UAB Synopsis, Vol. 26, No. 30, August 13, 2007

Outcomes data from UAB’s EatRight Program, published in the May issue of Obesity, show keeping caloric intake low plays a more significant role in weight maintenance than does exercise (2007;15:1226-1232).

“Exercise combined with a low-energy density diet is the best approach for weight loss and overall health,” says study coauthor and EatRight Medical Director Jamy D. Ard, MD. “However, for many individuals finding time for exercise sufficient to maintain their weight reduction is difficult.”

Although a large body of literature supports the efficacy of exercise for weight maintenance, most studies report that people need an hour or more of moderate-to-intense exercise on most days of the week to maintain weight loss. The 2005 US Dietary Guidelines, for example, note that people who have lost weight need 60 to 90 minutes of moderate physical activity on most days to avoid putting pounds back on.

“These recommendations can be intimidating,” Dr. Ard says. “Finding time for this amount of exercise is a major obstacle for many individuals. Failing to reach goals for physical activity can be discouraging and may lead some people to give up exercise programs altogether.” He notes that most Americans fail to meet even the minimum guidelines for physical activity — 30 to 60 minutes of exercise on most days — to maintain health and prevent disease.

Dr. Ard and colleagues followed 89 former EatRight participants for 2 years. Eighty percent successfully maintained their weight loss (defined as regaining <5% of their weight at the conclusion of the EatRight program). Few of these individuals met recommendations for physical activity.

“We found the low-calorie, low-energy density dietary pattern individuals learned through EatRight was the primary means through which participants maintained their weight,” says Tiffany L. Cox, MPH, the study’s lead author.

Although controlling energy intake and dietary energy density were the most important predictors of successful weight maintenance, participants who reported more physical activity regained less weight than their counterparts who got little or no exercise.

“Both exercise and a healthy diet have significant, independent benefits on health,” Dr. Ard says. “Combining the two produces even greater positive effects, but for those who find it hard to exercise, it is encouraging to know that permanently adopting a low-energy density diet can result in long-term weight control.”