Three components of the exercise prescription
The test battery was designed to measure three important components of physical fitness. These aspects of physical fitness are important for maintaining functional independence during healthy ageing and may be adversely affected by prostate cancer and its treatments.
To address the aspects of the physical fitness, the exercise prescription is made up of three components:
- exercises to develop cardiopulmonary fitness
- exercises to build upper-body strength
- exercises to build lower-body strength.
Each component available on three different levels (low, moderate or high). The exercises are bespoke to the respective fitness or strength level and structured to build up over the 12 week programme.
Each man will be given a 12 week personalised exercise programme, comprising strength training and aerobic exercise for building cardiopulmonary fitness. Please look into patient’s Man-ual for detail information on the exercise regimen.
The weekly schedule will comprise the following:
2 x upper-body strength training sessions per week using resistance bands
2 x lower-body strength training sessions per week using resistance bands
2 x aerobic exercise and core strength training sessions per week (core strength training sessions are paired with aerobic exercise sessions)
In addition, improved joint flexibility, mobility, balance and coordination will be developed through engaging in the resistance exercises, warm-up and cool-down routines.
The underlying principle for the dietary component of the lifestyle intervention is the Mediterranean diet.
The Mediterranean diet is largely plant based and is rich in fruit and vegetables, olive oil, nuts and oily fish, with moderate intakes of poultry and low intakes of red and processed meats, dairy products and sweets.
This diet discourages the consumption of fizzy drinks, spreadable fats, processed and red meats and shop-bought sweets and bakery goods.
Diet lowering BP
Diet lowering cholesterol
The body’s ability to clear fat and other nutrients from the blood after eating lessens as the day progresses, particularly for those who are deemed to have metabolic syndrome. It is for this reason that patients in this study are advised not to eat late in the evening and to try to eat their main meal earlier in the day. If fat stays in the blood for a long time after eating (also known as enhanced post-prandial lipaemia), it has more opportunity to cause damage. Low to moderate exercise prior to eating a meal may also improve the body’s ability to clear fat from the blood more effectively.
Who needs to lose weight?
Obesity, particularly central adiposity, is a classic feature of the metabolic syndrome which contributes to the cardio-metabolic risk in this condition, and can be reduced by dietary intervention. However using just one anthropometric proxy for obesity, such as BMI, may cause certain individuals to be overlooked in terms of a need to reduce adiposity. It is for this reason that the True NTH Exercise and Diet Intervention uses combination of BMI, waist circumference and waist to hip ratio to determine whether or not a person should be allocated to a group that provides weight management advice. If any of these parameters are above the normal range, the patient is allocated to a weight reduction group.
How to lose weight
Gradual weight loss over long periods of time achieved through lifestyle change, as opposed to periods of reduced oral intake followed by ‘normal eating’, may also help to prevent weight cycling. It is known that maintaining weight is less harmful than losing and then regaining weight. Therefore if patients are following the principles of the diet, but unable to maintain their weight loss, aiming for overall weight maintenance would be preferable. Losing 1 to 2lb per week over a number of weeks, and maintaining this loss, is the most effective approach to long-term maintenance of weight loss.
Prevention of muscle loss
An increase in adiposity and reduction in muscle mass (known as sarcopenia) is linked to cardio-metabolic risk. The results of the strength assessment will indicate whether the individual should be allocated to a dietary group which is given specific advice to either maintain or gain muscle mass. If a patient has low strength either in the lower-or upper-body, he will be allocated to a group that provides specific dietary advice about prevention of muscle wastage, ie ‘PLUS’ advice.
The Mediterranean diet is suitable for the prevention of type 2 diabetes and is also applicable for the treatment of cardio-metabolic risk in type 2 diabetes. It is important to note that for men who are insulin dependent or take oral hypoglycaemic medications, particularly for those in the weight loss groups, to ensure that they do not try to lose weight more rapidly by not eating and/or skipping meals.