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October 27, 1999

Lifestyle and Structured Interventions to Increase Physical Activity

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(16):1515-1517. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-16-jbk1027

To the Editor: The study by Dr Dunn and colleagues1 was particularly ambitious and commendable because of its 2-year duration and its focus on woefully unfit men and women, and the achievment of some modest risk reduction.2 However, neither intervention produced large initial or sustained increases in activity or, more importantly, in fitness. Bruce treadmill protocol time only increased 13.8 seconds for the lifestyle group and 22.2 seconds for the structured exercise group. Consequently, results for VO2peak were far less than would be expected (1-2 metabolic equivalents [METs]) from most aerobic exercise programs (an increase of 0.22 METs for lifestyle and 0.38 METs for structured) or, for that matter, what would be expected from resistance training.3 Overall, 70% to 80% of participants did not sufficiently improve fitness to be no longer considered in a high-risk category.1 While body fat decreased, the mean remained 29%.1

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