Results from the network meta-analyses confirmed these findings .
Conclusions Moderate- quality evidence from the present network meta- analysis suggests that D + E can be highly recommended for long-term obesity management .
Furthermore , the evidence suggests a moderate superiority of D over E with respect to anthropometric outcomes .
Background The aim of this meta- analysis was to compare the long-term efficacy of diet plus exercise ( D + E ) vs. diet ( D ) , D + E vs. exercise ( E ) and D vs. E on anthropometric outcomes and cardiovascular risk factors in overweight and obese participants .
A worksite program for overweight middle-aged men achieves lesser weight loss with exercise than with dietary change.
OBJECTIVE To compare changes in total and regional body composition using dual energy X-ray absorptiometry ( DEXA ) after subjects lost weight through change in diet or exercise .  DESIGN A 12-month , r and omized , controlled study of two weight-loss interventions -low-fat diet ad libitum or moderate , unsupervised exercise-in  free-living , middle-aged men . Compliance was determined at monthly measurement sessions through food records and activity logs ; DEXA scans were performed every 3 months . SUBJECTS/ SETTING Fifty-eight overweight men ( mean body mass index = 29.0 + /- 2.6 ; mean age = 43.4 + /- 5.7 years ) recruited from a national corporation were assigned r and omly to diet , exercise , or control groups . INTERVENTIONS One group reduced dietary fat to 26.4 % of energy intake but kept activity unchanged ; another group self-selected aerobic exercise ( three sessions per week at 65 % to 75 % maximum heart rate ) but kept diet unchanged . A control group maintained weight . MAIN OUTCOME MEASURES At 12 months , measurements of weight , total and regional fat mass and lean mass , energy intake , and percentage dietary fat ; physical activity indexes . STATISTICAL ANALYSES Results were analyzed using paired t tests and analysis of variance . RESULTS Mean weight loss was 6.4 + /- 3.3 kg in dieters and 2.6 + /- 3.0 kg in exercisers ; control subjects maintained weight . DEXA scans revealed that 40 % of dieters ' weight loss was lean tissue ; more than 80 % of weight lost by exercisers was fat . Exercisers maintained limb lean tissue and lost fat mass . CONCLUSIONS Greater total weight and lean tissue loss occurred when subjects lost weight through a low-fat diet consumed ad libitum than when subjects participated in unsupervised aerobic exercise . Use of DEXA enabled identification of progressive total and regional changes in fat and lean tissue
Results from the network meta-analyses confirmed these findings .
Conclusions Moderate- quality evidence from the present network meta- analysis suggests that D + E can be highly recommended for long-term obesity management .
Furthermore , the evidence suggests a moderate superiority of D over E with respect to anthropometric outcomes .
Background The aim of this meta- analysis was to compare the long-term efficacy of diet plus exercise ( D + E ) vs. diet ( D ) , D + E vs. exercise ( E ) and D vs. E on anthropometric outcomes and cardiovascular risk factors in overweight and obese participants .