Effects of small community walking intervention on physical activity, well-being, and social capital among older patients with cardiovascular disease in the maintenance phase: a randomized controlled trial.

[Purpose] Older patients with cardiovascular disease should increase their physical activity and prioritize positive psychological and social approaches in the maintenance phase of their cardiac rehabilitation. This study aimed to clarify the effect of small community walking on physical activity, well-being, and social capital in older patients with cardiovascular disease in the maintenance phase. [Participants and Methods] We conducted a multicenter study in Kumamoto, Japan. We randomly divided 55 patients with cardiovascular disease into two groups: small community walking and walking alone. For three months, a registered cardiac rehabilitation instructor provided walking guidance to both groups using a wearable device. We measured physical activity, social capital, and subjective happiness before and after the intervention. [Results] Results revealed a statistically significant main effect of time on physical activity and social participation. In the subjective happiness scale, there was an association between group and time. [Conclusion] Our results suggest that walking guidance using a wearable device was beneficial in improving overall physical activity, regardless of whether the individual did small community walking or walking alone. Furthermore, small community walking intervention may effectively enhance well-being. The relationship between physical activity and social participation needs to be further investigated.

Effects of social network incentives and financial incentives on physical activity and social capital among older women: a randomized controlled trial.

BACKGROUND: Financial incentives have been used to increase physical activity. However, the benefit of financial incentives is lost when an intervention ends. Thus, for this study, we combined social network incentives that leverage the power of peer pressure with financial incentives. Few reports have examined the impact of physical activity on social capital. Therefore, the main goal of this study was to ascertain whether a combination of two incentives could lead to more significant changes in physical activity and social capital during and after an intervention. METHODS: The participants were 39 older women over 65 years of age in Kumamoto, Japan. The participants were randomly divided into a financial incentive group (FI group) and a social network incentive plus financial incentive group (SNI + FI group). Both groups underwent a three-month intervention. Measurements of physical activity and social capital were performed before and after the intervention. Additionally, the effects of the incentives on physical activity and social capital maintenance were measured 6 months postintervention. The financial incentive group received a payment ranging from US$4.40 to US$6.20 per month, depending on the number of steps taken during the intervention. For the other group, we provided a social network incentive in addition to the financial incentive. The SNI + FI group walked in groups of three people to use the power of peer pressure. RESULTS: A two-way ANOVA revealed that in terms of physical activity, there was a statistically significant interaction between group and time (p = 0.017). The FI group showed no statistically significant improvement in physical activity during the observation period. In terms of the value of social capital, there was no significant interaction between group and time. CONCLUSION: Our results suggest that social network incentives, in combination with financial incentives, are more effective for promoting physical activity than financial incentives alone among older women and that these effects can continue after an intervention. In the meantime, further studies should be conducted on the effect of physical activity on social capital. TRIAL REGISTRATION: UMIN000038080 , registered on 09/22/2019 (Retrospectively registered).

Prolonged effectiveness of 12-month exercise-plus-diet intervention in Japanese adults at risk of impaired glucose or lipid metabolism.

BACKGROUND AND OBJECTIVES: To investigate the prolonged effects of a 12-month exercise-plus-diet intervention in Japanese adults at risk of impaired glucose or lipid metabolism. METHODS AND STUDY DESIGN: A total of 180 participants were randomly divided into an intervention group (n=94), and a control group (n=86). An exercise-plus- diet intervention was conducted on the intervention group for 12 months. The effects were evaluated by questionnaire, physical examinations, and blood tests at baseline, 3 months, 12 months (the end of intervention), and 24 months (one year after the end of intervention). The control group took only the same examinations as the intervention group. RESULTS: At the end of the 12-month intervention, body weight, waist circumference, fasting glucose, HbA1c, triglycerides, and LDL-cholesterol were improved in the intervention group compared to the control group (all p<0.05). One year after the end of the intervention, body weight, waist circumference, fasting glucose, triglycerides, and LDL-cholesterol were still decreased in the intervention group compared to the control group (all p<0.05), especially among non-overweight participants. Among overweight persons, only body weight in the intervention group was lower than the control group. The personal behaviours of physical activity and diet in the intervention group were also improved. CONCLUSIONS: The 12-month exercise-plus-diet programs were found to be effective in improving glucose and lipid metabolism, as well as personal behaviour one year after completion of the intervention.

Pedometer-determined physical activity and indicators of health in Japanese adults.

Recently, many cross-sectional studies observed that body mass index (BMI) and percentage of body fat (%BF) were inversely associated with pedometer-determined physical activities, but studies on Asian populations, including the Japanese, are sparse. Height, weight, body fat percentage (%BF, bioelectrical impedance analyzer), and waist circumference were measured on 117 women (62.8+/-4.5 years, 22.2+/-2.2 kg/m(2)) and 62 men (64.0+/-4.6 years, 23.6+/-2.5 kg/m(2)). Pearson correlations and partial correlation coefficients after controlling for age were calculated between steps/day and variables. Furthermore, participants were classified into four groups as follows: <5,000, 5,000-7,499, 7,500-9,999, and >or=10,000 steps/day, and analyzed using ANOVA across activity groups. In women, a significant correlation was found between steps/day and BMI (r=-0.217, p=0.018), %BF (r=-0.292, p=0.0014), and the relationship was still significant after controlling for age. The relationship between steps/day and waist circumference was not significant. In men, a significant relationship was not observed between steps/day and obesity indices. The correlations between steps/day and both BMI and %BF were significant in Japanese women, but weak compared with Caucasian and African-American women as reported previously. A possible cause is racial difference in degree of obesity and body shape. The effects of physical activity on body shape and composition may differ according to race.

Gentle exercise of 40 minutes with dietary counseling is effective in treating metabolic syndrome.

Obese people may succeed in reducing their weight temporarily, but most of them regain the lost weight within a few years. We, therefore, recommend moderate long-term changes in habit rather than a strict temporary program. The purpose of this study was to examine whether physical activity of 40 minutes, mainly walking, was effective in improving or preventing metabolic syndrome when combined with dieting. Participants, all of whom had a waist circumference >or= 85 cm (men) or >or= 90 cm (women), were assigned into one of two groups: the control group (10 men and 11 women, age: 64.2 +/- 3.4 [SD] years) and the intervention group (10 men and 12 women, age: 62.4 +/- 4.2 years). Participants (n = 22) enrolled in a 52-week program; their diets were assessed using a 3-day dietary record and daily steps were measured with a pedometer. No significant change was seen in their dietary records, but the mean number of daily steps increased from 5,806 to 8,000-9,000. In the intervention group, BMI, waist circumference, and systolic and diastolic blood pressures decreased significantly by week 12 (all p < 0.001) and remained low until week 52. In fact, no significant change was seen between weeks 12 and 52. The control group showed no significant changes in all variables. These results indicate that gentle exercise of about 40 minutes in combination with dieting is effective in preventing metabolic syndrome among a sedentary population, although its effect may be limited.

Favorable effects of non-instrumental resistance training on fat distribution and metabolic profiles in healthy elderly people.

This study examined the effect of a 12-week non-instrumental resistance training program using body weight as a load (RT-BW) on body composition, fat distribution and metabolic profiles in elderly males and females. Healthy, non-diabetic, elderly volunteers (22 males and 30 females) aged 65-82 years were non-randomly divided into RT-BW (12 males and 20 females) and control (10 males and 10 females) groups. The RT-BW subjects were trained three times per week for 12 weeks according to a specified protocol involving a combination of upper and lower body weight and rubber tubing exercises. We evaluated body composition and fat distribution using anthropometry, dual energy X-ray absorptiometry and ultrasonography, and measured serum lipid levels and HbA(1c) at baseline and after 12 weeks of training. Changes over 12 weeks were significantly greater in the RT-BW group compared with the control group, with a decrease in waist circumference, pre-peritoneal (visceral) fat thickness and thigh fat thickness, and an increase in thigh muscle thickness. On the other hand, the changes in body weight, fat mass and fat free mass were no different between the groups. Further, there were significantly greater changes of metabolic profiles in the RT-BW group with an increase in HDL cholesterol and a decrease in triglyceride and HbA(1c). There was a significant between-group difference in diastolic blood pressure. Relatively short-term, non-instrumental resistance training using body weight as a load was effective in improving fat distribution and metabolic profiles in healthy elderly people without weight loss.

Accuracy of body fat assessment by bioelectrical impedance in Japanese middle-aged and older people.

Bioelectrical impedance analysis (BIA) is commonly used to measure the percentage of body fat (%BF), but its accuracy is controversial. In addition, the equations are specific to the group for which they were established. As far as we know, there is no study examining the accuracy of BIA in Japanese middle-aged and older people. We compared %BF assessed using BIA with that of dual-energy X-ray absorptiometry (DEXA) in 102 female and 51 male local residents aged 40 to 78 y. Simple correlation coefficients were 0.79 for females and 0.69 for males, which are statistically significant (p<0.001). However, BIA tended to overestimate %BF in the lower BF group and underestimate it in the BF higher group, and only 45.1% for female and 47.1% for male subjects were measured accurately, i.e., within 10% of the measurement by DEXA. This result suggests that this model of BIA is an alternative for estimating %BF in Japanese middle-aged and older people as well as when subjects are within a normal body fat range, but greater accuracy is needed for lean and overweight subjects.

Effects of intentional weight cycling on non-obese young women.

This study investigated the effects of intentional weight cycling in non-obese, young women (n = 5; mean age, 24.6 years; mean body mass index [BMI], 20.5 kg/m(2)). During the first 30 days, the subjects lost more than 4 kg with energy restriction alone (first diet period). In the following 14 days, they regained more than the weight they had lost by eating ad libitum (free-living period). In the subsequent 30 days, they once again lost more than 4 kg with only energy restriction (second diet period). Height, weight, waist and hip circumferences, body composition, lipid profiles, thyroid hormones, systolic and diastolic blood pressures (SBP, DBP), and resting energy expenditure (REE) were examined. Measurements were taken at the beginning of the study (day 0), at the end of each diet period (day 30 and day 74), the end of the free-living period (day 44), and on day 180. The mean change in each variable from baseline (day 0) was used and controlled for the baseline value, baseline weight, and change in weight (Delta weight). Statistical tests were performed to determine the significance of the mean changes in the variables. By day 180, there were significant decreases in the subjects' lean body mass (P <.01), serum triiodothyronine (T(3)) (P <.001), serum total thyroxine (T(4)) (P <.001), and REE (P <.001), and significant elevations of SBP (P <.05) and DBP (P <.001). The lipid profiles had not changed except for increased triglycerides (TG). These results suggest that weight cycling through energy restriction alone may have negative health consequences in non-obese, young women.