Fontana · American journal of physiology. Endocrinology and metabolism 2007 · three-arm randomized controlled trial · n=48

Calorie restriction or exercise: effects on coronary heart disease risk factors. A randomized, controlled trial.

Level 2 - randomized trial

Individual randomized controlled trial

PubMed 17389710 · doi:10.1152/ajpendo.00102.2007 · record verified 2026-08-26

What was done

A 1-year randomized controlled trial evaluated 48 nonobese adults (aged 57 ± 3 years, BMI 27.3 ± 2.0 kg/m²; 29 women, 17 men reported) randomly assigned to three groups: a 20% calorie restriction diet (CR, n = 18), a 20% increase in energy expenditure via daily exercise with no intake increase (EX, n = 18), or healthy lifestyle guidelines (HL, n = 10). Measurements included total body fat by DEXA, lipoproteins, blood pressure, HOMA-IR, C-reactive protein (CRP), and estimated 10-year CHD risk score.

What was found

Body fat decreased by 6.3 ± 3.8 kg (24.9% baseline fat mass) in the CR group, 5.6 ± 4.4 kg (22.3%) in the EX group, and 0.4 ± 1.7 kg (1.2%) in the HL group. These reductions were accompanied by similar decreases in major CHD risk factors across both active intervention groups, including plasma LDL-cholesterol, total cholesterol/HDL ratio, HOMA-IR index, and CRP concentrations.

Why it matters

This study shows that achieving a negative energy balance through either calorie restriction or exercise produces comparable improvements in key cardiovascular risk factors in nonobese individuals.

Limits

The sample size was small (48 participants across three arms), limiting power to detect subtle differences between active interventions. The study evaluated surrogate metabolic markers and estimated risk rather than clinical cardiovascular events, and the abstract does not report specific numerical values for the individual lipid, blood pressure, or glycemic metrics.

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