title: Supervised vs. self-selected physical activity for individuals with diabetes and obesity: the Lifestyle Gym program.
abstract: The effectiveness of different programs of physical activity outside randomized studies is difficult to determine. We carried out an audit in two different units where either a supervised physical activity (PA) program or a self-selected PA program was in use in individuals with type 2 diabetes or obesity. The supervised PA cohort (n = 101) received progressive gym training (120 min, twice a week for 13 weeks) by a dedicated team, with nutritional counseling during resting periods. The self-selected PA cohort (n = 69) was enrolled in a 13-week cognitive-behavioral program (120 min/week, in groups of 12-15 individuals), chaired by an expert team. Body weight and physical fitness (6-min walk test) were measured at baseline and after 6 and 12 months. Outcome measures were attrition, weight loss ≥10 % initial body weight, 10 % increase in 6-min walk test; their association with a PA program was tested by logistic regression analysis. Attrition rate was lower in the supervised PA group (28 vs. 45 % than in the self-selected cohort, P = 0.023). After adjustment for confounders, the supervised PA program was associated with a lower risk of attrition at 1 year (odds ratio 0.45; 95 % confidence interval, 0.21-0.98) at logistic regression analysis. Body weight similarly decreased in both groups (more rapidly in the supervised PA cohort); also physical fitness improved in a similar way, and no differences in achieved targets of body weight (supervised, 31 %; self-selected, 18 %; P = 0.118) or fitness (supervised, 62 %; self-selected, 49 %; P = 0.312) were demonstrated. Different PA programs produce very similar health benefits, but an initially supervised program has lower attrition rates, which might translate into better outcomes in the long term.
authors.affiliation: Unit of Internal Medicine, Diabetes and Metabolic Disease Center, Romagna Health District, Rimini, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Mazzuca
authors.affiliation: Department of Medical and Surgical Sciences, "Alma Mater Studiorum" University, Bologna, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Montesi
authors.affiliation: Public Health Department and University Center for Sport-Applied Biomedical Studies, Ferrara, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Mazzoni
authors.affiliation: Public Health Department and University Center for Sport-Applied Biomedical Studies, Ferrara, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grazzi
authors.affiliation: Public Health Department and University Center for Sport-Applied Biomedical Studies, Ferrara, Italy.
authors.forename: Maria Maddalena
authors.initials: MM
authors.lastname: Micheli
authors.affiliation: Lifestyle Gym Group, Rimini, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Piergiovanni
authors.affiliation: Lifestyle Gym Group, Rimini, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Pazzini
authors.affiliation: Department of Medical and Surgical Sciences, "Alma Mater Studiorum" University, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Forlani
authors.affiliation: Department for Life Quality Studies, "Alma Mater Studiorum" University, Bologna, Italy.
authors.forename: Pasqualino
authors.initials: P
authors.lastname: Maietta Latessa
authors.affiliation: Department of Medical and Surgical Sciences, "Alma Mater Studiorum" University, Bologna, Italy. giulio.marchesini@unibo.it.|Unit of Metabolic Diseases, "Alma Mater Studiorum" University, S. Orsola-Malpighi Hospital, Via Massarenti, 9, I-40135, Bologna, Italy. giulio.marchesini@unibo.it.
authors.forename: Giulio
authors.identifier: http://orcid.org/0000-0003-2407-9860
authors.initials: G
authors.lastname: Marchesini
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D010809:Physical Fitness / Q000523:psychology*; D012648:Self Care / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D015431:Weight Loss
keywords: Body weight; Diabetes; Obesity; Physical activity; Physical fitness