The investigators are doing this study to learn more about how exercising at different times of the day (morning versus evening) affects body weight, sleep, eating patterns, and other factors.
Does the time of day that exercise is performed matter for weight loss? The objective of this proposal is to examine the impact of an equivalent dose of morning vs. evening aerobic exercise on change in body weight, energy intake (EI) and components of energy expenditure (EE) in adults with overweight or obesity. Nearly two-thirds of US adults who attempt to lose weight report engaging in exercise as a primary strategy for weight loss. However, weight loss from exercise alone is often substantially less than predicted based on calories burned in exercise. This is due to compensatory changes that occur in response to exercise initiation (e.g. increases in EI and decreases in non-exercise EE) that limit the energy deficit produced by exercise. Thus, strategies that reduce the compensatory response to exercise could enhance the weight loss efficacy of exercise. It is possible that exercise time of day could impact compensatory behaviors and weight loss, however, there have been no adequately powered, prospective, randomized studies comparing weight loss induced by morning vs. evening exercise. The study design is a 7-month supervised trial in which adults with overweight or obesity will be randomized to supervised aerobic exercise (2000 kcal/wk) performed either in the morning (AM-Ex, 6-10 AM) or the evening (PM-Ex, 3-7 PM). The supervised exercise phase will be followed by a 6-month maintenance phase during which participants continue to exercise at the target of 2000 kcal/week during the randomized AM or PM exercise windows, but exercise is no longer supervised. Aim 1 will compare the effects of AM-Ex vs. PM-Ex on changes in body weight and body composition with the primary study outcome of weight change at 7-months. Aim 2 will compare the effects of AM-Ex vs PM-Ex on changes in EI and appetite. Aim 3 will compare the effects of AM-Ex vs PM-Ex on changes in EE, non-exercise physical activity and sedentary time. Exploratory Aim 4 will compare the effects of AM-Ex vs PM-Ex on changes in meal and sleep timing. This approach is rigorous and innovative as the exercise energy deficit will be matched between groups, exercise will be prescribed based on EE, and free-living total daily energy expenditure (TDEE) and EI will be assessed objectively (using doubly-labeled water). This study is significant as it could provide important insight on how the timing of exercise impacts weight loss and compensatory behaviors.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
128
Morning Exercise will be instructed to perform 2000 kcal/wk of moderate to vigorous intensity aerobic exercise between the hours of 6 and 10 AM.
PM will be instructed to perform 2000 kcal/wk of moderate to vigorous intensity aerobic exercise between the hours of 3 and 7 PM.
University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
Weight Change (kg)
Body weight will be measured using a digital scale at baseline, 3.5, 7, and 13 months. The primary outcome will be change in weight from baseline to 7 months.
Time frame: Baseline (0) - 13 Months
Fat Mass
Fat mass will assessed using Dual-Energy X-Ray Absorptiometry (DXA) at baseline, 7, and 13 months.
Time frame: Baseline (0) - 13 Months
Lean Mass
Lean Mass will assessed using Dual-Energy X-Ray Absorptiometry (DXA) at baseline, 7, and 13 months.
Time frame: Baseline (0) - 13 Months
Energy Intake
Energy Intake (EI) will be assessed using the Doubly Labeled Water (DLW) Intake-Balance Method at baseline and 7
Time frame: Baseline (0) - 7 Months
Total Daily Energy Expenditure
Total Daily Energy Expenditure (TDEE) will be assessed using doubly labeled water (DLW) at baseline and 7 months
Time frame: Baseline (0) - 7 Months
Hunger and Satiety
Assessed with visual analog scale (0-100 range). Higher scores indicate higher levels of hunger (worse outcome) and satiety (better outcome). Measured at baseline, 3.5, 7, and 13 months
Time frame: Baseline (0) - 13 Months
Food Cravings
Assessed with 2 questionnaires at baseline, 3.5, 7, and 13 months: Food Cravings Questionnaire Trait-reduced (FCQ-T-r) and and FCI-II. Higher scores indicate greater cravings (worse outcome). Food Cravings Questionnaire-Trait-reduced (FCQ-T-r) is a Likert Scale using scoring associated with it Strongly disagree = 1, Disagree = 2, Neither agree nor disagree = 3, Agree= 4, Strongly agree = 5. The FCI-II is scored on a Likert scale from 1-5, with 1 being "Never," 5 being "Always/Almost every day." It has 4 subscales: High Fats, Sweets, Carbohydrates/Starches, and Fast-Food Fats. The score for each subscale is obtained by averaging the responses to the items listed for the subscale. The total score is obtained by averaging the responses to all 28 items.
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Time frame: Baseline (0) - 13 Months
Aspects of Eating Behavior
Measured via Three-Factor Eating Questionnaire at baseline, 3.5, 7, and 13 months. This assessment is designed to measure 3 dimensions of human eating behavior: cognitive restraint of eating (Factor I - 20 items), disinhibition (Factor II - 16 items), and hunger (Factor III - 15 items). The minimum score for factors I-II-III is therefore 0-0-0, and maximum possible score is 20-16-15. Part I includes items 1-36 and are rated either 1-True or 0-False. Part II includes items 37-51 and is rated on a 4-point scale with the exception of item 50, which is rated on a 6-point scale.
Time frame: Baseline (0) - 13 Months
Non-Exercise Physical Activity (NEPA)
NEPA will be measured with the ActivPAL device at baseline, 3.5, 7, and 13 months
Time frame: Baseline (0) - 13 Months
Sedentary Time
Sedentary Time will be measured with the ActivPAL device at baseline, 3.5, 7, and 13 months
Time frame: Baseline (0) - 13 Months