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Four-Year Physical Activity Levels among Intervention Participants with Type 2 Diabetes

Journal article
Authors J. L. Unick
S. A. Gaussoin
J. O. Hill
J. M. Jakicic
D. S. Bond
Margareta Hellgren
K. C. Johnson
A. L. Peters
M. Coday
D. W. Kitzman
S. Bossart
R. R. Wing
Published in Medicine & Science in Sports & Exercise
Volume 48
Issue 12
Pages 2437-2445
ISSN 0195-9131
Publication year 2016
Published at Institute of Medicine, School of Public Health and Community Medicine
Pages 2437-2445
Language en
Subject categories Diabetology, Public health science


Physical activity (PA) has numerous health benefits, particularly for those with diabetes. However, rates of long-term PA participation are often poor. Purpose This study examined the effect of an intensive lifestyle intervention (ILI) on objectively assessed PA for a 4-yr period among older adults with type 2 diabetes. Methods Data from 2400 participants (age = 59.3 ± 6.9 yr, body mass index = 36.1 ± 5.9 kg·m-2) with accelerometry data from the Look AHEAD trial were included in the analyses. Participants randomized to ILI were instructed to reduce caloric intake and progress to ≥175 min·wk-1 of moderate-to-vigorous-intensity PA (MVPA), whereas those randomized to Diabetes Support and Education (DSE) served as the control group. PA was measured at baseline, year 1, and year 4 using an RT3 accelerometer, and bout-related MVPA (PA ≥3 METs, accumulated in bouts of ≥10 min in duration) was calculated. Results Despite no differences at baseline (ILI = 93.4 ± 152.7 vs DSE = 88.4 ± 143.6 min·wk-1), bout-related MVPA was significantly greater in ILI compared with DSE at year 1 (151.0 ± 213.5 vs 87.5 ± 145.1 min·wk-1, P < 0.0001) and year 4 (102.9 ± 195.6 vs 73.9 ± 267.5 min·wk-1, P < 0.001), and more ILI participants achieved ≥175 min·wk-1 at year 1 (29.1% vs 16.3%, P < 0.001) and year 4 (18.3% vs 10.0%, P < 0.001). Forty-one percent of ILI participants who achieved ≥175 min·wk-1 at year 1 maintained this threshold of PA at year 4. However, the majority of ILI participants never achieved the ≥175 min·wk-1 threshold. Conclusions When measured objectively and compared with DSE, ILI engaged in significantly more bout-related MVPA for a 4-yr period. However, future intervention strategies should target the large percentage of individuals who fail to reach the MVPA goal as result of a lifestyle intervention. © 2016 by the American College of Sports Medicine.

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