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Cited by 30Dietary Effects on HealthDiet and metabolism studiesNutrition and Health in Aging

3-Year effect of weight loss via severe versus moderate energy restriction on body composition among postmenopausal women with obesity - the TEMPO Diet Trial

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Seimon, Radhika V., Wild-Taylor, Anthony L., McClintock, Sally, Harper, Claudia, Gibson, Alice A., Johnson, Nathan A., Fernando, Hamish A., Markovic, Tania P. +8 more·2020·Heliyon
DOI 10.1016/j.heliyon.2020.e04007PMC PMC7322133
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Abstract

We have previously shown that a severely energy-restricted diet leads to greater loss of weight, fat, lean mass and bone mineral density (BMD) at 12 months in postmenopausal women with obesity than a moderately energy-restricted diet. We now aim to evaluate whether these effects are sustained longer term (ie, at 36 months). 101 postmenopausal women were randomized to either 12 months of moderate (25 to 35%) energy restriction with a food-based diet (moderate intervention), or 4 months of severe (65 to 75%) energy restriction with a total meal replacement diet followed by moderate energy restriction for 8 months (severe intervention). Body weight and composition were measured at 0, 24 and 36 months. Participants in the severe intervention lost ~1.5 to 1.7 times as much weight, waist circumference, whole-body fat mass and visceral adipose tissue compared to those in the moderate intervention, and were 2.6 times more likely (42% versus 16%) to have lost 10% or more of their initial body weight at 36 months ( P < 0.01 for all). However, those in the severe versus moderate intervention lost ~1.4 times as much whole-body lean mass ( P < 0.01), albeit this was proportional to total weight lost and there was no greater loss of handgrip strength, and they also lost ~2 times as much total hip BMD between 0 and 36 months ( P < 0.05), with this bone loss occurring in the first 12 months. Thus, severe energy restriction is more effective than moderate energy restriction for reducing weight and adiposity in postmenopausal women in the long term (3 years), but attention to BMD loss in the first year is required. Trial registration Australian New Zealand Clinical Trials Registry Reference Number: 12612000651886, anzctr.org.au.

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  • Loss of muscle or bone mass may be particularly undesirable for some individuals such as adults with sarcopenic obesity or those with risk factors for osteoporosis.

    “However, the loss of muscle or bone mass may be particularly undesirable for some individuals such as adults with sarcopenic obesity or those with risk factors for osteoporosis [97].”

    From Nutritional considerations with antiobesity medications (2024) · cites this paper as [97]

    The Introduction reports greater lean-mass and hip bone-mineral-density loss with severe energy restriction, and the Discussion recommends protecting bone health during such diets. The paper does not specifically identify adults with sarcopenic obesity or people with osteoporosis risk factors as groups for whom those losses are particularly undesirable; its trial studied postmenopausal women with obesity. (LLM, conf=0.84)

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  1. [23]International Conference on Harmonisation Expert Working Group, ICH Harmonised Tripartite Guideline: Guideline for Good Clinical Practice

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Authors
Seimon, R. V., Wild-Taylor, A. L., McClintock, S., Harper, C., Gibson, A. A., Johnson, N. A., Fernando, H. A., Markovic, T. P., Center, J. R., Franklin, J., Liu, P. Y., Grieve, S. M., Lagopoulos, J., Caterson, I. D., Byrne, N. M., & Sainsbury, A.
Affiliations
  • The University of Sydney (AU)
  • Garvan Institute of Medical Research (AU)
  • University of California, Los Angeles (US)
  • University of Tasmania (AU)
Corresponding author
  • Seimon, Radhika V.
  • Sainsbury, Amanda
ORCID
Venue
Heliyon
Publisher
Elsevier BV
Published
2020-06
Volume
6
Issue
6
Pages
e04007
ISSN
2405-8440 (ISSN-L)
DOI
10.1016/j.heliyon.2020.e04007
PMC
PMC7322133
OpenAlex
W3037059485
Cited by
30
References
47
Citations by year
2026: 1 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 7 · 2021: 14 · 2020: 1
FWCI
3.61
Type
journal article
Language
en
Open access
Licence
Locations
  • Heliyon (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • UWA Profiles and Research Repository (UWA) (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • UTAS Research Repository (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by-nc-nd)
Funders
  • Endocrine Society of Australia
  • Heart Research Institute
  • University of Sydney
  • National Heart, Lung, and Blood Institute (1042555, 1135897, K24HL13632)
  • Sydney Medical School Foundation
  • Rebecca L. Cooper Medical Research Foundation
  • National Health and Medical Research Council (1072771)
Topics
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
  • Health Sciences › Medicine › Physiology › Diet and metabolism studies
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
Keywords
postmenopausal obesity, body composition, fat mass, visceral adipose tissue, lean body mass, bone mineral density, hip bone loss, long-term weight loss, grip strength, waist circumference

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