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Regular Weekly Exercise Trumps High Intensity
Workout
Walking briskly for 12 miles a week sufficient for
heart health
Oct. 10, 2005 A new study confirms indications
from earlier research that it is not necessary to engage in vigorous
exercise to make significant improvement in aerobic fitness and reduce
the risk of cardiovascular disease. Its the amount of exercise one gets
in a week that makes the difference, says a study of baby boomers and
young seniors - ages 40 to 65.
A study in the October issue of CHEST, the
peer-reviewed journal of the American College of Chest Physicians (ACCP),
shows that adults who participate in mild exercise, such as walking
briskly for 12 miles or exercising for 125 to 200 minutes a week at
moderate intensity, can significantly improve their aerobic fitness and
reduce their risk of cardiovascular disease. Unlike most exercise
interventions, this finding suggests that amount may be equally or more
important as exercise intensity.
"The classic exercise regimen has a component of
intensity up to 80 percent of someone's maximum for health benefits. Our
study demonstrates that you can exercise at an intensity much less than
that and still achieve fitness benefits," said lead author Brian D.
Duscha, Duke University Medical Center, Durham, North Carolina.
"People find exercise 'hard' and few people want to
exercise at an intensity higher than they have to. Walking briskly for
12 miles a week per week is realistic and does not require anyone to
incorporate a hardcore training regimen. Increasing your mileage or
intensity will give you even greater health benefits."
Researchers from Duke University Medical Center
examined the effects of different exercise training regimens on 133
sedentary, overweight, nonsmoking patients, ages 40 to 65 years, who had
abnormal levels of fat in their blood.
Patients were divided into four exercise groups:
high-amount/high-intensity (HAHI), the equivalent of jogging 20 miles
per week at 65 to 80 percent peak Vo2; low-amount/high-intensity (LAHI),
the equivalent of jogging/walking up an inclined treadmill approximately
12 miles per week at 65 to 80 percent peak Vo2; low-amount/moderate
intensity (LAMI), the equivalent of walking approximately 12 miles per
week at 40 to 55 percent peak Vo2; and a control group of nonexercising
patients. All patients underwent cardiopulmonary exercise testing twice
at baseline and after 7 to 9 months of exercise training.
All exercise groups significantly improved their
absolute and relative peak oxygen consumption and time to exhaustion (TTE)
compared to baselines scores. Although the HAHI group showed the
greatest improvements in peak Vo2 overall, increasing exercise intensity
from 40 to 55 percent to 65 to 80 percent (at a controlled amount of 12
miles/week) did not significantly improve peak oxygen consumption, yet
increasing the amount of exercise did produce improvements. An increase
in exercise amount also demonstrated a graded increase in TTE between
groups, although data were not statistically significant.
"Although our results did point toward amount being
more important, it is very likely fitness levels can be improved by
increasing either amount or intensity," said Duscha. "This is
illustrated by the tiered effect the exercise dose had on fitness
improvements across our groups. We believe with more people in the
study, increasing intensity would also have been significant."
Body mass index (BMI) was reduced in the LAHI and
HAHI, groups but remained unchanged in the LAMI group. All exercise
groups lost an average of 2.87 pounds after exercise. Baseline
characteristics of age, BMI, weight, peak and relative Vo2, and TTE were
not different between the groups.
"A second very important message is that subjects
enjoyed fitness benefits in the absence of weight loss. Many people
exercise with the purpose of losing weight. When they do not lose
weight, they do not think the exercise is benefiting them and they stop
exercising," said Duscha.
"The truth is, you can improve your cardiovascular
fitness and reduce your risk for heart disease by exercising without
losing weight. Even if individuals do not lose weight, it is likely that
they will lose body fat and increase lean muscle mass while reducing
other risk factors."
Researchers stress that adherence to exercise
requires motivation and making exercise a priority. When beginning an
exercise regimen, researchers recommend starting slow, choosing an
activity that you like, and making exercise a social activity. For
individuals with a known illness or medical problems, consulting a
physician before starting an exercise program is also recommended.
"If you distill our results down, the public health
message is: You only need to walk briskly for 12 miles per week or for
approximately 125 to 200 minutes per week to improve your health," said
Duscha. "This sheds more light on the question, What is the minimum
amount of exercise I need to do to get a health benefit?'
"Regular exercise is an important part of a
well-balanced lifestyle," said Paul A. Kvale, MD, FCCP, President of the
American College of Chest Physicians. "Physicians and other health-care
providers should encourage their patients to engage in regular exercise
in order to obtain pulmonary and cardiovascular benefits."
CHEST is a peer-reviewed journal published by the
ACCP. It is available online each month at
http://www.chestjournal.org/ . ACCP represents 16,500 members who
provide clinical respiratory, sleep, critical care, and cardiothoracic
patient care in the United States and throughout the world. The ACCP's
mission is to promote the prevention and treatment of diseases of the
chest through leadership, education, research, and communication. For
more information about the ACCP, please visit the ACCP Web site at
http://www.chestnet.org/ .
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