Abstract

BackgroundA dearth of knowledge exists regarding how multiple health behavior changes made within an exercise prescription programme can improve health parameters. This study aimed to analyse the impact of changing diet and increasing exercise on health improvements among exercise prescription patients.MethodsIn 2016, a representative sample of all enroled New Zealand exercise prescription programme (Green Prescription) patients were surveyed (N = 1488, 29% male, 46% ≥ 60 yr). Seven subsamples were created according to their associated health problems; metabolic (n = 1192), physiological (n = 627), psychological (n = 447), sleep problems (n = 253), breathing difficulties (n = 243), fall prevention (n = 104), and smoking (n = 67). After controlling for sex and age, multinomial regression analyses were executed.ResultsOverall, weight problems were most prevalent (n = 886, 60%), followed by high blood pressure/risk of stroke (n = 424, 29%), arthritis (n = 397, 27%), and back pain/problems (n = 382, 26%). Among patients who reported metabolic health problems, those who changed their diet were 7.2, 2.4 and 3.5 times more likely to lose weight, lower their blood pressure, and lower their cholesterol, respectively compared to the control group. Moreover, those who increased their physical activity levels were 5.2 times more likely to lose weight in comparison to controls. Patients who both increased physical activity and improved diet revealed higher odds of experiencing health improvements than those who only made one change. Most notably, the odds of losing weight were much higher for patients changing both behaviours (17.5) versus changing only physical activity (5.2) or only diet (7.2).ConclusionsAlthough it is not currently a programme objective, policy-makers could include nutrition education within the Green Prescription initiative, particularly for the 55% of patients who changed their diet while in the programme. Physical activity prescription with a complimentary nutrition education component could benefit the largest group of patients who report metabolic health problems.

Highlights

  • A dearth of knowledge exists regarding how multiple health behavior changes made within an exercise prescription programme can improve health parameters

  • Major risk factors of cardiovascular disease and metabolic syndrome are physical inactivity and poor diet [8] with physical inactivity positioned as the primary cause of most chronic diseases [9]

  • Compelling evidence exists for the efficacy of improving physical activity and diet [10] in treating individuals with multiple risk factors [11], usual care relies on pharmacotherapies which merely address disease symptoms [12]

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Summary

Introduction

A dearth of knowledge exists regarding how multiple health behavior changes made within an exercise prescription programme can improve health parameters. A lack of physical activity, tobacco smoking and an unhealthy diet contribute to almost 80% of the world’s risk of cardiovascular disease and type 2 diabetes [1]. Positioned as the leading cause of premature death globally [2], cardiovascular disease is an epidemic driven by type 2 diabetes and the metabolic syndrome [3]. Major risk factors of cardiovascular disease and metabolic syndrome are physical inactivity and poor diet [8] with physical inactivity positioned as the primary cause of most chronic diseases [9]. Compelling evidence exists for the efficacy of improving physical activity and diet [10] in treating individuals with multiple risk factors [11], usual care relies on pharmacotherapies which merely address disease symptoms [12]

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