3-Year effect of weight loss via severe versus moderate energy restriction on body composition among postmenopausal women with obesity - the TEMPO Diet Trial
Radhika V. Seimon,
Anthony L. Wild-Taylor,
Sally McClintock,
Claudia Harper,
Alice A. Gibson,
Nathan A. Johnson,
Hamish A. Fernando,
Tania P. Markovic,
Jacqueline R. Center,
Janet Franklin,
Peter Y. Liu,
Stuart M. Grieve,
Jim Lagopoulos,
Ian D. Caterson,
Nuala M. Byrne,
Amanda Sainsbury
Affiliations
Radhika V. Seimon
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Corresponding author.
Anthony L. Wild-Taylor
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
Sally McClintock
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
Claudia Harper
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
Alice A. Gibson
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
Nathan A. Johnson
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia
Hamish A. Fernando
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
Tania P. Markovic
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
Jacqueline R. Center
Bone Biology Program, Garvan Institute of Medical Research, St Vincent's Hospital Clinical School, University of New South Wales, Sydney, New South Wales, Australia
Janet Franklin
Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
Peter Y. Liu
Division of Endocrinology, Department of Medicine, Harbor-University of California Los Angeles Medical Center and Los Angeles BioMedical Research Institute, Los Angeles
Stuart M. Grieve
Imaging and Phenotyping Laboratory, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Department of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
Jim Lagopoulos
Sunshine Coast Mind and Neuroscience–Thompson Institute, University of the Sunshine Coast, Queensland, Australia
Ian D. Caterson
The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia; Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
Nuala M. Byrne
School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
Amanda Sainsbury
School of Human Sciences, Faculty of Science, The University of Western Australia, Crawley, Western Australia, Australia; Corresponding author.
We have previously shown that a severely energy-restricted diet leads to greater loss of weight, fat, lean mass and bone mineral density (BMD) at 12 months in postmenopausal women with obesity than a moderately energy-restricted diet. We now aim to evaluate whether these effects are sustained longer term (ie, at 36 months). 101 postmenopausal women were randomized to either 12 months of moderate (25 to 35%) energy restriction with a food-based diet (moderate intervention), or 4 months of severe (65 to 75%) energy restriction with a total meal replacement diet followed by moderate energy restriction for 8 months (severe intervention). Body weight and composition were measured at 0, 24 and 36 months. Participants in the severe intervention lost ~1.5 to 1.7 times as much weight, waist circumference, whole-body fat mass and visceral adipose tissue compared to those in the moderate intervention, and were 2.6 times more likely (42% versus 16%) to have lost 10% or more of their initial body weight at 36 months (P < 0.01 for all). However, those in the severe versus moderate intervention lost ~1.4 times as much whole-body lean mass (P < 0.01), albeit this was proportional to total weight lost and there was no greater loss of handgrip strength, and they also lost ~2 times as much total hip BMD between 0 and 36 months (P < 0.05), with this bone loss occurring in the first 12 months. Thus, severe energy restriction is more effective than moderate energy restriction for reducing weight and adiposity in postmenopausal women in the long term (3 years), but attention to BMD loss in the first year is required. Trial registration: Australian New Zealand Clinical Trials Registry Reference Number: 12612000651886, anzctr.org.au.