Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial

Willemijn A M van Gemert; Job van der Palen; Evelyn M Monninkhof; Anouk Rozeboom; Roelof Peters; Harriet Wittink; Albertine J Schuit; Petra H Peeters

doi:10.1371/journal.pone.0127520

Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial

PLoS One. 2015 Jun 1;10(6):e0127520. doi: 10.1371/journal.pone.0127520. eCollection 2015.

Authors

Willemijn A M van Gemert¹, Job van der Palen², Evelyn M Monninkhof¹, Anouk Rozeboom¹, Roelof Peters³, Harriet Wittink³, Albertine J Schuit⁴, Petra H Peeters¹

Affiliations

¹ University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands.
² Medisch Spectrum Twente Hospital, Department of Epidemiology, P.O. Box 50000, 7500 KA, Enschede, the Netherlands; University of Twente, Department of Research Methodology, Measurement, and Data Analysis, P.O. Box 217, 7500 AE, Enschede, the Netherlands.
³ Utrecht University of Applied Sciences, Research group Lifestyle and Health, Faculty of Health Care, P.O. Box 85182, 3508 AD, Utrecht, the Netherlands.
⁴ National Institute for Public Health and the Environment, Division of Public Health and Health Care, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands; VU University, Department of Health Sciences and EMGO Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.

Abstract

Introduction: This study investigates the effect of a modest weight loss either by a calorie restricted diet or mainly by increased physical exercise on health related quality of life (HRQoL) in overweight-to-obese and inactive postmenopausal women. We hypothesize that HRQoL improves with weight loss, and that exercise-induced weight loss is more effective for this than diet-induced weight loss.

Methods: The SHAPE-2 trial was primarily designed to evaluate any additional effect of weight loss by exercise compared with a comparable amount of weight loss by diet on biomarkers relevant for breast cancer risk. In the present analysis we focus on HRQoL. We randomly assigned 243 eligible women to a diet (n = 97), exercise (n = 98), or control group (n = 48). Both interventions aimed for 5-6 kg weight loss. HRQoL was measured at baseline and after 16 weeks by the SF-36 questionnaire.

Results: Data of 214 women were available for analysis. Weight loss was 4.9 kg (6.1%) and 5.5 kg (6.9%) with diet and exercise, respectively. Scores of the SF-36 domain 'health change' increased significantly by 8.8 points (95% CI 1.6;16.1) with diet, and by 20.5 points (95% CI 13.2;27.7) with exercise when compared with control. Direct comparison of diet and exercise showed a statistically significantly stronger improvement with exercise. Both intervention groups showed a tendency towards improvements in most other domains, which were more pronounced in the exercise group, but not statistically different from control or each other.

Conclusion: In a randomized trial in overweight-to-obese and inactive postmenopausal women a comparable 6%-7% weight loss was achieved by diet-only or mainly by exercise and showed improvements in physical and mental HRQoL domains, but results were not statistically significant in either the diet or exercise group. However, a modest weight loss does lead to a positive change in self-perceived health status. This effect was significantly larger with exercise-induced weight loss than with comparable diet-induced weight loss.

Trial registration: ClinicalTrials.gov NCT01511276.

Publication types

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

MeSH terms

Biomarkers / blood
Diet
Exercise / physiology*
Female
Humans
Male
Middle Aged
Obesity / blood*
Overweight / blood*
Postmenopause*
Quality of Life
Weight Loss / physiology

Substances

Biomarkers

Associated data

ClinicalTrials.gov/NCT01511276

Grants and funding

This work was supported by the Dutch Cancer Society (www.kwf.nl, grant number UU 2010-4843) and the Dutch Pink Ribbon Foundation (www.pinkribbon.nl, grant numbers PR110032 and PR110039). The support from the sponsors was unconditional, and the data collection, design, management, analysis, interpretation and reporting were performed without their interference. The role of the sponsors was limited to approving the scientific proposal of the study; covering salary costs of study personnel, costs for the data collection and costs for biochemical analyses.