Moderate Walking Enhances the Effects of an Energy-Restricted Diet on Fat Mass Loss and Serum Insulin in Overweight and Obese Adults in a 12-Week Randomized Controlled Trial.

BACKGROUND: Increased physical activity may be advantageous for weight loss. OBJECTIVE: We investigated the effects of an energy-restricted diet with and without moderate walking on body weight, body composition, resting energy expenditure (REE), and endocrine and cardiometabolic risk variables in overweight and obese participants. METHODS: A 12-wk, randomized, 2-arm, parallel, controlled, energy-restricted (500-800 kcal/d) dietary intervention study was conducted in 82 men and women [mean baseline characteristics: age, 39.4 y; weight, 99.3 kg; body mass index (in kg/m2), 31.9]. Participants were divided into 2 groups. One group received a hypoenergetic diet (DI) only (n = 44). The second group received the same DI and participated in a regular walking program of 2.5 h/wk (DI + walking; n = 38). RESULTS: After the 12-wk intervention, body weight was significantly decreased in the DI + walking group and the DI group (-8.8 compared with -7.0 kg, P = 0.064 for intergroup differences). The decrease in body weight was accompanied by a significant reduction in total fat mass, which was significantly more pronounced in the DI + walking group than in the DI group (-6.4 ± 3.1 compared with -4.8 ± 3.0 kg; P = 0.020). REE after 12 wk was not significantly different compared with the baseline REE. Diastolic blood pressure, mean arterial pressure, LDL cholesterol, and non-HDL cholesterol were similarly significantly improved by both interventions. In the DI + walking group, insulin and the homeostasis model assessment of insulin resistance index were also significantly reduced. Serum free triiodothyronine was significantly decreased and serum cortisol was significantly increased in both groups. CONCLUSIONS: Participation in a 12-wk weight-loss study resulted in significant reductions in body weight and fat mass and was associated with significant improvements in biomarkers for cardiovascular disease risk. Moderate weight loss was not accompanied by a reduction in REE. Additional moderate walking enhanced the effects of a DI on fat loss and serum insulin. This trial was registered at www.germanctr.de/ and http://apps.who.int/trialsearch/ as DRKS00006827.

Quantity versus quality of gait and quality of life in patients with osteoarthritis.

PURPOSE: This study investigated the relationship between the quality of life, quality of gait and the quantity of gait in patients with impairments in the lower extremities. METHODS: Twenty-six subjects (age 58.6+/-13.4 years) suffering from knee or hip osteoarthritis were investigated before implantation of an endoprosthesis. Quality of life was assessed using the SF-36 survey. The quality of gait was assessed with a six camera motion analysis system in combination with two force plates. For evaluation of the quantity of gait, two monitors were applied: (a) the accelerometer-based DynaPort activity monitor measured locomotion and posture for 1 day and (b) The Step-Activity-Monitor, a small microprocessor-operated acceleration sensor, measured the number of gait cycles in 1-min intervals for 1 week. Spearman correlation coefficients were calculated between quantity of gait, quality of gait and quality of life. RESULTS: The patients showed typical gait impairments caused by osteoarthritis. Locomotion accounted for 10.5+/-5% of the daily recorded time, 4782+/-2116 gait cycles were counted per day. The sub-categories of the SF-36 showed limited physical functioning and general health with 38 and 56 out of 100 points, respectively. Computation of Spearman-rho revealed no relevant correlations between quality and quantity of gait but moderate correlations between quality of life and quantity of gait. CONCLUSION: The findings underline that a patient's level of mobility cannot be reliably estimated from quality of gait or from quality of life. Instead, adequate methods should be chosen to measure the quantity of gait in daily life.