Tudor-Locke C, Bell R C, Myers A M, Harris S B, Ecclestone N A, Lauzon N, Rodger N W
Department Exercise and Wellness, Arizona State University East, Mesa, AZ 85212, USA.
Int J Obes Relat Metab Disord. 2004 Jan;28(1):113-9. doi: 10.1038/sj.ijo.0802485.
To conduct a randomised trial of a physical activity (PA) intervention, The First Step Program (FSP) for adults with type II diabetes.
A 16-week intervention study and 24-week follow-up assessment.
A total of 47 overweight/obese, sedentary individuals (age=52.7 +/- 5.2 y; BMI=33.3 +/- 5.6 kg/m2) recruited through a diabetes education centre.
daily PA assessed by pedometer (steps/day).
anthropometric measures (weight, BMI, waist girth, hip girth); indicators of cardiovascular health (resting heart rate and blood pressure); glycemic control (fasting glucose, insulin, HbA1c, glucose concentration 120 min postglucose load); plasma lipid status (total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides).
Relative to the CONTROL group, FSP participants increased their PA >3000 steps/day (approximately 30 min/day) during the intervention (P<0.0001). Waist and hip girth decreased (approximately 2-3 cm), but did not differ significantly between groups. Significant changes did not emerge for any of the other variables.
The FSP is a practical intervention that elicits an immediate and profound change in walking behaviour. Such change is an important 'first step' towards increasing the volume and/or intensity of PA necessary to improve long-term health outcomes in this largely sedentary and overweight or obese population. Relapse by 24 weeks indicates that other strategies such as booster sessions are needed to maintain lifestyle change. Further research must determine realistic and responsive health outcomes for this population that are achievable through practical, real-world programming.
对一项身体活动（PA）干预措施——针对2型糖尿病成年人的“第一步计划”（FSP）进行随机试验。
一项为期16周的干预研究和为期24周的随访评估。
通过糖尿病教育中心招募的47名超重/肥胖、久坐不动的个体（年龄 = 52.7 ± 5.2岁；体重指数 = 33.3 ± 5.6千克/平方米）。
通过计步器评估的每日身体活动量（步数/天）。
人体测量指标（体重、体重指数、腰围、臀围）；心血管健康指标（静息心率和血压）；血糖控制（空腹血糖、胰岛素、糖化血红蛋白、葡萄糖负荷后120分钟血糖浓度）；血浆脂质状况（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯）。
与对照组相比，FSP参与者在干预期间每日身体活动量增加超过3000步/天（约30分钟/天）（P<0.0001）。腰围和臀围减小（约2 - 3厘米），但两组间差异不显著。其他变量均未出现显著变化。
FSP是一项切实可行的干预措施，能使步行行为立即发生显著改变。这种改变是朝着增加该久坐不动且超重或肥胖人群改善长期健康结局所需的身体活动量和/或强度迈出的重要“第一步”。24周时出现复发表明需要其他策略（如强化课程）来维持生活方式的改变。进一步的研究必须确定通过切实可行的现实世界规划能够为该人群实现的实际且有效的健康结局指标。
