A Calorie-Burning Cardiac Rehab Program

Cardiac rehabilitation programs have traditionally emphasized aerobic exercise - relatively short (20 - 30 minutes) of relatively high-intensity exercise, aiming for a high target heart rate (generally, 50 - 85% of the person's maximum heart rate). The idea is to place a controlled amount of "strain" on the cardiovascular system in order to strengthen it.

But this week, investigators report in the medical journal Circulation that a different form of cardiac rehabilitation might be even better at improving a person's cardiac risk profile. It is called "high-calorie-expenditure exercise," and emphasizes sustained, low-intensity exercise aimed at burning as many calories as possible. Specifically, the program emphasizes walking at a moderate pace for at least 45 - 60 minutes per day, at least 5 - 6 days per week. For most individuals, this program will result in burning an "extra" 3000 - 3500 calories per week, which translates to nearly 1 pound of weight per week. (Typical rehab programs of shorter, higher-intensity exercise result in about 800 calories burned per week.) This new kind of rehab program also emphasizes counting (and limiting) the number of calories eaten, so that the overall result is designed to be a sustainable loss of weight.

In a small clinical trial involving 74 patients with significant coronary artery disease, those receiving the "calorie-burning" variety of cardiac rehab lost more weight, more total fat, and more abdominal fat (and more waist circumference) than those receiving the standard form of cardiac rehab, and had a significantly greater improvement in their cardiovascular risk profile (including cholesterol values). The significant improvement in cardiac risk persisted for the 1-year follow-up evaluation.

This small clinical trial will certainly not be sufficient to change clinical practice or formal medical guidelines. But it does point out that a) there is more than one way to accomplish cardiac rehabilitation, and b) a calorie-burning walking program can significantly improve your cardiac risk, whether you have known coronary artery disease or not.

For guidance on starting your own walking program, visit About.com's Walking site.

_Sources:

Ades PA, Savage PD, Toth MJ, et al. High-calorie-expenditure exercise. A new approach to cardiac rehabilitation for overweight coronary patients. Circulation 2009; DOI: 10.1161/CIRCULATIONAHA.108.834184.