title: Improved cardiovascular health following a progressive walking and dietary intervention for type 2 diabetes.
abstract: OBJECTIVE
  To examine the impact of two different lifestyle programmes on cardiovascular health and glycaemic control among people with type 2 diabetes.
  
  
  METHODS
  A two-phase 24-week randomized trial. During the first phase, participants were to increase daily steps using a pedometer. At week 12, participants were randomly allocated to either an enhanced lifestyle programme (ELP) targeting walking speed or a basic lifestyle programme (BLP) targeting total daily steps. Both programmes focused on increasing the intake of low glycaemic index foods but utilized different goal setting strategies. Clinical measurements were completed at baseline, week 12 and week 24. Principal outcomes were change in resting pulse rate (PR) and glycated haemoglobin A1c (A1c) between week 12 and week 24 compared between groups using analysis of covariance.
  
  
  RESULTS
  Forty-one participants [mean +/- s.d. : age = 56.5 +/- 7.2 years, body mass index (BMI) = 32.7 +/- 6.1 kg/m(2)] were randomized. After 12 weeks, we observed an increase in average total daily steps of 1688 (95% confidence interval: 330-3040, [corrected] p = 0.02). Weight, BMI and systolic and diastolic blood pressure improved (p < 0.01 for all). No changes were observed for energy intake. At week 24, those in the ELP had a lower resting PR (71 +/- 12 b.p.m.) compared with those in the BLP (78 +/- 12 b.p.m.) (adjusted p = 0.03), while no group differences for total daily steps or glycaemic control were observed.
  
  
  CONCLUSIONS
  Improvements in cardiovascular health can be expected following a pedometer-based lifestyle modification programme that progresses from walking more to walking faster.
authors.affiliation: Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: S T
authors.initials: ST
authors.lastname: Johnson
authors.forename: G J
authors.initials: GJ
authors.lastname: Bell
authors.forename: L J
authors.initials: LJ
authors.lastname: McCargar
authors.forename: R S
authors.initials: RS
authors.lastname: Welsh
authors.forename: R C
authors.initials: RC
authors.lastname: Bell
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000628:therapy*; D050528:Diet, Carbohydrate-Restricted; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D016138:Walking / Q000502:physiology*
chemical_list: D004040:Dietary Carbohydrates