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Background  There is evidence showing the effectiveness of a hypocaloric diet and the increase in physical activity on weight loss. However, the combined role of these factors, not only on weight loss but also body composition, remains unclear. The purpose of this study was to investigate the effect of a hypocaloric diet on the body composition of obese adult women throughout different degrees of physical activity during a weight loss program.    Methods  One hundred and seventeen healthy female volunteers were randomly assigned to one of the experimental groups: a control group with a low-level prescription of physical activity (1–4 METs), moderate physical activity group that performed 10.000 steps walking (5–8 METs) and intense physical activity group that trained exercises by at least 70% of VO2max three times a week (> 8 METs). All subjects followed a hypocaloric diet designed with a reduction of 500 kcal/day. Nutritional counseling was provided throughout the study period to help ensure dietary adherence.    Results  We found no differences in body weight compared to moderate and intense physical activity (ßstand. = − 0.138 vs. ßstand. = − 0.139). Body fat was lower in women following an intense activity (ßstand. = − 0.436) than those with moderate exercise (ßstand. = − 0.231). The high-intense activity also increased muscle mass at the end of the intervention, standing out above the moderate activity (ßstand. = 0.182 vs. ßstand. = 0.008).    Conclusions  These findings indicate that a hypocaloric diet, without prescription of physical activity, is adequate to lose weight in the short term (12 weeks), but physical activity is vital to modify the body composition in women with obesity. Body fat was lower when women practiced a moderate exercise compared to hypocaloric diet only, but an intense physical activity was the most effective protocol to obtain a reduction of body fat and maintain muscle mass.    Trial registration  The study protocol complied with the Declaration of Helsinki for medical studies, it was approved by the bioethical committee of Córdoba University, in the Department of Health at the Regional Government of Andalusia (Act n°284, ref.4156) and retrospectively registered in clinicaltrials.gov ( NCT03833791 ). Registered 2 January 2019.

bmc women's health

Changes in body composition with a hypocaloric diet combined with sedentary, moderate and high-intense physical activity: a randomized controlled trial