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Aerobic exercise in addition to severe caloric restriction was studied for its effects on resting energy expenditure (REE), weight loss, and lean tissue preservation in adult women. A formula diet providing 1.5 g protein and 0.5 g carbohydrate (CHO) per kilogram of ideal body weight daily (mean intake 720 kcal/d) was given to 12 overweight inpatients for 4 to 5 weeks. Six subjects remained sedentary (group 1), while the other six subjects (group 2) performed supervised endurance exercise (a total of 27 hours at 50% of maximal oxygen uptake (V̇O2max) over 4 weeks). Lean tissue preservation was excellent in both groups and was unaffected by the group 2 exercise regimen. Weight loss over 4 weeks in the two groups did not differ (group 1, 6.9 ± 0.7 kg; group 2, 6.5 ± 0.7 kg). The V̇O2max was not increased after 4 weeks of exercise compared with controls. The resting oxygen consumption (rV̇O2) of both groups declined 10% (P < .001) in the first seven days of dieting. Thereafter the rV̇O2 in group 1 remained stable, but a further 17% reduction occurred in group 2 (P < .03) by the third week of exercise. The free triiodothyronine (fT3) concentration also fell more in group 2 (P < .05), suggesting a relationship between fT3 and energy expenditure during severe caloric restriction. The ergometer exercise for up to two hours daily was well tolerated. The absence of either a training effect or accelerated weight loss in group 2 may be due to the limited duration (4 weeks) or intensity of the exercise. The significant reduction in rV̇O2 as a measure of REE is both surprising and difficult to explain. The lack of objective benefits from aggressive aerobic exercise concurrent with a severely restricted diet suggests that these therapeutic modalities be employed sequentially, rather than simultaneously, in the multidisciplinary approach to obesity.
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☆Supported in part by Grant GCRC RR-109 from the National Institutes of Health, AM 18535 and by Ross Laboratories, Inc.
© 1988 Published by Elsevier Inc.