Both a very common question as well as a “barrier to entry,” in a sense, is the problem of not knowing where to even begin. You know what you want goal-wise, but you’re not sure what those next steps need to be in order to make that a reality.
Do you start with the diet first? Well wait… there’s so much information out there about nutrition. What about exercise? Maybe hop on a program first? The question here is: what is the best way to kick off this change and get from point A to point B?
As you can see, this can easily become an overwhelming situation to find yourself in and you technically haven’t even started yet!
Thankfully we’ve got a couple of options to choose from here (literally nutrition, training, or both!) so it does narrow things down for us, but even so can easily be overthought and overcomplicated. Things can also get a little trickier when our level of experience and knowledge are taken into account. The study to be discussed will be putting this question to the test (as it relates to weight and body composition) and compare the use of dieting alone, training alone, or implementing diet and training together.
The Nutrition and Exercise in Women (NEW) Study
The NEW study was a 12-month randomized control trial conducted between 2005 to 2009. It used a 4-arm design to compare the impact of three different lifestyle interventions as well as a control (aka no lifestyle change) on the weight and body composition of overweight and obese women. Recruitment of the women was done via mailing campaigns and media outreach; out of all of the responses received, 439 women were randomly assigned to the 4 study protocols.
The 4 protocols being investigated were as follows: dietary weight loss, aerobic exercise (moderate to vigorous intensity), both diet and exercise interventions combined, and a no-lifestyle-change control. The targeted population for this study were women who were considered to be overweight or obese. In addition to this, all subjects had been participating in less than 100 minutes of exercise (moderate intensity or greater) per week.
Considerations like that of the women’s current physical activity levels are very important because it allows us to see a true difference if/when interventions and lifestyle variables are manipulated. This goes for any client who is looking to diet, whether it be lifestyle or competition-based – we must be in a spot to do so where we don’t enter the diet already having a lot of cardio in our routine. Same idea applies for calories too; if we have nothing to pull from or add to, the process will be much harder to reap substantial changes from.
Diet and Exercise Protocols
Diet changes were modified and based off pre-existing lifestyle and weight management programs. Some of the goals that were prescribed to the diet-alone group included adhering to a caloric intake ranging from 1,200 – 2,000 calories per day based on individual baseline weights, a reduction in daily fat intake (less than 30% of total calories coming from fat), and dropping 10% of their bodyweights within 6 months. They were asked to record all food consumed each day for at least 6 months, or until they hit their weight loss goal of -10%. At the 6-month mark, the women would then enter a maintenance phase for the remaining 6 months.
It’s not all about the diet though! The women were provided a lot of support via a study dietitian in order to set personalized goals throughout the dieting period. Weekly, in-person meetings were held for the women in the first 6 months. From months 7-12, dietitians remained in contact with the women twice per month both in-person as well as over the phone or email. Additional sessions were also provided for the women in case they needed some extra support and guidance. As we know, learning tools such as portion control, practicing calorie balance, how to make eating out work alongside our goals, and more nutrition education as a whole are essential in making long lasting changes.
As for the exercise-only group, the women were prescribed at least 45 minutes of moderate to vigorous intensity aerobic exercise, 5 days per week (or at least 225 minutes per week) for the duration of the 12 months. At least 3 of those sessions were to be completed under supervision at the study facility. A small amount of resistance exercise was recommended for joint health, although it was not required for the women to do.
Women in the diet + exercise group were given both dietary and aerobic exercise interventions to follow. Those in the control group were asked not to alter their typical diet and exercise habits for the duration of the study.
Adherence of the participants was measured through a variety of different methods including weight loss and self-weighing, food records and submission, and frequency of group session attendance. All in all, adherence to the diet and exercise protocols was shown to be excellent.
Fat intake dropped by 18% in the diet-alone group and by 20% for the diet + exercise group. As for behavior-change sessions, women in both the diet-alone and diet + exercise protocols attended 86% of the courses.
The exercise-alone group achieved about 80% of the set 225 minutes/week goal for aerobic cardio over the 12-month period. Women within the diet + exercise group were able to achieve about 85% of that weekly goal. In addition to this, both groups were shown to significantly increase their daily step counts compared to their prior activity levels
Concerning weight loss, women in the diet and exercise group and the diet-alone group experienced a significantly greater reduction in body weight compared to the exercise-alone group. Now, all groups were able to drop significant amounts of body weight, but the diet + exercise group was able to produce the largest drop in weight of about 10.8% on average (compared to 2.4% for exercise-alone subjects and 8.5% in diet-alone subjects). This isn’t too surprising when we think about it! More often than not, we cannot out-train a poor diet and this is a great example of that point.
So, what’s the answer here?
It’s clear that either form of behavior change can and will positively impact our quality of life, body composition, and weight management. As a prep and lifestyle coach, I always like to recommend focusing on both nutrition and exercise in conjunction with one another. Even though diet alone was able to produce results close to that of the diet + exercise group, implementing some activity will help to promote lean body mass retention and body composition improvements, which is exactly what we want!
It should be noted that not all clients have the same starting point, so this can vary greatly due a few factors like one’s level of experience, current knowledge about the diet and physical activity, and a multitude of lifestyle factors. Ultimately the goal is to mold these lifestyle changes to the client and their circumstances while educating them along the way.
These starting diet and lifestyle changes don’t have to be very complicated either. While the idea of making all of these changes at once may seem overwhelming and take some extra effort, setting up small and progressive changes to make weekly or biweekly can make the process more manageable and sustainable long term. Incorporating easy, daily habits such as getting protein in each meal, prepping your food, focusing on nutrient dense options, drinking enough water, getting some form of physical activity in each week, and much more.
There’s no formula for what approach will suit you best. Regardless of your starting point, it’s important to keep in mind that progress won’t be linear, and consistency and patience are always key. Small, positive changes will add up to substantial ones over time!
Foster-Schubert, K.E., Alfano, C.M., Duggan, C.R., et al. Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women. Obesity 2012. 20; 1628-1638.