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Supervised vs. self-selected physical activity for individuals with diabetes and obesity: the Lifestyle Gym program

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Abstract

The effectiveness of different programs of physical activity outside randomized studies is difficult to determine. We carried out an audit in two different units where either a supervised physical activity (PA) program or a self-selected PA program was in use in individuals with type 2 diabetes or obesity. The supervised PA cohort (n = 101) received progressive gym training (120 min, twice a week for 13 weeks) by a dedicated team, with nutritional counseling during resting periods. The self-selected PA cohort (n = 69) was enrolled in a 13-week cognitive-behavioral program (120 min/week, in groups of 12–15 individuals), chaired by an expert team. Body weight and physical fitness (6-min walk test) were measured at baseline and after 6 and 12 months. Outcome measures were attrition, weight loss ≥10 % initial body weight, 10 % increase in 6-min walk test; their association with a PA program was tested by logistic regression analysis. Attrition rate was lower in the supervised PA group (28 vs. 45 % than in the self-selected cohort, P = 0.023). After adjustment for confounders, the supervised PA program was associated with a lower risk of attrition at 1 year (odds ratio 0.45; 95 % confidence interval, 0.21–0.98) at logistic regression analysis. Body weight similarly decreased in both groups (more rapidly in the supervised PA cohort); also physical fitness improved in a similar way, and no differences in achieved targets of body weight (supervised, 31 %; self-selected, 18 %; P = 0.118) or fitness (supervised, 62 %; self-selected, 49 %; P = 0.312) were demonstrated. Different PA programs produce very similar health benefits, but an initially supervised program has lower attrition rates, which might translate into better outcomes in the long term.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

OR:

Odds ratio

PA:

Physical activity

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Author information

Authors and Affiliations

  1. Unit of Internal Medicine, Diabetes and Metabolic Disease Center, Romagna Health District, Rimini, Italy

    Paolo Mazzuca

  2. Department of Medical and Surgical Sciences, “Alma Mater Studiorum” University, Bologna, Italy

    Luca Montesi, Giulia Forlani & Giulio Marchesini

  3. Public Health Department and University Center for Sport-Applied Biomedical Studies, Ferrara, Italy

    Gianni Mazzoni, Giovanni Grazzi & Maria Maddalena Micheli

  4. Lifestyle Gym Group, Rimini, Italy

    Silvia Piergiovanni & Valeria Pazzini

  5. Department for Life Quality Studies, “Alma Mater Studiorum” University, Bologna, Italy

    Pasqualino Maietta Latessa

  6. Unit of Metabolic Diseases, “Alma Mater Studiorum” University, S. Orsola-Malpighi Hospital, Via Massarenti, 9, I-40135, Bologna, Italy

    Giulio Marchesini

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  1. Paolo Mazzuca
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Correspondence to Giulio Marchesini.

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Statement of human and animal rights

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study (clinical audit) formal consent is not required.

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Mazzuca, P., Montesi, L., Mazzoni, G. et al. Supervised vs. self-selected physical activity for individuals with diabetes and obesity: the Lifestyle Gym program. Intern Emerg Med 12, 45–52 (2017). https://doi.org/10.1007/s11739-016-1506-7

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  • DOI: https://doi.org/10.1007/s11739-016-1506-7

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