Effects of caloric restriction with different doses of exercise on fat loss in people living with type 2 diabetes: A secondary analysis of the DOSE-EX randomized clinical trial
Bibliographic record
Abstract
• In people living with newly diagnosed type 2 diabetes mellitus and overweight/obesity, adding caloric restriction with—or without exercise reduced fat mass, and body weight, and improved overall body composition. • Adding exercise to caloric restriction reduced fat mass—and preserved fat-free mass dose-dependently. • Adding exercise to caloric restriction may augment the therapeutic effects of dietary weight loss treatments by facilitating a reduction in fat mass and preservation of fat-free mass as compared to caloric restriction alone. Fat loss mainly conveys the benefits of caloric restriction for people living with type 2 diabetes. The literature is equivocal regarding whether exercise facilitates fat loss during caloric restriction. This analysis aimed to assess the dose–response effects of exercise in combination with a caloric restriction on fat mass (FM) and FM percentage (FM%) in persons with diagnosed type 2 diabetes. In this secondary analysis of a 4-armed randomized trial, 82 persons living with type 2 diabetes were randomly allocated to the control group (CON) ( n = 21), diet control (DCON) (25% caloric restriction; n = 20), diet control and exercise 3 times per week (MED) (n = 20), or diet control and exercise 6 times per week (HED) ( n = 21) for 16 weeks. The primary analysis was the change in FM% points. Secondary analyses included fat-free mass and visceral adipose tissue (VAT) volume (cm 3 ). FM% decreased compared to CON by a mean difference of –3.5% (95% confidence interval (95%CI): –5.6% to –1.4%), –6.3% (95%CI: –8.4% to –4.1%), and –8.0% (95%CI: –10.2% to –5.8%) for DCON, MED, and HED, respectively. Compared to DCON, MED, and HED decreased FM% by –2.8% (95%CI: –4.9% to –0.7%) and –4.5% (95%CI: –6.6% to –2.4%), respectively. The difference in FM% between HED and MED was –1.8% (95%CI: –3.9% to 0.4%). DCON and MED decreased fat-free mass compared to CON, whereas HED preserved fat-free mass (–0.2%; 95%CI: –2.0% to 1.7%). Compared to CON, VAT volume decreased by –666.0 cm 3 (95%CI: –912.8 cm 3 to –385.1 cm 3 ), –1264.0 cm 3 (95%CI: –1679.6 cm 3 to –655.9 cm 3 ), and –1786.4 cm 3 (95%CI: –2264.6 cm 3 to –1321.2 cm 3 ) more for DCON, MED, and HED, respectively. HED decreased VAT volume more than DCON (–1120.4 cm 3 ; 95%CI: –1746.6 cm 3 to –639.4 cm 3 ) while the remaining comparisons did not reveal any differences. All interventions were superior in reducing FM% compared to standard care. Adding exercise to a caloric restriction was superior in reducing FM% compared to a caloric restriction alone.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".