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"It's better to lose weight with a combination of caloric reduction and exercise rather than caloric reduction alone," said study author Dr. Enette Larson-Meyer, an assistant professor of family and consumer science at the University of Wyoming.
For the six-month study, the researchers assigned 36 overweight men and women, average age 39, to one of three groups. One group cut calories by 25%. The second cut calories by about 12.5% and exercised enough to increase energy output by 12.5%. A control group simply stayed on a weight-maintenance diet.
At the study's end, both the caloric-restriction group and the caloric-restriction plus exercise group lost about 10% of their body weight. The average weight at the study start was about 178 pounds, so the loss at the end was about 17 pounds on average.
The exercise prescription varied according to body weight at the start, but typically men walked for 50 minutes at a brisk pace five days a week, and women, 45 minutes five times a week, Larson-Meyer said. They could choose their preferred activity and intensity, however.
At the end, those who included exercise had better health outcomes, according to the study published in the January issue of the journal Medicine & Science in Sports & Exercise.
"The big improvement was related to blood pressure," Larson-Meyer said. The exercising and dieting group had greater blood pressure improvements, and improvement in cholesterol and insulin sensitivity, too, she said.
"It's not surprising at all," Larson-Meyer added. "They definitely work together."
Working with a professional to decide on calorie restriction and workout routine is best, she noted, especially for obese people with orthopedic problems.
The results make sense to Dr. Walt Thompson, a professor of kinesiology at Georgia State University who has studied exercise adherence for years. "I think it finally proves what we have been saying for a long time," he said. "Effective weight-loss programs have to include diet and exercise."
While it's not difficult for people to start an exercise program -- many people do so every January 1st, he noted -- sticking with it is hard for most. "By January 15, 50% are going to drop out," he predicted.
His tips for getting people to stay faithful? Identify what is important to you -- long-term goals. That might be weight loss. Then come up with short-term exercise goals to help you get to the long-term goal.
Hiring a wellness coach might help, too, he noted. They are experts in helping people change their behaviors.
Overcoming obstacles is important, Thompson said, and lack of time is a big one. When he hears that excuse, he asks people how much TV they watch. Two hours a day is the typical answer.
His suggestion: Record the programs to watch later, skip the commercials, and you've found your exercise time.
He tells potential exercisers to find something that motivates them. "Two things motivate me," said Thompson. "My dad had a heart attack at 52, and I was bound and determined not to."
His other motivation? About 32 years ago, before he married his wife, she said to him: "If you get fat, I will divorce you."
He's pretty sure she wasn't kidding. And now, it matters little. He remembers her saying it as if it were yesterday, and it still motivates him.
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