Effects of Different Doses of Physical Activity on Cardiorespiratory Fitness Among Sedentary, Overweight or Obese Postmenopausal Women With Elevated Blood Pressure

TLDR

Low cardiorespiratory fitness is linked to higher mortality risk, while improvements reduce that risk, yet the dose–response relationship between physical activity and fitness remains poorly understood. The study aimed to evaluate how 50%, 100%, and 150% of the NIH recommended physical activity dose affect fitness in sedentary, overweight or obese postmenopausal women. A 6‑month randomized controlled trial assigned 464 sedentary, overweight or obese postmenopausal women to a nonexercise control or to exercise groups targeting 4, 8, or 12 kcal/kg/week, with training intensity set at 50% of each woman’s peak oxygen uptake. Exercise increased peak oxygen consumption by 4.2%, 6.0%, and 8.2% for the 4-, 8-, and 12‑kcal/kg/week groups respectively, showing a graded dose‑response without affecting blood pressure. Trial registered at clinicaltrials.gov (NCT00011193).

Abstract

ContextLow levels of cardiorespiratory fitness are associated with high risk of mortality, and improvements in fitness are associated with reduced mortality risk. However, a poor understanding of the physical activity–fitness dose response relation remains.ObjectiveTo examine the effect of 50%, 100%, and 150% of the NIH Consensus Development Panel recommended physical activity dose on fitness in women.Design, Setting, and ParticipantsRandomized controlled trial of 464 sedentary, postmenopausal overweight or obese women whose body mass index ranged from 25.0 to 43.0 and whose systolic blood pressure ranged from 120.0 to 159.9 mm Hg. Enrollment took place between April 2001 and June 2005 in the Dallas, Tex, area.InterventionParticipants were randomly assigned to 1 of 4 groups: 102 to the nonexercise control group and 155 to the 4-kcal/kg, 104 to the 8-kcal/kg, and 103 to the 12-kcal/kg per week energy-expenditure groups for the 6-month intervention period. Target training intensity was the heart rate associated with 50% of each woman's peak O2.Main Outcome MeasureThe primary outcome was aerobic fitness assessed on a cycle ergometer and quantified as peak absolute oxygen consumption (O2abs, L/min).ResultsThe mean (SD) baseline O2abs values were 1.30 (0.25) L/min. The mean (SD) minutes of exercising per week were 72.2 (12.3) for the 4-kcal/kg, 135.8 (19.5) for the 8-kcal/kg, and 191.7 (33.7) for the 12-kcal/kg per week exercise groups. After adjustment for age, race/ethnicity, weight, and peak heart rate, the exercise groups increased their O2abs compared with the control group by 4.2% in the 4-kcal/kg, 6.0% in the 8-kcal/kg, and 8.2% in the 12-kcal/kg per week groups (P<.001 for each vs control; P for trend <.001). There was no treatment × subgroup interaction for age, body mass index, weight, baseline O2abs, race/ethnicity, or baseline hormone therapy use. There were no significant changes in systolic or diastolic blood pressure values from baseline to 6 months in any of the exercise groups vs the control group.ConclusionIn this study, previously sedentary, overweight or obese postmenopausal women experienced a graded dose-response change in fitness across levels of exercise training. Trial Registrationclinicaltrials.gov Identifier: NCT00011193