Background: Visceral adiposity is an essential component of metabolic syndrome. Reduction of excessive visceral fat prevents metabolic syndrome and improves atherosclerotic diseases. This study aimed to identify dietary patterns and physical exercise during the training-education period that predict visceral adiposity regain during the follow-up period. Methods: One hundred one moderately obese Japanese women, 23 to 67 years of age, participated in 0- to 4-month training-education and 12-month follow-up periods. Dietary patterns of food groups during training-education were analyzed by principal components analysis, and 3 major dietary patterns were derived. The change in visceral fat over the follow-up, adjusted for 4-rnonth visceral fat area (VFA) and 4- to 16-month body mass index change, was analyzed using stepwise multiple linear regression. Results: VFA and body weight decreased during training-education (P < 0.001) and were maintained during follow-up. One major dietary pattern (of 3) (P = 0.030) and standard deviations of daily exercise duration (P = 0.012) during training-education predicted VFA regain during follow-up. This regain correlated negatively with combinations of bread, milk and dairy products, fruits, seeds and nuts, and mushrooms, but positively with combinations of rice, pickles, miso, alcohol, and meat. The large standard deviation of daily exercise duration during training-education showed greater VFA regain during follow-up than did the smaller standard deviation (P = 0.023), but body mass index did not show a similar trend. Conclusion: Our results revealed that daily exercise fluctuations and dietary patterns were useful predictors of visceral fat regain.