): 661–665
Donnelly JE, Jacobsen DJ, Heelan KS, et al. The effects of 18 months of intermittent vs continuous exercise on aerobic capacity, body weight and composition, and metabolic fitness in previously sedentary, moderately obese females. Int J Obes 2000; 24 (5): 566–572
Sykes K, Choo LL, Cotterrell M. Accumulating aerobic exercise for effective weight control. J R Soc Health 2004; 124 (1): 24–28
Schmitz KH, Jensen MD, Kugler KC, et al. Strength training for obesity prevention in midlife women. Int J Obes 2003; 27 (3): 326–333
Cullinen K, Caldwell M. Weight training increases fat free mass and strength in untrained young women. J Am Diet Assoc 1998; 98 (4): 414–418
Byrne HK, Wilmore JH. The effects of a 20-week exercise training program on resting metabolic rate in previously sedentary, moderately obese women. Int J Sport Nutr Exerc Metab 2001; 11 (1): 15–31
Walberg JL. Aerobic exercise and resistance weight-training during weight-reduction: implications for obese persons and athletes. Sports Med 1989; 7 (6): 343–356
Speakman JR, Selman C. Physical activity and resting metabolic rate. Proc Nutr Soc 2003; 62: 621–634
Warwick PM, Garrow JS. The effect of addition of exercise to a regime of dietary restriction on weight-loss, nitrogen-balance, resting metabolic-rate and spontaneous physical-activity in 3 obese women in a metabolic ward. Int J Obes 1981; 5 (1): 25–32
Woo R, Garrow JS, Pisunyer FX. Effect of exercise on spontaneous calorie intake in obesity. Am J Clin Nutr 1982; 36 (3): 470–477
Klausen B, Toubro S, Ranneries C, et al. Increased intensity of a single exercise bout stimulates subsequent fat intake. Int J Obes 1999; 23 (12): 1282–1287
Lluch A, King NA, Blundell JE. No energy compensation at the meal following exercise indietary restrained and unrestrained women. Br J Nutr 2000; 84 (2): 219–225
Kempen KPG, Saris WHM, Westerterp KR. Energy-balance during an 8-wk energy-restricted diet with and without exercise in obese women. Am J Clin Nutr 1995; 62 (4): 722–729
Stubbs RJ, Sepp A, Hughes DA, et al. The effect of graded intake and balance levels of exercise on energy in free-living women. Int J Obes 2002; 26 (6): 866–869
Stubbs RJ, Hughes DA, Johnstone AM, et al. Rate and extent of compensatory changes in energy intake and expenditure in response to altered exercise and diet composition in humans. Am J Physiol Regul Integr Comp Physiol 2004; 286 (2): R350–R358
Provencher V, Drapeau V, Tremblay A, et al. Eating behaviors and indexes of body composition in men and women from the Quebec family study. Obes Res 2003; 11 (6): 783–792
Visona C, George VA. Impact of dieting status and dietary restraint on postexercise energy intake in overweight women. Obes Res 2002; 10 (12): 1251–1258
Frey-Hewitt B, Vranizan KM, Dreon DM, et al. The effect of weight loss by dieting or exercise on resting metabolic rate in overweight men. Int J Obes 1990; 14 (4): 327–334
Hays NP, Starling RD, Liu XL, et al. Effects of an ad libitum low-fat, high-carbohydrate diet on body weight, body composition, and fat distribution in older men and women: a randomized controlled trial. Arch Intern Med 2004; 164 (2): 210–217
Okura T, Nakata Y, Tanaka K. Effects of exercise intensity on physical fitness and risk factors for coronary heart disease. Obes Res 2003; 11 (9): 1131–1139
Racette SB, Schoeller DA, Kushner RF, et al. Effects of aerobic exercise and dietary carbohydrate on energy-expenditure and body-composition during weight-reduction in obese rate. Am J Clin Nutr 1995; 61 (3): 486–494
Gornall J, Villani RG. Short-term changes in body composition and metabolism with severe dieting and resistance exercise. Int J Sport Nutr 1996; 6 (3): 285–294
Doi T, Matsuo T, Sugawara M, et al. New approach for weight reduction by a combination of diet, light resistance exercise and the timing of ingesting a protein supplement. Asia Pac J Clin Nutr 2001; 10 (3): 226–232
Rice B, Janssen I, Hudson R, et al. Effects of aerobic or resistance exercise and/or diet on glucose tolerance and plasma insulin levels in obese men. Diabetes Care 1999; 22 (5): 684–691
Janssen I, Fortier A, Hudson R, et al. Effects of an energy-restrictive diet with or without exercise on abdominal fat, intermuscular fat, and metabolic risk factors in obese women. Diabetes Care 2002; 25 (3): 431–438
Geliebter A, Maher MM, Gerace L, et al. Effects of strength or aerobic training on body composition, resting metabolic rate, and peak oxygen consumption in obese dieting subjects. Am J Clin Nutr 1997; 66 (3): 557–563
Bryner RW, Ullrich IH, Sauers J, et al. Effects of resistance vs. aerobic training combined with an 800 calorie liquid diet on lean body mass and resting metabolic rate. J Am Coll Nutr 1999; 18 (2): 115–121
Marks BL, Ward A, Morris DH, et al. Fat-free mass is maintained in women following a moderate diet and exercise program. Med Sci Sports Exerc 1995; 27 (9): 1243–1251
Wadden TA, Vogt RA, Kuehnel RH, et al. Exercise in the treatment of obesity: effects of four interventions on body composition, resting energy expenditure, appetite, and mood. J Consult Clin Psychol 1997; 65 (2): 269–277
Kraemer WJ, Volek JS, Clark KL, et al. Physiological adaptations to a weight-loss dietary regimen and exercise programs in women. J Appl Physiol 1997; 83 (1): 270–279
Svendsen OL, Hassager C, Christiansen C. Effect of an energy-restrictive diet, with or without exercise, on lean tissue mass, resting metabolic-rate, cardiovascular risk-factors, and bone in overweight postmenopausal women. Am J Med 1993; 95 (2): 131–140
Evans WJ. Protein nutrition and resistance exercise. Can J Appl Physiol 2001; 26: S141–S152
Doi T, Matsuo T, Sugawara M, et al. New approach for weight reduction by a combination of diet, light resistance exercise and the timing of ingesting a protein supplement. Asia Pacific J Clin Nutr 2001; 10 (3): 226–232
Lafortuna CL, Resnik M, Galvani C, et al. Effects of non-specific vs individualized exercise training protocols on aerobic anaerobic and strength performance in severely obese subjects during a short-term body mass reduction program. J Endocrinol Invest 2003; 26 (3): 197–205
Forbes GB. Diet and exercise in obese subjects: self-report versus controlled measurements. Nutr Rev 1993; 51 (10): 296–300
Andersen RE, Franckowiak SC, Bartlett SJ, et al. Physiologic changes after diet combined with structured aerobic exercise or lifestyle activity. Metabolism 2002; 51 (12): 1528–1533
Forbes GB. Body fat content influences the body composition response to nutrition and exercise. Ann N Y Acad Sci 2000; 904: 359–365
Lennon D, Nagle F, Stratman F, et al. Diet and exercise training effects on resting metabolic rate. Int J Obes 1985; 9 (1): 39–47
Poehlman ET. Exercise and its influence on resting energy-metabolism in man: a review. Med Sci Sports Exerc 1989; 21 (5): 515–525
Poehlman ET, Horton ES. The impact of food-intake and exercise on energy-expenditure. Nutr Rev 1989; 47 (5): 129–137
Schuenke MD, Mikat RP, McBride JM. Effect of an acute period of resistance exercise on excess post-exercise oxygen consumption: implications for body mass management. Eur J Appl Physiol 2002; 86 (5): 411–417
Osterberg KL, Melby CL. Effect of acute resistance exercise on postexercise oxygen consumption and resting metabolic rate in young women. Int J Sport Nutr 2000; 10 (1): 71–81
De Feo P, Di Loreto C, Lucidi P, et al. Metabolic response to exercise. J Endocrinol Invest 2003; 26 (9): 851–854
Reynolds TH, Brown MD, Supiano MA, et al. Aerobic exercise training improves insulin sensitivity independent of plasma tumor necrosis factor-alpha levels in older female hypertensives. Metabolism 2002; 51 (11): 1402–1406
Goodpaster BH, Katsiaras A, Kelley DE. Enhanced fat oxidation through physical activity is associated with improvements in insulin sensitivity in obesity. Diabetes 2003; 52 (9): 2191–2197
Schrauwen P, Lichtenbelt WDV, Saris WHM, et al. Fat balance in obese subjects: role of glycogen stores. Am J Physiol 1998; 37 (6): E1027–E1033
Binzen CA, Swan PD, Manore MM. Postexercise oxygen consumption and substrate use after resistance exercise in women. Med Sci Sports Exerc 2001; 33 (6): 932–938
Mayo MJ, Grantham JR, Balasekaran G. Exercise-induced weight loss preferentially reduces abdominal fat. Med Sci Sports Exerc 2003; 35 (2): 207–213
Lindstrom J, Louheranta A, Mannelin M, et al. The Finnish Diabetes Prevention Study (DPS). Diabetes Care 2003; 26 (12): 3230–3236
Acknowledgements
Support for the preparation of this manuscript was provided by the School of Biosciences, University of Westminster. The authors have no conflicts of interest that are directly relevant to the content of this review.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Stiegler, P., Cunliffe, A. The Role of Diet and Exercise for the Maintenance of Fat-Free Mass and Resting Metabolic Rate During Weight Loss. Sports Med 36, 239–262 (2006). https://doi.org/10.2165/00007256-200636030-00005
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-200636030-00005