JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
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Randomized trial reveals that physical activity and energy expenditure are associated with weight and body composition after RYGB.

Obesity 2017 July
OBJECTIVE: This study investigated the associations of both physical activity time (PA) and energy expenditure (EE) with weight and fat mass (FM) loss in patients following Roux-en-Y gastric bypass (RYGB) surgery.

METHODS: Ninety-six nondiabetic patients were included in this analysis. Post-RYGB patients were randomized in one of two treatments: A 6-month exercise training program (RYBG+EX) or lifestyle educational classes (RYGB). Body composition was assessed by dual-energy X-ray absorptiometry and computed tomography. Components of PA and EE were quantified by a multisensory device. Dose-response relationships of both PA and EE with weight loss and body composition were explored according to quartiles of change in steps per day.

RESULTS: Patients in the highest quartiles of steps per day change lost more FM (3rd = -19.5 kg and 4th = -22.7 kg, P < 0.05) and abdominal adipose tissue (4th = -313 cm2 , P < 0.05), maintained skeletal muscle mass (3rd = -3.1 cm2 and 4th = -4.5 cm2 , P <  0.05), and had greater reductions in resting metabolic rate. Decreases in sedentary EE and increases in light EE and age were significant predictors of both Δweight and ΔFM (R2  = 73.8% and R2  = 70.6%, respectively).

CONCLUSIONS: Nondiabetic patients who perform higher, yet still modest, amounts of PA following RYGB have greater energy deficits and lose more weight and FM, while maintaining higher skeletal muscle mass.

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