title: Randomised, controlled walking trials in postmenopausal women: the minimum dose to improve aerobic fitness?
abstract: BACKGROUND
  The American College of Sports Medicine recommends 20-60 minutes of aerobic exercise three to five days a week at an intensity of 40/50-85% of maximal aerobic power (VO(2)MAX) reserve, expending a total of 700-2000 kcal (2.93-8.36 MJ) a week to improve aerobic power and body composition.
  
  
  OBJECTIVE
  To ascertain the minimum effective dose of exercise.
  
  
  METHODS
  Voluntary, healthy, non-obese, sedentary, postmenopausal women (n = 121), 48-63 years of age, were randomised to four low dose walking groups or a control group; 116 subjects completed the study. The exercise groups walked five days a week for 24 weeks with the following intensity (% of VO(2)MAX) and energy expenditure (kcal/week): group W1, 55%/1500 kcal; group W2, 45%/1500 kcal; group W3, 55%/1000 kcal; group W4, 45%/1000 kcal. VO(2)MAX was measured in a direct maximal treadmill test. Submaximal aerobic fitness was estimated as heart rates at submaximal work levels corresponding to 65% and 75% of the baseline VO(2)MAX. The body mass index (BMI) was calculated and percentage of body fat (F%) estimated from skinfolds.
  
  
  RESULTS
  The net change (the differences between changes in each exercise group and the control group) in VO(2)MAX was 2.9 ml/min/kg (95% confidence interval (CI) 1.5 to 4.2) in group W1, 2.6 ml/min/kg (95% CI 1.3 to 4.0) in group W2, 2.4 ml/min/kg (95% CI 0.9 to 3.8) in group W3, and 2.2 ml/min/kg (95% CI 0.8 to 3.5) in group W4. The heart rates in standard submaximal work decreased 4 to 8 beats/min in all the groups. There was no change in BMI, but the F% decreased by about 1% unit in all the groups.
  
  
  CONCLUSIONS
  Walking (for 24 weeks) at moderate intensity 45% to 55% of VO(2)MAX, with a total weekly energy expenditure of 1000-1500 kcal, improves VO(2)MAX and body composition of previously sedentary, non-obese, postmenopausal women. This dose of exercise apparently approaches the minimum effective dose.
authors.affiliation: Urho Kaleva Kekkonen Institute for Health Promotion Research, PO Box 30, FIN-33501 Tampere, Finland. tm.asikainen@sci.fi
authors.forename: T-M
authors.initials: TM
authors.lastname: Asikainen
authors.forename: S
authors.initials: S
authors.lastname: Miilunpalo
authors.forename: P
authors.initials: P
authors.lastname: Oja
authors.forename: M
authors.initials: M
authors.lastname: Rinne
authors.forename: M
authors.initials: M
authors.lastname: Pasanen
authors.forename: K
authors.initials: K
authors.lastname: Uusi-Rasi
authors.forename: I
authors.initials: I
authors.lastname: Vuori
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D001823:Body Composition / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010349:Patient Compliance; D010809:Physical Fitness / Q000502:physiology*; D017698:Postmenopause / Q000502:physiology*; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*