Weight Loss Maintained With Med Diet Plus Spinning

Marlene Busko

October 21, 2013

MONTREAL, QC — In obese people who are at high risk of cardiovascular disease, a small, pilot study suggests that a program combining high-intensity intervals on a stationary exercise bicycle with a Mediterranean diet might lead to sustained weight loss and avoid rebound weight gain[1].

In an oral presentation here at the Canadian Cardiovascular Congress (CCC) 2013 , lead author Gabriel Lapierre (Montreal Heart Institute, QC) explained that the 29 obese individuals in their study shed an average of 7 kg at the end of a nine-month diet and exercise program, which they sustained at 18 months.

"What's new is using what's been determined to be optimal in terms of diet and exercise in a combined fashion and using it for the length of time we did," senior author Dr Anil Nigam (Montreal Heart Institute) told heartwire .

"The take-home message is [that the program is] highly efficient for weight loss, improving cardiometabolic risk, improving exercise tolerance, and if you continue on it, you are able to maintain the benefits long term," he summarized.

Other studies have has shown that a Mediterranean diet is not associated with weight regain, which can be a problem with fad diets, he noted. Athletes have long recognized the benefits of high-intensity interval training, and at their center, Nigam and colleagues have shown that this is safe and well tolerated in patients undergoing cardiac rehabilitation.

They performed the current retrospective study to investigate health and fitness outcomes in 22 women and seven men with an average age of 52 who had participated in KILO-ACTIF , an intense lifestyle intervention, for nine months and then continued the program for another nine months.

When they had enrolled, on average, the participants weighed 98 kg, had a body-mass index (BMI) of 37, and a waist circumference of 113 cm.

The exercise part of the program, which was supervised by a kinesiologist, consisted of twice-weekly sessions. For the spinning part, participants had a five-minute warm-up on a stationary bicycle followed by two sets of 10 minutes of repeated bouts of 15 to 30 seconds of intense cycling followed by 15 to 30 seconds of rest and recovery, for a total of 34 minutes. This was followed by a 20-minute weight-training program.

The participants also received five counseling sessions with a dietician who explained the principles of a Mediterranean diet. Importantly, they were not advised to restrict calories.

After nine months, the participants' waist circumference had decreased by 8 cm, their systolic blood pressure had dropped by 6 mm Hg, and their maximal exercise capacity (METS) had increased from 7.8 to 9.4. LDL cholesterol and total cholesterol decreased slightly but significantly. On average, fasting blood glucose levels improved by 23% in the individuals with diabetes and by about 10% in those with prediabetes.

This suggests that obese individuals who are able to maintain this type of lifestyle intervention can improve their cardiovascular health, Nigam said, and diet and exercise seem to have a synergistic effect on weight loss.

A study limitation is that the people who participated, who paid to attend the program, may have been more motivated to lose weight than other obese individuals. And since "this was a proof-of-concept trial, the next step would be to compare a Mediterranean diet vs a traditional calorie-restricted diet, and to compare high-intensity interval exercise with standard moderate-intensity continuous exercise in a 2 x 2 factorial design with four intervention groups," he added.

These findings are very promising, said Heart and Stroke Foundation spokesperson Dr George Honos (Centre Hospitalier de l'Université de Montréal) and "the best news of all is that the usual [weight regain] was not seen." He speculated that "the diet is manageable and becomes implemented as a way of life . . . and the exercise is probably something that they've grown accustomed to and keep up of their own accord."

The Mediterranean diet "is something I can offer my patients and know that it is something they can follow and afford," Honos observed. This diet is very similar to the Dietary Approaches to Stop Hypertension (DASH) diet that is recommended by the Canadian Hypertension Education Program, which he is involved with, he added.

The authors have no relevant disclosures.


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