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October 27, 1999

Lifestyle and Structured Interventions to Increase Physical Activity—Reply

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

In Reply: We agree that vigorous exercise is likely to increase fitness more than moderate intensity exercise. However, our study aimed to increase the initiation and maintenance of activities of at least moderate intensity for 30 minutes or more on most days of the week in both exercise groups. Our purpose was to evaluate a program with a public health focus to help individuals solve problems related to long-term maintenance, not to compare exercise intensities or to discourage vigorous exercise in the lifestyle group. The maintenance intervention was minimal in both groups, and we tried to equalize contact with staff for 24 months. It is not reasonable to evaluate long-term maintenance while paying facility costs, which will not happen in the everyday world. We wanted to determine what individuals would do over time if given an intensive 6-month intervention of either a lifestyle or a fitness center–based program, followed by a minimal maintenance program.