CME article in Medscape this week:

CAN MODERATE EXERCISE EXTEND LIFE?
http://mp.medscape.com/cgi-bin1/DM/y/evTV0Jgw360Dz10G4rC0E

Extract only below.
well wishes,
kate
Physical Activity for Mental Health:
http://uk.groups.yahoo.com/group/PhysicalActivityforMentalHealth

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"Clinical Context

While it appears certain that exercise is part of a healthy lifestyle, what
constitutes an adequate program of exercise is less clear. In the current
issue of the Archives of Internal Medicine, Franco and colleagues examine
the study cohort from the Framingham Heart Study to compare levels of
physical activity in terms of their impact on life expectancy. Compared
with men aged 50 years or older with low levels of physical activity,
moderate and high levels of physical activity added a mean of 1.3 and 3.7
years of added life expectancy, respectively. The respective mean added
years without CVD were 1.1 and 3.2. These data for women participating in
the study were roughly similar to that of the men.

The current study by Duncan and colleagues further compares different
intensities and frequencies of exercise. The authors examine fitness levels
as well as lipid levels based on these exercise variables.

Study Highlights

* Patients eligible for study participation were adults between the
ages of 30 and 69 years old and who exercised at a moderate intensity for
less than 1 hour per week. Subjects had a body mass index between 19 to 45
kg pert m2 and a normal resting blood pressure.
* Participants underwent baseline testing for exercise capacity and
were then randomized to 1 of 4 treatment groups: a ModI-LowF, a ModI-HiF, a
HardI-LowF, and a HardI-HiF group. There was also a group that received
only physician advice regarding appropriate exercise (control group).
Exercise intensity was determined by heart rate zones determined at
baseline: moderate intensity correlated with the 45% to 55% increment of
this scale, while HardI correlated with the 65% to 75% increment. LowF was
defined as 3 to 4 days per week of exercise, while the HiF group exercised
5 to 7 days per week. All participants were instructed to walk 30 minutes
to achieve their exercise outcome.
* All subjects in the exercise group received regular counseling on
their intervention.
* Participants were followed up for maximum oxygen consumption during
exercise, HDL-C level, and total cholesterol/HDL-C level. These outcomes
were assessed at baseline and 6 and 24 months.
* 429 participants underwent randomization, including 315 women and
177 men. 76.4% of the cohort was white, and the percentage of African
American and Hispanic subjects was 15.9% and 4.1%, respectively. The mean
age of participants was 48.4 years. Baseline conditions were similar
between the randomization groups.
* 83.5% of participants were available for follow-up at 6 months, and
69.5% presented for evaluation at 24 months. In the ModI groups, 88% of
subjects were able to perform at their prescribed exercise level, and this
rate dropped to 71% in the HardI group.
* The metabolic equivalent hours per week of exercise varied between
6.77 in the HardI-HiF group to 3.64 in the ModI-LowF group.
* At 6 months, maximal oxygen consumption during exercise was
increased from baseline in the HardI-HiF, HardI-LowF, and ModI-HiF groups.
Moreover, subjects in the HardI-HiF group experienced a significant
improvement in this outcome vs the control group. At 24 months, the
exercise capacity of the HardI-HiF group remained better than the control
or ModI-LowF groups.
* At 6 months, only the HardI-HiF group demonstrated a significant
improvement in HDL-C (increases of 3.88 vs 0.99 mg/dL, respectively) and
total cholesterol/HDL-C (-3.32 vs 0.78, respectively). There was no
difference between the active intervention and control groups at 24 months.
* The exercise interventions did not significantly affect body weight,
blood pressure, or blood glucose levels.
* Based on these data, the authors recommend that 60 to 90 minutes per
week of brisk walking or 90 minutes per week of leisurely walking can
improve cardiorespiratory fitness in adults."