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Research Article| Volume 37, ISSUE 8, P758-765, August 1988

Effects of aerobic exercise on energy expenditure and nitrogen balance during very low calorie dieting

  • Stephen D. Phinney
    Correspondence
    Address reprint requests to Stephen D. Phinney, MD, PhD, Division of Clinical Nutrition, School of Medicine, TB-156, University of California, Davis, CA 95616.
    Affiliations
    General Clinical Research Center, University of Vermont College of Medicine, Burlington, VT, USA.

    Metabolic Unit, University of Vermont College of Medicine, Burlington, VT, USA.
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  • Betty M. LaGrange
    Affiliations
    General Clinical Research Center, University of Vermont College of Medicine, Burlington, VT, USA.

    Metabolic Unit, University of Vermont College of Medicine, Burlington, VT, USA.
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  • Maureen O'Connell
    Affiliations
    General Clinical Research Center, University of Vermont College of Medicine, Burlington, VT, USA.

    Metabolic Unit, University of Vermont College of Medicine, Burlington, VT, USA.
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  • Elliot Danforth Jr
    Affiliations
    General Clinical Research Center, University of Vermont College of Medicine, Burlington, VT, USA.

    Metabolic Unit, University of Vermont College of Medicine, Burlington, VT, USA.
    Search for articles by this author
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      Abstract

      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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      References

        • Bjorntorp P
        • Sjostrom L
        • Sullivan L
        The role of physical exercise in the management of obesity.
        in: Munro JF The Treatment of Obesity. MTP, Lancaster, England1979: 123-137
        • Stern JS
        • Schultz C
        • Mole P
        • et al.
        Effect of caloric restriction and exercise on basal metabolism and thyroid hormone.
        Alimen Nutr Metab. 1980; 1: 361
        • Lennon D
        • Nagle F
        • Stratmen F
        • et al.
        Diet and exercise training effects on resting metabolic rate.
        Int J Obes. 1985; 9: 39-47
        • Donahoe Jr, CP
        • Daria HL
        • Kirschenbaum DS
        • et al.
        Metabolic consequences of dieting and exercise in the treatment of obesity.
        J Consult Clin Psychol. 1984; 52: 827-836
        • Apfelbaum M
        The effects of very restrictive high protein diets.
        Clin Endocrinol Metab. 1976; 5: 417-430
        • Blackburn GL
        • Flatt JP
        • Clowes GHA
        • et al.
        Protein sparing therapy during periods of starvation with sepsis and trauma.
        Ann Surg. 1973; 177: 588-594
        • Genuth SM
        • Castro JH
        • Vertes V
        Weight reduction in obesity by outpatient semistarvation.
        J Am Med Assoc. 1974; 230: 987-991
        • Sours HE
        • Frattali VP
        • Brand CD
        • et al.
        Sudden death associated with very low calorie weight reduction regimens.
        Am J Clin Nutr. 1981; 34: 453-461
        • Lantigua RA
        • Amatruda JM
        • Biddle TL
        • et al.
        Cardiac arrhythmias associated with a liquid protein diet for the treatment of obesity.
        N Engl J Med. 1980; 303: 735-738
        • Felig P
        Four questions about protein diets.
        N Engl J Med. 1978; 298: 1025-1026
        • Van Itallie TB
        Liquid protein mayhem.
        J Am Med Assoc. 1978; 240: 140-145
        • Felig P
        Editorial Retrospective: Very-low-calorie protein diets.
        N Engl J Med. 1984; 310: 589-591
        • Marliss EB
        • Murray FT
        • Nakhooda AF
        The metabolic response to hypocaloric protein diets in obese man.
        J Clin Invest. 1978; 62: 468-479
        • Bistrian BR
        • Blackburn GL
        • Flatt JP
        • et al.
        Nitrogen metabolism and insulin requirements in obese diabetic adults on a protein-sparing modified fast.
        Diabetes. 1976; 25: 494-504
        • Hoffer LJ
        • Bistrian BR
        • Young VR
        • et al.
        Metabolic effects of very low calorie weight reduction diets.
        J Clin Invest. 1984; 73: 750-758
        • Wadden TA
        • Stunkard AJ
        • Brownell KD
        Very low calorie diets: Their efficacy, safety, and future.
        Ann Intern Med. 1983; 99: 675-684
        • Hultman E
        Studies on muscle metabolism of glycogen and active phosphate in man with special reference to exercise and diet.
        Scand J Clin Lab Med. 1967; 19: 1-63
        • Phinney SD
        • Horton ES
        • Sims EAH
        • et al.
        Capacity for moderate exercise in obese subjects after adaptation to a hypocaloric ketogenic diet.
        J Clin Invest. 1980; 66: 1152-1161
        • Phinney SD
        • Bistrian BR
        • Evans WJ
        • et al.
        The human metabolic response to chronic ketosis without caloric restriction: Preservation of submaximal exercise capability with reduced carbohydrate oxidation.
        Metabolism. 1983; 32: 769-776
        • Bogardus C
        • LaGrange BM
        • Horton ES
        • et al.
        Comparison of carbohydrate-containing and carbohydrate-restricted hypocaloric diets in the treatment of obesity.
        J Clin Invest. 1981; 68: 399-404
        • Society of Actuaries
        ed 9. Build and Blood Pressure Study. vols 1 and 2. Society of Actuaries, Chicago1959
        • National Research Council
        ed 9. Recommended Dietary Allowances. National Academy of Sciences, Washington, DC1980
        • Ward MWN
        • Owens CWI
        • Rennie MJ
        Nitrogen estimation in biological samples by use of chemoluminescence.
        Clin Chem. 1980; 26: 1336-1339
        • Calloway DH
        • Odell ACF
        • Margen S
        Sweat and miscellaneous nitrogen losses in human balance studies.
        J Nutr. 1971; 101: 775-786
        • Bergmeyer HV
        ed 2. Methods of Enzymatic Analysis. Academic, San Diego1971
        • Scheidegger K
        • O'Connell M
        • Robbins DC
        • et al.
        Effects of chronic beta-receptor stimulation on sympathetic nervous system activity, energy expenditure, and thyroid hormones.
        J Clin Endocrinol Metab. 1984; 58: 1-9
        • Saltin B
        • Blomqvist G
        • Mitchell JH
        • et al.
        Response to exercise after bedrest and after training.
        Circulation. 1968; 38: 1-78
        • American College of Sports Medicine
        Position statement on proper and improper weight loss programs.
        Med Sci Sports Exerc. 1983; 15: ix-xiii
        • Maehlum S
        • Grandmontagne M
        • Newsholme EA
        • et al.
        Magnitude and duration of excess postexercise oxygen consumption in healthy young subjects.
        Metabolism. 1986; 35: 425-429
        • Taylor HL
        • Buskirk ER
        • Brozek J
        • et al.
        Performance capacity and effects of caloric restriction with hard physical work on young men.
        J Appl Physiol. 1957; 10: 421-429
        • Warwick PM
        • Garrow JS
        The effect of addition of exercise to a regimen of dietary restriction on weight loss, nitrogen balance, resting metabolic rate and spontaneous physical activity in three women in a metabolic ward.
        Int J Obes. 1981; 5: 25-32
        • Buskirk ER
        • Thompson RH
        • Lutwak L
        • et al.
        Energy balance of obese patients during weight reduction: Influence of diet restriction and exercise.
        Ann NY Acad Sci. 1963; 110: 918-940
        • Woo R
        • Garrow JS
        • Pi-Sunyer F-X
        Voluntary food intake during prolonged exercise in obese women.
        Am J Clin Nutr. 1982; 36: 478-484
        • Krotkiewski M
        • Toss L
        • Bjorntorp P
        • et al.
        The effect of a very-low-calorie diet with and without chronic exercise on thyroid and sex hormones, plasma proteins, oxygen uptake, insulin and c-peptide concentrations in obese women.
        Int J Obes. 1981; 5: 287-293
        • Kelleher PC
        • Phinney SD
        • Sims EAH
        • et al.
        Effects of carbohydrate containing and carbohydrate-restricted hypocaloric and eucaloric diets on serum concentrations of retinol binding protein, thyroxine binding prealbumin, and transferrin.
        Metabolism. 1983; 32: 95-101
        • Stockholm KH
        Decrease in serum free triiodothyronine, thyroxine-binding globulin, and thyroxine-binding prealbumin whilst taking a very low calorie diet.
        Int J Obes. 1980; 4: 133-138
        • Balsam A
        • Leppo LE
        Effect of physical training on the metabolism of thyroid hormones in man.
        J Appl Physiol. 1975; 38: 212-215
        • Gervino EV
        The effects of a protein sparing modified fast and acute exercise on fibrinolytic activity and lipoprotein patterns in obese women.
        in: ed 2. Doctoral thesis. Boston University, Sargent College, 1982