Article Text

Download PDFPDF
Effectiveness of a lifestyle weight-loss intervention targeting inactive former elite athletes: the Champ4Life randomised controlled trial
  1. Analiza M Silva1,
  2. Catarina L Nunes1,
  3. Filipe Jesus1,
  4. Ruben Francisco1,
  5. Catarina N Matias2,3,
  6. Miguel Cardoso1,
  7. Inês Santos1,2,4,
  8. Eliana V Carraça1,2,
  9. Graham Finlayson5,
  10. Marlene Nunes Silva1,2,
  11. Stephanie Dickinson6,
  12. David Allison6,
  13. Cláudia S Minderico1,
  14. Paulo Martins7,
  15. Luis B Sardinha1
  1. 1Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
  2. 2CIDEFES, Universidade Lusófona, Lisboa, Portugal
  3. 3Bioperformance & Nutrition Research Unit, Bettery, Lisboa, Portugal
  4. 4Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
  5. 5Appetite Control Energy Balance Research Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
  6. 6Indiana University Bloomington School of Public Health, Bloomington, Indiana, USA
  7. 7Laboratory of Sport Psychology, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
  1. Correspondence to Dr Analiza M Silva, Exercise and Health Laboratory, CIPER, Universidade de Lisboa Faculdade de Motricidade Humana, Cruz Quebrada 1499-002, Lisboa, Portugal; analiza{at}


Objectives Many athletes struggle in managing the end of their career, often gaining weight and adopting unhealthy lifestyles. Lifestyle programmes targeting former athletes who have gained substantial fat mass (FM) postsports career are lacking. We studied the effects of the Champ4Life programme on body composition and other health-related outcomes in former elite athletes with overweight or obesity.

Methods Ninety-four former athletes(42.4±7.3 y, 34.0% female) were recruited and randomly assigned to either an intervention group (IG; n=49) or a control group (CG; n=45). The IG attended 12 educational sessions addressing physical activity, weight management and nutrition. They also had a nutrition appointment aimed to prescribe a moderate caloric deficit(~300–500 kcal/day). Dual-energy X-ray absorptiometry was used to assess body composition. The Short-Form Health Survey-36 questionnaire was used to measure general health-related quality of life. Blood samples were collected to assess cardiometabolic health parameters.

Results At 12 months, the IG lost more weight (estimated difference (ED)=−5.3 kg; −6.9 to −3.8), total FM (ED=−4.1 kg; −5.4 to −2.8) and abdominal FM (ED=−0.49 kg; −0.64 to −0.33) than did the CG (p’s<0.001). Cardiometabolic health markers also improved significantly (p<0.05) more in the IG at 12 months (insulin (ED=−4.9 μU/mL;−8.0 to −1.8); homoeostatic model assessment (ED=−1.2; −2.1 to −0.4); total cholesterol (ED=−21.8 mg/dL; -35.4 to −8.2); low-density lipoprotein (ED=18.2 mg/dL;−29.2 to −7.1)), as did quality-of-life dimensions (physical functioning (ED=11.7; 6.5 to 16.9); physical role (ED=17.6; 2.1 to 33.0); general health (ED=19.4; 11.4 to 27.4); vitality (ED=13.3; 5.3 to 21.3) and mental health (ED=12.3; 4.1 to 20.6)).

Conclusions The Champ4Life programme was effective in substantially reducing total and abdominal FM while preserving fat-free mass and improving health-related markers. These findings will enable evidence-based decisions when implementing lifestyle interventions targeting retired elite athletes.

Trial registeration number NCT03031951.

  • athletes
  • body composition
  • weight loss
  • quality of life
  • physical fitness

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. All data relevant to the study are included in the article or uploaded as supplementary information. For more information, please contact the corresponding author.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. All data relevant to the study are included in the article or uploaded as supplementary information. For more information, please contact the corresponding author.

View Full Text


  • Contributors The Champ4Life programme led by Primary Investigator AMS obtained funding for the research. All authors contributed to the design of the study. The first draft of this manuscript was produced by AMS and CLN. All authors have read and agreed to the published version of the manuscript.

  • Funding Financial support was provided by the Portuguese Institute of Sports and Youth and by the International Olympic Committee, under the Olympic Solidarity Promotion of the Olympic Values Unit (Sports Medicine and Protection of Clean Athletes Programme). The current work was also supported by national funding from the Portuguese Foundation for Science and Technology within the R&D units UIDB/00447/2020. CLN and RF were supported with a PhD scholarship from the Portuguese Foundation for Science and Technology (SFRH/BD/143725/2019 and 2020.05397.BD, respectively).

  • Disclaimer The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests In the last 36 months, DA has received personal payments or promises for same from: American Society for Nutrition; Alkermes; American Statistical Association; Big Sky Health; Biofortis; California Walnut Commission; Clark Hill PLC; Columbia University; Dynamic AQS; Fish &amp; Richardson, P.C.; Frontiers Publishing; Gelesis; Henry Stewart Talks; IKEA; Indiana University; Arnold Ventures (formerly the Laura and John Arnold Foundation); Johns Hopkins University; Kaleido Biosciences; Law Offices of Ronald Marron; MD Anderson Cancer Center; Medical College of Wisconsin; National Institutes of Health (NIH); Medpace; National Academies of Science; Sage Publishing; The Obesity Society; Sports Research; The Elements Agency; Tomasik, Kotin &amp; Kasserman; University of Alabama at Birmingham; University of Miami; Nestle; WW (formerly Weight Watchers International); Whistle Labs. Donations to a foundation have been made on his behalf by the Northarvest Bean Growers Association. DA was previously an unpaid member of the International Life Sciences Institute North America Board of Trustees. DA’s institution, Indiana University, and the Indiana University Foundation have received funds or donations to support his research or educational activities from: NIH; USDA; Soleno Therapeutics; American Egg Board; California Walnut Commission, Almond Board; Peanut Institute; Mondelez; National Cattlemen’s Beef Association; Eli Lilly and Co.; Reckitt Benckiser Group; Alliance for Potato Research and Education; American Federation for Aging Research; Dairy Management; Arnold Ventures; the Gordon and Betty Moore Foundation; the Alfred P. Sloan Foundation; and numerous other for-profit and non-profit organisations to support the work of the School of Public Health and the university more broadly.The remaining authors reported no conflicts of interest.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.