Exercise without dietary restriction as a means to long-term fat loss in the obese cardiac patient

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.

longitudinal training (preliminary study).

out-patient cardiac rehabilitation program.

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.

body mass, hydrostatic weighing, triglycerides, total, HDL- and LDL-cholesterol, resting and peak oxygen intake, one week food intake diaries.

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).

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.