Diet, Exercise Advice Works Best When Offered Together
April 22, 2013

Diet, Exercise Advice Works Best When Offered Together

Lawrence LeBlond for - Your Universe Online

It is common knowledge that to maintain a healthy lifestyle we should exercise more and eat the right foods. But current methods used to motivate people to get healthy are largely unsuccessful, in part because many focus on only one aspect of healthy living at a time. A new study by researchers from Stanford University School of Medicine has found that focusing on both exercise and diet at the same time will translate into a higher success rate, rather than tackling each area sequentially.

The research, published in Springer´s April 21 online issue of Annals of Behavioral Medicine, has also found that focusing on changing diet first — a practice weight-loss programs typically advocate — makes it more difficult for people to focus on consistent exercise routines later.

Abby King, PhD, lead author of the new study and professor of health research and policy and medicine at Stanford, said it would make more sense to offer both pieces of health advice at the same time. However, she noted, if one must come first, then it should be physical activity.

When healthy living advice comes in subsequent messages, it can be difficult for people to follow through. With each new goal given people are forced to further motivate themselves, and with the already busy and stressful lives most people lead, more demanding motivation may be too much for them to handle. Therefore, the new study tested one method against the other to see which one was more beneficial in the long-term.

For the study, the researchers split 200 initially inactive patients — ages 45 and older with poor diets — into four different groups. Each group received a different form of advice over the phone: either to make changes to diet and exercise at the same time; make dietary changes first and then two months later follow through with exercise changes; make exercise changes first and dietary changes later; and the last group was only given stress-management advice. Researchers tracked all four groups for a year.

The participants were offered advice based on national guidelines for healthy living. For exercise, 150 minutes per week; for nutrition, five to nine fruit and vegetable servings daily, and keeping calories from saturated fats to 10 percent or less of total intake.

The study found that those who followed the exercise plan first did a good job of meeting both exercise and dietary goals, but not quite as good as those who were given the advice for both changes at the same time. Those who started with diet first did a good job at meeting dietary goals but failed to meet their exercise goals.

King believes it may be too challenging and demanding for people to diet first then try to add an exercise regime at a later time. "With dietary habits, you have no choice; you have to eat," she said in a statement. "You don't have to find extra time to eat because it's already in your schedule. So the focus is more on substituting the right kinds of food to eat."

But when it comes time to add in the exercise, most people already have a busy schedule and find it hard-pressed to add in a new routine to their daily lives. She noted that even the most successful group in the study, those receiving both pieces of advice simultaneously, struggled to meet the physical activity goal at first, but over the course of the year eventually worked it in.

King said that it was likely the way health educators went about explaining diet and exercise to the participants that gave them the overall success and high retention rate in the study. The advisers met with each person just once before the start of the year-long study. After that, they called once per month, spending anywhere from 15 to 40 minutes offering further advice and support for diet and exercise.

King said this approach was the best overall method for the participants, whose stressful lives and busy schedules previously interfered with making healthy lifestyle choices. "These health behaviors aren't things that we change over a six-week period and then our job is done," she said. "They're things that people grapple with their whole lives, so to develop 'touches' of advice and support in a cost-efficient way is becoming more and more important."

"The results suggest that, in the current population, delivering physical activity and dietary interventions simultaneously may result in the most positive sustained outcomes across these two important health behaviors," report the authors in the research paper.

Participants in the latest study were not actively trying to lose weight, but were trying to develop healthy habits. The next goal for the team is to test the same sequential-versus-simultaneous approaches among people who are trying to lose weight.