title: Exercise without dietary restriction as a means to long-term fat loss in the obese cardiac patient.
abstract: 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
  
  
  
  METHODS
  longitudinal training (preliminary study).
  
  
  METHODS
  out-patient cardiac rehabilitation program.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Toronto Rehabilitation Centre, ON.
authors.forename: D J
authors.initials: DJ
authors.lastname: Mertens
authors.forename: T
authors.initials: T
authors.lastname: Kavanagh
authors.forename: R B
authors.initials: RB
authors.lastname: Campbell
authors.forename: R J
authors.initials: RJ
authors.lastname: Shephard
mesh_terms: D001823:Body Composition; D004435:Eating; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000503:physiopathology; D009765:Obesity / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010101:Oxygen Consumption; D016138:Walking / Q000502:physiology*; D015431:Weight Loss