OBJECTIVE: To study the effects of a comprehensive secondary prevention programme on weight loss and to identify determinants of weight change in patients with coronary artery disease (CAD).METHODS: We performed a secondary analysis focusing on the subgroup of overweight CAD patients (BMI ≥27 kg/m2) in the Randomised Evaluation of Secondary Prevention by Outpatient Nurse SpEcialists-2 (RESPONSE-2) multicentre randomised trial. We evaluated weight change from baseline to 12-month follow-up; multivariable logistic regression with backward elimination was used to identify determinants of weight change.RESULTS: Intervention patients (n=280) lost significantly more weight than control patients (n=257) (-2.4±7.1 kg vs -0.2±4.6 kg; p<0.001). Individual weight change varied widely, with weight gain (≥1.0 kg) occurring in 36% of interventions versus 41% controls (p=0.21). In the intervention group, weight loss of ≥5% was associated with higher age (OR 2.94), lower educational level (OR 1.91), non-smoking status (OR 2.92), motivation to start with weight loss directly after the baseline visit (OR 2.31) and weight loss programme participation (OR 3.33), whereas weight gain (≥1 kg) was associated with smoking cessation ≤6 months before or during hospitalisation (OR 3.21), non-Caucasian ethnicity (OR 2.77), smoking at baseline (OR 2.70), lower age (<65 years) (OR 1.47) and weight loss programme participation (OR 0.59).CONCLUSION: The comprehensive secondary prevention programme was, on average, effective in achieving weight loss. However, wide variation was observed. As weight gain was observed in over one in three participants in both groups, prevention of weight gain may be as important as attempts to lose weight.TRIAL REGISTRATION NUMBER: NTR3937.
Aim and method: To examine in obese people the potential effectiveness of a six-week, two times weekly aquajogging program on body composition, fitness, health-related quality of life and exercise beliefs. Fifteen otherwise healthy obese persons participated in a pilot study. Results: Total fat mass and waist circumference decreased 1.4 kg (p = .03) and 3.1 cm (p = .005) respectively. The distance in the Six-Minute Walk Test increased 41 meters (p = .001). Three scales of the Impact of Weight on Quality of Life-Lite questionnaire improved: physical function (p = .008), self-esteem (p = .004), and public distress (p = .04). Increased perceived exercise benefits (p = .02) and decreased embarrassment (p = .03) were observed. Conclusions: Aquajogging was associated with reduced body fat and waist circumference, and improved aerobic fitness and quality of life. These findings suggest the usefulness of conducting a randomized controlled trial with long-term outcome assessments.
BACKGROUNDThis systematic review and meta-analysis evaluates the additional effects of exercise to hypocaloric diet on body weight, body composition, glycaemic control, and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes.METHODSEmbase, Medline, Web of Science, and Cochrane Central databases were evaluated and 11 studies were included. Random-effects meta-analysis was performed on body weight and measures of body composition and glycaemic control, to compare the effect of hypocaloric diet plus exercise with hypocaloric diet alone.RESULTSExercise interventions consisted of walking or jogging, cycle ergometer training, football training, or resistance training, and duration varied from 2 to 52!weeks. Body weight and measures of body composition and glycemic control decreased during both the combined intervention and hypocaloric diet alone. Mean difference in change of body weight (0.77 kg [95% CI: 2.03; 0.50]), BMI (0.34 kg/m2 [95% CI 0.73; 0.05]), waist circumference (1.42 cm [95% CI: 3.84; 1.00]), fat-free mass (0.18 kg [95% CI 0.52; 0.17]), fat mass (1.61 kg [95% CI 4.42; 1.19]), fasting glucose (+0.14 mmol/l [95% CI 0.02; 0.30]), HbA1c (0.06 % [95% CI 0.25; 0.13]), and HOMA-IR (+0.01 [95% CI: 0.40; 0.42]) was not statistically different between the combined intervention and hypocaloric diet alone. Two studies reported VO2max and showed significant increases upon addition of exercise to hypocaloric diet.CONCLUSIONAdditional effects of exercise to hypocaloric diet in adults with overweight or obesity and type 2 diabetes were not shown for body weight, body composition, or glycaemic control, while cardio-respiratory fitness improves.
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