title: A standard ballroom and Latin dance program to improve fitness and adherence to physical activity in individuals with type 2 diabetes and in obesity.
abstract: OBJECTIVE
  To test the effectiveness of a dance program to improve fitness and adherence to physical activity in subjects with type 2 diabetes and obesity.
  
  
  METHODS
  Following a motivational interviewing session, 100 subjects with diabetes and/or obesity were enrolled either in a dance program (DP, n = 42) or in a self-selected physical activity program (SSP, n = 58), according to their preferences. Outcome measures were reduced BMI/waist circumference, improved metabolic control in type 2 diabetes (-0.3% reduction of HbA1c) and improved fitness (activity expenditure >10 MET-hour/week; 10% increase in 6-min walk test (6MWT)). Target achievement was tested at 3 and 6 months, after adjustment for baseline data (propensity score).
  
  
  RESULTS
  Attrition was lower in DP. Both programs significantly decreased body weight (on average, -2.6 kg; P < 0.001) and waist circumference (DP, -3.2 cm; SSP, -2.2; P < 0.01) at 3 months, and the results were maintained at 6 months. In DP, the activity-related energy expenditure averaged 13.5 ± 1.8 MET-hour/week in the first three months and 14.1 ± 3.0 in the second three-month period. In SSP, activity energy expenditure was higher but highly variable in the first three-month period (16.5 ± 13.9 MET-hour/week), and decreased in the following three months (14.2 ± 12.3; P vs. first period < 0.001). At three months, no differences in target achievement were observed between groups. After six months the odds to attain the MET, 6MWT and A1c targets were all significantly associated with DP.
  
  
  CONCLUSIONS
  Dance may be an effective strategy to implement physical activity in motivated subjects with type 2 diabetes or obesity (Clinical trial reg. no.NCT02021890, clinicaltrials.gov).
authors.affiliation: Unit of Endocrinology and Diabetology, General Hospital, Gavardo, Brescia, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Mangeri
authors.affiliation: Unit of Metabolic Diseases and Clinical Dietetics, "Alma Mater Studiorum" University of Bologna, Policlinico S. Orsola, Via Massarenti, 9 I-40138, Bologna, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Montesi
authors.affiliation: Unit of Metabolic Diseases and Clinical Dietetics, "Alma Mater Studiorum" University of Bologna, Policlinico S. Orsola, Via Massarenti, 9 I-40138, Bologna, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Forlani
authors.affiliation: Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Dalle Grave
authors.affiliation: Unit of Metabolic Diseases and Clinical Dietetics, "Alma Mater Studiorum" University of Bologna, Policlinico S. Orsola, Via Massarenti, 9 I-40138, Bologna, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Marchesini