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Cited by 355Dietary Effects on HealthRegulation of Appetite and ObesityObesity, Physical Activity, Diet

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Metabolic and Behavioral Compensations in Response to Caloric Restriction: Implications for the Maintenance of Weight Loss

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Redman, Leanne M., Heilbronn, Leonie K., Martin, Corby K., de Jonge, Lilian, Williamson, Donald A., Delany, James P., Ravussin, Eric, for the Pennington CALERIE team·2009·PLoS ONE
DOI 10.1371/journal.pone.0004377PMC PMC2634841
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Abstract

BACKGROUND: Metabolic and behavioral adaptations to caloric restriction (CR) in free-living conditions have not yet been objectively measured. METHODOLOGY AND PRINCIPAL FINDINGS: Forty-eight (36.8+/-1.0 y), overweight (BMI 27.8+/-0.7 kg/m(2)) participants were randomized to four groups for 6-months; CONTROL: energy intake at 100% of energy requirements; CR: 25% calorie restriction; CR+EX: 12.5% CR plus 12.5% increase in energy expenditure by structured exercise; LCD: low calorie diet (890 kcal/d) until 15% weight reduction followed by weight maintenance. Body composition (DXA) and total daily energy expenditure (TDEE) over 14-days by doubly labeled water (DLW) and activity related energy activity (AREE) were measured after 3 (M3) and 6 (M6) months of intervention. Weight changes at M6 were -1.0+/-1.1% (CONTROL), -10.4+/-0.9% (CR), -10.0+/-0.8% (CR+EX) and -13.9+/-0.8% (LCD). At M3, absolute TDEE was significantly reduced in CR (-454+/-76 kcal/d) and LCD (-633+/-66 kcal/d) but not in CR+EX or controls. At M6 the reduction in TDEE remained lower than baseline in CR (-316+/-118 kcal/d) and LCD (-389+/-124 kcal/d) but reached significance only when CR and LCD were combined (-351+/-83 kcal/d). In response to caloric restriction (CR/LCD combined), TDEE adjusted for body composition, was significantly lower by -431+/-51 and -240+/-83 kcal/d at M3 and M6, respectively, indicating a metabolic adaptation. Likewise, physical activity (TDEE adjusted for sleeping metabolic rate) was significantly reduced from baseline at both time points. For control and CR+EX, adjusted TDEE (body composition or sleeping metabolic rate) was not changed at either M3 or M6. CONCLUSIONS: For the first time we show that in free-living conditions, CR results in a metabolic adaptation and a behavioral adaptation with decreased physical activity levels. These data also suggest potential mechanisms by which CR causes large inter-individual variability in the rates of weight loss and how exercise may influence weight loss and weight loss maintenance. TRIAL REGISTRATION: ClinicalTrials.gov NCT00099151.

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Crossref · 10.1371/journal.pone.0004377

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Figure 1 Flow of participants through the Pennington Phase 1 CALERIE trial. The CONSORT diagram was published previously [6].
Figure 1 Flow of participants through the Pennington Phase 1 CALERIE trial. The CONSORT diagram was published previously [6].CC BY · PubMed Central
Figure 2 Experimental design (A) and body weight and composition changes (B) at the completion of the study.
Figure 2 Experimental design (A) and body weight and composition changes (B) at the completion of the study.CC BY · PubMed Central
Figure 3 The effect of caloric restriction on AREE (change in TDEE at M3 and M6 after adjusting for SMR (a measure of sedentary energy expenditure). * represents a significant change from baseline.
Figure 3 The effect of caloric restriction on AREE (change in TDEE at M3 and M6 after adjusting for SMR (a measure of sedentary energy expenditure). * represents a significant change from baseline.CC BY · PubMed Central
Figure 4 The effect of caloric restriction (CR, n = 12) on all components of daily energy expenditure (Top Panel). Total daily energy expenditure (TDEE) is measured by doubly labeled water over a 2-week period whereas sedentary 24-h energy expenditure (24h-EE) is measured in a respiratory chamber. Spontaneous physical activity was calculated as previously reported [7] whereas the thermic effect of food (TEF) was calculated in the chamber as per Tataranni et al [38] and the same percentage of energy intake (9–12% across subjects) was assumed to assess the extra TEF in free living conditions. The changes in total daily energy expenditure after 3 and 6 months of CR (Bottom Panel) are shown and those representing a metabolic adaptation (larger than due to weight loss) are highlighted in grey.
Figure 4 The effect of caloric restriction (CR, n = 12) on all components of daily energy expenditure (Top Panel). Total daily energy expenditure (TDEE) is measured by doubly labeled water over a 2-week period whereas sedentary 24-h energy expenditure (24h-EE) is measured in a respiratory chamber. Spontaneous physical activity was calculated as previously reported [7] whereas the thermic effect of food (TEF) was calculated in the chamber as per Tataranni et al [38] and the same percentage of energy intake (9–12% across subjects) was assumed to assess the extra TEF in free living conditions. The changes in total daily energy expenditure after 3 and 6 months of CR (Bottom Panel) are shown and those representing a metabolic adaptation (larger than due to weight loss) are highlighted in grey.CC BY · PubMed Central

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  1. MI Frisard, 2007, Physical activity level and physical functionality in nonagenarians compared to individuals aged 60–74 years., J Gerontol A Biol Sci Med Sci, 62, 783, 10.1093/gerona/62.7.783 · DOI

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Metadata

Authors
Redman, L. M., Heilbronn, L. K., Martin, C. K., de Jonge, L., Williamson, D. A., Delany, J. P., Ravussin, E., & for the Pennington CALERIE team
Affiliations
Pennington Biomedical Research Center (US)
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2009-02-09
Volume
4
Issue
2
Pages
e4377
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0004377
PMC
PMC2634841
OpenAlex
W2037703570
Cited by
355
References
39
Citations by year
2026: 8 · 2025: 8 · 2024: 10 · 2023: 15 · 2022: 18 · 2021: 18 · 2020: 12 · 2019: 9 · 2018: 22 · 2017: 20 · 2016: 22 · 2015: 52 · 2014: 37 · 2013: 20 · 2012: 23
FWCI
18.62
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • National Institutes of Health (5k23dk068052-04)
  • Medical Research Council
  • National Health and Medical Research Council
  • National Institute on Aging (U01AG020478, U01-AG20478)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K23-DK-068052, K23 DK068052-01A2, P30DK072476)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
caloric restriction, weight loss maintenance, metabolic adaptation, total energy expenditure, physical activity, hypocaloric diet, body composition, energy expenditure, overweight adults, free-living conditions, behavioral adaptation, doubly labeled water, sleeping metabolic rate, obesity treatment, compensatory behavior
MeSH terms
Adult, Body Composition, Energy Intake, Energy Metabolism, Female, Humans, Male, Middle Aged, Weight Loss, Body Mass Index, Caloric Restriction, Behavior Control

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