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Dietary Approaches and Exercise in the Management of Overweight and Obesity

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Obesity".

Deadline for manuscript submissions: 15 June 2025 | Viewed by 11075

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Prof. Dr. Clemens Drenowatz

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Guest Editor

Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria
Interests: sports nutrition; physical fitness; body composition; motor competence; physical activity; weight management; exercise
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Prof. Dr. Klaus Greier

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Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
Interests: diet; exercise science; physical fitness; motor learning; health promotion; physical education; strength and conditioning in youth
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Special Issue Information

Dear Colleagues,

The benefits of exercise and healthy dietary approaches on general health and body composition are well documented. Nevertheless, efforts to counter the global obesity epidemic have been of limited success, and policies implemented during the COVID-19 pandemic may have further contributed to poor dietary choices and insufficient exercise in individuals. Given the interaction between diet and exercise in the regulation of energy balance, both behaviors need to be considered when developing intervention strategies targeting excess body weight. For example, the potential benefits of a particular exercise intervention may be overridden if increases in energy expenditure lead to unhealthy food choices or an increase in sedentary time. Similarly, dietary interventions such as caloric restriction may result in compensatory reductions in exercise or physical activity.

Therefore, the goal of this Special Issue is to enhance the understanding of the contribution of exercise and diet regarding the regulation of body weight, with a special emphasis on the interaction and integration of both components. Reviews and original research articles, including observational and intervention studies, are both welcomed.

You may choose our Joint Special Issue in Dietetics

Prof. Dr. Clemens Drenowatz
Prof. Dr. Klaus Greier
Guest Editors

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Keywords

exercise
diet
physical activity
body weight
overweight
obesity
energy balance
weight management
health promotion
lifestyle
intervention

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Published Papers (6 papers)

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Research

17 pages, 1387 KiB

Open AccessArticle

Effects of a Hypocaloric Diet Plus Resistance Training with and Without Amino Acids in Older Participants with Dynapenic Obesity: A Randomized Clinical Trial

by Valentina Muollo, Andrea P. Rossi, Chiara Milanese, Valentina Cavedon, Federico Schena, Anna Giani, Silvia Urbani, Gloria Mazzali, Mauro Zamboni and Elena Zoico

Nutrients 2025, 17(3), 418; https://doi.org/10.3390/nu17030418 - 23 Jan 2025

Viewed by 1323

Abstract

Background/Objectives: Exercise and nutrition may be useful strategies in dynapenic and sarcopenic obesity management, but the identification of treatment modalities aimed at improving this condition is still lacking. We compared the effect of a five-month hypocaloric diet plus resistance training (RT) with and without essential amino acids (EAAs) on body composition, physical performance, and muscle strength among older adults with dynapenic obesity (DO). Methods: Older individuals (n = 48) with DO [(BMI ≥ 30 kg/m² and/or high waist circumference and low handgrip strength (HGS)] were randomized into two double-blind groups (RT without EAAs vs. RT+EAAs). All participants followed a hypocaloric diet (1 g of proteins/kg spread over three meals) and RT for five months. Pre- and post-intervention assessments included the body composition (DXA), Short Physical Performance Battery (SPPB), HGS, one-repetition maximum (1-RM), and maximal isometric torque with an isokinetic dynamometer. Results: Both groups reduced body mass (RT: −4.66 kg; RT+EAAs: −4.02 kg), waist circumference (RT: −4.66 cm; RT+EAAs: −2.2 cm), total fat mass (RT: −3.81 kg; RT+EAAs: −3.72 kg), and compartmental fat mass with no between-group differences. Both groups improved 1-RM strength (33–47%), isometric torque for body mass (RT: 14.5%; RT+EAAs: 10.6%), and functional performance (chair stand (RT: −3.24 s; RT+EAAs: −1.5 s) and HGS (RT: −2.7 kg; RT+EAAs: 2.9 kg)) with no between-group differences. Conclusions: A moderate hypocaloric diet combined with RT improves body composition and physical function in DO participants, but EAA supplementation did not provide additional benefits. Full article

(This article belongs to the Special Issue Dietary Approaches and Exercise in the Management of Overweight and Obesity)

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19 pages, 3294 KiB

Open AccessArticle

Development and Pragmatic Randomized Controlled Trial of Healthy Ketogenic Diet Versus Energy-Restricted Diet on Weight Loss in Adults with Obesity

by Su Lin Lim, Melissa Tay, Siew Min Ang, Shu Ning Wai, Kai Wen Ong, Wen Joo Neo, Qai Ven Yap, Yiong Huak Chan and Chin Meng Khoo

Nutrients 2024, 16(24), 4380; https://doi.org/10.3390/nu16244380 - 19 Dec 2024

Viewed by 2355

Abstract

Introduction: The ketogenic diet (KD) is widely used for weight management by reducing appetite, enhancing fat oxidation, and facilitating weight loss. However, the high content of total and saturated fats in a conventional KD may elevate low-density lipoprotein (LDL)-cholesterol levels, a known risk factor for cardiovascular diseases, highlighting the need for healthier alternatives. This study aimed to investigate the effect of a newly developed Healthy Ketogenic Diet (HKD) versus an Energy-Restricted Diet (ERD) on weight loss and metabolic outcomes among adults with obesity. Methods: Multi-ethnic Asian adults (n = 80) with body mass index ≥ 27.5 kg/m² were randomized either to HKD (n = 41) or ERD (n = 39) for 6 months. Both groups followed an energy-restricted healthy diet, emphasizing on reducing saturated and trans fats. The HKD group additionally limited net carbohydrate intake to no more than 50 g per day. Dietary adherence was supported via the Nutritionist Buddy app with dietitian coaching. The primary outcome was weight change from baseline at 6 months. Secondary outcomes included weight change at 3 months and 1 year, along with changes in metabolic profiles. Data were analyzed using linear regression with an intention-to-treat approach. Results: The HKD group achieved significantly greater mean weight loss at 6 months than the ERD group (−7.8 ± 5.2 kg vs. −4.2 ± 5.6 kg, p = 0.01). The mean weight loss percentage at 6 months was 9.3 ± 5.9% and 4.9 ± 5.8% for the HKD and ERD groups, respectively (p = 0.004). Improvements in metabolic profiles were also significantly better in the HKD group [glycated hemoglobin (−0.3 ± 0.3% vs. −0.1 ± 0.2%, p = 0.008), systolic blood pressure (−7.7 ± 8.9 mmHg vs. −2.6 ± 12.2 mmHg, p = 0.005), and aspartate transaminase (−7.6 ± 15.5 IU/L vs. 0.6 ± 11.5 IU/L, p = 0.01)], with no increase in LDL-cholesterol (−0.12 ± 0.60 mmol/L vs. −0.04 ± 0.56 mmol/L, p = 0.97) observed in either group. Conclusions: The HKD was more effective than the ERD in promoting weight loss and improving cardiometabolic outcomes without elevation in LDL-cholesterol. It can be recommended for therapeutic intervention in patients with obesity. Full article

(This article belongs to the Special Issue Dietary Approaches and Exercise in the Management of Overweight and Obesity)

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12 pages, 931 KiB

Open AccessArticle

Association of Physical Fitness and Diet with Body Weight in Austrian Adolescents

by Clemens Drenowatz, Gerson Ferrari, Tena Matolic, Maria do Carmo Greier and Klaus Greier

Nutrients 2024, 16(23), 4209; https://doi.org/10.3390/nu16234209 - 5 Dec 2024

Viewed by 1151

Abstract

Background/Objectives: Physical fitness and diet along with body weight are key determinants of health. Excess body weight, poor dietary choices, and low physical fitness, however, are becoming increasingly prevalent in adolescents. In order to develop adequate intervention strategies, additional research on potential interaction effects of these entities is needed. Therefore, this study examined the combined association of physical fitness and diet with body weight in Austrian adolescents. Methods: A total of 164 (56% male) adolescents between 11 and 14 years of age completed the German Motor Test, which consists of eight items that assess cardiorespiratory endurance, muscular endurance and power, speed and agility, flexibility, and balance, along with body weight and height measurements. Additionally, participants completed a standardized food frequency questionnaire. Results: Spearman correlation analyses showed an inverse association between physical fitness and processed foods consumption (rho = −0.25, p < 0.01), while sweet consumption was positively associated with physical fitness (rho = 0.17, p = 0.03). No significant interaction effects between diet and physical fitness on body weight were observed. However, both higher physical fitness and greater sweet consumption were associated with lower body weight (p < 0.01). Conclusions: The present study emphasizes the independent and combined interactions of key correlates of health. It also suggests that high fitness may offset detrimental effects of poor dietary choices. In order to address potential health risks early in life and facilitate future health and well-being, it is important to monitor and control physical fitness, diet, and body weight during adolescence. Full article

(This article belongs to the Special Issue Dietary Approaches and Exercise in the Management of Overweight and Obesity)

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12 pages, 884 KiB

Open AccessArticle

How Parents Perceive Their Children’s Body Weight: Insights from a Sample of Schoolchildren from Vienna, Austria

by Paula Moliterno, Stefanie Franceschini, Victoria Donhauser and Kurt Widhalm

Nutrients 2024, 16(23), 4094; https://doi.org/10.3390/nu16234094 - 27 Nov 2024

Viewed by 868

Abstract

Background/Objectives: Effective school-based childhood obesity prevention strategies should include parental involvement. In the EDDY (“Effect of sports and diet training to prevent obesity and secondary diseases and to influence young children’s lifestyle”) program, we aimed to describe parental perceptions of children’s body weight in a sample of schoolchildren from Vienna, Austria. Methods: A cross-sectional analysis, including 128 children from the third grade in three Viennese primary schools, was conducted. A self-administered questionnaire was used to collect sociodemographic data and parentally reported weight and height. Parental perception of the child’s weight status was assessed using the question, “In your opinion, you would describe your child as being”. Children’s nutritional status was assessed through measurements. Results: Almost 15% of the children had obesity. The median SDS-BMI was 0.39 (−1.00–2.83) and 0.21 (−1.39–2.47) for girls and boys, respectively. More mothers of girls had overweight/obesity compared to mothers of boys (59.2% vs. 41.1%, p = 0.05). Almost half (48.4%) of the parents underestimated their child’s weight. The percentage of mothers with overweight/obesity was higher in the group that underestimated their child’s weight (59.3% vs. 37.7%, p = 0.018). Parents perceived 59.4% of the children as having a normal weight, while BMI classification indicated that 71.9% had a normal weight. Misperception was higher among children who were overweight (75%) and obese (89.5%). Parents of children with a normal weight were less likely to underestimate [Adjusted OR = 0.16 (95% CI: 0.050–0.49)]. Conclusions: The prevalence of misperception was high, especially for children with overweight or obesity. These findings highlight the need to incorporate children’s adequate weight recognition into the EDDY program as part of parents’ content. Full article

(This article belongs to the Special Issue Dietary Approaches and Exercise in the Management of Overweight and Obesity)

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17 pages, 672 KiB

Open AccessArticle

An Interdisciplinary Intervention Based on Prescription of Physical Activity, Diet, and Positive Mental Health to Promote Healthy Lifestyle in Patients with Obesity: A Randomized Control Trial

by Marta Prats-Arimon, Montserrat Puig-Llobet, Oriol Barceló-Peiró, Ivet Ribot-Domènech, Cristina Vilalta-Sererols, Bárbara Fontecha-Valero, Mati Heras-Ojeda, Zaida Agüera, Teresa Lluch-Canut, Antonio Moreno-Poyato and Mª Carmen Moreno-Arroyo

Nutrients 2024, 16(16), 2776; https://doi.org/10.3390/nu16162776 - 20 Aug 2024

Cited by 2 | Viewed by 2803

Abstract

This study used a multimodal approach to address the issue of obesity among individuals with a Body Mass Index (BMI) between 30 and 40 residing in a rural region of north-east Spain. A pretest–posttest model was employed in a clinical trial design, comparing an intervention group with a control group. The intervention, which lasted for a period of nine months, was based on three main strategies: the prescription of physical activity, the promotion of healthy nutritional habits, and the management of emotional wellbeing through Positive Mental Health (PMH). A variety of assessment tools were employed, including the CLASS-AF scale and a stress test for physical activity levels; advanced anthropometry and blood analysis for metabolic and body composition variables; a Mediterranean diet adherence questionnaire for nutritional habits; and a PMH multifactorial questionnaire for the assessment of emotional management. The results revealed significant improvements in the level of physical activity and adherence to the Mediterranean diet in favor of the intervention group, where 89.4% (n = 17) of the participants went from being not very active/sedentary to being active. Also, adherence to the Mediterranean diet improved with a mean increase of 2.2 points on the scale [mean: 10.5 (CI 95%: 9.90, 11.09)]. In addition, significant reductions in body fat [mean: −2.50 kg (CI 95%: −3.56, −1.44)] and free fat mass [mean: −3.38% (IC 95%: −4.34, −2.41), along with decreased cholesterol levels (196 vs. 182 mg/dL), were observed, suggesting a decrease in cardiovascular and metabolic risk. In conclusion, this multimodal intervention was effective at improving the lifestyle of people with obesity and reducing their cardiovascular and metabolic risk. The combination of interventions focused on physical activity, diet, Positive Mental Health, and metabolic changes and were perceived as a comprehensive and complementary strategy in obesity care. These findings highlight the importance of approaching this condition from multiple perspectives to ensure optimal health outcomes. Full article

(This article belongs to the Special Issue Dietary Approaches and Exercise in the Management of Overweight and Obesity)

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12 pages, 424 KiB

Open AccessArticle

Meal Duration and Obesity-Related Indicators among Adolescents: Insights from the EHDLA Study

by Mayra Fernanda Martínez-López and José Francisco López-Gil

Nutrients 2024, 16(16), 2769; https://doi.org/10.3390/nu16162769 - 20 Aug 2024

Cited by 1 | Viewed by 1777

Abstract

Purpose: This paper aims to examine the association between meal duration and obesity indicators among Spanish adolescents. Methods: We conducted a cross-sectional analysis using data from the Eating Healthy and Daily Life Activities (EHDLA) project involving 755 adolescents aged 12 to 17 years (54.8% girls) from three secondary schools in the Valle de Ricote Region of Murcia, Spain. To evaluate overall meal duration, participants were asked how long (on average) breakfast, morning snacks, lunch, afternoon snacks, and dinner typically last. Subsequently, global meal duration was measured, and the participants were categorized into tertiles. Obesity-related indicators, including body mass index (BMI) z score, waist circumference (WC), and skinfold thickness, were assessed. The analyses were adjusted for potential confounders such as sex, age, socioeconomic status, physical activity, sedentary behavior, diet quality, and energy intake. Results: Concerning meal duration status, adolescents with long meal durations had the lowest estimated marginal means of BMI z score, WC, and body fat percentage (using the sum of triceps and calf skinfolds). However, significant differences between adolescents with a long meal duration and those with a short meal duration were observed only for BMI z score (p = 0.008), and WC (p = 0.020). Furthermore, significant differences in BMI z score (p = 0.017) between adolescents with a long meal duration and those with a moderate meal duration were identified. Conclusions: These findings underscore the importance of promoting slower eating habits as part of obesity prevention strategies. Future studies should explore the causality of this association and its potential for behavioral interventions. Full article

(This article belongs to the Special Issue Dietary Approaches and Exercise in the Management of Overweight and Obesity)

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