Increased physical activity in abdominally obese women through support for changed commuting habits: a randomized clinical trial.
BACKGROUND
Abdominally obese women can reduce their health risk through regular physical activity. There is, however, little evidence on the effectiveness of interventions that promote physical activity long-term, such as cycling and walking to and from work.


METHODS
This intervention focused on physically active commuting (cycling and walking) in middle-aged (30-60 years), abdominally obese (waist circumference > or = 88 cm) women (n=120), recruited by newspaper advertisement. The intervention group was a moderate-intensity programme with physician meetings, physical activity prescriptions, group counselling and bicycles. The control group was a low-intensity group support programme with pedometers. We used a randomized, controlled, 2-armed design with 18 months duration and intention-to-treat analysis (data collection 2005-2006). Treatment success was defined as bicycling > or = 2 km/d (primary) or walking 10,000 steps per day (secondary).


RESULTS
At baseline, mean (s.d.) age was 48.2 years (7.4), waist circumference 103.8 cm (7.8), walking 8471 steps per day (2646), bicycling 0 km per day. Attrition at 18 months was 10% for the intervention group and 25% in the control group (P=0.03). The intervention group was more likely to achieve treatment success for cycling than controls: 38.7 vs 8.9% (odds ratio (OR)=7.8 (95% confidence interval=4.0 to 15.0, P<0.001)), but with no difference for compliance with the walking recommendation: 45.7 vs 39.3% (OR=1.2 (95% CI=0.7 to 2.0, P=0.50)). Commuting by car and public transport were reduced by 34% (P<0.01) and 37% (P<0.001), respectively, with no differences between groups. Both groups attained similar waist reductions (-2.1 and -2.6 cm, P=0.72).


CONCLUSIONS
Abdominally obese women can increase PA long-term through moderate-intensity behavioural support aimed at changing commuting habits.
Department of Medicine (Huddinge), Karolinska Institutet, Obesity Unit, Karolinska University Hospital, Stockholm, Sweden. erik.hemmingsson@ki.se
E
E
Hemmingsson
J
J
Uddén
M
M
Neovius
U
U
Ekelund
S
S
Rössner
D000328:Adult; D000886:Anthropometry; D001642:Bicycling / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D056128:Obesity, Abdominal / Q000628:therapy*; D010349:Patient Compliance; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D014186:Transportation; D016138:Walking / Q000502:physiology*