Resistance training during a 12-week protein supplemented VLCD treatment enhances weight-loss outcomes in obese patients

Edward Jo; Phillip R Worts; Marcus L Elam; Ann Frost Brown; Andy V Khamoui; Do-Houn Kim; Ming-Chia Yeh; Michael J Ormsbee; Carla M Prado; Angelina Cain; Katie Snyder; Jeong-Su Kim

doi:10.1016/j.clnu.2017.12.015

Resistance training during a 12-week protein supplemented VLCD treatment enhances weight-loss outcomes in obese patients

Clin Nutr. 2019 Feb;38(1):372-382. doi: 10.1016/j.clnu.2017.12.015. Epub 2017 Dec 23.

Authors

Affiliations

¹ Human Performance Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University Pomona, Pomona, CA, USA.
² Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA.
³ Department of Movement Sciences, University of Idaho, Moscow, ID, USA.
⁴ Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, FL, USA.
⁵ Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA; Institute of Sports Sciences and Medicine, Florida State University, Tallahassee, FL, USA; Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, South Africa.
⁶ Department of Agriculture, Food, and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
⁷ Tallahassee Memorial Hospital, Tallahassee, FL, USA.
⁸ Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, USA; Institute of Sports Sciences and Medicine, Florida State University, Tallahassee, FL, USA. Electronic address: jkim6@fsu.edu.

PMID: 29352654
DOI: 10.1016/j.clnu.2017.12.015

Abstract

Background: This investigation evaluated the efficacy by which resistance training enhances body composition, metabolic, and functional outcomes for obese patients undergoing a 12-week medically supervised hypocaloric treatment.

Methods: This was a single-blind, randomized, parallel-group prospective trial. Morbidly obese patients were prescribed a 12-week proprietary very low calorie diet (VLCD) treatment (Optifast^®) with supplemental protein (1120 kcals/day) and were placed in one of two groups for 14 weeks: 1) Standard Treatment Control (CON) (n = 5) or 2) Resistance Training (RT) (n = 6). Both groups underwent a pedometer-based walking program; however only RT performed resistance training 3 days/week for 12 weeks. Body composition, resting energy expenditure (REE), neuromuscular function, and serum biomarkers were measured at weeks 0, 6, and 13.

Results: Both groups exhibited a significant loss of total body mass (TBM) (CON: -19.4 ± 2.3 kg, p = 0.0009 vs. RT: -15.8 ± 1.5 kg, p = 0.0002) and fat mass (FM) (CON: -14.7 ± 1.8 kg, p = 0.0002 vs. RT: -15.1 ± 2.1 kg, p = 0.0002) with no group differences. CON lost 4.6 ± 0.8 kg (p = 0.004) of lean mass (LM) while RT demonstrated no changes. Group differences were found for the relative proportion of total weight-loss due to FM-loss (CON: 75.6 ± 3.4% vs. RT: 96.0 ± 6.0%, p = 0.03) and LM-loss (CON: 24.4 ± 3.2% vs. RT: 4.0 ± 6.5%, p = 0.03). CON demonstrated a 328.6 ± 72.7 kcal/day (-14.3 ± 2.4%) (p = 0.02) decrease in REE while RT exhibited a non-significant decrease of 4.6 ± 1.6% (p = 0.78). RT demonstrated greater improvements in all measures of contractile function and strength when compared to CON (p < 0.05). At post-treatment, RT exhibited greater serum free fatty acids (p = 0.01), glycerol (p = 0.003), and β-hydroxybutyrate (p = 0.005) than CON.

Conclusion: Resistance training was advantageous for weight-loss composition by preservation of LM without compromising overall weight- or fat-loss in morbidly obese men and women undergoing a protein supplemented VLCD. These changes accompanied positive adaptations for resting metabolism and muscular function.

Keywords: Body composition; Caloric restriction; Resistance exercise; Skeletal muscle; Weight-loss.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Diet, Reducing / methods*
Dietary Proteins / administration & dosage*
Dietary Supplements*
Female
Humans
Male
Middle Aged
Obesity, Morbid / therapy*
Prospective Studies
Resistance Training / methods*
Single-Blind Method
Therapeutics
Weight Loss*

Substances

Dietary Proteins