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Long-Term Commitment continued...

At follow-up, 161 active and 136 sedentary people were studied. There was no difference in drop-outs between the groups, say the researchers. Most of the exercise group met their criteria.

That's rare. "In our experience and supported in the literature, retention and compliance with these programs is difficult over the long term," they write, calling for more work to try to change that.

Some people in the comparison group (8%) said they had exercised during the study. That was fine with the researchers; they weren't about to discourage anyone from working out. However, those adults didn't exercise for more than 18 consecutive months, and none said they were following a specific training plan or guidelines.

The exercise group fared best across the board. Their gains included:

  • Higher fitness level. A small increase in fitness was seen in the exercise group, compared with a 13% drop in that of the sedentary group.
  • Lower prevalence of risk factors linked to heart disease. Metabolic syndrome was seen in 11% of the exercise group, compared to 28% of the sedentary group after 10 years. Metabolic syndrome is a group of risk factors that increase the risk of heart disease and can lead to type 2 diabetes. The risks include excess body fat (especially around the waist), high blood fat (triglycerides), high blood pressure, and low HDL "good" cholesterol.
  • Fewer signs and symptoms of heart disease during exercise.
  • Fewer illnesses besides heart disease (comorbid conditions).
  • Increase in HDL "good" cholesterol. A 9% increase in HDL occurred in the exercise group, compared with an 18% drop in the sedentary group.

The numbers of participants who died of heart problems or entered a nursing home during the study were very small in both groups, but the active group had a slight edge.

Seven exercise participants entered a nursing home, compared with 16 from the sedentary group.

Four deaths in the exercise group stemmed from the heart, compared with six in the sedentary group.

Other Influences?

Like exercise, diet can make a big difference in health. But the study didn't track how participants ate. No one knew what the adults were putting on their plates.

It's also possible that because the exercise group wanted to work out instead of being told to, they might be a bit different from other people. The researchers say they tried to take that into account, but that wasn't their main focus.

"It was not the objective of this study to test the multifaceted issues of exercise adoption and maintenance in the community, but rather to determine how older individuals who self-selected participation in an exercise training program differed in terms of metabolic risk from those who did not," write Robert Petrella, MD, PhD, and colleagues.

Their study appears in the March issue of Diabetes Care.

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