[Efficacy of a community-based weight reduction program to improve exercise and diet behavior in overweight adults].

OBJECTIVE: The study was a non-randomized, parallel-group comparison to evaluate the efficacy of a community-based weight reduction program with exercise and diet modification for overweight adults using existing community health services. METHODS: The study population consisted of 1,115 community-dwelling people who underwent annual health checkups in 2002 and were screened by exclusion criteria (age> 65, body mass index (BMI) < 24.2). They received a mail request to select one of two courses; a usual single-session health instruction course (control group) or a 9-month weight management course (intervention group). Forty six patients registered in the intervention group, and fifty patients in the control group. The analyzed sample consisted of 76 participants (9 males and 67 females) excluding dropouts from November 2002 to July 2003. Intervention included monthly classes (2 hours per class, 9 classes) consisting of an individual support program for behavioral change and a community support program for continuation after the class. The control group participants received conventional instructions based on their health status. RESULTS: No significant inter-group differences were observed at baseline, except in age and height of females. The mean BMI decreased from 27.2 (SD = 2.8) kg m(-2) to 25.3(3.1) kg m(-2) in the intervention group, and 26.4 (1.7) kg m(-2) to 26.1(1.7) kg m(-2) in the control group. Repeated measures analysis of variance showed significant time and group interaction adjusted for gender and age. The proportion showing maintenance and action in stage of exercise behavior increased in the intervention group (31% to 60%), but remained stable in the control group (45% to 48%) . The proportion showing maintenance and action in stage of diet behavior increased in the intervention group (24% to 80%), but remained stable in the control group (29% to 26%). CONCLUSION: Community-based weight reduction programs may be effective to facilitate change in exercise and diet behavior for body weight reduction in overweight adults.

A 6-year cohort study on relationship between functional fitness and impairment of ADL in community-dwelling older persons.

We measured functional fitness in older subjects and performed a follow-up survey for 6 years to clarify whether the level of functional fitness at a given point contributes to prediction of the subsequent occurrence of impairment of functions necessary for independent living. The longitudinal data were obtained for 391 persons aged 60 years or over, who were independently living in the community. Four items of functional fitness, i.e. the ability to perform standing/sitting movements, ability to perform traveling movements, ability to perform housekeeping movements, and ability to perform personal grooming activities, were assessed. The relationship between functional fitness and the risk of the occurrence of impairment of independence in daily living was evaluated using a binomial logistic regression model. In males, all the 4 items of functional fitness were significantly related to the risk of impairment of activities of daily living (ADL). In females, however, none of the items was significantly related to the risk of ADL impairment. In conclusion, functional fitness appears to be valid as a predictive parameter of future occurrence of ADL impairment in relatively healthy and independent elderly males. However, its validity in elderly females needs further evaluation.