| High-calorie-expenditure exercise: a new approach to cardiac rehabilitation for overweight coronary patients. | |
| | |
MedLine Citation:
|
PMID: 19433757 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: More than 80% of patients entering cardiac rehabilitation (CR) are overweight, and >50% have metabolic syndrome. Current CR exercise protocols result in little weight loss and minimal changes in cardiac risk factors. We sought to design an exercise protocol that would lead to greater weight loss and risk factor change. METHODS AND RESULTS: We performed a randomized controlled clinical trial to evaluate the effect of high-calorie-expenditure exercise (3000- to 3500-kcal/wk exercise-related energy expenditure) compared with standard CR exercise (7 to 800 kcal/wk) on weight loss and risk factors in 74 overweight patients with coronary heart disease. Both groups were counseled for weight loss and taking evidence-based preventive medications. High-calorie-expenditure exercise resulted in double the weight loss (8.2+/-4 versus 3.7+/-5 kg; P<0.001) and fat mass loss (5.9+/-4 versus 2.8+/-3 kg; P<0.001) and a greater waist reduction (-7+/-5 versus -5+/-5 cm; P=0.02) than standard CR exercise at 5 months. High-calorie-expenditure exercise reduced insulin resistance, measured with the euglycemic hyperinsulinemic clamp, along with the ratio of total to high-density lipoprotein cholesterol and components of the metabolic syndrome, more than standard CR exercise (each P<0.01). Overall, fat mass loss best predicted improved metabolic risk, and the prevalence of metabolic syndrome decreased from 59% to 31%. Changes in cardiac risk factors included decreased insulin resistance, increased high-density lipoprotein cholesterol, and decreased measures of insulin, triglycerides, blood pressure, plasminogen activator inhibitor-1, and the ratio of total to high-density lipoprotein cholesterol (each P<0.05). Significant weight loss was maintained at 1 year. CONCLUSIONS: High-calorie-expenditure exercise promotes greater weight loss and more favorable cardiometabolic risk profiles than standard CR for overweight coronary patients. |
| | |
Authors:
|
Philip A Ades; Patrick D Savage; Michael J Toth; Jean Harvey-Berino; David J Schneider; Janice Y Bunn; Marie C Audelin; Maryann Ludlow |
Related Documents
:
|
18597107 - Effect of physical activity on heart rate variability in normal weight, overweight and ... 21030947 - Physical activity patterns using accelerometry in the national weight control registry. 19936157 - Adherence to a behavioral weight loss treatment program enhances weight loss and improv... 18581957 - Complete decongestive physiotherapy with and without pneumatic compression for treatmen... 19092707 - End-tidal co2 pressure and cardiac performance during exercise in heart failure. 8814507 - Effects of strenuous exercise on serum myosin heavy chain fragments in male triathletes. |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2009-05-11 |
Journal Detail:
|
Title: Circulation Volume: 119 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2009 May |
Date Detail:
|
Created Date: 2009-05-27 Completed Date: 2009-06-24 Revised Date: 2010-09-27 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
|
Languages: eng Pagination: 2671-8 Citation Subset: AIM; IM |
Affiliation:
|
Division of Cardiology, University of Vermont College of Medicine, Burlington, VT, USA. Philip.ades@vtmednet.org |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT00628277 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adipose Tissue Adult Aged Aged, 80 and over Coronary Disease / prevention & control, rehabilitation* Energy Metabolism / physiology* Exercise Therapy / methods* Female Humans Insulin Resistance Lipids / blood Male Metabolic Syndrome X Middle Aged Overweight / rehabilitation Rehabilitation Waist Circumference Weight Loss / physiology* |
| Grant Support | |
ID/Acronym/Agency:
|
M01 RR000109-445419/RR/NCRR NIH HHS; R01 HL072851-04A1/HL/NHLBI NIH HHS; R01-HL72851/HL/NHLBI NIH HHS; RR-109/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Lipids |
| Comments/Corrections | |
Comment In:
|
Circulation. 2009 May 26;119(20):2650-2
[PMID:
19433752
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Lowering plasma cholesterol levels halts progression of aortic valve disease in mice.
Next Document: Diagnosis of acute aortic dissection by D-dimer: the International Registry of Acute Aortic Dissecti...