A worrisome increase in obesity levels in much of the world
suggests that current methods of motivating people to eat healthier food and
get more exercise are not all that successful. Much of today's research focuses
on ways of delivering messages in order to obtain the best sustained adherence
to these two key health behaviours.
One such study by Abby King and colleagues from the Stanford
School of Medicine in California looks at the timing of giving exercise and
nutrition advice. The researchers found that a higher success rate might be
possible when the advice is given at the same time. Their study is published in
Springer's Annals of Behavioral Medicine.
Healthy living a source
Given the busy and stressful lives many people lead, advice
on healthy eating or physical activity often ends up being just another source
of stress. Many health professionals believe that people find multiple messages
overwhelming and this has led to an emphasis on making small changes, one at a
time. However, some researchers suggest that this method may actually end up
Each subsequent change requires another bout of motivation
which may, by then, be in short supply. The current study was therefore
designed to systematically test one method against the other to see which might
be more beneficial long-term.
The researchers divided 200 participants into four groups.
All participants were aged 45 years and older, did little exercise, ate fewer
than five fruit and vegetable portions per day and had a higher than
recommended saturated fat intake. They also reported elevated stress levels.
The four groups were given differing sequences of telephone-based advice: one
group received exercise advice first, then nutrition advice was added after
four months; a second group was given nutrition advice first, then exercise
advice was added after four months; the third group received simultaneous
delivery of nutrition and exercise advice; and a control group was advised on
stress management only.
What the study found
While all three groups showed positive increases in their
dietary patterns relative to controls, there were differences in success when
it came to physical activity. Participants who had received the exercise advice
first significantly increased their physical activity levels at four months
relative to controls, whereas physical activity did not increase significantly
in the 'simultaneous' group at this early stage. However, by 12 months, both
the exercise-first and simultaneous groups had increased their exercise to the
nationally recommended levels.
In contrast, the group obtaining the nutrition advice first
was not, on average, able to increase their exercise to the recommended levels
by 12 months. Those in the simultaneous group were the only ones who succeeded
in meeting the national recommendations for both dietary and physical activity behaviours
at 12 months.
These results suggest that it may be easier to incorporate
changes in eating habits than exercise, particularly when eating patterns are
targeted at the beginning of a program. This could be because eating is already
a scheduled activity. Adding physical activity to an already busy schedule may
be more difficult, especially when people are attempting to change their eating
habits as well. Focusing similar attention on both health behaviours from the
start may signal the importance of making both a priority.
According to the authors, "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 behaviours." Similarly, the potential interference
effects of early dietary intervention on subsequent physical activity changes
merit further study.