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Time course for changes in aerobic capacity and body composition in overweight men and women in response to long-term exercise: the Midwest Exercise Trial (MET)
Kirk EP, Jacobsen DJ, Gibson C, Hill JO, Donnelly JE
International Journal of Obesity and Related Metabolic Disorders 2003 Aug;27(8):912-919
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine the time course for changes in aerobic capacity, body weight (BW), and composition in overweight adults in response to a supervised exercise trial with a targeted energy expenditure of 2,000 kcal/week. DESIGN: The Midwest Exercise Trial (MET) was a randomized, controlled, 16-month verified, supervised exercise trial. Aerobic exercise progressed to 45 min/day, 5 days/week over 6-months and was then maintained for 10 months. Controls maintained their normal physical activity and all participants maintained ad libitum diets. SUBJECTS: A total of 131 participants were randomized to exercise or control groups and 74 completed the intervention and all laboratory testing. MEASUREMENTS: At baseline and months 4, 9, 12, and 16, aerobic capacity (VO2max) was measured by indirect calorimetry, BW by digital scale, and fat weight and fat-free weight by hydrostatic weighing. RESULTS: Aerobic capacity (ml/kg/min) increased (p < 0.05) from baseline (39.2 +/- 5.2, mean +/- SD) to 9 months (48.8 +/- 4.3) in exercising men as well as women (32.8 +/- 4.2 to 39.6 +/- 5.5) with no significant changes occurring at 12 or 16 months. From baseline to 9 months BW (94.0 +/- 12.6 to 88.7 +/- 9.7 kg) and fat weight (26.8 +/- 6.8 to 21.8 +/- 4.5 kg) significantly decreased in exercising men with no changes occurring at 12 or 16 months. There were no changes in fat-free weight across the 16 months for exercising men or for BW or composition in exercising women. Further, there were no significant changes for the control men for aerobic capacity, BW, or body composition across 16 months. Women in the control group showed significant increases in weight of 2.9 +/- 5.5 kg and fat weight of 2.1 +/- 4.8 kg at 16 months only. CONCLUSIONS: We recommend that investigations that use exercise without diet as the stimulus for weight loss have at least a 9-month duration to provide sufficient time for the full effects to be realized, should such effects be present.

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