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The Journal of Sports Medicine and Physical Fitness 1998 December;38(4):310-6
Copyright © 1999 EDIZIONI MINERVA MEDICA
lingua: Inglese
Exercise without dietary restriction as a means to long-term fat loss in the obese cardiac patient
Mertens D. J. 1, Kavanaghi T. 2, Campbell R. B. 1, Shephard R. J. 1, 3, 4, 5
1 Toronto Rehabilitation Centre, Toronto, ON; 2 Department of Medicine, Faculty of Medicine, University of Toronto, ON; 3 Faculty of Physical Education and Health, Faculty of Medicine, University of Toronto, ON; 4 Department of Public Health Sciences, Faculty of Medicine, University of Toronto, ON; 5 Health Studies Programme, Brock University, St. Catharines, ON, Canada
Background. To examine the effects of a 12-month daily walking program without dietary restriction on the metabolic rate, body composition and blood lipid profile of overweight and moderately obese patients following myocardial infarction.
Methods. Design: longitudinal training (preliminary study). Setting: out-patient cardiac rehabilitation program. Participants: twelve consecutive volunteers (8M, 4F) with a body mass index of 25-40 kg/m2. Relative to average cardiac patients, the men but not the women were significantly heavier (100.8 vs 77.4 kg [M], 70.7 vs 74.2 kg [F]) and fatter (hydrostatic estimate of body fat 34.0% vs 23.1% [M]; 38.3% vs 36.3% [F]) than the general cardiac patient. Measures: body mass, hydrostatic weighing, triglycerides, total, HDL- and LDL-cholesterol, resting and peak oxygen intake, one week food intake diaries.
Results. Daily walking increased progressively from 20 min to 43 min over 3 months, and was then held constant for 9 months.
Peak aerobic power increased 24%, from 19.9 to 24.6 ml/[kg.min] (p<0.001). Resting oxygen intake rose from 3.1 to 3.4 ml/[kg.min], (p<0.05). Energy intake increased from 6.10 to 6.57 MJ/day, but body mass decreased by an average of 4.5 kg (p<0.05, 4.1 kg [M], 5.1 kg [F]), and body fat content diminished from 35.4 to 33.2% (p<0.02, 1.8% [M], 3.2% [F]), with no change in lean body mass (57.7 vs 57.8 kg). Triglycerides diminished from 2.63 to 2.28 mmol/L (p<0.005). Total and LDL-cholesterol also tended to change favorably (from 6.15 to 5.80 and 4.44 to 3.80 mmol/L respectively, but HDL-cholesterol was unchanged).
Conclusions. A daily walking program without dietary restriction induces a favorable change in body composition and lipid profile in moderately obese cardiac patients. An exercise-induced increase of resting metabolism apparently makes an important contribution to this outcome.