Effect of diet with or without exercise on abdominal fat in postmenopausal women - a randomised trial

BMC Public Health. 2019 Feb 11;19(1):174. doi: 10.1186/s12889-019-6510-1.


Background: We assessed the effect of equivalent weight loss with or without exercise on (intra-) abdominal fat in postmenopausal women in the SHAPE-2 study.

Methods: The SHAPE-2 study is a three-armed randomised controlled trial conducted in 2012-2013 in the Netherlands. Postmenopausal overweight women were randomized to a diet (n = 97), exercise plus diet (n = 98) or control group (n = 48). Both intervention groups aimed for equivalent weight loss (6-7%) following a calorie-restricted diet (diet group) or a partly supervised intensive exercise programme (4 h per week) combined with a small caloric restriction (exercise plus diet group). Outcomes after 16 weeks are amount and distribution of abdominal fat, measured by magnetic resonance imaging (MRI) with the use of the three-point IDEAL Dixon method.

Results: The diet and exercise plus diet group lost 6.1 and 6.9% body weight, respectively. Compared to controls, subcutaneous and intra-abdominal fat reduced significantly with both diet (- 12.5% and - 12.0%) and exercise plus diet (- 16.0% and - 14.6%). Direct comparison between both interventions revealed that the reduction in subcutaneous fat was statistically significantly larger in the group that combined exercise with diet: an additional 10.6 cm2 (95%CI -18.7; - 2.4) was lost compared to the diet-only group. Intra-abdominal fat loss was not significantly larger in the exercise plus diet group (- 3.8 cm2, 95%CI -9.0; 1.3).

Conclusions: We conclude that weight loss of 6-7% with diet or with exercise plus diet reduced both subcutaneous and intra-abdominal fat. Only subcutaneous fat statistically significantly reduced to a larger extent when exercise is combined with a small caloric restriction.

Trial register: NCT01511276 (clinicaltrials.gov), prospectively registered.

Keywords: Exercise; Intra-abdominal fat; Subcutaneous fat; Weight loss.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Abdominal Fat*
  • Aged
  • Caloric Restriction*
  • Exercise*
  • Female
  • Humans
  • Middle Aged
  • Netherlands
  • Obesity
  • Overweight / prevention & control*
  • Postmenopause*
  • Program Evaluation
  • Weight Reduction Programs / methods*

Associated data

  • ClinicalTrials.gov/NCT01511276