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The Importance of Good Nutrition on Physical Fitness: Why You Need Both

Verywell / Alexandra Shytsman

Nutrients and Your Athletic Performance

What to eat for optimal performance, hydration makes a difference, sustainable nutrition habits, frequently asked questions.

Physical activity has many health benefits, whether you're a competitive athlete, play a recreational sport, or practice yoga. Nutrition and physical activity go hand in hand when maximizing your workouts or improving athletic performance.

What we eat before and after exercise—and every day—greatly affects how we feel and perform during activity. The right balance of macro and micronutrients may vary depending on your fitness level and the activity you perform. Still, it is important to get enough nutrition to maintain your health and optimize performance.

Proper nutrition is imperative to maximize athletic performance. Without enough carbohydrates , proteins , and fats, athletes may feel sluggish during a workout or ravenously hungry. Athletes may also need to focus on specific vitamins and minerals for fitness performance, such as iron, vitamin D , and zinc.

Nutrition for physical activity is highly individualized, so it is helpful to consult a sports dietitian to review your needs and make specific recommendations for your body and activity level.

Good Nutrition Supports Physical Activity

While we frequently think about the health benefits of nutrition and physical activity separately, there is evidence that integrating both nutrition and physical activity produces greater benefits than focusing on one or the other.

Additionally, research shows that exercise informs food choices, and individuals who exercise may make more nutritious choices. Nutrition may also support muscle recovery by reducing inflammation. One study showed that individuals who were more physically active and had higher antioxidant intake had lower levels of systemic inflammation.

The Importance of Balance and Timing of Macronutrients

Consuming adequate amounts of macronutrients—carbohydrates, protein, and fat—to fuel our bodies is imperative for optimal exercise performance.

  • Carbohydrates are our bodies' preferred source of fuel. They give us the energy we need to go about our day and maximize workouts and athletic performance.
  • Protein is important for building muscle and the recovery of bones, joints, and ligaments after a workout.
  • Fat keeps us satiated, helps cushion our bones and joints, and increases the absorption of fat-soluble vitamins A, E, D, and K.

When it comes to fueling for exercise, finding the right balance and optimal timing of macronutrients for your body is key. Physical performance and recovery after exercise are enhanced by consuming carbohydrates and protein.

One study reviewed the effects of protein and carbohydrates on skeletal muscle regeneration given to athletes by shake or meal. Thirty-five individuals ran 10 kilometers (6.2 miles) and consumed either a protein and carbohydrate shake, a meal of white bread and sour milk cheese, or nothing. The study indicated that consuming carbohydrates and protein by shake or food was preferable, as it reduced exercise-induced skeletal muscle damage and had anti-inflammatory effects.

"Superfood" is a word used frequently by the food industry to market specific foods as offering maximum nutritional benefits or being exceptionally nutrient-dense.

While some foods are more nutritious than others and may positively affect health, it is essential to note that no single food is responsible for optimal health or disease prevention.

If you want to increase the nutrient density of your diet, including some of the following nutritious foods is an excellent place to start. These foods—including leafy greens, berries, eggs , sweet potato , and turmeric, contain antioxidants, complex carbohydrates , and protein and are beneficial for athletic performance.

Dark Leafy Greens

Dark green leafy vegetables are packed with important nutrients such as folate, zinc, calcium, magnesium , iron, vitamin C, and fiber. Eating leafy greens, such as spinach , kale , collard greens , and Swiss chard, can muscle function in men and women engaging in physical activity.

Additionally, nitrates in leafy greens convert to nitric oxide, opening blood vessels and improving blood flow during exercise . You can incorporate dark leafy green vegetables into your diet by making kale salads, sautéing spinach into eggs for breakfast, or blending them into a smoothie .

Berries are known for their powerful antioxidant properties, making them an important part of an athlete's diet. Exercise causes oxidative stress, which results in the production of free radicals, muscle damage, and fatigue. Including antioxidants in the diet may help enhance athletic performance by decreasing muscle damage and inflammation.

Top a yogurt parfait with blueberries , blend strawberries into a smoothie, or add raspberries or blackberries to a salad to get an antioxidant punch.

Eggs, including the yolks, are rich in B vitamins , choline, iron, antioxidants, and high-quality protein, which is important for muscle recovery and repair. The protein in eggs is considered to have high bioavailability, meaning it is easily digested and efficiently metabolized by the body.

Additionally, eggs contain fatty acids that are important for heart health as well as vitamins and minerals that help with cell growth and tissue repair. Eggs are an easy and quick breakfast, scrambled with veggies or hardboiled for grab-and-go.

Sweet Potato

Sweet potatoes are root vegetables packed with potassium, fiber, and vitamins A and C. They are an excellent source of complex carbohydrates needed by athletes for fuel. Getting enough potassium also reduces fatigue, muscle cramps, and the feeling of weakness.

Sweet potatoes can be incorporated into your diet in several ways. Top a baked sweet potato with Greek yogurt and almond butter for breakfast, roast potato wedges and add them to a salad, or bake until crispy and enjoy as sweet potato fries with a burger .

Turmeric is a bright yellow spice, originally from India, used for cooking and medicinal benefits. It is best known for its antioxidant and anti-inflammatory effects and may play a role in preventing chronic diseases such as cancer, heart disease, and diabetes.

Turmeric is also a more recent focus of post-exercise recovery research. Evidence suggests individuals who use turmeric after a workout reduced muscle pain and damage, and decreased inflammatory markers.

Incorporate turmeric into your routine by sprinkling the spice on roasted vegetables , adding it to a curry , or making golden milk . Turmeric is also available in supplement form .

Adequate hydration is imperative to overall health and exercise performance. We all lose water through normal bodily functions like breathing, digestion, and sweating. Athletes need to replace additional water and electrolytes lost through exertion during exercise.

Dehydration can lead to cardiovascular strain, altered metabolic function, and increased body temperature. Individuals also lose sodium , potassium, calcium, and magnesium with sweat. To avoid dehydration, it is important to ensure you are drinking before , during, and after exercise to maintain adequate hydration levels.

Whether you're training to run one mile, your first 5K, or a marathon, start with small and realistic nutrition and hydration goals. Trying to overhaul your entire diet at once can feel overwhelming, and is likely unsustainable. Small goals are more sustainable and, therefore, more beneficial in the long term.

If you feel your hydration is lacking, try investing in a fun water bottle . Flavor your water with fresh fruit or liquid beverage enhancers if you like your water to have a taste. Try adding one extra glass of water to your day.

Looking to include more antioxidants in your diet? Try adding one fruit and one vegetable to your meals each day. Pick one new nutrient-dense food and add it to your weekly meal plan . Add one each week, and soon enough, you will have greatly increased the variety of vitamins and minerals in your diet.

A Word From Verywell

The importance of good nutrition on physical fitness cannot be overstated. Sustainable, enjoyable nutrition habits are key to reaching your goals. It can be tempting to follow a fad diet or social media trend, but frequently these diets are restrictive and unsustainable. If you have questions or concerns or want individualized nutrition recommendations, seek advice from a registered dietitian .

S.M.A.R.T goals stand for Specific, Measurable, Achievable, Realistic, and Time-Bound. S.M.A.R.T goals serve as small, doable action steps to help you change your behavior and achieve your goal. An example of a S.M.A.R.T goal is "I will include one vegetable at dinner 3 nights this week."

Nutrition impacts so much of our ability to function, from our physical to mental wellbeing. Incorporating nutritious foods in your diet and eating a balance of carbohydrates, protein, and fat appropriate for your needs can positively affect your everyday life and fitness performance.

Nutrition needs vary based on many factors, including age and life stage. As we age, we may experience some changes, such as bone loss, loss of muscle mass, thinner skin, and less stomach acid. Some of these changes may make you prone to nutrient deficiencies and you may need to increase your intake of certain foods or add supplements. Aging also causes a slower metabolism and decreased calorie needs.

Several factors affect your nutritional needs, including genetics, health status, environment , gut health, stage of life, fitness and activity level, and medications. Speak with a registered dietitian to better estimate your individual nutritional needs.

Koehler K, Drenowatz C. Integrated Role of Nutrition and Physical Activity for Lifelong Health .  Nutrients . 2019;11(7):1437. doi:10.3390/nu11071437

Gustafson CR, Rakhmatullaeva N, Beckford SE, Ammachathram A, Cristobal A, Koehler K. Exercise and the Timing of Snack Choice: Healthy Snack Choice is Reduced in the Post-Exercise State .  Nutrients . 2018;10(12):1941. doi:10.3390/nu10121941

Draganidis D, Jamurtas AZ, Stampoulis T, et al. Disparate Habitual Physical Activity and Dietary Intake Profiles of Elderly Men with Low and Elevated Systemic Inflammation .  Nutrients . 2018;10(5):566. doi:10.3390/nu10050566

Vitale K, Getzin A. Nutrition and Supplement Update for the Endurance Athlete: Review and Recommendations .  Nutrients . 2019;11(6):1289. doi:10.3390/nu11061289

Isenmann E, Blume F, Bizjak DA, et al. Comparison of Pro-Regenerative Effects of Carbohydrates and Protein Administrated by Shake and Non-Macro-Nutrient Matched Food Items on the Skeletal Muscle after Acute Endurance Exercise .  Nutrients . 2019;11(4):744. Published 2019 Mar 30. doi:10.3390/nu11040744

Sim M, Blekkenhorst LC, Bondonno NP, et al. Dietary Nitrate Intake Is Positively Associated with Muscle Function in Men and Women Independent of Physical Activity Levels .  J Nutr . 2021;151(5):1222-1230. doi:10.1093/jn/nxaa415

Hoon MW, Johnson NA, Chapman PG, Burke LM. The effect of nitrate supplementation on exercise performance in healthy individuals: a systematic review and meta-analysis.   Int J Sport Nutr Exerc Metab . 2013;23(5):522-532. doi:10.1123/ijsnem.23.5.522

Mason SA, Trewin AJ, Parker L, Wadley GD. Antioxidant supplements and endurance exercise: Current evidence and mechanistic insights .  Redox Biol . 2020;35:101471. doi:10.1016/j.redox.2020.101471

López Sobaler AM, Aparicio Vizuete A, Ortega RM. Papel del huevo en la dieta de deportistas y personas físicamente activas [ Role of the egg in the diet of athletes and physically active people ].  Nutr Hosp . 2017;34(Suppl 4):31-35. doi:10.1016/j.redox.2020.101471

Lindinger MI, Cairns SP. Regulation of muscle potassium: exercise performance, fatigue and health implications .  Eur J Appl Physiol . 2021;121(3):721-748. doi:10.1007/s00421-020-04546-8

Mahmood K, Zia KM, Zuber M, Salman M, Anjum MN. Recent developments in curcumin and curcumin based polymeric materials for biomedical applications: A review .  Int J Biol Macromol . 2015;81:877-890. doi:10.1016/j.ijbiomac.2015.09.026

Campbell MS, Carlini NA, Fleenor BS. Influence of curcumin on performance and post-exercise recovery .  Crit Rev Food Sci Nutr . 2021;61(7):1152-1162. doi:0.1080/10408398.2020.1754754

Thomas DT, Erdman KA, Burke LM. American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance [published correction appears in Med Sci Sports Exerc . 2017 Jan;49(1):222].  Med Sci Sports Exerc . 2016;48(3):543-568. doi:10.1249/MSS.0000000000000852

Sipponen P, Maaroos HI. Chronic gastritis .  Scand J Gastroenterol . 2015;50(6):657-667. doi:10.3109/00365521.2015.1019918

The Journal of Clinical Endocrinology & Metabolism,  Water-Induced Thermogenesis , Michael Boschmann, 7/2/13

  • Di Noia J.  Defining Powerhouse Fruits and Vegetables: A Nutrient Density Approach .  Prev Chronic Dis . 2014;11:130390.
  • Emilio Ros,  Health Benefits of Nut Consumption , National Institutes of Health, 2010

By Darla Leal Darla Leal is a Master Fitness Trainer, freelance writer, and the creator of Stay Healthy Fitness, where she embraces a "fit-over-55" lifestyle.

good nutrition is more important than exercise essay

Is Diet More Important than Exercise? An In-Depth Look at This Age-Old Question

"The content below is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition."

It’s the question everyone asks when trying to lose weight, get in shape, or simply better their health:

“Is diet more important than exercise?”

Diet vs. exercise is a constant debate, and it can be frustrating to try and understand which one is the most important when it comes to living the healthiest life. 

At HealthierU, we want you to feel confident in your decisions about your health, which is why we created this guide.

Keep reading to learn more about what is more important — exercise or diet — and how to maintain a healthy lifestyle.

Table of Contents

What is more important: diet or exercise, can you lose weight by just dieting and not exercising.

  • Diet vs. Exercise: 4 Reasons a Healthy Lifestyle Involves Both

Nutrition Contributes to Everything: Make Sure You Understand How to Fuel Your Body

Unsure if your diet or exercise plan is aligning with your health or weight loss goals healthieru can help.

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Importance of Healthy Nutrition Essay

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  • As a template for you assignment

To stay alive, the human body requires proper nutrients. These nutrients are absorbed from the food we eat. The absorbed food will help the cells in the human body stay alive and function optimally.

Nutrition is important to all human beings. One cannot survive without proper nutrition. However, nutrition is more important in certain stages of life than others (Wardlaw & Smith 2011). Nutrition is very important during childhood.

The reason for this is that children require more energy than adults. The macronutrients and micronutrients that the body needs are absorbed according to the body size. The smaller the body size the more nutrients the body will need. Children also have a higher growth rate.

Proper nutrition is also important to the elderly. This is due to the slow growth of their body cells. Proper nutrition is required to maintain normal cell growth and improve the rate of cell growth (Insel 2011). They also need proper nutrition to maintain good mental health, immunological health and cardiovascular health.

The lifestyle of most people will affect them in future. The food we eat today will affect our health in future. The consumption of healthy foods minimizes the chance of contracting certain diseases (Wardlaw & Smith 2011). These diseases include; cancer, arthritis and stroke. Obesity is also among the diseases that can be avoided if we eat healthy.

Recent research has shown that more people are at risk of suffering from these diseases due to lack of proper nutrition. Their lifestyles have forced them to consume fatty foods commonly referred to as junk food. Eating healthy food will help boost the body’s immune system while reducing the risk of trauma. The ability of the body to grow and operate optimally depends on the food we eat.

Recent findings have revealed that obesity is the most common health condition affecting young adults. The number of overweight children has been growing day by day. The reason behind this is poor nutrition. Change in lifestyle has also been found to be the main cause of this problem (Insel 2011). Most parents are now fully employed. This leaves them with no option but to take their children to fast food joints to have meals. Fast food joints are expanding daily and relocating to more strategic places.

The government has an important role to play in order to control this menace. They need to come up with various legislations that will help put a stop to this worrying trend. A good example would be banning all fast food joints within a certain radius from educational institutions (Wardlaw & Smith 2011). This will make it harder for children to access these joints.

The government should also encourage awareness campaigns that will help in the fight against obesity. These campaigns will focus more on sensitizing parents and children on the need for proper nutrition. The effects of poor nutrition should also be addressed during these campaigns. With time, this will raise the awareness levels and help in the fight against obesity (Insel 2011).

The recent statistics leaves the government with no choice. The productive population of the society is slowly dying from health related diseases (Wardlaw & Smith 2011). These are the future leaders, employees and workers that will help grow the economy when the current leaders have retired. It is also the responsibility of the government to make sure that all citizens are healthy and protected from all health issues that would endanger their lives.

Insel, P. M. (2011). Nutrition . Sudbury, Mass.: Jones and Bartlett Publishers.

Wardlaw, G. M., & Smith, A. M. (2011). Contemporary nutrition . New York, NY: McGraw-Hill.

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  • Reinforcing Nutrition in Schools to Reduce Diabetes and Childhood Obesity
  • Implementing a Permanent Exercise Regimen in Schools to Decrease Childhood Obesity
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IvyPanda. (2022, May 16). Importance of Healthy Nutrition. https://ivypanda.com/essays/importance-of-healthy-nutrition/

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1. IvyPanda . "Importance of Healthy Nutrition." May 16, 2022. https://ivypanda.com/essays/importance-of-healthy-nutrition/.

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Why Good Nutrition is Important

Unhealthy eating and physical inactivity are leading causes of death in the u.s. .

Unhealthy diet contributes to approximately  678,000 deaths  each year in the U.S., due to nutrition- and obesity-related diseases, such as heart disease, cancer, and type 2 diabetes. 1  In the last 30 years, obesity rates have  doubled  in adults,  tripled  in children, and  quadrupled  in adolescents. 2, 3, 4

Risk Factors and the Number of Deaths in the US, 2016​ 1

The typical American diet is too high in calories, saturated fat, sodium, and added sugars, and does not have enough fruits, vegetables, whole grains, calcium, and fiber. Such a diet contributes to some of the leading causes of death and increases the risk of numerous diseases 5 , including:

  • heart disease;
  • high blood pressure;
  • osteoporosis; 6  and
  • cancers , including cervical, colon, gallbladder, kidney, liver, ovarian, uterine, and postmenopausal breast cancers; leukemia; and esophageal cancer (after researchers took smoking into account). 7

Leading Causes of Death (2012) 7

599,711
582,623
3. Chronic lower respiratory disease143,489
128,546
5. Unintentional injuries (accidents)127,792
6. Alzheimer’s disease83,637
73,932
8. Influenza and pneumonia50,636
9. Nephritis, nephrotic syndrome and nephrosis (kidney disease)45,622
10. Intentional self-harm (suicide)40,600

*Diseases to which poor diet contributes are in bold

Unhealthy eating habits and inactivity affect quality of life and cause disabilities

Few recognize that unhealthy diet is a leading cause of disability. Yet unhealthy eating habits and physical inactivity are leading causes of loss of independence:

  • Diabetes is a leading cause of blindness and amputations . Roughly 73,000 people have lower-limb amputations each year due to diabetes. 8
  • Bone injuries due to osteoporosis are most likely to occur in the hips, spine, and wrist. Even just a slight fracture in these areas can result in loss of independence. Twenty percent of seniors who break their hip die within just  one year . Those who survive often require long-term (nursing home) care . 8, 9
  • Heart attack or stroke can result in difficulty with everyday activities—such as walking, bathing, or getting into or out of bed—or cognitive impairment. 10

Number of Americans Living with Diseases Related to Diet and Inactivity  

78,100,000
High Blood Pressure 66,900,000
Diabetes 29,100,000
Heart disease 26,600,000
Cancer 20,073,000
9,900,000
Stroke 6,400,000

Obesity rates are skyrocketing

Over two-thirds (67.5%) of American adults are overweight or obese . 2

Obesity rates in children have tripled over the last three decades, and one in three children and adolescents 2-19 years old is overweight or obese. 4, 16

Read more about how public policies could help reduce obesity.

It's expensive to ignore prevention

Costs of diseases associated with diet and inactivity *.

$245 billion
Cancer $216.6 billion
Coronary heart disease $204.4 Billion
Obesity $190 Billion
$46.4 Billion
$36.5 Billion
Osteoporosis $19 Billion

* Estimates of annual direct + indirect costs for diseases overall (including portions caused by factors other than diet and physical inactivity), except for the figure for obesity, which is an estimate of direct (medical) costs only.

Health care costs $8,900 per person per year. 21    According to the Centers for Disease Control and Prevention (CDC),  a 1% reduction in dietary health risks such as weight, blood pressure, glucose, and cholesterol risk factors would save $83 to $103 per person per year  in medical costs. 22

According to the Trust for America’s Health , if obesity trends were lowered by reducing the average adult body mass index (BMI) by only 5 percent, millions of Americans could be spared serious health problems, and our country could save $158 billion over the next 10 years. 23

Current investments to promote healthy eating and physical activity are insufficient

  • Funding for the  Division of Nutrition and Physical Activity  at CDC in FY15: $47.6 million.
  • The Hershey Company spends 12 times that amount to promote its chocolate and other products ($562 million). 24
  • Amount food companies spend on advertising each year: $33 billion. 25, 26   Amount the food industry spends on advertising and promotions to children each year: $1.8 billion . 27
  • https://vizhub.healthdata.org/gbd-compare/
  • Centers for Disease Control and Prevention (CDC), NCHS Health E-Stat: Prevalence of Overweight, Obesity, and Extreme Obesity among Adults, United States, 1960-1962 through 2011-2012. Accessed here  on November 3, 2014.
  • Ogden C, Carrol M.  Prevalence of Obesity among Children and Adolescents: United States , Trends 1963-1965 through 2007-2008, 2010. Accessed here  on October 2, 2015.
  • CDC.  Childhood Obesity Facts ,. Accessed here  on December 17, 2014.
  • U.S. Department of Agriculture (USDA), U.S. Department of Health and Human Services.  Dietary Guidelines for Americans 2010 . U.S. Government Printing Office, December 2010.
  • Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silvia I, Leon DA, Smeeth L. "Body-Mass Index and Risk of 22 Specific Cancers: A Population-Based Cohort Study of 5.34 Million UK Adults."  The Lancet  2014, vol. 384, pp. 755-765.
  • Xu J, Kochanek KD, Murphy SL, Arias E.  NCHS Data Brief: Mortality in the United States, 2012.  Accessed here  on November 3, 2014.
  • CDC.  National Diabetes Statistics Report, 2014 . Accessed here  on April 30, 2015.
  • National Osteoporosis Foundation.  What Is Osteoporosis?  Accessed at on September 11, 2014.
  • Levine DA, Davydow DS, Hough CL, et al. "Functional Disability and Cognitive Impairment after Hospitalization for Myocardial Infarction and Stroke."  Circulation: Cardiovascular Quality and Outcomes  2014, vol. 7, pp. 863-871.
  • Ogden CL, Carroll MD, Kit BK, Flegal KM. "Prevalence of Obesity in the United States, 2009–2010."  National Center for Health Statistics 2012 , NCHS data brief, no 82. Accessed here  on October 2, 2015.
  • CDC. Vital Signs: Awareness and Treatment of Uncontrolled Hypertension among Adults-United States, 2003-2010.  MMWR  2012, vol. 61, no. 35, pp. 703-9.
  • CDC.  National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States , 2014. Atlanta, GA: U.S. Department of Health and Human Services.
  • Blackwell DL, Lucas JW, Clarke TC. "Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2012." National Center for Health Statistics.  Vital Health Stat 2014 , vol. 10, no. 260.
  • National Osteoporosis Foundation.  2014 Clinician's Guide to Prevention and Treatment of Osteoporosis . Accessed here  on April 30, 2015.
  • Ogden CL, Carroll MD, Kit BK, Flegal KM. "Prevalence of Childhood and Adult Obesity in the United States, 2011-2012."  Journal of the American Medical Association 2014 , vol. 311, pp. 806-814.
  • Child Trends Data Bank. Percentage of Children Who Are Overweight, by Selected Groups. Accessed here  on November 3, 2014.
  • CDC.  United States Cancer Statistics: Technical Notes . Accessed on April 30, 2015.
  • American Heart Association (AHA).  Heart Disease and Stroke Statistics-At a Glance . Accessed here  on October 2, 2015.
  • Cawley J, et al. "The Medical Care Costs of Obesity: An Instrumental Variables Approach."  Journal of Health Economics  2012, vol. 31, pp. 219‐230.
  • Centers for Medicare and Medicaid Services. National Health Care Expenditures: Aggregate and Per Capita Amounts. Accessed here  on October 31, 2014.
  • Centers for Disease Control and Prevention. Investing in Prevention Improves Productivity and Reduces Employer Costs. Accessed here  on October 31, 2014.
  • Trust for America's Health.  The State of Obesity: Better Policies for a Healthier America 2014 . Accessed here  on November 3, 2014.
  • The Hershey Company. Form 10-K, 2013. Accessed here .
  • U.S. Department of Agriculture (USDA).  Food Dollar Series: Documentation. Washington, DC: USDA, March 2013. Accessed here .
  • U.S. Department of Agriculture (USDA).  Food and Alcoholic Beverages: Total Expenditures.  Washington, DC: USDA, November 2013. Accessed here .
  • Federal Trade Commission (FTC). A Review of Marketing Food to Children and Adolescents: Follow-Up Report. Washington, D.C.: Federal Trade Commission, 2012. Accessed here .

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Is Diet More Important Than Exercise for Weight Loss?

good nutrition is more important than exercise essay

Exercise is often thought of as one of the most important factors in any weight loss plan. But is that really the case? 

It turns out that what you eat has a greater impact on your weight loss goals than how much you exercise. Why is this the case? And what is a healthy and sustainable way to lose weight?

Vanessa Imus, a registered dietitian at the  Center for Weight Loss and Metabolic Surgery at UW Medical Center - Roosevelt , explains why diet is such a key factor in weight loss and shares nutrition strategies you can take on to reach your health goals. 

Diet vs. exercise

The key to weight loss is consuming fewer calories than your body burns. You technically can reach that calorie deficit through exercise alone, but it is much more difficult to achieve — and maintain.

“It’s a lot easier to not eat the 500-calorie slice of cake than to burn 500 calories,” says Imus. “It takes a couple seconds to not have the cake, but it may take 45 minutes or more to exercise off that 500 calorie cake.”

In other words, exercising to lose weight without healthy eating is like swimming upstream. It’s much more efficient and effective to lose weight by cutting the number of calories consumed instead of increasing the number of calories burned while exercising.

“It is technically possible to out-exercise an unhealthy diet, strictly in terms of weight loss, as long as the number of calories out is higher than the number of calories you’re taking in. However, you’re still going to feel bad as long as you’re eating an unhealthy diet,” says Imus.

Instead, prioritize healthy eating — and all the  benefits  that go along with it — to help you reach your weight loss goals.

Creating a calorie deficit

OK, so the verdict is in: It’s easier to lose weight through diet than exercise. But just how do you go about cutting the right number of calories so that you’re not hangry 24/7, but also seeing results?

Imus has a formula for that.

“We use the Mifflin-St Jeor equation, a plug and chug formula to figure out your calorie needs,” she says. “It’s supposed to be accurate for 80% of the public. If we start someone at that calorie goal, we find that around 80% of the people are losing weight.”

While  studies  have shown this formula to be the most reliable in predicting the right calorie goals for each individual, Imus notes that it doesn’t work for everyone, as an individual’s metabolism might be faster or slower than the formula predicts.

“If this is the case, we figure out how many calories you’re averaging per day and subtract 500 calories from this number to come up with your daily calorie goal,” says Imus. “A 500-calorie deficit a day is equal to one pound per week of weight loss. One to two pounds a week of weight loss is usually sustainable. We generally wouldn’t recommend women to reduce calories below 1200 and men below 1500.”

To make sure you are cutting the right number of calories, and losing weight in a healthy and sustainable way, work with a  nutritionist .

Healthy not hangry

As you begin any weight loss plan, it’s normal to want to see results — fast. But if you lose weight too rapidly, it can actually be unhealthy, hinder your weight loss results and make it difficult to keep off the pounds you lost in the long run. 

“If you over-restrict calories, you might be dramatically losing weight, but you’ll be constantly battling hunger,” says Imus. “And if you lose a lot of weight rapidly, you’ll hit a plateau that will be difficult to overcome since you can’t continue to reduce calories to less than your body’s basic needs.”

That plateau in weight loss happens when your metabolism slows. If you cut so many calories to start, you won’t have room to gradually cut more calories down the road. 

“By not cutting calories so drastically to start, we’ve got room to cut calories incrementally,” says Imus. “That also keeps your metabolism running more efficiently.”

As you cut calories, make sure you’re fueling your body with the nutrients you need with  healthy meals  (needless to say, 500 calories of cake will not provide you with the same nutrients as 500 calories of  vegetables , lean protein and whole grains).

How exercise can help  

While it is entirely possible to lose weight with diet alone, incorporating exercise into your weight loss plan has benefits beyond burning calories.

“I find that exercise is so helpful for people to maintain a healthy diet, because if they’re stressed, they’ll turn to food,” says Imus. “Exercise is a great way to de-stress.”

By turning to exercise instead of food when you’re stressed, you can  boost your well-being  and  maintain your weight loss goals . A win-win scenario.

Another thing exercise can replace? Boredom.

“If you’re bored, some people will fill that time by eating,” says Imus. “If you instead turn to exercise, it gives you something to fill that time.”

So instead of grabbing that bag of chips when you’re bored, grab your shoes and head out for a  walk . 

The bottom line

Diet and exercise both play a role in weight loss, but it’s easier to create the calorie deficit needed to lose weight with what you consume. 

If you’re on a mission to lose weight, prioritize what’s on your plate and think of exercise as a tool to support your health goals.

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Essay: The Importance of Nutrition for Good Health

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Nutrition, a source of nourishment, is among the key factors of good health, preventing at least four of the ten leading causes of death in the United States. For example, heart disease, cancer, stroke, and diabetes are directly related to the way we eat. Back in 400 B.C., Hippocrates said, “Let food be your medicine and medicine be your food.” Today, good nutrition is more important than ever and must be a daily habit to maintain a healthy lifestyle.

Understanding Nutrition

Good nutrition involves consuming the right balance of carbohydrates, fats, and proteins, the three main components of nutrition. Additionally, the body needs vitamins, minerals, and other substances from various foods. While some foods are better than others, no single food or food group provides all the necessary nutrients. Therefore, eating a variety of different foods is essential.

Balance, Variety, and Moderation

The keys to good nutrition are balance, variety, and moderation. Balance refers to consuming the right proportions of different nutrients to maintain health and energy levels. Carbohydrates, fats, and proteins must be consumed in appropriate amounts because they serve different functions in the body. Carbohydrates are the body’s primary energy source, fats provide essential fatty acids and help absorb vitamins, and proteins are crucial for growth and repair of tissues.

Variety means eating many different foods to ensure the body gets a range of nutrients. No single food can supply all the essential nutrients, so a varied diet helps cover nutritional gaps. This approach includes consuming fruits, vegetables, whole grains, lean proteins, and healthy fats.

Moderation involves eating neither too much nor too little of any food or nutrient. Overeating can lead to excess weight and health issues like obesity, diabetes, and heart disease. Conversely, eating too little can result in nutrient deficiencies, low body mass, and weakened immunity.

Nutrition and Disease Prevention

A nutritious diet plays a significant role in preventing and managing chronic diseases. Heart disease, cancer, stroke, and diabetes are all linked to dietary habits. For example, diets high in saturated fats, trans fats, and cholesterol can increase the risk of heart disease. Conversely, diets rich in fruits, vegetables, whole grains, and lean proteins can reduce this risk.

Atherosclerosis, the hardening of the arteries, can begin in early childhood but can be stopped or even reversed with dietary changes. Consuming a diet low in saturated fat and high in fiber can help prevent and manage this condition.

Similarly, osteoporosis, a condition characterized by gradual bone thinning, can be slowed with adequate calcium intake, maintaining vitamin D levels, and engaging in weight-bearing exercise. Ensuring these nutrients are part of your diet from a young age can help maintain bone health into old age.

Diabetes is another condition heavily influenced by diet. While genetics play a role in the risk of developing diabetes, lifestyle choices such as diet and exercise can prevent or delay the onset of the disease. Maintaining a healthy weight through balanced nutrition and regular physical activity is crucial for managing blood sugar levels.

The Role of Genetics and Lifestyle

While good nutrition is critical, it is only one part of a healthy lifestyle. Regular exercise, not smoking, limiting alcohol consumption, managing stress, and minimizing exposure to environmental hazards are also essential. However, genetics also play a significant role in an individual’s health. Even with the best diet, some people may still be at risk for certain health conditions due to their genetic makeup.

Despite this, the influence of nutrition and lifestyle should not be underestimated. For instance, someone genetically predisposed to high cholesterol can still manage their cholesterol levels through diet and lifestyle changes. Consuming a diet rich in fruits, vegetables, whole grains, and lean proteins while avoiding trans fats and excessive saturated fats can significantly impact cholesterol levels and overall heart health.

Nutrition Throughout Childhood

Good nutrition throughout childhood plays a major role in future health. Establishing healthy eating habits early in life can reduce the risk of developing chronic diseases later on. Children who eat a balanced diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats are more likely to maintain these habits into adulthood.

Moreover, physical activity is crucial for children’s health. Encouraging regular exercise helps build strong bones and muscles, maintains a healthy weight, and reduces the risk of developing chronic diseases. Combined with good nutrition, regular physical activity sets the foundation for a healthy lifestyle.

Practical Tips for Healthy Eating

  • Plan Your Meals : Planning meals ahead of time can help ensure that your diet is balanced and varied. Include a mix of different food groups in your meals.
  • Portion Control : Be mindful of portion sizes to avoid overeating. Using smaller plates can help control portion sizes and prevent excessive calorie intake.
  • Read Food Labels : Understanding food labels can help you make healthier choices. Look for foods low in saturated fats, trans fats, cholesterol, and sodium.
  • Stay Hydrated : Drinking plenty of water is essential for good health. Water helps with digestion, nutrient absorption, and maintaining body temperature.
  • Limit Processed Foods : Processed foods often contain high levels of unhealthy fats, sugars, and salt. Opt for whole foods like fruits, vegetables, whole grains, and lean proteins.
  • Healthy Snacking : Choose healthy snacks such as fruits, nuts, yogurt, or whole-grain crackers instead of sugary or salty snacks.
  • Cook at Home : Preparing meals at home allows you to control the ingredients and cooking methods, leading to healthier meals.
  • Mindful Eating : Pay attention to what and how much you eat. Avoid distractions like TV or smartphones while eating, as they can lead to overeating.

Good nutrition is a cornerstone of good health. It involves a balance of carbohydrates, fats, and proteins, along with a variety of vitamins and minerals from different foods. Eating a balanced, varied diet in moderation can help prevent chronic diseases such as heart disease, cancer, stroke, and diabetes. While genetics play a role in health, lifestyle choices like diet and exercise have a significant impact. Establishing healthy eating habits from childhood can lead to better health outcomes in adulthood. By taking control of your diet and making informed choices, you can nourish your body and promote a healthier, longer life.

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Diet vs. Exercise: What’s More Important?

Written By Michael Greger M.D. FACLM • January 17, 2013 Last updated: March 7, 2022 • 2 min read

good nutrition is more important than exercise essay

When trying to lose weight, which is  most  important: diet or exercise? The vast majority of those surveyed believe that both monitoring food and beverage consumption and physical activity are  equally  important in weight maintenance and weight loss. After equally important, people go with exercise, and then diet. As you can see in my 2-min. video Diet vs. Exercise for Weight Loss , most people get it wrong.

Note the caloric expenditure equivalencies I present in the video are assuming no dietary compensation–something seen quite dramatically, for example, with  nut consumption . Given how hard it is to work off food, let’s make our calories count by choosing the most nutrient dense foods, as detailed in my 4-min. video  Calculate Your Healthy Eating Score .

Another misconception is that weight alone is a good predictor of disease risk. Body mass index is better since it takes height into account, but it doesn’t describe what or where that mass is. Body-builders can have huge BMIs (especially since muscle is heavier than fat), but that doesn’t mean they’re obese.

As I document in my 2-min. video  Keep Your Waist Circumference to Less Than Half Your Height , it is now accepted that health risks can be determined as much by the relative  distribution  of the excess fat as by its total amount. It’s not so much body fat, but visceral fat–abdominal fat, the fat around our internal organs–that most increases our risk of dying prematurely. Waist circumference takes care of both the “what” and “where” of the weight, so the best metric may be waist-to-height ratio. Move over BMI; we now have WHR.

The target is to keep our waist circumference to less than half our height. Take a cloth measuring tape and measure halfway between the top of your hipbones and the bottom of your ribcage. Stand up straight, breathe deep, exhale, let it all hang out and that measurement should be half our height. If it’s not, we should consider cutting down on our consumption of meat, as I cover in my video Meat and Weight Gain in the PANACEA Study . It may also help to cut back on refined plant foods, such as white flour products. Three servings a day of whole grains, however, was recently associated with a slimmer waist in the  Framingham Heart Study .

– Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by  clicking here  and watch my full 2012 – 2015 presentations  Uprooting the Leading Causes of Death , More than an Apple a Day , From Table to Able , and Food as Medicine .

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Diet, exercise or diet with exercise: comparing the effectiveness of treatment options for weight-loss and changes in fitness for adults (18–65 years old) who are overfat, or obese; systematic review and meta-analysis

James e clark.

Division of Mathematics, Science, and Health Careers; Department of Science, Manchester Community College, Manchester, CT 06045-1046 USA

There are number of means of methods to alter body composition, and metabolic issues, available for the adult who is overfat. The following is a systematic review and meta-analysis focused on comparing changes from treatment program for adults who are overfat based on analysis of aggregated effect size (ES) of inducing changes. So as to determine the relative effectiveness of such protocols and intervention plans of choice. This tiered meta-analysis of 66-population based studies, and 162-studywise groups, a clear pattern of ES being established across and within treatments. First, hypocaloric balance is necessary for changing body composition, but the effectiveness for establishing imbalance does not equate with the effectiveness for body compositional changes, or any biomarkers associated with metabolic issues. With analysis showing that there is a necessity to include exercise in combination with diet effectively elicit changes in body composition and biomarkers of metabolic issues. More importantly, the combination, resistance training (RT) was more effective than endurance training (ET) or combination of RT and ET, particularly when progressive training volume of 2-to-3 sets for 6-to-10 reps at an intensity of ≥75% 1RM, utilizing whole body and free-weight exercises, at altering body compositional measures (ES of 0.47, 0.30, and 0.40 for loss of BM, FM, and retention of FFM respectively) and reducing total cholesterol (ES = 0.85), triglycerides (ES = 0.86) and low-density lipoproteins (ES = 0.60). Additionally RT was more effective at reducing fasting insulin levels (ES = 3.5) than ET or ET and RT. Even though generally lower ES than RT, the inclusion of ET was more effective when performed at high intensity (e.g. ≥70% VO 2max or HR max for 30-minutes 3-4x’s/wk), or in an interval training style than when utilizing the relatively common prescribed method of low-to-moderate (e.g., 50-70% VO 2max or HR max for at least equal time) steady state method, ES of 0.35, 0.39, and 0.13 for BM, FM, and FFM respectively. Thus indicating that focus of treatment should be on producing a large metabolic stress (as induced by RT or high levels of ET) rather than an energetic imbalance for adults who are overfat.

Introduction

Accompanying the epidemic rise in the rate of obesity and obesity related diseases over the past half-century there has also been a rise in a variety of therapeutic interventions to address this epidemic. Most notable amongst these interventions have been numerous protocols that attempt to change body composition, most often through total mass reduction (i.e. weight loss). Resulting not only in a multibillion-dollar industry, but a greater absolute number of US adults currently engaging in behaviors (e.g., hypocaloric dieting, or involvement of general exercise and physical activity), with the focus based on the implication that all mass as being equal in the equation of body mass, obesity and disease [ 1 - 3 ]. To support such a position, several authors [ 4 - 9 ] have previously noted that there are limited differences in results for absolute changes in body composition with comparison between the various methodologies employed for treatment of weight issues for an individual who is overfat. While others [ 4 , 9 - 12 ] have indicated the responses are more related to an energetic imbalance (e.g., kcal/day, kJ/day) between dietary caloric load and expenditure from activity that results from the intervention of choice (e.g., diet, exercise, or combination therein) than the actual intervention for the adult who is overfat.

However, the discussion of effective outcome must go beyond any reduction in body mass or even health factors. Instead, the overall outcome has to involve a large change in self-selected and self-motivated behaviors. A change that serves to increase health and fitness behaviors and invoke a psychological adherence to exercise that most adults who are overfat might not intrinsically possess. Something that has become evident in the low attrition rates within many exercise programs and the high rate of repeated hypocaloric diet attempts [ 13 - 16 ]. Yet many of the marketing verbiage, seen through any scan of popular media, of intervention programs lead to the idea of adherence to any program appears related to the ability for that program to alter body mass. Which comes without mention or regard to any of the other physiological modifications, or alleviation of pathophysiological conditions, that arise throughout treatment that has been noted in the continuum of fitness and fatness factors impacting the overall health of the adult who is overfat [ 17 - 21 ]. This single focus on body mass alteration alone, leads to growing confusion within the general population as it relates to which therapeutic intervention may provide greatest benefit. Especially, given that there are any number of anecdotal, and single study results, indicating effectiveness of any of the various methods for weight loss and health improvement for the adult who is overfat. And more so are discussions of such reports within the scientific community, and popular press, which increase such confusion by indicating distinct advantages (or disadvantages) that are in conflict with each other. But also indicate the aforementioned limited differences between methods of intervention for the adult who is overfat.

Moreover, the differences between intervention methods used within single studies and the methods of comparison within previous reviews, lead to inherent issues of comparability of absolute changes between studies and the conclusion stipulated thereby [ 22 , 23 ]. In particular, the wide differences in the length of interventions and the vast elaboration and complexity within the design of some interventions utilized. Where most of the complexities that appear in some programs are at a level of elaboration for the sake of being elaborate, to function as a marketing ideal, and not based on the elaboration necessitated by principles of periodization and progressive training [ 24 , 25 ]. Likewise, the length of intervention time between comparisons varied greatly. Where, not surprisingly, the longer the intervention the greater absolute change relative to a shorter duration intervention. And taken together, may be the underlying rationale for the perplexing stats. Where even given an elevated current awareness of health issues of overfatness, there are reports by the Centers for Disease Control and Prevent (CDC) [ 1 ] identifying that fewer than 21% of US adults meet the general recommendation for exercise behaviors. And that only approximately 51% of US adults meet the recommendation for aerobic (endurance) training while only 29% meet the recommendation for strength (resistance) training each week [ 1 , 3 ].

Even if it is well understood that altering any health behaviors leads to a reduction in the risk factors for preventable non-communicable diseases [ 18 , 20 , 26 - 33 ]. And can lead to greater use of other healthy behaviors leading to greater overall levels of fitness [ 15 , 27 ]. Where these improvements appear to stem from a number of endocrinological changes that occur with both expression of overfatness and following exposure to exercise that ultimately alters the health status for the individual who is overfat [ 18 , 19 , 26 , 28 , 30 , 32 - 34 ]. The greatest impact of these changes appears to be related to alterations in sex hormone (i.e. testosterone and androgens), growth hormone, and a host of adipokines [ 29 , 34 - 46 ]. With low utilization of healthy behaviors eliciting changes indicated to increase the risk for the development of metabolic issues, which may culminate in Type 2 Diabetes Mellitus (T2DM), and are readily associated with reduced work capacity and anabolic hormone response for the individual who is overfat [ 18 , 26 , 27 ]. And are reversed with exposure to physical activity (e.g., exercise) with speculation that resistance exercise may provide the greatest impact on reversing such issues [ 28 , 47 - 50 ] and evidence for greater change in body composition from utilization of resistance exercise, both with and without conjunction with hypocaloric diet [ 51 ].

Given this level of understanding, it is perplexing that there would be such low investment in beneficial health behaviors that are highly associated with alleviating many of the aforementioned health issues [ 19 , 26 , 28 , 31 ]. Which leads to the question, if it is generally understood that physical activity is beneficial to not only in body mass reduction, in particular fat mass (FM) but not fat-free mass (FFM), along with improvements in many health functions, then why are so few adults engaging in such behaviors? As it has been reported that some 5-million U.S. deaths from non-communicable diseases could be prevented, even with a possible stagnation in the total proportion of the population classified as overweight or obese via current measures [ 1 , 2 ]. And may be related to the way in which exercise (in particular RT) is discussed in relation to the alteration of body mass, resolving metabolic issues and improvements in the overall health status for the adults who are overfat [ 20 , 21 , 52 - 54 ]. Along with the means by which we discuss changes elicited along with the process of comparison and generalization of findings to the population large. And a methodological bias in the employment of exercise that leads to an over recommendation of a single type of exercise based on personal preference [ 27 , 55 - 57 ]. Which, is compounded by the trove of anecdotal reports for response, from a self-professed exercise expert, that are easily accessible via any Internet search-engine for topics related to issue of weight loss.

However, just because there are issues related to direct comparison, due to methodological differences and taking into account the large inter-study discrepancies for responses, one can still compare responses. Comparison of responses must not come from the absolute value for changes indicated by each study, but as performed here through the aggregation of responses based on the pooled effect for ES that over the sum of all studies. Thus reflecting a more reliable overall effectiveness and provide a greater insight into the treatment phenomenon being offered [ 22 , 23 ]. Therein, the focus of this review here will examine the various outcomes from treatments utilized for improvements in the health status for the individual who is overfat that can be incorporated long-term behavioral modification. With analysis based on the effectiveness of treatment (e.g., effect size, ES) and not on the evaluation of absolute changes relative to either the initial state, or in comparison to a control group, within the included studies. Thus providing support to the health-care practitioner, or fitness club employee, to advice patients (or clients) as to which protocol schematics should provide the most effective means to not only change body composition (thus providing the reinforcement reward to elicit continual behavioral modification) but also improve the health status for the adult who is overfat.

Hence, the purpose of this systematic review is explore the current understanding of changes elicited to body composition in light of the understanding related to the endocrinological and health improvements seen with the various intervention programs based solely on population-based studies. That is related to treatment utilization of diet, diet and exercise or strictly exercise intervention for means of body mass reduction (i.e. weight loss), change in blood lipids and hormone levels. In an attempt to address the question if there is a difference in response between the various methods in (not absolute loss but effect size for) loss of body mass, fat mass and fat-free mass along with changes in blood lipid profiles and hormonal levels? Upon which, analysis will examine four distinct hypotheses. First, that exercise interventions will provide a greater effectiveness means for FM reduction than any diet intervention. Second, within exercise methods the use of RT will provide a stimulus that induces a greater effectiveness for change in body mass change (reduction in FM with retention of FFM) than ET, without regard to the addition of diet to the intervention. Thirdly, exercise will provide the stimulus that is more effective than any diet intervention at reverse hormone and adipokine/cytokine signals to normal “healthy” ranges. Lastly, that RT will be able to produce an effectiveness of treatment that matches the effectiveness of treatment from ET for both altering hormone and adipokine/cytokine signals but also for changing blood lipids.

As shown in the overview of the study in Figure  1 , relevant studies (e.g., studies only involving human volunteers that fit into category of population based evidence) were retrieved from electronic database search engines (PubMed, EBSCO Host (CINAHL, SPORTDiscus) and Scopus) using the following key words in combination with each other: obesity, exercise, resistance training, endurance training, strength training, aerobic training, diet, adipokine (adiponectin, leptin), cytokine (CRP,IL-1, IL-6, IL-10, TNF- α ), anabolic hormone(testosterone, growth hormone),thyroid hormone, insulin, inflammation, weight loss, fat mass, and fat-free mass. From the journal articles returned by the search engine, articles were included and excluded based on the following criteria. Additional studies were determined to be included for review based on citations within relevant articles.

An external file that holds a picture, illustration, etc.
Object name is 40200_2015_154_Fig1_HTML.jpg

Description summarizing the steps for inclusion/exclusion and method leading to classification and analysis of studies involved within the meta-analysis.

Inclusion criteria:

  • Published original research from January 1980-April 2013
  • Published in English or translation of article available
  • Utilized only human participants with reported average age for volunteers ranging from 18 and 65 years of age during the duration for the experiment
  • Study population was either identified as either “overweight” or “obese” by authors or was indicated within the study as meeting at least 1 of the classification metrics for being overweight or obese (i.e. BMI > 25 kg/m 3 or WHO levels of %BF for classification based on age and gender)
  • Studies compared at least two conditions (either within subject cross-over design or comparison to a control or basal/baseline) and involved random assignment to training group(s) or control and to the order or method of training
  • Study designs examined chronic adaptations (i.e. multiple training sessions, or interventions lasting at least 4 weeks in duration)
  • Main purpose was to examine hormonal or cellular responses to exercise or diet
  • Main purpose was to examine changes in body mass in response to exercise or diet
  • Main purpose was to examine chronic responses to either exercise modes (e.g., resistance exercise or endurance exercise), hypocaloric diet, or combination of one of the exercise modes with hypocaloric diet, or combination of both exercise modes with hypocaloric diet.

Exclusion criteria:

  • Publication was a review article
  • Not published in English or no translation available
  • Study design utilized an animal model for the problem
  • Population age could be classified as adolescent, or juvenile, (average age < 18 years of age) and/or elderly (average age > 65 years of age)
  • Study population either failed to meet metrics for classification as “obese” or “overweight”, or was indicated to have secondary disease (e.g., cancer, osteoporosis, cardiovascular disease) or had populations indicated to have history of metabolic variables and concurrent treatments (e.g., smoking, pharmacologically controlled type-2 diabetes mellitus (T2DM), cardiovascular diseases) that might confound the response to exercise and/or diet treatment
  • Study design did not randomly assign subjects to a training group or control, or order of intervention
  • Study design examined strictly acute responses (i.e., single exercise bout, or intervention lastly fewer than 4 weeks in duration)
  • Main purpose did not involve measure of hormonal or cellular response to exercise or diet
  • Results did not report absolute changes in hormones or body mass following intervention
  • Indication of use of dietary supplement, or pharmacological dosing of anabolic or androgenic hormones.

Following retrieval and evaluation for inclusion, study data (reported means and standard deviation/error for measures of interest, number of subjects in each study groups, duration of study) were entered into database for subsequent analysis, see Figure  1 . From the initial abstracts screened, a total of 66 studies were included in the meta-analysis, from which 162 study groups were included for comparison of responses within the review. Each included study was then classified by parameter of measurement and method, along with categorization of the method, of therapeutic intervention, see Table  1 , for pooling and tabulating data for analysis based not only on the outcome of measure but for demographic information. From this pooled data for treatment responses averages, standard deviations were calculated across the studies classified by therapeutic intervention and measure of interest regardless of duration of intervention or any additional unique characteristics of the individual studies. Following which, pooled ES and confidence intervals (CI .95 ) of ES for each measure of interest was determined to examine the overall effect relative to a case of no change (i.e. CI .95 crossing zero within the 95% of all expected scores) based on each of the following comparisons, 1) relative to diet-only interventions; 2) relative to combination of diet and ET interventions; 3) relative to the combination of diet and RT interventions; and 4) relative to the combination of diet with ET and RT interventions.

Summary of studies include in meta-analysis indicating the therapeutic intervention used, and the principle measure of interest reported used for comparison within analysis

Ahmadizad [ ] ET (8-M)3x’s/wk for 12-wkET: 75–85% of MHR for 20-30-min (progressive),BM, I, Adip
RT (8-M)RT: 4x12 CRT of 11 exercises @ 50–60% 1RM
Anderssen [ ]D (34-M)ET: 3x’s/wk for 52-wksD: Low FatBM, FM, FFM, Cal
ET (34-M)ET: 60–80% of PHR for 60-min
D(E) (43-M)
Ara [ ]RT (12-M)RT: 3x’s/wk for 6-wksRT: 1–3 x 3–12 @ Progressive 1RM (range 50-90%) for Squats, Leg Press, Leg Curl/Ext, Hip Flexion w/ 90 s rest @ total expenditure of 220–300 kcal/sessionBM, FM, FFM, T, OB
Ballor [ ]ET (9-M)3 x’s/wk for 12-wkET: 50% VO max x 20–60 min (progressive)BM, FM, FFM
RT: 3x8 @ 50-80% 1RM (progressive) Squat, Bench, Leg Ext/Curl, Arm Ext/Curl, Lateral Pulldown
RT (9-M)
Ballor [ ]D (10-W)RT: 3x’s/wk for 8-wksD: hypocaloric @ -1000 kcal/day w/ Protein >1.0 g/kgBM, FM, FFM, Cal
RT (10-W)
D(R) (10-W)
RT: 3x10-12 @ 10RM for: Chest Press, Leg Press, Lateral Pull-down, Arm Curl/Ext, Leg Curl/Ext, Calf Raise
Borg [ ]D (90-M)D: 2-month ET&RT: 3x’s-wk for 24-wkD: Hypocaloric @ =1200 kcal/d for first and last wk and −500 kcal/d betweenBM, FM, FFM, Cal
ET (25-M)
RT (28-M)ET: 45 min @ 60-70% VO max
RT: 3x8 @ 60-80% 1RM CRT
Bouchard [ ]D (11-W)RT: 3x’s/wk for 12-wkD: Hypocaloric @BM, FM, FFM
RT (11-W)−500 kcal/d
D(R) (12-W)RT: 3x8 @ 80% 1RM for (leg press, chest press, leg extension, shoulder press, sit-up, seated row, triceps extension, arm curl, and calf extension) w/ 60–90 s rest
Brehm [ ]D, LF (20-W)24-wksD,LF: Hypocaloric @ ≈ 1250 kcal/d with ~54% CHO, ~18% protein, ~28% fat of kcal/dBM, FM, FFM, TC, TG, LDL, HDL
D, LC: Hypocaloric @ ≈ 1160–1300 kcal/d with ~15-30% CHO, ~25% protein, ~46-57% fat of kcal/d
D, LC (22-W)
Brochu [ ]D (71-W)RT: 3x’s/wk for 24-wkD: Hypocaloric @ -500 kcal/dBM, FM, FFM, TC, HDL, LDL, TG, CRP, I, Cal
RT: 3–4 x 8–12 @ 65-80% 1RM (progressive) for (Leg Press, Chest Press, Lateral Pulldown, Shoulder Press, Arm Curl/Ext) w/ 60–90 s rest
D(R) (36-W)
Bryner [ ]D(E) (2-M/8-W)ET: 4x’s/wk RT: 3x’s/wk for 12-wkD: Hypocaloric @ ≈ 800 kcal/dBM, FM, FFM, Cal
ET: 20–60 min (progressive) @ self-paced
D(R) (1-M/9-W)RT: 2-4x15-12 @ 15RM-to-8-RM (progressive) for 10-exercise CRT w/ 60-s rest
Campbell [ ] D (8-W)RT: 3x’s/wk for 16-wkD: Hypocaloric @ -500 kcal/dBM, FM, FFM, Cal
RT: 3x8-12 @ 80% 1RM (for Leg Ext/Curl, Leg Press, Chest Press, Arm Pull) w/ 60–120 s rest
D(R) (8-W)
Christiansen [ ]D (29-M/W)ET: 3x’s/wk for 12-wkD: Hypocaloric @ ≈ 600 kcal/dBM, I, OB, TC, HDL, Cal
D(E) (25-M/W)
ET: 60–75 min @ unknown intensity to equate to 500–600 kcal/session
ET (25-M/W)
Cuff [ ]D(E) (10-W)3x’s/wk for 16-wkE + R: 75-min @ 60-75% HRR w/ RT@ 2x12 for Leg Press, Leg Curl, Hip Ext, Chest Press, Latissimus Pulldown @ unknown intensity or rest E: 75 min @ 60-75% HRRBM
D(E + R) (9-W)
Donnelly [ ] D (26-W)ET & RT: 4x’s/wk for 12-weeksD ET: 20–60 min (progressive) @ 70% HRR RT: 2–3 x 6–8 @ 70-80% 1RM (progressive) on CRT exercises unknown, rest unknownBM, FM, FFM, Cal
D(E) (16-W)
D(R) (18-W)
D(E + R) (9-W)
Donnelly [ ] D (7-W)RT: 3x’s/wk for 12-wksD: Hypocaloric @ =700 kcal/dBM, FM, FFM, Cal
RT: 3 sets 8,6,6 @ 70% 1RM, progress to 4 sets 8.6.6.4 @ 80% 1RM for Bench Press, Latissimus Pull-down, Leg Ext/Curl, Shoulder Press, Arm Pullover, Arm Curl/Ext
D(R) (7-W)
Donnelly [ ] ET (16-M/25-W)5x’s/wk for 68-wksET: 20–45 min @ 60%-75% HRR for 1 24-wks then 55%-70% of HRM (progressive) for ≈ 2000 kcal/wk (400 kcal/session)
Dunstan [ ] D (17-M/W)RT: 3x’s/wk for 24-wksD: HypocaloricBM, FM, FFM, I, TC, HDL, LDL, TG, Cal
RT: 3x8-10 @ 50-85% 1RM (progressive) for Bench Press, Leg Ext/Curl, Upright Row, Lateral Pull-down, Shoulder Press, Arm Curl/Ext, Abdominal exercises
D(R) (19-M/W)
Fisher [ ] D (29-W)ET & RT: 3x’s/wk for 8-wksD: Hypocaloric @ ≈ 800 kcal/dBM, FM, FFM, CRP, IL-6, TNF-α, Cal
ET: 20–40 min @ 65-80% MHR (progressive)
D(E) (43-W)
RT: 1-2x10 @ 60-80% 1RM (progressive) for Leg Press, Squats, Leg Ext/Curl, Arm Curl, Lateral Pull-down, Bench Press, Military Press, Trunk Exercises
D(R) (54-W)
Foster [ ] D, HP (12-M/21-W)52-wksD, HP: Hypocaloric following BM, FM, FFM, Cal
D (8-M/22-W)D: Hypocaloric @ M ≈ 1500–1800 kcal/d; W ≈ 1200–1500 kcal/d for 60%CHO, 15% protein, 25% fat
Geliebter [ ]D (8-M/14-W)ET & RT: 3x’s/wk for 8-wksD: Hypocaloric @ <70% RMRBM, FM, FFM, Cal
D(E) (9-M/14-W)ET: 8-min bicycle erg, 8-min arm erg, 8-min cycle erg @ 55-70% VO peak (progressive)
D(R) (8-M/14-W)
RT: 2x6, 1xfatigue for Leg Ext/Curl, Chest Press, Arm Pull-over, Arm Curl/Ext, Leg Press w/30 s rest
Goddpaster [ ]D (63-M/W)ET: 5 d/wk for 24-wksD: Hypocaloric @ ≈ 1200–2100 kcal/d with 50-55% CHO, 20-25% protein, 20-30% fatBM, FM, FFM, Cal
D(E) (67-M/W)
ET: total 60-min/d unknown intensity
Hallsworth [ ]RT (11-M/W)3x’s/wk for 8-wksRT: 2–3 sets x unknown rep @ 50-70% 1RM (progressive) for: Arm Curl/Ext, Chest Press, Leg Curl/Ext, Lateral Pulldown, Shoulder PressBM, I, TC, TG
Hammer [ ] D, LF (14-W)ET: 5x’s/wk for 6-wksD: hypocaloric VL @ =800 kcal/d, LF @ = 1195 kcal/dBM, FM, FFM, Cal
D, VL (12-W)
ET (12-W)ET: distance of 1.6-4.8 km/session (progressive) @ 60-85% HRM (progressive)
D(E), LF (8-W)
D(E), VL (6-W)
Hill [ ]D (3-W)ET: daily for 5-wksD: hypocaloric @ 800 kcal/dBM, FM, FFM
D(E): distance of 1.6-5.6 km/session (progressive) @ unknown intensity
D(E) (5-W)
Hill [ ]D (6-W)ET: 5x’s/wk for 12-wksD: hypocaloric vary from 600–1500 kcal/d, LF @ 1200 kcal/dBM, FM, FFM
D, LF (8-W)
D(E) (10-W)
D(E), LF (8-W)ET: 20–50 min (progressive) @ 60-70% HRM
Ho [ ]D(E) (15-M/W)ET & RT: 5x’s/wk for 12-wksD: hypocaloricBM, FM, FFM, I, OB, TC, HDL, LDL, TG, Cal
ET: 30-min @ 60% HRR
D(R) (16-M/W)RT: 4x12 @ 10RM for Leg Press, Leg Curl/Ext, Bench Press, Seated Row w/ 60 s rest
D(E + R) (15-M/W)
E + R: ET for 15-min @ 60% HRR & RT for 2x12 @75%1RM
Ibanez [ ]D (12-W)RT: 2-3x’s/wk for 16-wkD: Hypocaloric @ -500 kcal/dBM, FM, FFM, I, Adip, OB, TC, HDL, LDL, TG, Cal
RT: 3-4x10-15 @ 50-80%
D(R) (13-W)1RM (progressive) CRT for 8-wks & 3-5x10-12@60-80% or 3-5x 4-6@80-90% alternate for 8-wks
Irving [ ] E(Low-Intense) (3-M/10-W)3-5 x’s/wk for 16-wksLow-Intensity: unknown time @ RPE of 10–12 equate to 300–400 kcal/sessionBM, FM, FFM, GH, IGF, HDL, TG, Cal
E(High-Intense) (3-M/8-W)High Intensity: unknown time @ RPE of 15–17 to equate to 300–400 kcal/session
Josse [ ] D(E + R), HP (30-W)ET: 7x’s/wk RT: 2x’s/wk for 16-wksET: 7x’s/wk @ total expenditure of 250 kcal unknown duration or intensityBM, FM, FFM, Cal, IL-6
D(E + R), LP (30-W)
D(E + R), MP (30-W)
RT: 3x10 unknown intensity & rest interval
Kempen [ ]D (10-W)ET: 3x’s/wk for 8-wksD: Hypocaloric @ =500-750 kcal/dBM, FM, FFM, Cal
D(E) (10-W)ET: 90-min group exercise sessions @ 50-60% VO max
Kerksick [ ] E + R (17-W)ET&RT: 3x’s/wk for 14-wksE + R: @ HR of 60-80% MHR using CRT of 14 exercises either paired:BM, FM, FFM, Cal
D(E + R), HC + P
(11-W)
D(E + R),VL/HPArm Ext/Curl, Leg Ext/Curl, Shoulder Press/Lateral Pulldown, Hip Abd/Add, Chest Press/Seated Row, Abdominal Crunch/Back Extension, Shoulder Shrug/Dip; or unpaired: Leg Press, Squat, Pec-Deck, Oblique, Hip Ext, side bends, stepping) x 30 s @ unknown %1RM w/ callisthenic 30 s between sets/paired exercise
(48-W) D(E + R),LC (37-W)
D(E + R),HC (41-W)
Klimcakova [ ] D(R) (12-M)RT: 3x’s/wk for 12-wksD: HypocaloricBM, FM, FFM, I, Adip, OB, TNF-α, TC, HDL, TG
RT: 1x12-15 @ 60-70% for 17-exercise CRT
Kraemer [ ]D (8-M)RT & ET: 3x’s/wk for 12-wksD: HypocaloricBM, FM, FFM, Cal
ET: 30–50 min (progressive) @ 70-80% PHR
ET&RT: ET then, 1-3x5-10 @5-7RM or 8-10RM (alternate) for Squat, Military Press, Bench Press, Lateral Pull-down, Seated Row, Trunk exercises, Leg Press, Leg Curls, Calf Raises, Arm Curls with 60–180 sec rest (load dependent)
D(E) (11-M)
D(E + R) (10-M)
Larsen [ ] D, HGI/HPHypocaloric for 26-wksAll diets w/ < 25-30% total kcal from fatBM, FM, FFM, Cal
(97-M/W)
D, LGI/HPLP: PRO:CHO ratio of 1:5 (10–15% total kcal protein and 57–62% total kcal CHO)
(124-M/W)
D, HGI/LP
HP: PRO:CHO ratio: of 1:2 (23–28% total kcal protein and 45–50% total kcal CHO)
(106-M/W)
D, LGI/HP
HGI: no change in GI diets w/ ~ 12% total kcal from protein
(124-M/W)
LGI: reduction of 15 GI points compared with the high-GI diets w/ ~ 12% total kcal from protein
Layman [ ] D, HP (12-W)10-wksD, HP: ≈1700 kcal/d @1.6 g/kg protein in ratio of CHO:protein ~1.4 and <30% fat of kcal/dBM, FM, FFM, I, TH, TC, HDL, DLD, TG
D, HC (12-W)D, HC: ≈1700 kcal/d @0.8 g/kg protein and ratio of CHO:protein >3.5 and <30% fat of kcal/d
Layman [ ] D, HP (12-W)ET: 5x’s/wk RT: 2x’s/wk for 16-wksD, HP: ≈1700 kcal @ 1.6 g/kg for protein with CHO:protein ratio <1.5 and fat <30% of kcal/dBM, FM, FFM, Adip, OB, Ghrelin, I, TC, HDL, LDL, TG, Cal
D(E + R), HP (12-W)D, HC: ≈1700 kcal/d @ 0.8 g/kg for protein with CHO:protein ratio >3.5 and fat <30% of kcal/d
D, HC (12-W)
D(E + R), HC (12-W)
ET: 30-min @ unknown intensity
RT: 1x12 @ unknown resistance intensity for 7 exercise in CRT
Maiorana [ ] E + R (14-M/2-W)3x’s/wk for 8-wksE + R: CRT for RT @ 45 s of RT @ 55–65% MVC (progressive) w/ 15 s rest between RT followed by 5-min ET @ 70–85% PHR (progressive) intermittent to RT-exercisesBM, HDL, LDL, TC, TG
Marks [ ]D (10-W)ET & RT: 3x’s/wk for 20-wksD: Hypocaloric general low fat @ -628 kcal/dBM, FM, FFM, Cal
ET: 12–36 min (progressive) @ 70-85% HRM
D(E) (8-W)
D(R) (11-W)RT: 2x8-12 @ 70-90% 1RM for: Leg Ext/Curl, Seated Row, Chest Press, Arm Ext/Curl, and abdominal curls, with unknown rest
D(E + R) (9-W)
ET&RT: 12–24 min of ET and 1 set of RT
Moreira [ ] E(S) (8-M/W)3x’s/wk for 12-wksE(S):20–60 min (progressive) @ 10% of Anaerobic ThresholdBM, FM, FFM, TC, TG
E(I): 20–60 min (progressive) total time @ 2:1 ratio of 120% Anaerobic Threshold to Rest time
E(I) (8-M/W)
Nicklas [ ]D (53-M/W)ET & RT: 3x’s/wk for 72-wksD: Hypocaloric @ -500 kcal/dBM, CRP, IL-6, TNF-α, Cal
ET: 30–45 min @ 50-75% HRR
ET (53-M/W)
E + R: 15-min ET @ 50-75% HRR, followed by 15-min RT @ 2x12 CRT, followed by 15-min ET @ 50-75% HRR
D(E + R) (53-M/W)
Oberbach [ ] ET (40-M/W)4x’s/wk for 4-wksET: 3-days: 60-min unknown intensity (20-min calisthenics/20-min steady state/20-min “power-training” & 1-day: 60-min swimmingBM, FM, FFM, Adip, OB, IL-6, IL-10, CRP, TC, HDL, LDL, TG
Olson [ ]RT (16-W)2x’s/wk for 52-wkRT: 3x8–10 @ 8-10RM (Progressive) for unknown exercises indicated as isotonic variable resistance machines and free weights targeting the following major muscle groups: quadriceps, hamstrings, gluteals, pectorals, latissimus dorsi, rhomboids, deltoids, biceps and tricepsBM, FM, FFM, I, Adip, Il-6, CRP, TC, HDL, LDL, TG
Pavlou [ ] D (41-M)ET: 3x’s/wk for 8-wksD: Hypocaloric @ = 800 kcal/dBM, FM, FFM
D(E) (31-M)ET: 70-85% MHR for 20–45 min (progressive)
Phinney [ ]D, HP (6-W)ET: 6-hrs/wk for 4-wksD: hypocaloric @ =720 kcal/dBM, FM, FFM, Cal
D(E) (6-W)ET: 6-hrs/wk total time @ 50% VO max
Polak [ ]ET (25-W)5x’s/wk for 12-wksET: 45-min @ 50-65% VO max (progressive) for 2x’s/wk group exercise class, 3x’s/wk cycle ergometerBM, FM, FFM I, Adip, OB, IL-6, TC, HDL, TG
Pritchard [ ]D, LF: (18-M)ET: 5x’s/wk for 52-wksD: hypocaloric @ -500 kcal/d & 20-25% fat of kcal/dBM, FM, FFM, Cal
ET (21-M)ET: 30–45 min @ 65-75% HRM
Racette [ ]D (17-W)ET: 3x’s/wk for 12-wksD: hypocaloric @ =75% BMRBM, FM, FFM, Cal
D(E) (13-W)
D(E): 35-min @ 65% VO max
Rice [ ]D (9-M/W)ET: 5x’s/wk RT: 3x’s/wk for 16-wksD: Hypocaloric @ -1000 kcal/dBM, FM, FFM
ET: 20–60 min @ 50-85% MHR (progressive)
D(E) (10-M/W)
RT: 1x8-12 @ 8-12RM (progressive) for Leg Ext/Curl, Latissimus pull-over, Bench Press, Should Press, Arm Ext/Curl
D(R) (10-M/W)
Rolland [ ] D, HP (1-M/16-W)36-wksD,HP: hypocaloric @ 800–1500 kcal/d, @ 20%CHO,40% protein, 40% fat of kcal/dBM, FM, FFM, I, Adip, OB, HDL, TC
D, LF (5-M/9-W)D, LF: hypocaloric @ -500 kcal/d @ 35%, CHO, 36% protein, 28% fat of kcal/d
Ross [ ]D (15-W)ET: daily x 14-wksD: Hypocaloric @ -500 kcal/dBM, FM, FFM, I, Cal
ET: self-selected duration @ ~80% MHR (equate to 500 kcal/session)
D(E) (17-W)
ET (12-W)
Ryan [ ] D (23-W)ET & RT: 3x’s/wk for 24-wksD: Hypocaloric @ -250-350 kcal/dBM, FM, FFM
ET: 45-min @ 50-75% HRR (progressive)
D(E) (24-W)
D(R) (16-W)RT: variable resistance for 15-rep (3RM to 15 RM) 2–3 sets for Leg Press, Chest Press, Chest Flies, Latissimus Pull-down, Leg Curl/Ext, Arm Curl/Ext w/ 30 s rest
Schjerve [ ] E(S) (13-M/W)3x’s/wk for 12-wksIT: 10-min @ 50-60% MHR followed by 4 cycles of 4-min:3-min ratio of 85-95% MHR then 50-60% MHR followed by 5-min @ 50-60% MHRBM, FM, FFM, TC, HDL, TG
E(I) (14-M/W)
RT (13-M/W)ET: 47-min @60-70% MHR
RT: 4x5 @ 90% 1RM (progressive) for Leg Press or Squats, trunk exercises @ 3x30 w/ 30 s rest
Shue [ ]D (21-W)12-wksD: Hypocaloric @ -500-1000 kcal/dI, Adip, OB, IL-6, IL-10, TNF-α, TC, HDL, LDL, TG
Sigal [ ]D(E) (60-M/W)ET & RT: 3x’s/wk for 24-wksET: 15–45 min @ 60-75% MHR (progressive)BM, FM, FFM, HDL, LDL, TG
D(R) (64-M/W)RT:2-3x7-9 @ unknown intensity in CRT w/ unknown exercises
D(E + R) (64-M/W)
E + R: combined both
Slentz [ ]ET (22-M/26-W)3x’s/wk for 32-wksET: equivalent to 12 mi/wk @ 75% VO peakBM, FM (as indicated by abdominal)
RT (22-M/30-W)RT:3x8-12 @ unknown RM in CRT fashion
E + R (19-M/25-W)
E + R: full sessions of both ET & RT
Strasser [ ] D (10-W)ET: 3 x’s/wk for 8-wksD: Hypocaloric @ -500 kcal/dBM, FM, FFM, TC, HDL, LDL, TG, Cal
D(E) (10-W)ET: 60-min @ 60% VO max
Tjønna [ ]E(I) (4-M/7-W)3x’s/wk for 16-wksIT: 10-min @ 70% MHR followed by 4-cyles of 4-min:3-min @ 90% MHR and 70% MHR, then 5-min @ 50-60% MHRBM, FM, FFM, I, Adip, HDL, TG
E(S) (4-M/4-W)
ET:47-min @ 70% MHR
Tokmakidis [ ] D(E + R) (9-W)4x’s/wk (2x’s ET, 2 x’s RT) for 16-wksET: 2x’s/wk: 45-min @60-80% MHR (progressive)BM, FM, FFM,I
RT: 2x’s/wk: 3x12 @ 60% 1RM (progressive) for Bench Press, Row, Leg Ext/Curl, Latissimus, Pec Deck w/ 45–60 s rest Pull-down,
Trapp [ ]E(I) (15-W)3x’s/wk for 15-wksIT: cycle ergometer @ 8-sec sprint:12-sec recover intervals progress from 5-min to 20-min total timeBM, FM, FFM,I, Adip, OB
E(S) (15-W)
ET: 10–40 min @60% VO peak (progressive)
Volpe [ ] D (13-M/15-W)ET: 3–5 x’s/wk for 36-wksD: hypocaloric @ ≈ −500 kcal/dBM, FM, FFM, OB, TC, HDL, LDL, TG, Cal
ET (17-M/17-W)
D(E) (14-M/14-W)ET: 15–30 min for 3–5 x’s/wk (progressive) @ unknown intensity via ski-ergometer
Wang [ ] D, HGI/HP(24-W)8-wks hypocaloric and 24-wks 1 of 4 maintaining dietsD: 8-wks of low fat/ Hypocaloric @ =800 kcal/d & 24-wks of:BM, I, TC, HDL, LDL, TG, Cal
LF: < 25-30% total kcal from fat with compensatory increase in protein and CHO
D, LGI/HP (24-W)
D, HGI/LP (24-W)LP: PRO:CHO ratio of 1:5 (10–15% total kcal protein and 57–62% total kcal CHO)
HP: PRO:CHO ratio: of 1:2 (23–28% total kcal protein and 45–50% total kcal CHO)
D, LGI/HP (24-W)
HGI: no change in GI diets w/ ~ 12% total kcal from protein
LGI: reduction of 15 GI points compared with the high-GI diets w/ ~ 12% total kcal from protein
Watkins [ ]ET (14-M/W)ET: 3–4 x’s/wk for 26-wksD: hypocaloric @ ≈ 1200–1500 kcal/d w/ fat @ 15-20% total kcal/dBM, FM, FFM, I, TC, HDL, LDL, TG, Cal
D(E) (14-M/W)ET: 30–35 min @ 70-80% HRR
Wycherely [ ]D (16-M/W)RT: 3x’s/wk for 16-wksD: Hypocaloric @ ≈ 1200–1250 kcal/day w/ 0.7 g/kg proteinBM, FM, FFM, I, CRP, TC, HDL, LDL, TG
D,HP (12-M/W)
D(R) (17-M/W)
D,HP: Hypocaloric @ ≈ 1200-
1250 kcal/day @1.2 g/kg protein
D(R), HP (14-M/W)RT: 2x8-12@70-85% 1RM for Leg Press, Leg Ext, Chest Press, Latissimus Pull-down, Seated Row, Arm Ext w 60 s rest

Note *denotes only treatment ES determined for diet-only intervention, $ denotes only treatment ES determined within exercise interventions. Legend: D = diet, RT = resistance training, ET = Endurance Training, E + R = combination of exercise, HP = high protein diet/low carb, HC + P = high carbohydrate & protein, HC = high carbohydrate/low fat, GI = glycemic indexed diet, HGI = high glycemic diet, LGI = low glycemic diet, LC = low carb/no protein change, LF = low fat (American Heart Assoc.), VL = very low caloric diet, LP = low protein, MP = moderate protein, D(R) = diet and resistance training, D(E) = diet and endurance training, D(E + R) = diet and combination of exercise, E(S) = steady state endurance, E(I) = interval endurance training, MHR = maximal heart rate; PHR = peak heart rate, HRR = heart rate reserve, CRT = circuit resistance training, IT = interval training, MVC = maximal volitional contraction, RPE = rating perceived exertion, TC = total cholesterol, HDL = high-density lipoproteins, LDL = low-density lipoproteins, TG = triglycerides, T = testosterone, GH = growth hormone, I = insulin, TH = thyroid hormones, IGF = insulin-like growth factor, Adip = adiponectin, OB = leptin, CRP = c-reactive protein, Cal = Caloric Expenditure or reduction from diet, M = men, W = women.

In order to complete comparisons between dissimilar experimental designs, all studies were evaluated for a standardized effect size (ES). Based on the premise for comparing ES previously utilized [ 58 - 60 ], for each of the measures of interest based on the therapeutic intervention (Figure  1 ). This standardized ES across all studies was undertaken in an effort to control for difference in methods of measurement and distinct (unique) qualified differences in the therapeutic interventions (see Table  1 ). And thus allow for comparison between and within the various parameters measured based on the therapeutic intervention in a pooled fashion of ES for response. Each of measure of interest and within all groups (interventions as well as indicated control) the treatment ES were calculated via ( μ post − treatment  −  μ pre − treatment )/( σ pooled within ). After which, each measure of interest had a pooled ES determined between the various treatment protocol groupings and the control grouping to elicit the pooled therapeutic effect, via equation ( μ change treatment  −  μ change control )/( σ pooled with control ). Additional comparison of the pooled ES for changes were made on between the responses noted in the various measures of interest across, and relative to the pooled response for the control groups, indicated in the studies included in the analysis, based on the equation, ( μ change across − treatment # 1  −  μ change across − treatment # 2 )/( σ pooled between treatment ). Following which, a standardized confidence interval (CI) for ES was calculated within each treatment intervention for use in the comparison of responses between interventions for each measure of interest based on the pooling of studies for comparison.

In an effort to establish a secondary directionality for difference between treatments, the within study treatment ES were then clustered for 2x2 χ 2 analysis to determine if any difference in the level of response, standardized ES, by outcome based on the measure of interest for comparison between responses based on relationship (i.e. above or below) to the pooled ES for that given treatment, and compared between the type of treatment and then based on sub-classification of physical activity within the treatment (e.g., resistance exercise, RT, endurance exercise, ET, organized exercise program, or general physical activity program), type of diet (e.g., general hypocaloric, low-fat, or low-carbohydrate diet), the combination of the diet with exercise programs, and based on the length of intervention within the grouping of treatment.

Pooled effects

As seen in Table  2 , there are a wide variety of results that were obtained from each of the therapeutic interventions utilized. Not only for the reduction of body mass (including FM and FFM) but also for changes in adipokines, hormones, and blood lipid profiles. Such findings indicate that all treatments provide an effective means to elicit change relative to status at start of treatment or to the control treatment. Interestingly, there were differences noted between effects favoring the combination of diet with ET versus diet alone for alterations in body mass (χ 2  = 3.09, p = 0.055). And differences indicate an effectiveness favoring for the combination of diet with RT versus diet along for reduction in FM (χ 2  = 3.8, p < 0.05) and retention of FFM (χ 2  = 6.7, p < 0.0001). With no significant difference noted between the effectiveness for diet with ET or diet with RT for alterations to BM, but a difference for effectiveness that favors RT over ET for FFM retention (χ 2  = 10.15, p < 0.01). When examining the effect of ET, when separated from the aspect of additional diet intervention, ET alone appears to less effective to allow for the retention of FFM than dieting alone, or in a combination with use of diet (χ 2  = 7.458, p < 0.01). While the use of RT, both alone as well as in combination with diet provides greater stimulus for retention of FFM (χ 2  = 3.5, p < 0.05). There were also distinct differences noted in responses based on gender and the type of treatment utilized. Where males tend to have a larger pooled ES for responses to diet with RT retention of FFM and reduction in FM relative to female groups (χ 2  = 3.94, and 3.64, p < 0.05, respectively). Along with males indicated has having a greater level of effectiveness relative to females for loss of FM and retention of FFM following an intervention of diet with combination of both ET and RT (χ 2  = 3.64, p < 0.05). While females trended toward having a larger pooled ES for responses to diet alone, χ 2  = 2.09 (p = 0.11), and in combination to ET for reduction in total body mass, χ 2  = 1.94 (p = 0.12), and FM, χ 2  = 3.1 (p = 0.09), but not FFM. Lastly, as related to changes in caloric (energetic) balance there were no differences noted between any of the pooled ES for the assumed differences in energetic balance across the various treatment interventions.

Summary of response based on the pooled therapeutic effect size (ES), from the 32 studies that indicated control group, ES (CI for ES), based on method of therapeutic intervention and measure of interest

1.24
(0.25, 2.23)
1.19
(0.14, 2.25)
0.2
(−0.38, 0.78)
1.06
(0.07, 3.12)
0.25
(0.007, 0.42)
0.57
(0.29, 0.84)
0.88
(0.22, 1.53)
1.07
(0.41, 1.73)
−0.16
(−0.80, 0.49)
0.63
(0.13, 1.57)
0.36
(−0.30, 0.59)
0.14
(−0.86, 1.13)
0.48
(0.001, 0.95)
0.02
(−1.05, 1.08)
0.80
(0.61, 0.99)
1.08*
(0.61, 1.56)
2.23*
(−1.5, 5.95)
0.20
(−0.18, 0.57)
0.30
(−0.03, 0.63)
0.55
(−0.24, 1.34)
0.11
(−0.49, 0.72)
0.47
(0.01, 0.95)
0.79
(−0.81, 2.39)
0.30
(−0.03, 0.63)
0.13
(−0.18. 0.43)
−0.84
(−3.01, 1.33)
1.27
(−0.02, 2.54)
1.35
(−0.66, 3.36)
1.05
(−0.05, 2.14)
−0.38
(−1.88, 1.11)
1.57
(1.25, 1.90)
1.07
(0.46,1.67)
−0.38
(−1.88, 1.11)
0.39
(−0.13, 0.90)
0.16
(−0.35, 0.67)
−0.16
(−0.67. 0.34)
0.32
(−1.13, 1.76)
0.001
(−0.22, 0.22)
0.93
0.11
(−0.14, 0.37)
0.38
(−0.13, 0.90)
0.96
(0.31, 1.60)
−0.31*
(−1.11, 0.48)
−0.19*
(−1.00, 0.62)
−0.01
(−0.20, 0.18)
−0.09
(−0.69, 0.50)
−0.30
(−0.33, −0.28)
0.04
(−0.89, 0.96)
−0.45
(−1.46, 0.56)
−0.05
(−0.20, 0.11)
0.14
(−0.07, 0.24)
−0.28
(−0.81, 0.24)
0.24
(0.03, 0.45)
−0.27
(−0.48, −0.06)
0.61
(0.08, 1.14)
0.48
(−0.15, 1.11)
0.49
(−0.15, 1.13)
1.16*
(0.15, 2.18)
0.19
(−0.50, 0.79)
0.48
(−0.15, 1.11)

Note that a negative ES favors the control intervention while a positive ES favors the therapeutic intervention and that for measures of changes to fat-free mass, the indication for retention of mass is considered to be positive. Cells left empty did not have enough responses to indicate either a pooled therapeutic ES relative to control or a CI for ES. Note that D indicates intervention of diet only, ET indicates endurance training, RT indicates resistance training, D(E) indicates intervention of diet with ET, D(R) indicates intervention of diet with resistance training, D(E + R) indicates intervention of diet with combination of training methods.

*Indicates significantly greater response than diet-only intervention, $ Indicates difference between modes of endurance exercise intervention, # indicates difference between intensity used for resistance exercise intervention, ¢ indicates difference in gender response (male > female), ¢* indicates difference in gender response (female > male), for χ 2 -value > χ 2 CV, p < 0.05.

In comparison of blood lipid profiles, e.g., total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides (TG), all treatment options once again provided an effective means for change relative to either the pre-intervention status or in comparison to the control conditon. The responses invoked by RT, whether alone or in combination with diet, showed a greater effectiveness for eliciting changes in TC and LDL relative to the diet only options (χ 2  = 7.18, 4.95, respectively) and trends toward significance for HDL (χ 2  = 3.38, p = 0.068). But showed no difference to the responses invoked by ET, either with or without the combination of diet. While the use of ET either alone, or in combination with diet, show no difference for effectiveness at eliciting changes blood lipids (TC, LDL and TG) versus the changes elicited by a diet only intervention. Yet trended toward favoring ET for effectiveness in changes seen in HDL (χ 2  = 2.842, p = 0.089). Additionally, there were no differences noted on the pooled effect for treatment based on the gender of the participant groups for any of the treatment intervention options. However there was a trend for women utilizing ET in combination with diet for having a great effect in the changes in HDL levels versus those seen in men (χ 2  = 2.0, p = 0.12).

Similar to the changes seen with blood lipids, effectiveness for eliciting positive changes to adipokines (adiponectin and leptin) or cytokines (c-reactive protein (CRP), TNF-α) of interest were noted occurring from all treatment interventions. Furthermore, there were very few differences in the pooled effect size versus the diet only intervention, with difference in ES for changes of adiponectin and leptin being elicited by the use of RT, either with or without diet, trending toward significant difference, χ 2  = 3.085 (p = 0.07) and χ 2  = 3.45 (p = 0.06), respectively. While there were no differences noted between the therapeutic effectiveness for treatment in the responses to either CRP or TNF-α between any of the combinations for interventions.

Comparison between treatment effects

In comparison of body compositional changes based on the method of intervention, as would be expected, there are effect size differences in treatment responses that favor the combination of intervention methods. While a diet alone treatment did induce a beneficial treatment effect following intervention. It was not more effective than other treatments at inducing changes in FM, see Figure  2 . While the combination of diet and ET was not as effective as any of the other treatments with respect to changing of body composition. ET appears to be effective at inducing a larger loss of FFM relative to diet with combination of RT (χ 2  = 6.531, p = 0.01). With respect to the combination of diet and RT, this intervention appears to be able to induce favorable adaptions in, measurements of both FM and FFM (χ 2  = 9.24 and χ 2  = 8.02, p < 0.01, respectively). While producing equivalent ES for body mass changes as either diet alone, or diet in combination with ET, see Figure  2 . Interestingly, there were no differences noted showing a favor toward the combination of diet with both ET and RT versus the other intervention methods. In continuation with what was noted in the pooled therapeutic effect size, a trend toward gender difference for effectiveness of treatment was noted in the change in FFM for the utilization of diet with RT only in male groups versus female counterparts (χ 2  = 3.3, p = 0.06).

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of ET, or versus diet with combination of RT) methods for changes in either Body Mass (BM), Fat Mass (Fat), and Fat-Free Mass (FFM). Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.

Eliciting energetic imbalance indicates a pattern that favors an intervention that is a combination of diet with any type of exercise versus that of either diet, or exercise, alone, Figure  3 . Furthermore, the treatment ES for energetic imbalance for the combination of diet and ET were more favorable than any other treatment intervention combinations. Interestingly, while the combination of diet with ET and RT was more effective then either a diet alone or exercise alone it was less effective then either ET or RT in combination with diet at inducing an energetic imbalance. Additionally, there were no differences between gender groups that would indicate a greater effectiveness of a treatment methodology for a specific gender grouping.

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of either ET, RT, or combination of ET and RT) methods for changes in energetic imbalance as assumed established within the intervention protocol. Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.

In regards to changes in the blood lipid profiles, there were not only indications for difference between treatments, there is also a very interesting finding that therapeutic interventions may actually induce elevations in certain lipids. While the diet only intervention did have a positive impact on TC and HDL levels, it has only minimal impact on either LDL or TG levels, Figures  4 , ​ ,5 5 and ​ and6. 6 . Additionally, the treatment interventions that combined diet with ET induced a much larger ES, Figure  4 , for measures TC and LDL. And diet in combination with RT induces a larger ES in TC, HDL, LDL and TG changes relative to those changes seen in diet only treatments, Figures  4 , ​ ,5 5 and ​ and6. 6 . Moreover, diet with combination of RT was able to produce a much lager ES for these measures in comparison to those induced by diet with combination of ET, for each of these measures, see Figures  4 , ​ ,5 5 and ​ and6. 6 . As far as changes in TG, diet with combination of RT appears be the least effective for inducing changes relative to either the diet only or the diet with combination of ET, Figures  4 , ​ ,5 5 and ​ and6. 6 . Additionally, there appears to be a pattern where the induction for changes in lipid profiles cannot be established through the use of ET only for all measures. While RT is the only intervention that appears to be slightly more effective than diet alone or diet in combination of ET for changes in HDL and TG, Figures  4 , ​ ,5 5 and ​ and6. 6 . There were gender differences noted for effectiveness of treatment for HDL and TG but not for LDL or TC, both of which indicate a larger effectiveness for treatment in female grouping versus male counterparts.

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination ET) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of RT) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.

The most prominently reported hormones and cytokine signal throughout the studies was insulin, followed by adiponectin, leptin, IL-6, CRP, and TNF-α. And as such are the hormone and cytokines reported on here as they provide a large enough N-size to allow for comparison of a pooled ES and CI for ES based on treatment intervention. In which ES for eliciting changes in insulin, Figure  7 , indicates that ET in combination with diet (or as a stand-alone intervention) induces a lower effect than diet alone. While the use of RT either alone, or in combination with diet, was more effective than diet alone it was less effective than ET or the combination of diet with ET and RT, see Figure  7 . There was a gender difference to response and effectiveness indicated within the analysis for insulin changes, with treatments appearing to be more effective in male groupings than in female groups.

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of ET, or versus diet with combination of RT) methods for response related to changes in Insulin. Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.

There were highly variable responses for effectiveness for each treatment method to induce changes to circulating levels of adiponectin, leptin, TNF-α, or CRP (Figures  8 , ​ ,9 9 and ​ and10). 10 ). In which, diet alone and in combination with ET, were more effective than what was seen with changes induced by the incorporation of RT for changes to adiponectin and leptin, Figures  8 , ​ ,9 9 and ​ and10. 10 . While the changes induced in CRP and TNF-α, Figures  8 , ​ ,9 9 and ​ and10, 10 , were nearly identical, i.e. ES that crosses 0, for differences in effectiveness for changes between diet alone, or diet in combination with exercise (either ET, RT or combination of ET and RT). And all were more effective than the exercise alone treatments. Further there were no indication for a more effective means to change cytokine or adipokine levels with the utilization of diet in combination with both ET and RT. Interestingly, there were no gender differences indicated throughout the analysis of ES for any of the changes to the level of cytokines or adipokines following treatments, regardless of the methodology employed.

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of ET) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.

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Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of RT) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.

Comparison within treatment methods

Not only were there differences indicated between the treatment options, but also within the various treatment methods. First is the differences based on diet method. With the use of a high protein diet, indicated here as a diet with >1.5 g protein*kg −1 body mass (>25% of total kcal/d), in a hypocaloric model inducing a larger effect for body compositional changes relative to any of the other diet methods, ES of 0.60, 0.54, 0.38 for loss of body mass, FM and retention of FFM respectively. Further, lower fat diet was less effective when compared to either a glycemically controlled diet, or the high protein/low carbohydrate diet for the change of any body compositional measures, ES of −0.64. Especially in relation to the high protein/low carbohydrate diet, ES of −1.04. Similarly, the lower carbohydrate and higher protein model lead to a greater effect in changes to blood lipids and cytokines (adiponectin and leptin) with an ES of 0.60, 2.14, 0.59, and 0.77, for TC, HDL, adiponectin and leptin respectively.

Also exercise of high intensity (indicted as with RT training intensities ≥75% of 1RM at a training volume of 2–4 sets of 6–10 reps and when free-weight resistance is utilized or ET utilizing interval intensities or a steady-state with intensities ≥70% VO 2max or HR max ) elicited greater effectiveness at inducing changes to body composition, insulin levels, blood lipids, and cytokines (adiponectin, CRP, IL-6), with an ES of 0.49, 0.66, 0.37, 0.50, 0.75, 0.78, 0.75, 0.66, 1.15, and 0.92 for BM, FM, FFM, Insulin, TC, LDL, TG, adiponectin, CRP, and IL-6 respectively. As should be of no surprise, the combination of a high level of training intensity (regardless of method of exercise, ET or RT or ET and RT, or in combination with diet or not) induced a greater effect on the level of energetic imbalance than a lower level of training intensity. When comparisons based on training intensity indicate a clear preference towards use of higher levels of training intensity. Where higher intensity training once again elicited a greater effect in the responses than lower intensities (ES of 0.66, 0.3, 0.42, 1.15, 0.92 for adiponectin, leptin, TNF-α, CRP and IL-6 respectively). And is better than the diet only option for treatment (ES of 0.26, 0.59, 0.29, 0.86, 0.33 for adiponectin, leptin, TNF-α, CRP and IL-6 respectively). Comparison between exercise modalities indicates RT protocols produced a greater ES for changes in adiponectin for higher intensities (ES of 0.74), but not for lower (ES of −1.14) with no differences noted for changes in leptin, relative to ET. Likewise, RT induced a greater ES for changes in IL-6 and CRP relative to ET, at higher (ES of 0.27 and 1.34, respectively) and lower intensities (ES of 0.36 and 0.76, respectively). Furthermore there is an indication for favoring higher intensity RT at an ES of 0.47 for BM, of 0.30 for FM and 0.40 for FFM, respectively to any of the ET protocols, ET and RT combination or lower intensity RT. And favor higher intensity ET at an ES for 0.35 for BM and 0.39 for FM but not for retention of FFM 0.13 relative to lower intensity ET. Where comparisons between exercise intensities within the ET and the RT protocols, indicated favor toward ET (ES of 0.66, 1.13, 0.61, and 0.96 for TC, HDL, LDL, and TG respectively), and RT (ES of 0.85, 0.86, and 0.60 for TC, LDL, and TG respectively).

Given that any change in behavior in highly sedentary individuals who are overfat should result in an immediate effective means for altering both body composition and health status. That occurs regardless of the methods utilized for the adult who is overfat. And given that all studies in publication indicate an ability to produce a positive effect to both body composition and health status. It should not be surprising to find ES across studies that indicate and effective treatment regardless of methodology utilized. Yet, while all treatment options show a favor for effective treatment for inducing changes in body mass. The effectiveness by which the body composition measures changed was highly variable based on the specific methodology being utilized. Moreover, they varied widely in the effectiveness for the biomarkers of health status of the adult who is overfat, Table  2 . Moreover, the analysis of ES pooled across studies in aggregate indicate here is that what has been the general classically recommend treatment for overfatness, and associated diseases, may not actually be the most effective. Where the methodological, and sociological, bias towards said programs may be the inherent rationale for continued praise and high recommendation to individuals who are overfat. And may promote the reoccurring cycles of repetitive diets and exercise programs for changes in body morphology and health status [ 13 , 14 , 15 , 16 ].

As evident in the fact that classically recommended, and routinely cited in popular press, lower fat diet was less effective for changing any body compositional measures relative to the other dietary only options. With the higher protein diets being more effective than the glycemic controlled diets relative to the lower fat diets. Therefore, should a diet-only intervention be recommended, and in agreement with previous reviews on the topic [ 61 - 64 ], a hypocaloric high-protein/low carbohydrate diet appears to generate the greatest ES for change relative to all hypocaloric, and low fat, diets. This effectiveness appears within diet interventions that utilized a level >1.5 g protein*kg −1 body mass (>25% of total kcal/d), within the hypocaloric diet with a CI for ES induced always favoring the high protein diet, while not with diets with lower protein, ~1.0 g of protein*kg −1 BM (<20% of total kcal/d), and higher carbohydrate (regardless of glycemic load) threshold for ES induced a CI .95 that crosses into the area of having no effect (i.e. ES ≤ 0) at changing of body composition.

Further, the addition of exercise provided stimulus for responses that are at least as effective as any diet-only method for altering body composition, see Table  2 and Figure  2 . And analysis of effectiveness showed preference of favor toward RT rather than the classically recommended ET at being more effective to elicit beneficial changes. When combined with diet, exercise interventions were more effective at inducing responses in body compositional changes than either an exercise, or diet, alone option for intervention. The effectiveness for exercise becomes more pronounced with higher levels of intensity of exercise regardless of the methodology employed (i.e. ET, RT, or combination therein) within the intervention protocol. Additionally, there is a clear delineation between the modes of exercise used and the effectiveness at inducing responses. While heavy recommended by a number of organizations and through a variety of position stands [ 17 , 55 , 65 ], or stated in previous reviews on the subject [ 4 , 7 - 10 , 12 ], as being more effective at inducing changes in body composition the use of a ET alone, or in combination with RT, and in combination with diet interventions were not more effect than the combination of RT with diet, Figure  2 .

Within this difference of effectiveness for treatment, diet with RT was not only more effective at altering BM in the most beneficial pattern (i.e. reduction of FM with retention of FFM), without regard to level of training, versus any of the other categorization of the methods for exercise. And when employed at even lower levels of stimulation (e.g., <70% 1RM, single set for at least 12 repetitions, use of pneumatic or selectorized machines, and performance of circuit resistance training) RT provides responses that mimic the ES from ET, or the combination to ET and RT. Where responses mirror each other, whether or not diet is involved in the treatment. And becomes more effective at higher levels of stimulation RT (e.g., >75-80% 1RM for at least 3 sets with repetition ranges of 5-to-10 with 60-to-90 second rest intervals) at inducing changes in body composition that leads to the reduction of BM and FM, while retaining (and in some cases increases of) FFM for the individual who is overfat. Further, ET appeared to have its greatest effect when either in an interval style of ET, or at higher intensities of at ≥75% VO 2max (or HR max/peak ), while not at the traditionally recommended moderate (e.g., 55-75% VO 2max , or HR max/peak ) steady-state ET for response to changes in BM and FM, but not for changes in FFM.

There is also the classically held view of the relationship between caloric imbalance and the altering body composition for adults who are overfat. Where if the assumption is correct, there should be a relationship of equivalence in effectiveness for changing caloric balance with body compositional changes between treatment methods. However, based on analysis here, the effectiveness for inducing changes in caloric imbalance does not match the effectiveness to induce body compositional changes for the adult that is overfat. This alternate view to the equation indicates, as previously speculated [ 19 , 27 ], that the issue of overfatness is one that is highly complex. Where there a variety of interconnected factors at play beyond the simplistic caloric balance issue relative to not only body composition but also the alteration of health status for the adult who is overfat. And hints at a possible problem for continually linking these two factors in relationship to changes, not only body compositional changes but also the health status change. As there are number of problem rationales for such an argument, namely changes in hormonal functions related to energetic balance (i.e. leptin, ghrelin) and tightly associated with metabolic markers of exertional stress (i.e. AMPK) [ 5 , 12 , 66 , 67 ]. Along with the inherent problem related to measuring the absolute of energetic imbalance that may be incurred from any intervention. Principally that the indicated energetic imbalances are an assumed difference in energetic balance. As very few protocols directly measure the imbalance and no study reviewed on the topic directly measured the energetic shift from either the exercise sessions, the recovery from said sessions. With only a few indicated changes in resting metabolic rate related to either the hypocaloric diet or exercise or combination therein. Thus it becomes troubling that such relationships are continually stated as an absolute as opposed to the assumption that it appears to be. Therefore, it may be more beneficial to discuss intervention methods based on metabolic stress (and demand) rather than on the energetic imbalance, based on the assumed difference, for the adult who is overfat.

While changes to body composition appear to be key in the reinforcement necessary for continual use of the treatment protocols over long periods of time, providing the cheerleader effect for continuation of an intervention. The changes elicited in humoral factors (e.g., hormone/cytokines, blood lipids and biomarkers of inflammation) are necessary for improvement in health status that many have previously discussed in a number of reviews on this topic [ 18 - 21 , 26 , 31 , 32 , 34 , 42 ]. As one of the key indicators for metabolic health issues for adults that are overfat is high levels of circulating insulin, it would be expected that an effective therapeutic treatment would elicit reductions in fasting levels of insulin would indicate improvements in metabolic and immune conditions [ 19 , 26 , 28 , 31 - 34 , 42 ].

In such, there are patterns of responses indicating a spectrum of effectiveness, within and across the various methods of diet, exercise or combination of diet with exercise. As indicated with inducing changes in fasting levels of insulin, where dieting alone is shown to be overall less effective than any of the exercise or diet in combination with exercise modalities. Once again the high-protein (regardless of carbohydrate modification) diet was more effective than the simply having a hypocaloric, or the traditional low fat, diet within the spectrum of diet options examined, ES of 0.49. And is seen even more so when combined with an exercise programs, ES of 0.77. Lending further support to the evolving opinion regarding the employment of higher protein diets for adults who are overfat.

Additionally, exercise was more effective at inducing changes in fasting insulin levels than diet. And in congruence with many of the position stands offered and classically recommend [ 1 , 17 , 55 ], the use of ET (both alone and in combination with diet or in conjunction of diet and RT) was more effective than RT (either when used alone or in combination with diet) for eliciting changes in insulin. This difference in treatment effectiveness is reversed with incorporation of the high protein/low carbohydrate diet with combination of exercise where RT is more effective than ET, regardless of intensity (ES of 3.5). It should also be noted that the combination of diet with RT was only intervention that provided a pooled therapeutic ES that did not elicit the possibility of no response (i.e. crosses a point of ES = 0) from treatment relative to the control. And not surprisingly, the use of higher-intensity exercise was more effective than lower-intensity exercise without regard to diet selection. While these findings support the use of ET within treatment protocols, there is an indication that RT is a viable option for the adult who is overfat and does not self-select towards an ET mode of exercise [ 13 , 15 , 27 , 28 ]. Thus given the findings here, utilizing RT can be a more effective treatment for reversing insulin resistance, as the psychological adherence to the program may provide additional reinforcement for continual use of exercise within a treatment regimen. And when combined with the combination of a high protein/low carbohydrate diet, RT exercise (regardless of level of intensity) can be significantly more effective than the standard ET recommendations.

There is also a spectrum effectiveness to elicit responses in blood lipids form the various treatments indicates trends in the data towards the use of exercise (ET, RT or combination thereof) either alone or in combination with diet for effectiveness of treatment over the use of simple dietary interventions. In which all treatments offer a small degree of effectiveness for altering lipid profiles for the individual who is overfat. With the combination of diet and exercise was more effective than diet alone or exercise alone. And as indicated here, there is a favor toward use of RT is seen with eliciting reductions of blood lipids levels, TC, LDL and TG, relative to either dieting alone, or in combination of diet with ET. Which lends further support toward using RT within the treatment methods. As previously noted, this difference in effectiveness becomes even more pronounced in favor of the higher intensity exercise protocols (regardless of using ET or RT).

This spectrum for a continuum of effectiveness continues as related to the levels of cytokines (e.g., TNF-α, CRP, leptin and adiponectin) related to inflammation and chronic immune response. Where any treatment is able to produce an effective change that leads toward a normal “healthy” range, thus leading to a reduced risk for development of cardiovascular disease and improvements in work capacity and overall health [ 18 , 26 , 32 , 34 , 42 , 68 ]. However, these responses were highly variable and most of the indications for effectiveness, both as a therapeutic effect and treatment effect, near that point of zero difference in effect (i.e. ES = 0). Most interesting were responses seen in changes to levels of CRP, found in relation to diet alone and diet with RT. Where diet combined with RT induced an almost equal level of effectiveness to that of diet alone. With both indicated as being less effective than the combination of diet with ET or the combination of diet with ET and RT. Indicating a possible metabolic difference between exercise modalities that might induce the differential cardiovascular adaptations noted following these distinct intervention protocols.

Moreover, there are differences in effectiveness noted between RT and ET. This is seen regardless of being utilized alone or with modification to diet, or based on the intensities of training. Based on such stratification there is an indication for the role of the metabolic demand of treatment eliciting differential response to cytokine and adipokine signals that alter whole body metabolism. Where it appears that the better means for prescription of exercise is at the higher levels of training intensities. And when associated with the concept of self-selection toward distinct exercise modes leading to greater utilization [ 13 , 15 , 56 ], supports the indication for practitioners to recommend and prescribe the use of RT within treatment options that have been speculated about previously [ 28 , 47 - 50 ]. As incorporating RT may provide the metabolic stimulus to not only the means for improvement of health status but as it may be more readily self-selected lead to longer periods of utilization such activities throughout one’s remaining lifespan as been previously suggested [ 15 , 69 ]. Especially if RT is prescribed at the higher levels of training intensities than what has been previously recommended and closer to what is traditionally utilized for hypertophication responses in lean and active individuals.

While one intention of the study here was to examine the changes in anabolic hormones that have shown reduced levels with overfatness (e.g., testosterone (T) and growth hormone (GH)) in particular relative to the therapeutic interventions of diet, exercise or combination of diet and exercise. There were too few studies that looked at these changes in relation to the treatments that were used, that did not involve a pharmaceutical intervention. From the few studies that examined this change, the relative changes in absolute values note an increase in testosterone and growth hormone that seem to not be related to the intervention used, but instead changes in FM following treatment. While a number of studies have examined the issue in responses acutely either to exercise relative to differences between the normal fat control and the overfat population, or in relation to a pharmaceutical treatment option without use of exercise. Given the current opinions [ 36 , 70 - 72 ] regarding the role of such hormones in relation to body composition and disease it seems that studying such changes may prove to be a very fruitful avenue for future research in the various intervention programs. Especially given the previously noted changes in GH from hypocaloric diets and within various exercise treatments utilized [ 73 , 74 ]. Which is matched with the changes in levels of T, binding proteins and peripheral receptors for T that are associated with exercise, in particular RT in a fasting state (which should relate well with a hypocaloric model), and may mirror the hormone replacement therapy treatment application for some individuals with this population [ 45 , 46 , 132 , 75 - 78 ]. However, there is limited analysis to speculate either to the extent, beyond expected changes toward normal levels, or time frame for changes within anabolic hormones for adults who are overfat. But given the compatibility of immunological and metabolic profiles between the overfat and the elderly populations, it can be speculated that use of exercise, in particular RT should mimic what has been shown with elderly populations [ 79 - 82 ].

Conclusions

Analysis of effectiveness of responses both within and between interventions differences for treatment options modalities (e.g., diet, exercise, or combination therein) along with submodality of treatment (e.g., high intensity versus low intensity, high protein/low carbohydrate diets) indicate a continuum of effectiveness. Most importantly is that protocols utilizing exercise were more effective than those that employed just a hypocaloric diet. With the combination of diet with exercise (especially RT) being more effective than diet or diet with ET in reduction of body mass and fat mass while retaining of FFM following treatment. And are at least as effective for changing hormonal levels and blood lipid profiles. Also, while popular ideas suggest the necessity for acute energetic imbalance, there appears to be no relationship between any treatments effectiveness for inducing acute changes in energetic balance with the effectiveness for induced responses to body composition or biomarkers of health from said treatment program. All of which reinforces the idea of a more complex network of factors that influence overall body composition and health issues for the adult who is overfat, and further stresses the idea to focus treatment on generating a metabolic stress to induce chronic endocrinological (and cytokine) changes as opposed to the focus on the kcal/d (kJ/d) ratios of intake to expenditure.

Further, based on ES for responses to RT (in combination with diet, or with diet and ET), one would be able to expect that at the very least 55% of any population of overfat adults should have beneficial responses in all body compositional measures from the incorporation of RT into a treatment play, along with an even greater percentage having a favorable response to altering fasting levels of insulin, total cholesterol, low-density lipoproteins and triglycerides. Additionally, when exercise is utilized at appropriate intensities (i.e. higher levels) both ET and RT provides an effective stimulus to alter TNF-α, CRP, leptin and adiponectin levels that all indicate a reduction in the risk for cardiovascular disease and improved metabolic flexibility for the adult who is overfat. With RT producing a greater level of effectiveness for altering these measures, especially when RT is progressive and periodized with a training volume of 2-to-3 sets at 6-to-10 reps with an intensity of ≥75% 1RM and a rest interval of 60–90 seconds, and utilizes whole body (and free-weight) exercises. And thus indicates that RT should be more readily recommended as an appropriate treatment option to adults who are overfat than what has been recommended currently.

Yet, however the effectiveness of this combination of diet and RT might be for inducing changes, the concept of self-selection of exercise patterns means that some adults who are overfat may select toward protocols of ET for exercise. For those who self-select toward ET, it appears that ET is more effective when performed at high intensity (e.g., ≥70% VO 2max , or HR max ) steady-state method or as an interval training style (based on ES calculated gives an expectations of at least 40% of the population showing beneficial responses to intervention). Likewise, some may select away from exercise altogether, which based on overall effectiveness should be discouraged but if utilized as a stand alone intervention, diets can be effective if hypocaloric and comprised of a higher percentage of total caloric intake from protein, with an expectation for at least 55% of the population showing a beneficial response from the intervention.

Lastly, there needs to be further examination of findings noted here. First, related to the ongoing understanding of the anabolic dysregulation that accompanies the situation of being overfat. In this light there is a need to examine the relationship of changes in said hormones based on intervention within populations of individuals who are overfat. Not with simply acute comparison to lean active population, but within the concept of altering levels of anabolic hormones, responses at peripheral tissues and the relative timeframe for seeing such hormonal responses based on the various interventions utilized. And how the impact of periodization and concurrent exercise exposure has on these responses. Second, related to the issues of differential response between genders to identify if there may be a more beneficial response for males versus those for females, and vice versa. Third, based on the current understanding of application of exercise modalities if there are differential responses to programs based on location for intervention and professional associated with overseeing intervention (e.g., in hospital versus out-patient physical therapy clinic versus community health center/gymnasium or for-profit health center/gymnasium). Additionally, and as noted earlier, there needs to be an evaluation of programs and protocols readily available to the populous or utilized within studies for this population. Most exercise programs seem to be highly elaborate for the sake of complexity. In what appears as an effort of marketing the program as being different, as opposed to being elaborate for the sake of progressive periodization. Where the elaboration for periodization of exercise is meant to provide stimulus for continual adaptations within the exerciser. Finally, most programs that have been established based on the idea of energetic imbalance need to be careful with establishing such an idea, as the energetic imbalance is based on an assumption that might not be held in all cases. As changes to not only body composition but also health status comes from manipulation of highly elaborate network of factors that interact, compliment and confound the impact of each other for the adult who is overfat leading to not only body compositional changes, but reversal of the deleterious health outcome of being overfat.

Abbreviations

DDiet
ETEndurance Training
RTResistance Training
E + RCombination of ET and RT
D(E)Diet with ET
D(ER)Diet with combination of ET and RT
D(R)Diet with RT
BMBody mass (kg)
BMIBody mass index (kg*m )
%BFThe percent of body mass comprised on fat mass
FMFat mass (kg, or as determined by %body fat)
FFMFat-free mass (kg, or as determined by %fat-free mass)
TGPlasmal triglycerides
TCPlasmal total cholesterol
HDLHigh-density lipoproteins
LDLLow-density lipoproteins
ESEffect size as determined by pooled effect size via random effect computation
T2DMType 2 diabetes mellitus or metabolic syndrome
TTestosterone
GHGrowth hormone
CRPC-reactive protein
TNF-αTumor necrotic factor-alpha
VO Maximal aerobic capacity
HR Maximal sustainable heart rate
1RMMaximal level of resistance for a single repetition (i.e. maximal strength)

Competing interests

The author declares that he has no competing interests.

Importance of Exercise Essay

500 words essay on exercise essay.

Exercise is basically any physical activity that we perform on a repetitive basis for relaxing our body and taking away all the mental stress. It is important to do regular exercise. When you do this on a daily basis, you become fit both physically and mentally. Moreover, not exercising daily can make a person susceptible to different diseases. Thus, just like eating food daily, we must also exercise daily. The importance of exercise essay will throw more light on it.

importance of exercise essay

Importance of Exercise

Exercising is most essential for proper health and fitness. Moreover, it is essential for every sphere of life. Especially today’s youth need to exercise more than ever. It is because the junk food they consume every day can hamper their quality of life.

If you are not healthy, you cannot lead a happy life and won’t be able to contribute to the expansion of society. Thus, one needs to exercise to beat all these problems. But, it is not just about the youth but also about every member of the society.

These days, physical activities take places in colleges more than often. The professionals are called to the campus for organizing physical exercises. Thus, it is a great opportunity for everyone who wishes to do it.

Just like exercise is important for college kids, it is also essential for office workers. The desk job requires the person to sit at the desk for long hours without breaks. This gives rise to a very unhealthy lifestyle.

They get a limited amount of exercise as they just sit all day then come back home and sleep. Therefore, it is essential to exercise to adopt a healthy lifestyle that can also prevent any damaging diseases .

Benefits of Exercise

Exercise has a lot of benefits in today’s world. First of all, it helps in maintaining your weight. Moreover, it also helps you reduce weight if you are overweight. It is because you burn calories when you exercise.

Further, it helps in developing your muscles. Thus, the rate of your body will increases which helps to burn calories. Moreover, it also helps in improving the oxygen level and blood flow of the body.

When you exercise daily, your brain cells will release frequently. This helps in producing cells in the hippocampus. Moreover, it is the part of the brain which helps to learn and control memory.

The concentration level in your body will improve which will ultimately lower the danger of disease like Alzheimer’s. In addition, you can also reduce the strain on your heart through exercise. Finally, it controls the blood sugar levels of your body so it helps to prevent or delay diabetes.

Get the huge list of more than 500 Essay Topics and Ideas

Conclusion of Importance of Exercise Essay

In order to live life healthily, it is essential to exercise for mental and physical development. Thus, exercise is important for the overall growth of a person. It is essential to maintain a balance between work, rest and activities. So, make sure to exercise daily.

FAQ of Importance of Exercise Essay

Question 1: What is the importance of exercise?

Answer 1: Exercise helps people lose weight and lower the risk of some diseases. When you exercise daily, you lower the risk of developing some diseases like obesity, type 2 diabetes, high blood pressure and more. It also helps to keep your body at a healthy weight.

Question 2: Why is exercising important for students?

Answer 2: Exercising is important for students because it helps students to enhance their cardiorespiratory fitness and build strong bones and muscles. In addition, it also controls weight and reduces the symptoms of anxiety and depression. Further, it can also reduce the risk of health conditions like heart diseases and more.

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How to Exercise During Menopause

Your body changes during the menopause transition. So should your fitness routine.

Alison Gittelman runs down a tree-lined street in shorts and a sleeveless top.

By Christine Yu

When Alison Gittelman turned 49, she found that she couldn’t run as fast or as long as she had before. She was an experienced marathoner and triathlete, but suddenly, as she entered menopause, her heart rate was unusually elevated while running. Her joints hurt. She gained weight. She started experiencing debilitating menstrual cramps.

“I hadn’t anticipated this at all,” said Ms. Gittelman, now 51. “I thought I would breeze through menopause.”

Soon, Ms. Gittelman realized that she had to adjust her exercise routine. She started to run less and rededicated herself to strength training and mobility exercises.

Whether you work out regularly or you’re just building a fitness habit, exercise can feel harder as you reach menopause, which typically occurs in your 40s or 50s . But that doesn’t mean you should hang up your sneakers. “Exercise can be a tool to build up your resilience to the shifts that are going to happen,” said Dr. Alyssa Olenick, an exercise physiologist who studies metabolism and menopause.

In your mid-40s, your ovaries start producing less estrogen and other reproductive hormones. This transitional phase, called perimenopause, lasts between four and eight years on average. Then, your estrogen plummets.

Beyond regulating reproductive function, estrogen plays an important role in preserving muscle mass and in protecting the heart, blood vessels, metabolic function and bone health. With less estrogen circulating in the body, a woman’s risk for diabetes and cardiovascular disease increases. Bone density declines too, leaving women at greater risk for fractures and osteoporosis.

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