Women participating in Curves program experience more favorable changes in body composition compared to Weight Watchers

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2011 ISSN Annual Meeting

Comparative effectiveness of two popular weight loss programs in women I:  body composition and resting energy expenditure

M Mardock, B Lockard, JM Oliver, M Byrd, S Simbo, A Jagim, JY Kresta, C Baetge, Y Jung, M Koozehchian, D Khanna, M. Greenwood, C Rasmussen, R Kreider. 
Exercise & Sport Nutrition Lab, Texas A&M University, College Station, TX 77843
 
Background

A number of commercial diet and exercise programs are promoted to help people lose weight and improve fitness.  However, few studies have compared the effects of following different types of exercise and diet interventions on weight loss.  The purpose of this study was to compare the efficacy of a more structured meal plan based diet intervention and supervised exercise program to a traditional point based diet program with weekly counseling and encouragement to exercise. 

Methods
 
51 sedentary women (35±8 yrs, 163±7 cm; 90±14 kg; 47±7% body fat, 34±5 kg/m2) were randomized to participate in the Curves (C) or Weight Watchers (W) weight loss programs for 16-wks.   Participants in the C program were instructed to follow a 1,200 kcal/d diet for 1-week, 1,500 kcal/d diet for 3 weeks, and 2,000 kcals/d diet for 2-weeks consisting of 30% carbohydrate, 45% protein, and 30% fat.  Subjects then repeated this diet.  Subjects also participated in the Curves circuit style resistance training program 3 days/week and were encouraged to walk at brisk pace for 30-min on non-training days.  This program involved performing 30-60 seconds of bi-directional hydraulic-based resistance-exercise on 13 machines interspersed with 30-60 seconds of lowimpact callisthenic or Zumba dance exercise.   Participants in the W group followed the W point-based diet program, received weekly counseling at a local W facility, and were encouraged to increase physical activity.   Dietary records, the International Physical Activity Questionnaire (IPAQ), dual energy X-ray absorptiometer (DEXA) determined body composition, and fasted resting energy expenditure (REE) measurements were obtained at 0, 4, 10, & 16 weeks and analyzed by multivariate analysis of variance (MANOVA) with repeated measures.  Data are presented as changes from baseline for the C and W groups, respectively, after 4, 10, and 16 weeks. 

Results
 
Participants in the W group reported a greater reduction energy intake (C -270±450, -364±443, -386±480; W -636±510, -610±524, -549±522 kcals/d, pq=0.008) from baseline levels (C 1,693±430; W 1,954±524 kcals/d) with carbohydrate intake higher (19.6±11 grams/d, 6.0±1.9 %) and protein intake lower (-14.4±4 grams/d, -4.2±1 %) in the W group.  Changes in group mean IPAQ walking (241±366 MET-min/wk, p=0.50), moderate PA (177±347 MET-min/wk, p=0.61), vigorous PA (502±122 MET-min/wk, p=0.001), and total PA (925±587 MET-min/wk, p=0.12) were higher in the C group. A significant overall MANOVA time (p=0.001) and diet (p=0.01) effect was seen in body composition results.  Univariate analysis revealed that both groups lost a similar amount of weight (C -2.4±2.1, -4.4±3.6, -4.9±4.0; W -2.7±1.3, -5.3±2.4, -6.2±4.1 kg, p=0.31).  However, fat mass loss (C -3.9±5.5, -4.6±5.3, -6.4±5.9; W -0.4±5.7, -2.1±6.7, -2.9±7.8 kg, p=0.09) and reductions in percent body fat (C -3.3±5.2, -3.2±4.6, -4.7±5.4; W 0.6±6.7, -0.6±8.3, -1.4±8.1 %, pq=0.054) tended to be greater in the C group while fat free mass was increased in the C while decreasing in the W group (C 1.5±4.3, 0.5±3.7, 1.3±4.0; W -1.8±5.4, -2.4±5.8, -2.5±5.1 kg, p=0.01).  REE values increased over time in both groups and were non-significantly higher in the C group (C 0.9±2.2, 1.4±2.3, 1.3±1.9; W 0.6±2.0, 0.7±2.0, 0.6±2.3 kcals/kg/d, p=0.19). 
 
Conclusion 

Results indicate that 16-wks of participation in the C program that involved a more structured meal plan based diet and supervised exercise program promoted more favorable changes in body composition than participation in the W program that involved adherence to a point based diet, weekly counseling, and encouragement to increase physical activity.   
 
Funding
 
Supported by Curves International (Waco, TX)

Comparative effectiveness of two popular weight loss programs in women II:  metabolic markers

M Byrd, M Mardock, B Lockard, JM Oliver, S Simbo, A Jagim, JY Kresta, C Baetge, Y Jung, M Koozehchian, D Khanna, M. Greenwood, C Rasmussen, R Kreider. 
Exercise & Sport Nutrition Lab, Texas A&M University, College Station, TX 77843
 
Background
 
A number of commercial diet and exercise programs are promoted to help people lose weight and improve fitness.  However, few studies have compared the effects of following different types of exercise and diet interventions on weight loss.  The purpose of this study was to compare the efficacy of a more structured meal plan based diet intervention and supervised exercise program that included resistance-exercise to a traditional point based diet program with weekly counseling and encouragement to exercise.
 
Methods
 
51 sedentary women (35±8 yrs, 163±7 cm; 90±14 kg; 47±7% body fat, 34±5 kg/m2) were randomized to participate in the Curves (C) or Weight Watchers (W) weight loss programs for 16-wks.   Participants in the C program were instructed to follow a 1,200 kcal/d diet for 1-week, 1,500 kcal/d diet for 3 weeks, and 2,000 kcals/d diet for 2-weeks consisting of 30% carbohydrate, 45% protein, and 30% fat.  Subjects then repeated this diet.  Subjects also participated in the Curves circuit style resistance training program 3 days/week and were encouraged to walk at brisk pace for 30-min on non-training days.   This program involved performing 30-60 seconds of bi-directional hydraulic-based resistance-exercise on 13 machines interspersed with 30-60 seconds of lowimpact callisthenic or Zumba dance exercise.   Participants in the W group followed the W point-based diet program, received weekly counseling at a local W facility, and were encouraged to increase physical activity. Fasting blood samples were obtained at 0, 4, 10, & 16 wks and analyzed by multivariate analysis of variance (MANOVA) with repeated measures for changes in triglycerides (TG), total cholesterol (CHL), low density lipoprotein cholesterol (LDL-c), high density lipoprotein cholesterol (HDL-c), the CHL:HDL-C ratio, and blood glucose.  Data are presented as percent changes from baseline for the C and W groups, respectively, after 4, 10, and 16 weeks.  
 
Results
 
MANOVA analysis of fasting lipids data revealed an overall Wilks’ Lamda significant time (p=0.001) and diet (p=0.03) effect with no significant time x diet effect (p=0.19).  No significant time (p=0.72) or time x diet (p=0.36) effects were seen in changes in TG levels (C -8.0±26, -11.7±18,-2.3±26; W 4.0± 25, 5.0±32, 7.8±5 %); however, an effect of diet was seen with the C group experiencing a greater reduction in TG (p=0.06).  CHL levels (p=0.001) and LDL-c levels (p=0.01) decreased in both groups over time with no differences observed between groups in changes in CHL (C -6.1±11.0, -37.9±25.8, -2.3±9.5; W -6.8±9.4, -34.2±27.4, -6.3±13.0 %, p=0.53) or LDL-c (C -6.9±17.3, -2.7±13.6, -4.6±17.2; W -5.6±14.5, -2.8±19.7, -11.4±15.9 %, p=0.16).  Changes in HDL-c (C -2.1±12.5, 3.0±12.3, 5.9±18.3; W -9.5±11.5, -9.5±12.7, -1.6±14.6 %, pq=0.001) and the CHL:HDL-c ratio (C -1.8±13.1, -4.0±10.1, -3.8±12.2; W 3.4±13.4, 5.3±12.5, -3.4±14.2 %, pq=0.009) were greater in the C group.  No significant time (p=0.38) or time by diet (p=0.31) effects were seen in changes in blood glucose (C -1.9±13, -0.5±12,-3.6±9; W 1.0±12, -1.0±11, 0.9±12 %). 
 
Conclusion
 
Results indicate that 16-wks of participation in the C and W programs promoted improvements in CHL and LDL-c.   However, adherence to a more structured meal plan based diet and supervised exercise program promoted more favorable changes in TG, HDL-c and the ratio of CHL:HDL-c.  
 
Funding
 
Supported by Curves International (Waco, TX)

Comparative effectiveness of two popular weight loss programs in women III:  health and fitness markers

JM Oliver, M Mardock, B Lockard, M Byrd, S Simbo, A Jagim, JY Kresta, C Baetge, Y Jung, M Koozehchian, D Khanna, M. Greenwood, C Rasmussen, R Kreider. 
Exercise & Sport Nutrition Lab, Texas A&M University, College Station, TX 77843
 
Background
 
A number of commercial diet and exercise programs are promoted to help people lose weight and improve fitness.  However, few studies have compared the effects of following different types of exercise and diet interventions on weight loss and/or changes in health and fitness markers.  The purpose of this study was to compare the efficacy of a more structured meal plan based diet intervention and supervised exercise program that included resistance-exercise to a traditional point based diet program with weekly counseling and encouragement to increase physical activity. 
 
Methods
 
51 sedentary women (35±8 yrs, 163±7 cm; 90±14 kg; 47±7% body fat, 34±5 kg/m2) were randomized to participate in the Curves (C) or Weight Watchers (W) weight loss programs for 16-wks.   Participants in the C program were instructed to follow a 1,200 kcal/d diet for 1-week, 1,500 kcal/d diet for 3 weeks, and 2,000 kcals/d diet for 2-weeks consisting of 30% carbohydrate, 45% protein, and 30% fat.  Subjects then repeated this diet.  Subjects also participated in the Curves circuit style resistance training program 3 days/week and were encouraged to walk at brisk pace for 30-min on non-training days.   This program involved performing 30-60 seconds of bi-directional hydraulic-based resistance-exercise on 13 machines interspersed with 30-60 seconds of lowimpact callisthenic or Zumba dance exercise.   Participants in the W group followed the W point-based diet program, received weekly counseling at a local W facility, and were encouraged to increase physical activity. Body mass index (BMI), waist and hip circumference; as well as changes in resting heart rate (RHR) and blood pressure (BP) were obtained at 0, 4, 10, & 16 wks and analyzed by multivariate analysis of variance (MANOVA) with repeated measures for changes. Measurements of strength and endurance were obtained at 0 and 16 weeks.
 
Results
 
MANOVA analysis of anthropometry data revealed an overall Wilks’ Lamda significant time (p=0.001) and diet (p=0.05) effect with no significant time x diet effect (p=0.29).  After 16 weeks both groups decreased BMI (C -2.5±1.9, -4.6±3.2, -5.1±3.7; W -3.1±1.5, -6.0±2.7, -7.1±4.7 %; p=0.10), waist circumference(C -2.8±3.7, -5.4±5.2, -6.2±5.1; W -1.1±5.6, -4.2±6.0, -5.9±5.5 %; pq=0.21) and hip circumference (C -1.7±2.1, -4.1±3.4, -4.7±4.0; W -1.5±3.3, -4.3±3.2, -6.2±4.1 %; pq=0.15) over time; with no differences seen between groups. MANOVA analysis of RHR and BP data revealed an overall Wilks’ Lambda significant time (p=0.008) effect with no diet (p=0.71) or time x diet (0.11) effect. Both groups significantly decreased RHR (C -5.6±13.2, -7.4±13.8, -0.7±11.3; W -5.9±18.1, 0.2±20.9, -0.9±20.9 %; pq=0.22), systolic BP (C -2.4±6.5, -2.9±9.3, -3.8±8.8; W -4.3±8.6, -3.5±10.1, -4.1±7.5 %; pq=0.53), and diastolic BP (C -5.1±10.4, -1.5±13.0, -1.6±13.0; W -5.1±11.4, -6.4±11.6, -5.7±10.0 %; p=0.11) over time; with no differences seen between groups. MANOVA analysis of strength and strength endurance revealed a significant difference between groups (p=0.008) participants in C improved their leg press 1RM (C 5.6±16; W 0.0±19 %), bench press 1RM (C 4.5±15; W -0.9±10 %), leg press endurance (C 22.3±85; W 7.1±54 %), and bench press endurance (C 45.4±97; W -10.5±39 %) to a greater degree. No significant difference were seen in changes in peak oxygen uptake (C 11.1±11.5; W 9.3±8.5 %; p=0.52).
 
Conclusion
 
Results indicate that participation in C and W programs improved several markers of health and fitness. However, adherence to a more structured meal plan based diet combined with a supervised exercise program promoted more favorable changes in strength and endurance.
 
Funding
 
Supported by Curves International (Waco, TX)

Comparative effectiveness of two popular weight loss programs in women IV:  quality of life and diet satisfaction

A Jagim, M Mardock, B Lockard, JM Oliver, M Byrd, S Simbo, JY Kresta, C Baetge, Y Jung, M Koozehchian, D Khanna, M. Greenwood, C Rasmussen, R Kreider. 
Exercise & Sport Nutrition Lab, Texas A&M University, College Station, TX 77843
 
Background
 
A number of commercial diet and exercise programs are promoted to help people lose weight and improve fitness.  However, few studies have compared the effects of following different types of exercise and diet interventions on weight loss, health, and quality of life.  The purpose of this study was to compare the efficacy of a more structured meal plan based diet intervention and supervised exercise program that included resistance-exercise to a traditional point based diet program with weekly counseling and encouragement to exercise.
 
Methods
 
51 sedentary women (35±8 yrs, 163±7 cm; 90±14 kg; 47±7% body fat, 34±5 kg/m2) were randomized to participate in the Curves (C) or Weight Watchers (W) weight loss programs for 16-wks.   Participants in the C program were instructed to follow a 1,200 kcal/d diet for 1-week, 1,500 kcal/d diet for 3 weeks, and 2,000 kcals/d diet for 2-weeks consisting of 30% carbohydrate, 45% protein, and 30% fat.  Subjects then repeated this diet.  Participants also participated in the Curves circuit resistance training program 3 days/week for 30-minutes.  This program involved performing 30-60 seconds of bi-directional hydraulic-based resistance-exercise on 13 machines interspersed with 30-60 seconds of lowimpact callisthenic or Zumba dance exercise.   Participants in the W group followed the W point-based diet program, received weekly counseling, and were encouraged to increase physical activity. Eating satisfaction and SF-36 quality of life and questionnaires were obtained at 0, 4, 10, & 16 wks and analyzed by multivariate analysis of variance (MANOVA) with repeated measures.  Data are presented as changes from baseline for the C and W groups, respectively. 
 
Results
 
MANOVA analysis of SF36 quality of life indices revealed an overall Wilks’ Lamda time effect (p=0.09) with no significant diet (p=0.44) or time x diet effect (p=0.45). Within subjects univariate analysis revealed that both programs increased rating of physical function (17.3±36 %, p=0.002), role physical (17.5±56 %, p=0.03), role emotional (11.8±30 %, p=0.02), vitality (20.8±35 %, p=0.001), role emotion (19.1±30 %, p=0.001), bodily pain (19.1±34 %, p=0.001) and general health (12.6±23 %, p=0.001) with no time effect on social functioning (3.0±20 %, p=0.57) following 16 weeks. No significant interactions were seen between diet groups. MANOVA analysis of eating satisfaction inventories revealed significant within subjects time effects (p=0.001) with a trend toward a significant interaction effect (p=0.059). Univariate analysis revealed that both programs decreased rating of appetite (-0.5±1.5, p=0.003), amount of energy (-1.6±2.0, p=0.001), and overall quality of diet (-2.5±2.7, p=0.001) with no time effect on hunger (0.1±1.6, p=0.38) or satisfaction from food (-0.3±2.0, p=0.64) following 16 weeks. Perceptions of feelings of fullness were significantly higher in the C group (C 0.4±1.9, 0.0±1.7, 0.5±1.4; W -0.8±1.8,-0.7±1.9, -0.8±1.4; p=0.04). 
 
Conclusion
 
Results indicate that participation in the C and W programs generally improve markers of quality of life and participants following the C program experience fullness to a greater fullness than those following the W program.
 
 
Funding
 
Supported by Curves International (Waco, TX)

Experiencing the impact of weight loss on work capacity prior to initiation of a weight loss program enhances success     

M. Greenwood, M Mardock, B Lockard, JM Oliver, M Byrd, S Simbo, A Jagim, JY Kresta, C Baetge, Y Jung, M Koozehchian, D Khanna, C Rasmussen, R Kreider. 
Exercise & Sport Nutrition Lab, Texas A&M University, College Station, TX 77843
 
Background

A number of psychological interventions have been employed prior to and/or during exercise and weight loss interventions in an attempt to influence exercise adherence, compliance, and/or success.   However, few studies have evaluated whether these types of efforts influence program efficacy. The purpose of this study was to determine whether having sedentary and overweight individuals experience the impact of losing weight on work capacity prior to initiation of an exercise and/or weight loss program would influence weight loss success. 
 
Methods
 
51 sedentary women (35±8 yrs, 163±7 cm; 90±14 kg; 47±7% body fat, 34±5 kg/m2) were randomized to walk on an AlterG Anti-Gravity Treadmill® (AG) at 3 mph at 100% and 80% of body mass or were entered into a weight loss program directly (WL).   Participants were then randomized to participate in the Curves (C) exercise and weight loss program or the Weight Watchers (W) weight loss program for 16-wks in order to examine whether this strategy may be more effective depending on the type of weight loss program employed. Participants in the C program were instructed to follow a 1,200 kcal/d diet for 1-week, 1,500 kcal/d diet for 3 weeks, and 2,000 kcals/d diet for 2-weeks consisting of 30% carbohydrate, 45% protein, and 30% fat.  Subjects then repeated this diet.  Subjects also participated in the Curves circuit style resistance training program 3 days/week and were encouraged to walk at brisk pace for 30-min on non-training days. This program involved performing 30-60 seconds of bi-directional hydraulic-based resistance-exercise on 13 machines interspersed with 30-60 seconds of lowimpact callisthenic or Zumba dance exercise.   Participants in the W group followed the W point-based diet program, received weekly counseling at a local W facility, and were encouraged to increase physical activity.   Four-day dietary records, the International Physical Activity Questionnaire (IPAQ), and dual energy X-ray absorptiometer (DEXA) determined body composition measurements were obtained at 0, 4, 10, & 16 weeks and analyzed by MANOVA with repeated measures.  Data are presented as changes from baseline for the WL and AG groups, respectively, after 4, 10, and 16 weeks. 

Results
 
No significant differences were observed in energy intake or macronutrient intake among those in the AG or WL groups. The amount of vigorous PA performed at each data point in the AG group was significantly greater throughout the study (WL 953±1,221, 844±653, 1,338±1,767, 1,266±1,535; AG 803±1,282, 1,332±1,719, 1,286±1,974, 1,579±2,091 MET-min/wk, p=0.01) despite even distribution of participants among supervised and non-supervised exercise programs. Overall, MANOVA revealed a significant time by intervention effect (p=0.02) in body composition variables. Univariate analysis revealed that both groups lost a similar amount of weight (WL -2.8±2.1, -5.3±3.4, -5.9±4.4; AG -2.3±1.1, -4.3±2.4, -5.1±3.5 kg, p=0.40) and fat mass loss (WL -2.0±6.1, -2.4±6.4, -4.1±7.8; AG -2.1±5.7, -4.4±5.7, -5.2±6.4 kg, p=0.43) while changes in fat free mass (WL -0.3±5.4, -2.1±5.2, -1.5±5.2; AG -0.3±5.1, 0.3±4.7, 0.2±4.6 kg, p=0.08) and percent body fat (WL -1.0±5.9, -0.2±6.1, -1.7±6.6; AG -1.5±6.9, -3.9±7.5, -4.5±7.6 %, p=0.07) tended to be more favorable in the AG group.
 
Conclusion 

Results indicate that experiencing the impact of losing weight on work capacity prior to initiation of an exercise and/or weight loss program has a positive impact on increasing vigorous activity and changes in body composition. More research is needed to examine whether use of this strategy more often during a weight loss program may affect adherence and/or efficacy of different types of weight loss programs
 
Funding
 
Supported by Curves International (Waco, TX) and AlterG, Inc. (Fremont, CA)