Successful Dieting [3/5]: Calorie Restriction, Higher Protein, Exercise and Recomposition


We have seen before that higher protein diets and exercise, especially weight training have additive effects on lean body mass maintenance or even gain of lean body mass in a caloric deficit. Higher protein diets and supplemental exercise tends to increase weight loss, but has greater effects on body composition through the preservation of lean body mass while increasing fat loss.


A minimum of 150 min per week of moderate-intensity physical activity for overweight and obese adults was recommend to improve health and 200-300 min per week was recommended for long-term weight loss (1). An update of that evidence indicates that more physical activity may be necessary to prevent weight regain after weight loss. Moderate-intensity physical activity between 150 and 250 min per week improve weight loss in addition to moderate diet restriction but not severe diet restriction (2). Weight maintenance is improved with physical activity >250 min per week, and while resistance training does not enhance weight loss it may increase fat-free mass and increase loss of fat mass (2).

A dose-response relationship exists between amount of exercise and long-term weight loss (3). In one randomized controlled trial (RCT), 115 overweight women completed an 18 month behavioral weight control program. Women were divided into 3 groups: long-bout exercise (LB), multiple short-bout exercise (SB), or multiple short-bout exercise with home exercise equipment (SBEQ) using a treadmill. After 18months mean (SD) weight loss was significantly greater in individuals exercising more than 200 min/week (-13.1 kg) compared with individuals exercising 150 to 200 min/week (-8.5kg) or less than 150 min/week (-3.5kg) (3).

Another RCT with 52 obese men randomly assigned to one of four study groups (diet-induced weight loss, exercise-induced weight loss, exercise without weight loss, and control) for 3 months observed greater average reductions (1.3kg) in the exercise-induced weight loss group than in the diet-induced weight loss group (4). Weight loss induced by increased daily physical activity without caloric restriction substantially reduced obesity (particularly abdominal obesity) and insulin resistance. Exercise without weight loss reduces abdominal fat and prevents further weight gain.

More RCTs support the additive role of exercise while dieting in preserving lean body mass. Strength training but not aerobic training preserved more lean body mass in a group with a diet of energy content at 70% of resting metabolic rate (RMR) and protein intake ≥ 1.5 g/kg of ideal body weight and 1g/kg of actual body weight (5). 

In another RCT, 40 obese women were given a deficit of 1000kcal with a diet with 50% carbs, 27 % protein and 23 % fats. Protein supplements were given to ensure ≥ 1 g/kg of protein. Exercise plus diet preserved more lean body mass (0.43kg) than diet without exercise (-0.91kg) after 8 weeks (6). Furthermore, upper-arm muscle areas increased also increased more for dieting plus exercise (11.2 cm2) compared with diet without exercise (2.1 cm2). This is yet another RCT among many to show that adding weight training exercise to a caloric restriction program results in maintenance of LBW compared with diet alone.

A more recent study in healthy, premenopausal, overweight, and obese women, compared the effect of 3 diets for 16 weeks: high protein, high dairy with 1.3g/kg of total protein (HPHD); adequate protein, medium dairy with 0.84g/kg of total protein (APMD), and adequate protein, low dairy with 0.72g/kg of total protein (APLD) differing in the quantity of total dietary protein and dairy food-source protein consumed with 28 and 15%, 18 and 7.5%, or 16 and <2% of energy, respectively. Carbohydrate content also varied, with 41% for the HPHD group, 58% for the APMD and 56% for the APLD group.


All women were put in a diet with a deficit of 500 kcal per day and participated in resistance training 2 days per week (upper body, lower body split) with 3 sets of 10 repetitions, and aerobic training 7 days per week. In each workout participants expended 250 kcal.

Despite similar total weight loss between diets, there was significantly greater fat mass loss and lean mass preservation in women consuming higher protein/dairy (1.3 g/kg of total protein with 15% % from dairy). In fact, the higher protein/dairy group in this study was able to gain lean body mass (0.7kg) during the weight loss intervention (despite having the lower carbohydrate content), meaning that the weight lost was exclusively accounted for by fat (7). Lean body mass remained unchanged in the APMD group (0.2 kg), and decreased in the APLD group (0.7kg).

In another study, Paoli et al. (8) subjected elite gymnasts to a 30-day ketogenic diet during which they performed their normal training. The diet consumed was primarily made of beef and veal, poultry, fish, raw and cooked green vegetables without restriction, cold cuts (dried beef, carpaccio and cured ham), eggs and seasoned cheese (e.g. parmesan). The percentage distribution of total daily energy macronutrients was 54.8% fat, 40.7% protein (200g) and 4.5% carbohydrates (22g). During the ketogenic diet subjects consumed 1266 KJ (302kcal) less than during the western diet (crossover) with 47% carbs (266g), 15% protein (83g) and 38% fat.

After the diet, subjects experienced a -1.9kg decrease of body weight in the form fat mass, with a non-significant increase in muscle mass, and no decrements in performance (8).

Finally comes a more recent study from Stu Phillips et al., also experimenting with different amounts of protein and exercise during an energy deficit of 40% for 4 weeks (9). Subjects were overweight but not obese and were randomly assigned (n = 20/group) to consume either a lower-protein (1.2 g/kg) control diet (CON) or a higher-protein (2.4 g/kg) diet (PRO). All participants were “recreationally active” and at the time were not regularly performing resistance exercise nor were they were regularly performing structured progressive aerobic or anaerobic training. All subjects performed resistance exercise training combined with high-intensity interval training for 6 d/wk. 

Participants were provided with all meals and beverages to consume throughout the intervention period. The control group consumed 15% protein, 50% carbohydrates, and 35% fat vs. 35% protein, 50% carbohydrates, and 15% fat in the PRO group. Both groups consumed the same carbohydrate content at 50%. (Carbohydrate content of a hypocaloric diet will become important in the last article of this series).


After 4 weeks LBM increased in the PRO group (1.2 kg) and to a greater extent compared with the CON group (0.1 kg). The PRO group had a greater loss of fat mass than did the CON group (-4.8kg vs. -3.5 kg). Note that even the control group with 1.2g/kg of protein was able to maintain LBM.

Results showed that, during a marked energy deficit, consumption of a diet containing 2.4 g/kg of protein was more effective than consumption of a diet containing 1.2 g/kg of protein in promoting increases in LBM and losses of fat mass when combined with a high volume of resistance and anaerobic exercise (9).

Such results are in contrast with a previous study by Pasiakos et al (10), discussed in the previous article Successful Dieting [2/5]: Protein Intake. Briefly, in that study there was a deficit of 30%, with protein intakes of RDA (0.8g/kg), 2xRDA (1.6g/kg) and 3x RDA (2.4g/kg). Results indicated then that the 2x RDA group with 1.6g/kg lost more body fat and less lean body mass and was better in both regards than 3x RDA with 2.4g/kg; in other words dietary protein three times the current RDA failed to confer further fat free mass protection or protein metabolic advantage.

A difference between these two studies was the exercise type. Pasiakos et al. included a daily low-to-moderate–intensity (40–60% GraphicO2max) treadmill and cycling as well as thrice weekly lower-intensity resistive-type exercise (3 sets of 15 repetitions). Phillips et al. involved intense high-volume resistance exercise and HIT/SIT: a full-body resistance exercise circuit (2 times/wk with no rest between exercises) of 10 repetitions/set for 3 sets at 80% of 1RM, with the last set of each exercise to volitional failure; HIT/SIT (2 times/wk); a weekly 250-kJ time trial on a cycle ergometer during which participants were instructed to complete the trial as quickly as possible while self-adjusting the ergometer resistance; and a plyometric body weight circuit with a 30-s rest between exercises.

This difference in exercise type and intensity may account for the differences seen in both studies. However there is another difference regarding study participants. Pasiakos et al. used physically active military personnel while Phillips et al. used “recreationally active” subjects.

Taking a closer look at the data we can see that subjects were already bench pressing 99-107g pre-intervention and increased to 126-146kg (+27-39kg) after 4 weeks. They were also leg pressing 162-171kg pre-intervention and increased to 318-340kg (+156-169kg) after 4 weeks. Does that look like only recreationally active subjects? Subjects were more likely detrained and quickly regained strength and LBM, in fact Stu Phillips himself said they were detrained (somewhere in social media).


There is yet another possible reason for the disparity of results between these 2 studies, and also between Pasiakos et al. and other similar studies! But I will save that for later! You better stay tuned.

In conclusion, there is a synergism between resistance exercise training and high-protein intakes during weight loss, resulting in an even greater ratio of fat to lean mass loss when the two strategies are combined as more studies show (11,12,13).

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Summary of 34 articles with 36.528 words and 1121 references on
Exercise and nutrition



References:

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