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Amount and intensity effects of exercise training alone versus a combined diet and exercise lifestyle intervention on health-related quality of life in the STRRIDE-PD randomized trial [with consumer summary]
Collins KA, Ross LM, Piner LW, Fos LB, Slentz CA, Bateman LA, Willis LH, Bales CW, Siegler IC, Wolever RQ, Huffman KM, Kraus WE
BMJ Open Diabetes Research & Care 2022 Jan;10(1):e002584
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: To determine the relative contributions of various amounts and intensities of exercise alone to a combined lifestyle intervention on health-related quality of life (HrQoL) measures. RESEARCH DESIGN AND METHODS: Participants (n = 162) were sedentary, overweight/obese, with pre-diabetes, and randomized to one of four 6-month interventions: (1) high amount/moderate intensity exercise-energy expenditure of 16 kcal/kg of body weight/week (KKW) at 50% oxygen consumption (VO2) reserve; (2) high/vigorous-16 KKW at 75% VO2 reserve; (3) low/moderate-10 KKW at 50% VO2 reserve; (4) low/moderate plus diet-10 KKW at 50% VO2 reserve plus a calorically restricted diet. The 36-Item Short-Form Survey (SF-36) and Satisfaction with Physical Function and Appearance (SPF/SPA) survey were assessed at baseline and post-intervention. Analyses of covariance determined differences in change scores among groups (p < 0.05). Paired t-tests determined significant pre-intervention versus post-intervention scores within groups (p < 0.05). RESULTS: Across the intervention, all groups (p < 0.05) improved the physical component, SPF, and SPA scores. Only the low/moderate/diet group (p < 0.001) significantly improved the mental component score. The high/vigorous group achieved 84.5% of the low/moderate/diet group effect for change in physical component score, and the low/moderate group achieved 83.7% of the low/moderate/diet group effect for change in mental component score. CONCLUSIONS: In general, a low amount of moderate intensity exercise combined with diet was the most effective intervention for improving HrQoL. Of the exercise-only interventions, vigorous intensity exercise provided the greatest impact on changes in physical function. On the other hand, low amounts of moderate intensity exercise provided the greatest impact on mental well-being, potentially being a more attainable exercise dose for previously sedentary individuals with pre-diabetes to achieve.

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