Effects of caloric restriction on cardiorespiratory fitness, fatigue, and disability responses to aerobic exercise in older adults with obesity: a randomized controlled trial
Open accessAbstract
BACKGROUND: Obesity compounds aging-related declines in cardiorespiratory fitness, with accompanying fatigue and disability. This study determined the effects of two different levels of caloric restriction (CR) during aerobic training on cardiorespiratory fitness, fatigue, physical function, and cardiometabolic risk. METHODS: The INFINITE study was a 20-week randomized trial in 180 older (65-79 years) men and women with obesity (body mass index = 30-45 kg/m2). Participants were randomly assigned to (i) aerobic training (EX; treadmill 4 days/wk for 30 minutes at 65%-70% of heart rate reserve), (ii) EX with moderate (-250 kcal/d) CR (EX + Mod-CR), or (iii) EX with more intensive (-600 kcal/d) CR (EX + High-CR). Cardiorespiratory fitness (peak aerobic capacity, VO2 peak, primary outcome) was determined during a graded exercise test. RESULTS: One hundred and fifty-five participants returned for 20-week data collection (87% retention). VO2 peak increased by 7.7% with EX, by 13.8% with EX + Mod-CR, and by 16.0% with EX + High-CR, and there was a significant treatment effect (EX + High-CR = 21.5 mL/kg/min, 95% confidence interval = 19.8-23.2; EX + Mod-CR = 21.2 mL/kg/min, 95% confidence interval = 19.4-23.0; EX = 20.1 mL/kg/min, 95% confidence interval = 18.4-21.9). Both CR groups exhibited significantly greater improvement in self-reported fatigue and disability and in glucose control, compared with EX. CONCLUSION: Combining aerobic exercise with even moderate CR is more efficacious for improving cardiorespiratory fitness, fatigue and disability, and glucose control than exercise alone and is as effective as higher-dose CR.
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Adding aerobic training to calorie restriction improves cardiorespiratory fitness.
“As assessed according to peak oxygen consumption, the addition of AT to CR in dieting adults further improves cardiorespiratory fitness (21).”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [21]
The Abstract reports improved peak oxygen uptake with aerobic training plus caloric restriction in older adults with obesity. But the trial compared those groups with aerobic training alone, not caloric restriction alone, so it does not establish that adding aerobic training to a diet further improves fitness. The claim also generalizes beyond the study population. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAdding aerobic training to calorie restriction in dieting adults further improves cardiorespiratory fitness as assessed by peak oxygen consumption.
“As assessed according to peak oxygen consumption, the addition of AT to CR in dieting adults further improves cardiorespiratory fitness (21).”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [21]
The Abstract (page unavailable) reports greater improvement in peak oxygen consumption with aerobic training plus caloric restriction than with aerobic training alone. It does not test the claimed comparison—adding aerobic training to caloric restriction—because there was no caloric-restriction-only group. The trial also studied older adults with obesity, rather than dieting adults generally. (LLM, conf=0.88)
Experimental — accuracy not yet measured
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Self-citation
- Authors
- Nicklas, B. J., Brinkley, T. E., Houston, D. K., Lyles, M. F., Hugenschmidt, C. E., Beavers, K. M., & Leng, X.
- Affiliations
- Wake Forest University Health Sciences (US)
- Wake Forest University (US)
- Corresponding author
- Nicklas, Barbara J
- ORCID
- Venue
- The Journals of Gerontology: Series A
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-07-05
- Volume
- 74
- Issue
- 7
- Pages
- 1084-1090
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- PMC
- PMC6580693
- OpenAlex
- W2887132315
- Cited by
- 47
- References
- 8
- Citations by year
- 2026: 2 · 2025: 13 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 4 · 2018: 1
- FWCI
- 6.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (am)
- Locations
- The Journals of Gerontology Series A (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (R01HL093713, K01AG033652, K01AG030506, K01AG043547)
- Wake Forest Claude D. Pepper Older Americans Independence Center (P30AG21332)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- caloric restriction, obesity, older adults, aerobic exercise training, cardiorespiratory fitness, peak oxygen uptake, fatigue, disability, physical function, glycemic control, cardiometabolic risk, negative energy balance
- MeSH terms
- Cardiorespiratory Fitness, Physical Functional Performance, Aged, Blood Glucose, Disability Evaluation, Exercise Test, Fatigue, Female, Humans, Male, Obesity, Oxygen Consumption, Exercise, Body Mass Index, Outcome Assessment, Health Care, Exercise Tolerance, Caloric Restriction
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