***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background It has been suggested that exercise training results in compensatory mechanisms that attenuate weight loss . However , this has only been examined with large doses of exercise . The goal of this analysis was to examine actual weight loss compared to predicted weight loss ( compensation ) across different doses of exercise in a controlled trial of sedentary , overweight or obese postmenopausal women ( n = 411 ) . Methodology /Principal Findings Participants were r and omized to a non-exercise control ( n = 94 ) or 1 of 3 exercise groups ; exercise energy expenditure of 4 ( n = 139 ) , 8 ( n = 85 ) , or 12 ( n = 93 ) kcal/kg/week ( KKW ) . Training intensity was set at the heart rate associated with 50 % of each woman 's peak VO2 and the intervention period was 6 months . All exercise was supervised . The main outcomes were actual weight loss , predicted weight loss ( exercise energy expenditure/ 7700 kcal per kg ) , compensation ( actual minus predicted weight loss ) and waist circumference .  The study sample had a mean ( SD ) age 57.2 ( 6.3 ) years , BMI of 31.7 ( 3.8 ) kg/m2 , and was 63.5 % Caucasian . The adherence to the intervention was > 99 % in all exercise groups . The mean ( 95 % CI ) weight loss in the 4 , 8 and 12 KKW groups was −1.4 ( −2.0 , −0.8 ) , −2.1 ( −2.9 , −1.4 ) and −1.5 ( −2.2 , −0.8 ) kg , respectively . In the 4 and 8 KKW groups the actual weight loss closely matched the predicted weight loss of −1.0 and −2.0 kg , respectively , result ing in no significant compensation . In the 12 KKW group the actual weight loss was less than the predicted weight loss ( −2.7 kg ) result ing in 1.2 ( 0.5 , 1.9 ) kg of compensation ( P<0.05 compared to 4 and 8 KKW groups ) . All exercise groups had a significant reduction in waist circumference which was independent of changes in weight . Conclusion In this study of previously sedentary , overweight or obese , postmenopausal women we observed no difference in the actual and predicted weight loss with 4 and 8 KKW of exercise ( 72 and 136 minutes respectively ) , while the 12 KKW ( 194 minutes ) produced only about half of the predicted weight loss . However , all exercise groups had a significant reduction in waist circumference which was independent of changes in weight . Trial Registration Clinical Trials.gov NCT CONTEXT Obesity in the United States has increased dramatically during the past several decades . There is debate about optimum calorie balance for prevention of weight gain , and proponents of some low-carbohydrate diet regimens have suggested that the increasing obesity may be attributed , in part , to low-fat , high-carbohydrate diets . OBJECTIVES To report data on body weight in a long-term , low-fat diet trial for which the primary end points were breast and colorectal cancer and to examine the relationships between weight changes and changes in dietary components . DESIGN , SETTING , AND PARTICIPANTS R and omized intervention trial of 48,835 postmenopausal women in the United States who were of diverse background s and ethnicities and participated in the Women 's Health Initiative Dietary Modification Trial ; 40 % ( 19,541 ) were r and omized to the intervention and 60 % ( 29,294 ) to a control group . Study enrollment was between 1993 and 1998 , and this analysis includes a mean follow-up of 7.5 years ( through August 31 , 2004 ) . INTERVENTIONS The intervention included group and individual sessions to promote a decrease in fat intake and increases in vegetable , fruit , and grain consumption and did not include weight loss or caloric restriction goals . The control group received diet-related education material s. MAIN OUTCOME MEASURE Change in body weight from baseline to follow-up . RESULTS Women in the intervention group lost weight in the first year ( mean of 2.2 kg , P<.001 ) and maintained lower weight than control women during an average 7.5 years of follow-up ( difference , 1.9 kg , P<.001 at 1 year and 0.4 kg , P = .01 at 7.5 years ) . No tendency toward weight gain was observed in intervention group women overall or when stratified by age , ethnicity , or body mass index . Weight loss was greatest among women in either group who decreased their percentage of energy from fat . A similar but lesser trend was observed with increases in vegetable and fruit servings , and a nonsignificant trend toward weight loss occurred with increasing intake of fiber . CONCLUSION A low-fat eating pattern does not result in weight gain  in postmenopausal women . Clinical Trial Registration Clinical Trials.gov , NCT00000611 Objective : The aim of this study was to investigate the effect of a 12-month moderate-to-vigorous exercise program combining aerobic and muscle strength training on body composition among sedentary , postmenopausal women . Methods : A r and omized controlled trial was conducted . A total of 189 sedentary postmenopausal women ( age 50 - 69 y , body mass index 22 - 40 kg/m2 ) were r and omly assigned to an exercise ( n = 96 ) or a control group ( n = 93 ) . Study parameters measured at baseline , 4 months , and 12 months were as follows : body weight and body height ( body mass index ) , waist and hip circumference ( body fat distribution ) , and dual-energy x-ray absorptiometry ( total body fat and lean mass ) . Differences in changes in study parameters between exercise and control group were examined with generalized estimating equations analysis . Results : The exercise program did not result in significant effects on weight , body mass index , and hip circumference . The exercise group experienced a statistically significant greater loss in total body fat , both absolute ( −0.33 kg ) ( borderline ) as in a percentage ( −0.43 % ) compared with the control group . In addition , lean mass increased significantly ( + 0.31 kg ) , whereas waist circumference ( −0.57 cm ) decreased significantly compared with the control group . Conclusions : We conclude that a 12-month exercise program combining aerobic and muscle strength training did not affect weight but positively influenced body composition of postmenopausal women . Affecting body fat distribution and waist circumference may have important health implication s because it is an independent risk factor in obese but also in nonobese people . Therefore , this study gives further credence to efforts of public health and general practitioners aim ing to increase physical activity levels of postmenopausal women Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE To determine what effect diet-induced approximately 12 kg weight loss in combination with exercise training has on body composition and resting energy expenditure ( REE ) in premenopausal African-American ( AA ) and European-American ( EA ) women . METHODS AND PROCEDURES This study was a longitudinal , r and omized weight loss clinical intervention , with either aerobic ( AT ) , resistance ( RT ) , or no exercise training ( NT ) .  Forty-eight AA and forty-six EA premenopausal overweight ( BMI between 27 and 30 ) women underwent weight loss to a BMI < 25 .  Body composition ( densitometry ) , REE ( indirect calorimetry ) , maximal oxygen uptake ( VO2max ) , and muscular strength ( isometric elbow flexion ) were evaluated when subjects were in energy balance . RESULTS AA women lost less fat-free mass ( FFM , P < or=0.05 ) ( 47.0+/-4.6 to 46.9+/-5.0 kg ) than EA women ( 46.4+/-4.9 to 45.2+/-4.6 kg ) . Regardless of race , RT maintained FFM ( P < or=0.05 ) following weight loss ( 46.9+/-5.2 to 47.2+/-5.0 kg ) whereas AT ( 45.4+/-4.2 to 44.4+/-4.1 kg ) and NT ( 47.9+/-4.7 to 46.4+/-5.1 kg ) decreased FFM ( P < or=0.05 ) . Both AT and NT decreased in REE with weight loss but RT did not . Significant time by group interactions ( all P < or=0.05 ) for strength indicated that RT maintained strength and AT did not . DISCUSSION AA women lost less FFM than EA women during equivalent weight losses . However , following weight loss in both AA and EA , RT conserved FFM , REE , and strength fitness when compared to women who AT or did not train Background Aging and obesity increase the risk for mobility limitations in women . Although trunk muscle composition is important to physical function , the implication of ectopic fat in the trunk muscles with respect to physical fitness and its potential for modification by lifestyle changes is unknown . Methods The effects of a 6-month period of either weight loss ( WL ) alone or of aerobic exercise ( AEX ) plus WL ( AEX+WL ) , on trunk body composition , as measured by dual-energy X-ray absorptiometry ( DXA ) ( to measure trunk fat and lean mass ) and computed tomography ( CT ) ( to measure the erector spinae , psoas , lateral abdominal , rectus abdominis muscle , and intramuscular fat , and the intramuscular adipose tissue [ IMAT ] areas ) was determined in 65 overweight and obese postmenopausal women ( aged 50–76 years ) . Results The area of the erector spinae , psoas , and rectus abdominis muscles declined with age in the women ( P<0.05 ) . Both the spinal and abdominal muscle areas were related to the maximal oxygen uptake ( VO2max ) ( P<0.05 ) . Body weight decreased by 8 % after both AEX+WL and WL ( P<0.001 ) . The VO2max increased by 11 % after AEX+WL ( P<0.001 ) but did not change with WL alone ( group effect , P<0.001 ) . The DXA-measured trunk fat mass decreased by 16 % after AEX+WL ( P<0.001 ) and by 12 % after WL ( P<0.001 ) . When both groups were combined , the IMAT decreased in all four muscle groups − by 6 % in the erector spinae ( P<0.01 ) , by 9 % in the psoas ( P<0.01 ) , by 11 % in the lateral abdominals ( P<0.001 ) , and by 6 % in the rectus abdominis ( P<0.05 ) . The loss of fat mass was related to the loss of IMAT of the erector spinae and the lateral abdominals . Conclusions A lifestyle modification of diet-induced WL alone , or with AEX training , results in a significant reduction of the fat infiltration in the abdominal and spinal muscles of the trunk region . Our finding that losses of total body fat predict a reduction in the IMAT of the trunk supports the idea that WL reduces fat depots throughout the body Lifestyle interventions for weight loss are the cornerstone of obesity therapy , yet their optimal design is debated . This is particularly true for postmenopausal women ; a population with a high prevalence of obesity yet toward whom fewer studies are targeted . We conducted a year-long , 4-arm r and omized trial among 439 overweight-to-obese postmenopausal sedentary women to determine the effects of a calorie-reduced , low-fat diet ( D ) , a moderate-intensity , facility-based aerobic exercise program ( E ) , or the combination of both interventions ( D+E ) , vs. a no-lifestyle-change control ( C ) on change in body weight and composition . The group-based dietary intervention had a weight-reduction goal of ≥10 % , and the exercise intervention consisted of a gradual escalation to 45-min aerobic exercise 5 day/week . Participants were predominantly non-Hispanic whites ( 85 % ) with a mean age of 58.0 ± 5.0 years , a mean BMI of 30.9 ± 4.0 kg/m(2 ) and an average of 47.8 ± 4.4 % body fat .  Baseline and 12-month weight and adiposity measures were obtained by staff blinded to participants ' intervention assignment . Three hundred and ninety nine women completed the trial ( 91 % retention ) . Using an intention-to-treat analysis , average weight loss at 12 months was -8.5 % for the D group ( P < 0.0001 vs. C ) , -2.4 % for the E group ( P = 0.03 vs. C ) , and -10.8 % for the D+E group ( P < 0.0001 vs. C ) , whereas the C group experienced a nonsignificant -0.8 % decrease . BMI , waist circumference , and % body fat were also similarly reduced . Among postmenopausal women , lifestyle-change involving diet , exercise , or both combined over 1 year improves body weight and adiposity , with the greatest change arising from the combined intervention Objectives To compare the effects of weight loss with and without exercise on 1 ) dietary prescription adherence and 2 ) non-structured activity in postmenopausal women . Design Long 
    Output:
    
Conclusions : Dietary interventions  reduced body weight and body composition profile parameters in peri- and postmenopausal women more than exercise alone .
The addition of exercise reinforced the effect of dietary interventions on changing body weight and composition