title: Body fat distribution's impact on physiologic outcomes during cardiac rehabilitation.
abstract: BACKGROUND
  High waist-to-hip ratios (WHRs) predispose individuals to metabolic syndromes that may affect outcome responses to cardiac rehabilitation programs.
  
  
  METHODS
  A total of 101 male patients who had undergone coronary artery revascularization surgery and completed 12 weeks of cardiac rehabilitation were divided into lower (LOWHR, n = 51) and higher (HIWHR, n = 50) waist-to-hip groups. Outcomes were measured at week 1 and week 12 of cardiac rehabilitation.
  
  
  RESULTS
  Waist-to-hip ratio and body weight were greatest for HIWHR (P < 0.001) with no between-group differences in the amount of change from week 1 to 12. Triceps and subscapular skin-folds were greater for HIWHR (P < 0.001) with no difference in the amount of change between groups. Caloric expenditure during exercise class was higher for LOWHR (P = 0.022). Daily caloric expenditure was greater for LOWHR (P = 0.034) as was daily caloric intake (P < 0.001). There were no group differences for VO2peak and ventilatory anaerobic threshold (VAT) with nonsignificant trends for greater increases in LOWHR.
  
  
  CONCLUSIONS
  Cardiac rehabilitation patients with greater WHRs expend less calories during exercise classes. To enhance overall caloric expenditure and obtain positive outcomes, cardiac rehabilitation professionals must emphasize greater activity with less sedentary time throughout the patients normal daily routine. The validity of using self-reported caloric intake and expenditure values in the cardiac rehabilitation population is questionable.
authors.affiliation: Department of Cardiology, Geisinger Medical Center, Danville, PA 17822-2160, USA. tmcconnell@psghs.edu
authors.forename: T R
authors.initials: TR
authors.lastname: McConnell
authors.forename: R J
authors.initials: RJ
authors.lastname: Palm
authors.forename: W M
authors.initials: WM
authors.lastname: Shearn
authors.forename: C A
authors.initials: CA
authors.lastname: Laubach
mesh_terms: D000273:Adipose Tissue / Q000502:physiology*; D001824:Body Constitution / Q000502:physiology*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000378:metabolism / Q000534:rehabilitation* / Q000601:surgery; D004734:Energy Metabolism; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005500:Follow-Up Studies; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D008055:Lipids