Abstract
Background: STRRIDE (Studies Targeting Risk Reduction Interventions through Defined Exercise) was an eight-month exercise study conducted from 1998–2003. Subjects were randomized to control or one of three exercise groups differing in intensity and amount. To determine if there were legacy effects, we invited 161 individuals who completed the intervention phase to return for a 10-year Reunion study.Methods: Subjects completed medical history and physical activity questionnaires. Height, body weight, blood pressure, waist circumference, and peak VO2 were measured. Fasting blood samples were analyzed for glucose, insulin and lipids. Of 161 original subjects, 153 were within 10 years of STRRIDE completion. Of these, 28 were lost to follow-up and 21 declined to participate in the Reunion study. Overall, 104 subjects (83% eligible) participated. Change over time was computed as the 10-year Reunion value minus the pre-intervention value. Significant within group changes were calculated using two-tailed t-tests. ANCOVA determined differences among groups with pre-intervention values as covariates. Bonferroni corrections were applied to account for multiple comparisons.Results: Ten years after completing STRRIDE, there were a number of group-specific health and fitness legacy effects. Original participation in either the moderate intensity exercise or control group resulted in a 10.5% decrease in peak VO2 over the ensuing 10 years. Conversely, both vigorous intensity groups experienced only a 4.7% decrement in cardiorespiratory fitness over that time period. As compared to controls, all three exercise groups experienced smaller increases in waist circumference. Those who participated in moderate intensity exercise experienced the greatest 10-year reduction in fasting insulin. Compared to all other groups, the moderate intensity subjects had greater reductions in mean arterial pressure at the Reunion timepoint.Summary: Ten years after completing a randomized eight-month exercise training intervention, previously sedentary individuals exhibited group-specific differences consistent with an intervention-based legacy effect on cardiorespiratory fitness and cardiometabolic parameters. These findings highlight the critical need to better understand the sustained legacy health effects of exercise training interventions.
Highlights
According to the 2008 United States Physical Activity Guidelines Advisory Committee Report, “Very strong scientific evidence based on a wide range of well-conducted studies shows that physically active people have higher levels of health-related fitness, a lower risk profile for developing a number of disabling medical conditions, and lower rates of various chronic diseases than do people who are inactive” (Physical Activity Guidelines Advisory Committee, 2008)
Aerobic exercise interventions lead to improvements in cardiorespiratory fitness and cardiometabolic disease risk factors
Between-group differences in glycated hemoglobin were lost within one year of treatment cessation, over 66,000 person-years of followup revealed significant, persistent cardiovascular benefits of intensive blood glucose control therapy on micro- and macrovascular complications compared to patients randomized to the conventional therapy group (Holman et al, 2008)
Summary
According to the 2008 United States Physical Activity Guidelines Advisory Committee Report, “Very strong scientific evidence based on a wide range of well-conducted studies shows that physically active people have higher levels of health-related fitness, a lower risk profile for developing a number of disabling medical conditions, and lower rates of various chronic diseases than do people who are inactive” (Physical Activity Guidelines Advisory Committee, 2008). The legacy effect concept was first discussed in the medical literature by Holman et al (2008) regarding 10-year post-trial followup of the United Kingdom Prospective Diabetes Study. Between-group differences in glycated hemoglobin were lost within one year of treatment cessation, over 66,000 person-years of followup revealed significant, persistent cardiovascular benefits of intensive blood glucose control therapy (sulfonylurea-insulin or metformin) on micro- and macrovascular complications compared to patients randomized to the conventional therapy group (Holman et al, 2008). Additional results supporting potential legacy health effects have been documented from longterm follow-up of lipid-lowering statin trials, including reduced cardiovascular events and all-cause mortality, and increased quality-of-life compared to controls (Sever et al, 2011; Kashef and Giugliano, 2016). To determine if there were legacy effects, we invited 161 individuals who completed the intervention phase to return for a 10-year Reunion study
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