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More Exercise May Provide Greater Gains in Heart Disease

Last Updated: May 14, 2009.

A program featuring greater amounts of exercise and energy expenditure may be preferable to standard cardiac rehabilitation exercise in overweight patients with coronary heart disease, according to research published online May 11 in Circulation.

THURSDAY, May 14 (HealthDay News) -- A program featuring greater amounts of exercise and energy expenditure may be preferable to standard cardiac rehabilitation exercise in overweight patients with coronary heart disease, according to research published online May 11 in Circulation.

Philip A. Ades, M.D., of the University of Vermont College of Medicine in Burlington, and colleagues analyzed data from 74 overweight individuals -- mean age of 64 years and mean body mass index of 32 -- with coronary heart disease. Patients were randomized to high-calorie-expenditure exercise (3,000 to 3,500 calories weekly) or standard cardiac rehabilitation exercise (700 to 800 calories weekly).

At five months, the researchers found that those in the high-expenditure group had twice the weight loss (8.2 versus 3.7 kilograms) and fat mass loss (5.9 versus 2.8 kilograms). This group also had larger decreases in insulin resistance, total to high-density lipoprotein cholesterol ratio, and elements of the metabolic syndrome. No exercise-related cardiac events were noted, and adherence to the interventions was good, the authors write.

"Considering the negative consequences and increasing prevalence of obesity and metabolic syndrome, high-calorie-expenditure exercise training, combined with a hypocaloric diet, should be considered the exercise approach of choice for overweight patients with coronary heart disease," the authors conclude. "Some individuals with no exercise experience whatsoever may initially benefit from a standard cardiac rehabilitation exercise protocol and then gradually evolve to four to six sessions per week as they improve their fitness."

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