The acceptability of a high-calorie-expenditure (HCE) exercise program in older coronary heart disease patients participating in a behavioral weight-control program was evaluated. Seventy-four overweight patients (median age 63 yr) were randomly assigned to a 5-mo intervention of HCE exercise (3,000–3,500 kcal/wk daily walking) or standard cardiac-rehabilitation (CR) exercise (700–800 kcal/wk). Both groups received counseling to achieve a dietary caloric deficit of 3,500 kcal/ wk. Assessments at baseline and 5 mo included self-reported measures of quality of life and psychosocial variables. The HCE group experienced significantly greater weight loss (8.2 ± 4 vs. 3.7 ± 5 kg, p < .001). Changes from baseline to 5 mo on scores of physical, emotional, and social functioning were greater for the HCE than CR group (p < .05). HCE exercise also resulted in greater positive change in exercise enjoyment (p = .05), which was mediated by weight change. Even high-risk older adults can be successful in an HCE exercise program and experience no adverse physical or emotional changes.
Pope and Harvey-Berino are with the Dept. of Nutrition and Food Sciences, and Bunn, the Div. of Biometry, University of Vermont, Burlington, VT. Savage, Ludlow, and Ades are with the Div. of Cardiology, University of Vermont College of Medicine. Oldridge is with the University of Wisconsin School of Medicine and Public Health, Milwaukee, WI.