title: Effects of a web-based intervention on physical activity and metabolism in older adults: randomized controlled trial.
abstract: BACKGROUND
  Lack of physical activity leads to detrimental changes in body composition and metabolism, functional decline, and increased risk of disease in old age. The potential of Web-assisted interventions for increasing physical activity and improving metabolism in older individuals holds great promise but to our knowledge it has not been studied.
  
  
  OBJECTIVE
  The goal of our study was to assess whether a Web-based intervention increases physical activity and improves metabolic health in inactive older adults.
  
  
  METHODS
  We conducted a 3-month randomized, waitlist-controlled trial in a volunteer sample of 235 inactive adults aged 60-70 years without diabetes. The intervention group received the Internet program Philips DirectLife, which was directed at increasing physical activity using monitoring and feedback by accelerometer and digital coaching. The primary outcome was relative increase in physical activity measured objectively using ankle- and wrist-worn accelerometers. Secondary outcomes of metabolic health included anthropometric measures and parameters of glucose metabolism.
  
  
  RESULTS
  In total, 226 participants (97%) completed the study. At the ankle, activity counts increased by 46% (standard error [SE] 7%) in the intervention group, compared to 12% (SE 3%) in the control group (P(difference)<.001). Measured at the wrist, activity counts increased by 11% (SE 3%) in the intervention group and 5% (SE 2%) in the control group (P(difference)=.11). After processing of the data, this corresponded to a daily increase of 11 minutes in moderate-to-vigorous activity in the intervention group versus 0 minutes in the control group (P(difference)=.001). Weight decreased significantly more in the intervention group compared to controls (-1.5 kg vs -0.8 kg respectively, P=.046), as did waist circumference (-2.3 cm vs -1.3 cm respectively, P=.036) and fat mass (-0.6% vs 0.07% respectively, P=.025). Furthermore, insulin and HbA1c levels were significantly more reduced in the intervention group compared to controls (both P<.05).
  
  
  CONCLUSIONS
  This was the first study to show that in inactive older adults, a 3-month Web-based physical activity intervention was effective in increasing objectively measured daily physical activity and improving metabolic health. Such Web-based interventions provide novel opportunities for large scale prevention of metabolic deregulation in our rapidly aging population.
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands. c.a.wijsman@lumc.nl.
authors.forename: Carolien A
authors.initials: CA
authors.lastname: Wijsman
authors.forename: Rudi Gj
authors.initials: RG
authors.lastname: Westendorp
authors.forename: Evert Alm
authors.initials: EA
authors.lastname: Verhagen
authors.forename: Michael
authors.initials: M
authors.lastname: Catt
authors.forename: P Eline
authors.initials: PE
authors.lastname: Slagboom
authors.forename: Anton Jm
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Karen
authors.initials: K
authors.lastname: Broekhuizen
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Diana
authors.initials: D
authors.lastname: van Heemst
authors.forename: Frans
authors.initials: F
authors.lastname: van der Ouderaa
authors.forename: Simon P
authors.initials: SP
authors.lastname: Mooijaart
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008660:Metabolism; D008875:Middle Aged; D009043:Motor Activity; D011795:Surveys and Questionnaires; D014850:Waiting Lists
keywords: Internet; accelerometry; aging; metabolism; physical activity; self-monitoring