Eat less; swim more

Strange advice from USA Today, "Double up: Diet, exercise together are key to success". We've known all along that if you want to get into good shape you need to eat less and swim more:

Folks who want to get in better shape and eat healthier are often encouraged to make one change at a time, but a new study finds that people are the most successful when they tackle their diet and exercise habits simultaneously.

"It comes down to making them both priorities and thinking about both throughout the day," says lead researcher Abby King, professor at the Stanford (University) Prevention Research Center.

King and colleagues worked with 200 inactive, mostly overweight people, 45 years and older, who had relatively unhealthy diets that didn't include enough fruits and vegetables and contained too much saturated (animal) fat.

Published online in Annals of Behavioral Medicine, the study shows participants were divided into four groups: One learned to make diet and exercise changes at the same time; another learned to make diet changes first and then a few months later began working on their exercise habits. A third group changed their exercise habits first, then their diet later. And the fourth group learned stress-management techniques but did not get diet and exercise guidance.

Participants weren't trying to lose weight, just live healthier lifestyles. Health educators met with them at the beginning of the year and then called them once a month to provide advice and support.

The goals were for participants to meet the government's physical activity guidelines of doing at least 150 minutes a week of moderate-intensity physical activity, such as walking, eat five to nine servings of fruits and vegetables a day and keep their saturated fat intake to 10% or less of daily calories.

The findings after one year: Those who made changes in their diet and exercise habits at the same time did the best at meeting all three goals — eating enough fruits and vegetables, limiting saturated fat and exercising enough to meet the government's guidelines.

Participants who started with exercise first also did pretty well at meeting diet and exercise goals, but not quite as well as the group that did both at the same time, King says. Those who started with diet first managed to meet dietary goals but not their exercise goals.

She says the results were surprising, because doctors and nutritionists often encourage people to make one change at a time. "For some people, that may be the best approach, but we found that you may get the most bang for your buck by making these changes together."

This was not a weight-loss study, and participants were not taught portion control and other strategies important for weight loss, King says. However, some people did drop pounds, and researchers are studying those results now.

Tim Church, director of preventive medicine research at Pennington Biomedical Research Center in Baton Rouge, says, "This provides really strong evidence that you might as well do both from the beginning of your program."

Felicia Stoler, a registered dietitian and exercise physiologist in Holmdel, N.J., says when she works with patients she gives them both a nutrition plan and a physical-activity plan. Many people would rather change the foods they eat than their physical activity, she says. "But when people become more physically active they feel better about themselves, and they often no longer want to put bad food in their system."