The effects of aerobic exercise on metabolic risk, insulin sensitivity and intrahepatic lipid in healthy older people from the Hertfordshire Cohort Study: a randomised controlled trial.
OBJECTIVE
We sought to determine the effect of an aerobic exercise intervention on clustered metabolic risk and related outcomes in healthy older adults in a single-centre, explanatory randomised controlled trial.


METHODS
Participants from the Hertfordshire Cohort Study (born 1931-1939) were randomly assigned to 36 supervised 1 h sessions on a cycle ergometer over 12 weeks or to a non-intervention control group. Randomisation and group allocation were conducted by the study co-ordinator, using a software programme. Those with prevalent diabetes, unstable ischaemic heart disease or poor mobility were excluded. All data were collected at our clinical research facility in Cambridge. Components of the metabolic syndrome were used to derive a standardised composite metabolic risk score (zMS) as the primary outcome. Trial status: closed to follow-up.


RESULTS
We randomised 100 participants (50 to the intervention, 50 to the control group). Mean age was 71.4 (range 67.4-76.3) years. Overall, 96% of participants attended for follow-up measures. There were no serious adverse events. Using an intention-to-treat analysis, we saw a non-significant reduction in zMS in the exercise group compared with controls (0.07 [95% CI -0.03, 0.17], p = 0.19). However, the exercise group had significantly decreased weight, waist circumference and intrahepatic lipid, with increased aerobic fitness and a 68% reduction in prevalence of abnormal glucose metabolism (OR 0.32 [95% CI 0.11-0.92], p = 0.035) compared with controls. Results were similar in per-protocol analyses.


CONCLUSIONS
Enrolment in a supervised aerobic exercise intervention led to weight loss, increased fitness and improvements in some but not all metabolic outcomes. In appropriately screened older individuals, such interventions appear to be safe.


BACKGROUND
Controlled-trials.com ISRCTN60986572


BACKGROUND
Medical Research Council.
Finucane
F M
FM
MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Box 285, Hills Road, Cambridge CB2 0QQ, UK. francis.finucane@mrc-epid.cam.ac.uk
Sharp
S J
SJ
Purslow
L R
LR
Horton
K
K
Horton
J
J
Savage
D B
DB
Brage
S
S
Besson
H
H
De Lucia Rolfe
E
E
Sleigh
A
A
Martin
H J
HJ
Aihie Sayer
A
A
Cooper
C
C
Ekelund
U
U
Griffin
S J
SJ
Wareham
N J
NJ
D000368:Aged; D000369:Aged, 80 and over; D001642:Bicycling / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control; D004739:England / Q000453:epidemiology; D015444:Exercise; D005951:Glucose Tolerance Test; D006801:Humans; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D010809:Physical Fitness; D012307:Risk Factors; D012984:Software; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference; D015431:Weight Loss
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008055:Lipids; D014280:Triglycerides