Points-based physical activity: a novel approach to facilitate changes in body composition in inactive women with overweight and obesity

Adrian Holliday, Alice Burgin, Elyzabeth Vargas Fernandez, Sally A. M. Fenton, Frank Thielecke, Andrew K. Blannin

Physical activity (PA) interventions for the promotion of weight-management may benefit from increased choice and flexibility to overcome commonly-perceived barriers to PA. The aim of this study was to investigate the effects of a novel "points-based" approach to PA on body composition in inactive women, who are overweight or obese. Seventy-six overweight or obese, inactive women were randomly allocated to one of three conditions: 'Points-based' PA (PBPA; 30 "PA points"•week- 1), Structured exercise (StructEx; 150 min moderate-intensity exercise•week- 1) or control (CONT; continue habitual inactive lifestyle) for a 24-week intervention. PA points for activities were adapted from MET values, and 30 points was equivalent to 150 min of brisk walking. Measures of body composition (dual-energy x-ray absorptiometry) and anthropometry were obtained at weeks 0, 4, 12 and 24. Self-report activities were recorded weekly, with objective measures of PA (tri-axial accelerometry) and self-report measures of food intake obtained at weeks 0 and 24. Fifty-eight women completed the study and provided data for primary outcomes. Of these, n = 41 and n = 19 provided data for food intake and objectively assessed PA. Mixed-design ANOVAs demonstrated that those in PBPA achieved a significant weight-loss at 24 weeks of - 3.3 ± 5.9 kg (- 3.4 ± 7.1%, p = 0.004). Waist circumference was reduced in PBPA at 24 weeks (- 2.8 ± 4.6 cm), compared with CONT (+ 2.1 ± 6.6 cm, p = 0.024). There was a trend for greater reductions in fat mass for those in PBPA vs. CONT (- 2.3 ± 4.6 kg vs. + 0.1 ± 2.0 kg, p = 0.075). Android fat was reduced in PBPA at both 12 weeks (- 6.1 ± 12.6%, p = 0.005) and 24 weeks (- 10.1 ± 18.4%, p = 0.005), while there was a trend for greater reductions in visceral adipose tissue in PBPA (- 5.8 ± 26.0%) vs. CONT at 24 weeks (+ 7.8 ± 18.3%, p = 0.053). Body composition, body weight and waist circumference were unchanged in StructEx. There were trends for increases in light-activity and reductions in sedentary time in PBPA. There was a trend for a reduction in daily energy intake of - 445 ± 564 kcal (p = 0.074), and a significant reduction in daily fat intake (p = 0.042) in PBPA. A "points-based" approach to physical activity appears to be an effective strategy for inducing modest reductions in body weight and body fat in inactive women with overweight and obesity. NCT02020239 . Registered 12th December 2013.