Effect of severe versus moderate energy restriction on physical activity among postmenopausal female adults with obesity: a pre-specified secondary analysis of the TEMPO Diet randomized controlled Trial

BackgroundAn under-explored strategy for increasing physical activity is the dietary treatment of obesity, but empirical evidence is lacking.ObjectivesTo compare the effects of weight loss via severe versus moderate energy restriction on physical activity over 36 months.Methods101 postmenopausal female adults (45–65 years, 30–40 kg/m2, ResultsCompared to the moderate group, the severe group exhibited greater mean levels of: total volume of physical activity; duration of moderate-to-vigorous-intensity physical activity (MVPA); duration of light-intensity physical activity; and step counts, as well as lower mean duration of sedentary time. All these differences (except step counts) were apparent at 6 months (e.g., 1006 [95% confidence interval 564, 1449] MET-minutes per week for total volume of physical activity), and some were also apparent at 4 and/or 12 months. There were no differences between groups in the two other outcomes investigated (self-efficacy to regulate exercise; and proportion of participants meeting the World Health Organization's 2020 Physical Activity Guidelines for MVPA). When the analyses were adjusted for weight at each time point, the differences between groups were either attenuated or abolished.ConclusionsAmong female adults with obesity, including a dietary component to reduce excess body weight—notably one involving severe energy restriction—could potentially enhance the effectiveness of physical activity interventions