Beginning an exercise program and embarking on a diet are difficult behaviors independently, much less trying to do both at the same time. But new research suggests a person may be more compliant and successful with their program if both new behaviors are initiated at the same time.
The study, by Abby King, Ph.D., and colleagues from the Stanford School of Medicine is published in the journal Annals of Behavioral Medicine.
Medical professionals, health experts and policy advisers know that 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.
Until now, health professionals were concerned that people would find multiple messages overwhelming and had encouraged making small changes, one at a time.
Researchers now believe this method may actually end up reducing compliance. 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.
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 behaviors 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.
Experts believe that focusing similar attention on both health behaviors from the start may signal the importance of making both a priority.