Exercise-induced Changes in Central Adiposity During an RCT: Effect of Exercise Dose and Associations With Compensation

Context: Exercise can decrease central adiposity, but the effect of exercise dose and the relationship between central adiposity and exercise-induced compensation is unclear.Objective: Test the effect of exercise dose on central adiposity change and the association between central adiposity and exercise-induced weight compensation.Methods: In this ancillary analysis of a 6-month randomized controlled trial, 170 participants with overweight or obesity (mean +/- SD BMI: 31.5 +/- 4.7 kg/m(2)) were randomized to a control group or exercise groups that reflected exercise recommendations for health (8 kcal/kg/week [KKW]) or weight loss and weight maintenance (20 KKW). Waist circumference was measured, and dual-energy X-ray absorptiometry assessed central adiposity. Predicted weight change was estimated and weight compensation (weight change minus predicted weight change) was calculated.Results: Between-group change in waist circumference (control: 0.0 cm [95% CI: -1.0,1.0], 8 KKW: -0.7 cm [95% CI: -1.7,0.4], 20 KKW: -1.3 cm [95% CI: -2.4, -0.2]) and visceral adipose tissue (VAT; control: -0.02 kg [95% CI: -0.07,0.04], 8 KKW: -0.01 kg [95% CI: -0.07,0.04], 20 KKW: -0.04 kg [95% CI: -0.10,0.02]) was similar (P >= 0.23). Most exercisers (82.6%) compensated (predicted weight change lower than actual weight change). Exercisers who compensated exhibited a 2.5 cm (95% CI: 0.8,4.2) and 0.23 kg (95% CI: 0.14,0.31) increase in waist circumference and VAT, respectively, versus those who did not (P<0.01). Desire to eat predicted VAT change during exercise (beta=0.21; P=0.03).Conclusions: In the presence of significant weight compensation, exercise at doses recommended for health and weight loss and weight maintenance leads to negligible changes in central adiposity.