دانلود رایگان مقاله انگلیسی ترکیب رژیم غذایی و فعالیت بدنی در بهبود نتایج سلامتی برای بیماران نیوزیلند - NCBI 2018

Abstract

Background: A 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. Methods: In 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. Results: Overall, 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). Conclusions: Although 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.

Conclusion

Exercise prescription patients who made behavior changes to diet and physical activity gained greater health improvements than those who changed only one behaviour. This suggests that undertaking two energy balance behavior changes within an exercise prescription programme can improve the likelihood of achieving health improvements. This study supports existing evidence [16] that changing one’s health status requires a manipulation of an elaborate network of interacting, complimenting, and confounding factors. Adding a nutrition component to physical activity prescription programmes may increase the potential for patients to experience improvements in metabolic, physical and psychological health, potentially enabling them to reverse the deleterious co-morbidities they are at risk of experiencing otherwise. Exercise prescription programmes would become more robust and can be further personalised in their delivery approach if dietary counselling is included as part of usual care. Further studies are needed to determine the impact and economic viability of incorporating a nutritional component to exercise prescription programmes [16].