title: Combined effects of weight loss and physical activity on all-cause mortality of overweight men and women Maintaining vigorous activity attenuates 7-yr weight gain in 8340 runners. Lifestyle intervention and coronary heart disease risk factor changes over 18 months in postmenopausal women: the Women On the Move through Activity and Nutrition (WOMAN study) clinical trial. Physical activity and body mass: changes in younger versus older postmenopausal women. The Physical Activity Scale for the Elderly (PASE): development and evaluation. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial.
abstract: Objective : To estimate the excess deaths associated with weight loss in combination with leisure time physical activity among overweight or obese people . Design : Prospect i ve cohort study .Subjects : In two consecutive examinations in 1976–1978 and 1981–1983 , 11 135 people participated in the Copenhagen City Heart Study . Of these , 3078 overweight or obese participants lost weight or remained weight stable from 1976–1978 to 1981–1983 , and were without pre-existing diagnosis of diabetes , stroke , ischaemic heart disease or cancer in 1981–1983 . They were followed up until 2007 in the Danish Civil Registration System , with a < 0.2 % loss to follow-up only . Measurements : The following measurements were taken : body mass index ( BMI ) and physical activity in 1976–1978 and 1981–1983 and hazard ratio ( HR ) of mortality during 53 976 person-years of follow-up . Results : Of the initially overweight or obese subjects who either lost weight or remained weight stable , 2060 died . Overall , weight loss was associated with excess mortality when compared with weight stability . Weight loss was associated with a higher mortality among those who became physically inactive , compared with those who remained active while losing weight ( men : HR 2.25 , 95 % confidence interval 1.31–3.84 ; women : 1.43 , 1.07–1.91 ) . However , losing weight while remaining physically active was still associated with excess mortality when compared with those who were weight stable and initially active ( men : 1.72 , 1.27–2.34 ; women : 1.57 , 1.06–2.31 ) . Among those who remained physically inactive , weight loss seemed associated with excess mortality when compared with weight loss among those who became active , although not statistically significant ( men : 2.00 , 0.94–4.29 ; women : 1.40 , 0.82–2.39 ) . Finally , weight loss among those who became physically active was not associated with excess mortality when compared with those who were weight stable and initially inactive ( men : 1.12 , 0.61–2.07 ; women : 1.19 , 0.58–2.43 ) . Conclusion : Weight loss among the overweight or obese seemed hazardous to survival . However , weight loss seemed less hazardous to survival among those who remained physically active or those who became active INTRODUCTION / PURPOSE Body weight generally increases with aging in Western societies . Although training studies show that exercise produces acute weight loss , it is unclear whether the long-term maintenance of vigorous exercise attenuates the trajectory of age-related weight gain . Specifically , prior studies have not tested whether the maintenance of physical activity , in the absence of any change in activity , prevents weight gain . METHODS Prospect i ve study of 6119 male and 2221 female runners whose running distances changed < 5 km x wk(-1 ) between baseline and follow-up surveys 7 yr later . RESULTS On average , men who maintained modest ( 0 - 23 km x wk(-1 ) ) , intermediate ( 24 - 47 km x wk(-1 ) ) , or prolonged running distances ( > or = 48 km x wk(-1 ) ) all gained weight through age 64 ; however , those who maintained > or = 48 km x wk(-1 ) had one half the average annual weight gain of those who maintained < 24 km x wk(-1 ) . For example , between the ages of 35 and 44 in men and 30 and 39 yr in women , those who maintained < 24 km x wk(-1 ) gained , on average , 2.1 and 2.9 kg more per decade than those averaging > 48 km x wk(-1 ) . Age-related weight gain , and its attenuation by maintained exercise , were both greater in younger than in older men . Men 's gains in waist circumference with age , and its attenuation by maintaining running , were the same in older and younger men . Regardless of age , women increased their body weight , waist circumference , and hip circumference over time , and these measurements were attenuated in proportion to their maintained running distance . In both sexes , running disproportionately prevented more extreme increases in weight . CONCLUSION As they aged , men and women gained less weight in proportion to their levels of sustained vigorous activity . This long-term beneficial effect is in addition to the acute weight loss that occurs with increased activity OBJECTIVES In this paper , we present the results of changes in risk factors by use of hormone therapy ( HT ) at 18 months in the Women On the Move through Activity and Nutrition ( WOMAN ) r and omized trial . METHODS The trial was design ed to test the hypothesis that aggressive dietary changes and increased physical activity to reduce weight , waist circumference ( WC ) , glucose , insulin , and lipoproteins would reduce progression of sub clinical atherosclerosis , carotid intimal media thickness and plaque , coronary artery calcification , and pulse wave velocity ( PWV ) . The study focused on postmenopausal women ( n = 508 ) , mean age of 57 , who were r and omized to the Lifestyle Change ( LC ) or Health Education ( HE ) group .  RESULTS At 18 months of follow-up , there was significant , 17 lb , weight loss and 10 cm WC decrease in the LC group . There were significant differences in changes in low-density lipoprotein cholesterol ( LDL-C ) , insulin , glucose , large LDL , and LDL particles between the LC and HE groups . Risk factor changes were greater for women in the LC who lost a significant amount of weight ( > or=18.8 lb ) . Participants at 18 months were subdivided into women who had stayed on HT , 125 ( 28 % ) ; stopped HT after r and omization , 145 ( 33 % ) ; and not on HT at baseline but stopped an average of 7 months prior to r and omization , 173 ( 39 % ) . Weight loss in the LC was similar for all three groups , but LDL lipoprotein response was better for women who stopped HT after r and omization or were not on HT at baseline . CONCLUSIONS The trial has been successful in increasing exercise and diet changes and reduction in weight and WC and variables related to metabolic syndrome PURPOSE The study 's purpose was to investigate the relationship of sedentary ( ≤ 100 MET · min · wk(-1 ) ) , low ( > 100 - 500 MET · min · wk(-1 ) ) , moderate ( > 500 - 1200 MET · min · wk(-1 ) ) , and high ( > 1200 MET · min · wk(-1 ) ) habitual physical activity  with body weight , body mass index , and measures of fat distribution ( waist-to-hip ratio ) in postmenopausal women by age decades . METHODS A prospect i ve cohort study of 58,610 postmenopausal women age 50 - 79 yr weighed annually during 8 yr at one of 40 US clinical centers was analyzed to determine the relationship of high versus low habitual physical activity with changes in body weight and fat distribution by age group . RESULTS Among women age 50 - 59 yr , there was significant weight loss in those expending > 500 - 1200 MET · min · wk(-1 ) ( coefficient = -0.30 , 95 % confidence interval = -0.53 to -0.07 ) compared with the group expending ≤ 100 MET · min · wk(-1 ) . Among women age 70 - 79 yr , higher physical activity was associated with less weight loss ( coefficient = 0.34 , 95 % confidence interval = 0.04 - 0.63 ) . Age at baseline significantly modified the association between physical activity and total weight change , whereas baseline body mass index did not . CONCLUSIONS High habitual physical activity is associated with less weight gain  in younger postmenopausal women and less weight loss  in older postmenopausal women . These findings suggest that promoting physical activity among postmenopausal women may be important for managing body weight changes that accompany aging A Physical Activity Scale for the Elderly ( PASE ) was evaluated in a sample of community-dwelling , older adults . Respondents were r and omly assigned to complete the PASE by mail or telephone before or after a home visit assessment . Item weights for the PASE were derived by regressing a physical activity principal component score on responses to the PASE . The component score was based on 3-day motion sensor counts , a 3-day physical activity dairy and a global activity self- assessment . Test-retest reliability , assessed over a 3 - 7 week interval , was 0.75 ( 95 % CI = 0.69 - 0.80 ) . Reliability for mail administration ( r = 0.84 ) was higher than for telephone administration ( r = 0.68 ) . Construct validity was established by correlating PASE scores with health status and physiologic measures . As hypothesized , PASE scores were positively associated with grip strength ( r = 0.37 ) , static balance ( r = + 0.33 ) , leg strength ( r = 0.25 ) and negatively correlated with resting heart rate ( r = -0.13 ) , age ( r = -0.34 ) and perceived health status ( r = -0.34 ) ; and overall Sickness Impact Profile score ( r = -0.42 ) . The PASE is a brief , easily scored , reliable and valid instrument for the assessment of physical activity in epidemiologic studies of older people CONTEXT The increasing prevalence of obesity is a major public health concern . Physical activity may promote weight and body fat loss . OBJECTIVE To examine the effects of exercise on total and intra-abdominal body fat overall and by level of exercise . DESIGN R and omized controlled trial conducted from 1997 to 2001 . SETTING AND PARTICIPANTS A total of 173 sedentary , overweight ( body mass index > or = 24.0 and > 33 % body fat ) , postmenopausal women aged 50 to 75 years who were living in the Seattle , Wash , area . INTERVENTION Participants were r and omly assigned to an intervention consisting of exercise facility and home-based moderate-intensity exercise ( n = 87 ) or a stretching control group ( n = 86 ) . MAIN OUTCOME MEASURE Changes in body weight and waist and hip circumferences at 3 and 12 months ; total body , intra-abdominal , and subcutaneous abdominal fat at 12 months . RESULTS Twelve-month data were available for 168 women . Women in the exercise group participated in moderate-intensity sports/recreational activity for a mean ( SD ) of 3.5 ( 1.2 ) d/wk for 176 ( 91 ) min/wk . Walking was the most frequently reported activity . Exercisers showed statistically significant differences from controls in baseline to 12-month changes in body weight ( -1.4 kg ; 95 % confidence interval [ CI ] , -2.5 to -0.3 kg ) , total body fat ( -1.0 % ; 95 % CI , -1.6 % to -0.4 % ) , intra-abdominal fat ( -8.6 g/cm2 ; 95 % CI , -17.8 to 0.9 g/cm2 ) , and subcutaneous abdominal fat ( -28.8 g/cm2 ) ; 95 % CI , -47.5 to -10.0 g/cm2 ) . A significant dose response for greater body fat loss was observed with increasing duration of exercise . CONCLUSIONS Regular exercise such as brisk walking results in reduced body weight and body fat among overweight and obese postmenopausal women CONTEXT Five-year survival rates for early stage colorectal , breast , and prostate cancer currently exceed 90 % and are increasing . Cancer survivors are at greater risk for second malignancies , other comorbidities , and accelerated functional decline . Lifestyle interventions may provide benefit , but it is unknown whether long-term cancer survivors can modify their lifestyle behaviors sufficiently to improve functional status . OBJECTIVE To determine whether a telephone counseling and mailed print material -based diet and exercise intervention is effective in reorienting functional decline in older , overweight cancer survivors . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial of 641 overweight ( body mass index > or = 25 and < 40 ) , long-term ( > or = 5 years ) survivors ( aged 65 - 91 years ) of colorectal , breast , and prostate cancer , who were r and omly assigned to an intervention group ( n = 319 ) or delayed intervention ( control ) group ( n = 322 ) in Canada , the United Kingdom , and 21 US states . Individuals were recruited for the Reach out to Enhance Wellness ( RENEW ) trial from July 1 , 2005 , through May 17 , 2007 . INTERVENTION A 12-month , home-based tailored program of telephone counseling and mailed material s promoting exercise , improved diet quality , and modest weight loss . The control group was wait-listed for 12 months . MAIN OUTCOME MEASURES Change in self-reported physical function on the Short-Form 36 physical function subscale ( score range , 0 - 100 ; a high score indicates better functioning ) from baseline to 12 months was the primary end point . Secondary outcomes included changes in function on the basic and advanced lower extremity function subscales of the Late Life Function and Disability Index ( score range , 0 - 100 ) , physical activity , body mass index , and overall health-related quality of life . RESULTS The mean baseline Short-Form 36 physical function score was 75.7 . At the 12-month follow-up , the mean function scores declined less rapidly in the intervention group ( -2.15 ; 95 % confidence interval [ CI ] , -0.36 to -3.93 ) compared with the control group ( -4.84 ; 95 % CI , -3.04 to -6.63 ) ( P = .03 ) . The mean baseline basic lower extremity function score was 78.2 . The mean changes in basic lower extremity function were 0.34 ( 95 % CI , -0.84 to 1.52 ) in the intervention group compared with -1.89 ( 95 % CI , -0.70 to -3.09 ) in the control group ( P = .005 ) . Physical activity , dietary behaviors , and overall quality of life increased significantly in the intervention group compared with the control group , and weight loss also was greater ( 2.06 kg [ 95 % CI , 1.69 to 2.43 kg ] vs 0.92 kg [ 95 % CI , 0.51 to 1.33 kg ] , respectively ; P < .001 ) . CONCLUSION Among older , long-term survivors of colorectal , breast , and prostate cancer , a diet and exercise intervention reduced the rate of self-reported functional decline compared with no intervention . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00303875
target: In sum , exercise and physical activity can effectively prevent weight gain in older adults and postmenopausal women either in terms of weight loss or maintenance .
  They can preserve lean body mass and thus are important for the balance between potentially positive and negative effects of weight reduction in later life .
  In addition , since all intervention studies were conducted with an overweight sample , it seems that primordial prevention ( in terms of preventing the development of risk factors such as excess weight in the first place ) might be a neglected issue in geriatric and postmenopausal prevention
background: This review examines the role of exercise and physical activity for preventing  weight gain in older people .