The researchers divided 200 participants into four groups. All participants were aged 45 years and older, did little exercise, ate fewer than five fruit and vegetable portions per day and had a higher than recommended saturated fat intake.
The four groups were given differing sequences of telephone-based advice: one group received exercise advice first, then nutrition advice was added after four months; a second group was given nutrition advice first, then exercise advice was added after four months; the third group received simultaneous delivery of nutrition and exercise advice; and a control group was advised on stress management only.
While all three groups showed positive increases in their dietary patterns relative to controls, there were differences in success when it came to physical activity.
Participants who had received the exercise advice first significantly increased their physical activity levels at four months relative to controls, whereas physical activity did not increase significantly in the ‘simultaneous’ group at this early stage.
Until now, health professionals were concerned that people would find multiple messages overwhelming and had encouraged making small changes, one at a time.
Researchers now believe this method may actually end up reducing compliance. Each subsequent change requires another bout of motivation which may, by then, be in short supply.