In contrast to the traditional exercise regimen for improving heart health following heart attack − which calls for vigorous exercise three times a week − new research suggests that longer, slower, and more frequent exercise routines may actually be of greater benefit to overweight heart patients. The study was published in the May 11, 2009 online edition of the journal, Circulation.

Moderate walking is a much more effective exercise than biking or swimming because it requires the person to fully support his or her body weight.

Typically, patients in cardiac rehabilitation are told to bike, row, or walk briskly for periods of 25 to 40 minutes three times a week, but lead author Philip A. Ades says that patients don't actually burn enough calories during these routines to lose weight and help their hearts. He suggests that moderate walking is a much more effective exercise than biking or swimming because it requires the person to fully support his or her body weight (unlike in the other two activities, in which the person's weight is partially supported by the bike or water).

In the current study, 74 overweight individuals with coronary heart disease were divided into two groups. The first group was asked to do the typical types of exercises, like biking, rowing, and walking three times a week in 25 to 40 minute sessions; they burned between 700 and 800 calories per day. Participants in the second group walked five to seven times per week and burned between 3,000 and 3,500 calories per day, in hour−long sessions (they worked up to these longer sessions over a period of time).

After five months of completing their respective routines, participants in the traditional, low−calorie−burning group lost an average of eight pounds. Those in the high−calorie−burning group lost an average of 18 pounds; but not only this, they also showed increases in insulin sensitivity, reductions in cholesterol and blood pressure, as well as improvements in other factors related to cardiac and respiratory health.

A year after the study was completed, people in the low−calorie−burning group had gained back an average of 2.9 pounds. Participants in the high−calorie−burning group gained back only two pounds, a much lower percentage of total weight lost.

The authors urge health care providers to encourage their patients to participate in a higher calorie−burning regimen, wherever possible. "However you lose weight is good for heart patients and should reduce their risk," Ades said. "But don't forget the exercise. It's a big part of how to lose weight. Walking daily, walking far, really made a big difference in reducing cardiac risk."