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JAMA. 1999 Jan 27;281(4):327-34.

Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial.

Author information

  • 1The Cooper Institute for Aerobics Research, Dallas, TX 75230, USA. adunn@cooperinst.org

Abstract

CONTEXT:

Even though the strong association between physical inactivity and ill health is well documented, 60% of the population is inadequately active or completely inactive. Traditional methods of prescribing exercise have not proven effective for increasing and maintaining a program of regular physical activity.

OBJECTIVE:

To compare the 24-month intervention effects of a lifestyle physical activity program with traditional structured exercise on improving physical activity, cardiorespiratory fitness, and cardiovascular disease risk factors.

DESIGN:

Randomized clinical trial conducted from August 1, 1993, through July 31, 1997.

PARTICIPANTS:

Sedentary men (n = 116) and women (n = 119) with self-reported physical activity of less than 36 and 34 kcal/kg per day, respectively.

INTERVENTIONS:

Six months of intensive and 18 months of maintenance intervention on either a lifestyle physical activity or a traditional structured exercise program.

MAIN OUTCOME MEASURES:

Primary outcomes were physical activity assessed by the 7-Day Physical Activity Recall and peak oxygen consumption (VO2peak) by a maximal exercise treadmill test. Secondary outcomes were plasma lipid and lipoprotein cholesterol concentrations, blood pressure, and body composition. All measures were obtained at baseline and at 6 and 24 months.

RESULTS:

Both the lifestyle and structured activity groups had significant and comparable improvements in physical activity and cardiorespiratory fitness from baseline to 24 months. Adjusted mean changes (95% confidence intervals [CIs]) were 0.84 (95% CI, 0.42-1.25 kcal/kg per day; P<.001) and 0.69 (95% CI, 0.25-1.12 kcal/kg day; P = .002) for activity, and 0.77 (95% CI, 0.18-1.36 mL/kg per minute; P = .01) and 1.34 (95% CI, 0.72-1.96 mL/kg per minute; P<.001) for VO2peak for the lifestyle and structured activity groups, respectively. There were significant and comparable reductions in systolic blood pressure (-3.63 [95% CI, -5.54 to -1.72 mm Hg; P<.001] and -3.26 [95% CI, -5.26 to -1.25 mm Hg; P = .002]) and diastolic blood pressure (-5.38 [95% CI, -6.90 to -3.86 mm Hg; P<.001] and -5.14 [95% CI, -6.73 to -3.54 mm Hg; P<.001) for the lifestyle and structured activity groups, respectively. Neither group significantly changed their weight (-0.05 [95% CI, -1.05 to 0.96 kg; P = .93] and 0.69 [95% CI, -0.37 to 1.74 kg; P = .20]), but each group significantly reduced their percentage of body fat (-2.39% [95% CI, -2.92% to -1.85%; P<.001] and -1.85% [95% CI, -2.41 % to -1.28%; P<.001]) in the lifestyle and structured activity groups, respectively.

CONCLUSIONS:

In previously sedentary healthy adults, a lifestyle physical activity intervention is as effective as a structured exercise program in improving physical activity, cardiorespiratory fitness, and blood pressure.

PMID:
9929085
[PubMed - indexed for MEDLINE]
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