Physical Activity and the Risk of Cardio-Metabolic Disease in the Elderly: Dose Recommendations as Seen in the Nakanojo
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PHYSICAL ACTIVITY (D WARBURTON, SECTION EDITOR)
Physical Activity and the Risk of Cardio-Metabolic Disease in the Elderly: Dose Recommendations as Seen in the Nakanojo Study Roy J. Shephard & Yukitoshi Aoyagi
Published online: 17 April 2014 # Springer Science+Business Media New York 2014
Abstract Previous information on exercise recommendations for an elderly population, based mainly on self-reports of habitual physical activity, are reviewed in the context of the Nakanojo study, where accurate objective information on a group of 5200 independently living men and women aged 65– 84 years from a small Japanese town has been obtained by continuous pedometer/accelerometer monitoring over periods of 1–5 years. Measures of physical fitness, metabolic risk factors and cardiovascular health all show correlations with habitual physical activity. Some health benefits are associated with quite low levels of activity (counts of around 6000 steps/ day and/or 9–10 minutes of activity at an intensity >3 METs), but health increases progressively with activity level to step counts of 7000–8000/day, with 15–20 minutes at an intensity >3 METs. Benefit is associated more closely with habitual activity than with aerobic fitness, and there is no evidence of the activity threshold suggested in some earlier research. A smaller proportion of health costs is attributable to cardiometabolic disease than would be the case in younger individuals. A large proportion of total health-care costs is attributable to those people in the lowest category of physical activity, but the gradation of costs from low to high activity categories is less steep for cardio-metabolic conditions than for other forms of chronic ill-health. Substantial financial benefits might accrue if at least a proportion of those in each activity category could be persuaded to increase their habitual activity This article is part of the Topical Collection on Physical Activity R. J. Shephard (*) Faculty of Kinesiology & Physical Education, University of Toronto, PO Box 521, Brackendale, BC V0N 1H0, Canada e-mail: [email protected] Y. Aoyagi Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan e-mail: [email protected]
by at least one category, a change of activity pattern showing the largest cost-benefit ratio for those in the lowest activity category. Keywords Accelerometer . Aging . Dependency . Economics, Exercise prescription, Health costs . Health policy . Maximal aerobic power . Metabolic risk factors . Pedometer . Sex differences
Introduction The clear documentation of associations between habitual physical activity and many forms of chronic disease [1, 2] created an urgent need to define dose-response relationships [3], and to specify minimum daily activity requirements for a population that claimed to find difficulty in allocating more extensive periods of time to regular physical exercise. It was suggested that currently the majority of the population in most developed societies was taking insufficient regular exerci
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