BACKGROUND: Weight maintenance (WM) after weight reduction (WR) is difficult, but increased physical activity may help. We studied whether adding exercise to diet counseling decreases the occurrence of the metabolic syndrome (MBO). METHODS: Ninety voluntary middle-aged men with a BMI range of 30 to 40 and a waist girth > 100 cm were recruited to the research institute's clinic in 1997. After a very-low-energy diet for 2 months (WR), the men were randomized into a walking, resistance training or control group for 6 months (WM). All groups received similar dietary advice. After WM, there was a 23-month follow-up. Diagnosis of MBO was based on >= 3 components. RESULTS: After WR, the mean weight loss was 14.2 kg. At the end, the weight decrease was 4.8 kg (n = 68) with no statistically significant difference between the groups. All groups had improved some components (insulin, HDL cholesterol, body composition) of MBO. When the groups were combined, the odds ratio for the occurrence of MBO (versus baseline) was 0.10 after WR, 0.08 after WM and 0.29 at the end. CONCLUSIONS: Adding structured exercise to diet counseling did not alleviate MBO better than diet only. However, the occurrence of MBO was reduced in all groups at the end.
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