J. Med. Internet Res. - Dose-response effects of a Web-based physical activity program on body composition and metabolic health in inactive older adults: additional analyses of a randomized controlled trial.

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Resumo

CKGROUND: Low physical activity is a major risk factor for several age-related diseases. Recently, we showed in a randomized controlled trial that a 12-week Web-based intervention (Philips DirectLife) to increase physical activity was effective in increasing physical activity levels and metabolic health in an inactive population aged 60-70 years.OBJECTIVE: The goal of this paper was to assess how many participants successfully reached the physical activity level as targeted by the intervention and what the effects of the intervention on body composition and metabolic health in these successful individuals were to provide insight in the maximum attainable effect of the intervention.METHODS: Among the 235 participants in a randomized controlled trial of the Actief en Gezond Oud (AGO) study, we assessed the effects of the intervention on metabolic parameters in those who had successfully reached their personalized physical activity target compared with the entire intervention group. Furthermore, we studied the dose-response effect of increase in physical activity on metabolic outcome within the intervention group.RESULTS: Of the intervention group, 50 of 119 (42.0%) participants successfully reached the physical activity target (corresponding to a 10% increased daily physical activity on average). This group showed markedly higher effects of the intervention compared to the entire intervention group, with greater decreases in body weight (2.74 vs 1.49 kg), waist circumference (3.74 vs 2.33 cm), insulin resistance (HOMA index: 0.23 vs 0.20), and in cholesterol/HDL ratio (0.39 vs 0.20) and Framingham risk score (0.90% vs 0.54%). We found that men compared to women were more likely to be successful. The dose-response analysis showed that there was a significant association between increase in minutes spent in moderate-to-vigorous activity and body weight loss, BMI reduction, waist circumference reduction, HDL cholesterol increasing, and cholesterol/HDL ratio lowering.CONCLUSIONS: Of the intervention group, 42.0% (50/119) reached their daily physical activity end goal, which was associated with a markedly better effect on body composition and metabolic health compared to the effect in the entire intervention group. In this population, men are more likely to be successful in increasing physical activity. Findings demonstrate that improving the effect of such physical activity interventions requires finding new ways to increase the proportion of the population reaching the targeted goal.TRIAL REGISTRATION: Dutch Trial Registry: NTR 3045; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3045 (Archived by WebCite at http://www.webcitation.org/6KPw52dCc).

Resumo Limpo

ckground low physic activ major risk factor sever agerel diseas recent show random control trial week webbas intervent philip directlif increas physic activ effect increas physic activ level metabol health inact popul age yearsobject goal paper assess mani particip success reach physic activ level target intervent effect intervent bodi composit metabol health success individu provid insight maximum attain effect interventionmethod among particip random control trial actief en gezond oud ago studi assess effect intervent metabol paramet success reach person physic activ target compar entir intervent group furthermor studi doserespons effect increas physic activ metabol outcom within intervent groupresult intervent group particip success reach physic activ target correspond increas daili physic activ averag group show mark higher effect intervent compar entir intervent group greater decreas bodi weight vs kg waist circumfer vs cm insulin resist homa index vs cholesterolhdl ratio vs framingham risk score vs found men compar women like success doserespons analysi show signific associ increas minut spent moderatetovigor activ bodi weight loss bmi reduct waist circumfer reduct hdl cholesterol increas cholesterolhdl ratio loweringconclus intervent group reach daili physic activ end goal associ mark better effect bodi composit metabol health compar effect entir intervent group popul men like success increas physic activ find demonstr improv effect physic activ intervent requir find new way increas proport popul reach target goaltrial registr dutch trial registri ntr httpwwwtrialregisternltrialregadminrctviewasptc archiv webcit httpwwwwebcitationorgkpwdcc

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