title: Four-Year Physical Activity Levels among Intervention Participants with Type 2 Diabetes.
abstract: Physical activity (PA) has numerous health benefits, particularly for those with diabetes. However, rates of long-term PA participation are often poor.
  
  
  
  This study examined the effect of an intensive lifestyle intervention (ILI) on objectively assessed PA for a 4-yr period among older adults with type 2 diabetes.
  
  
  
  Data from 2400 participants (age = 59.3 ± 6.9 yr, body mass index = 36.1 ± 5.9 kg·m) with accelerometry data from the Look AHEAD trial were included in the analyses. Participants randomized to ILI were instructed to reduce caloric intake and progress to ≥175 min·wk of moderate-to-vigorous-intensity PA (MVPA), whereas those randomized to Diabetes Support and Education (DSE) served as the control group. PA was measured at baseline, year 1, and year 4 using an RT3 accelerometer, and bout-related MVPA (PA ≥3 METs, accumulated in bouts of ≥10 min in duration) was calculated.
  
  
  
  Despite no differences at baseline (ILI = 93.4 ± 152.7 vs DSE = 88.4 ± 143.6 min·wk), bout-related MVPA was significantly greater in ILI compared with DSE at year 1 (151.0 ± 213.5 vs 87.5 ± 145.1 min·wk, P < 0.0001) and year 4 (102.9 ± 195.6 vs 73.9 ± 267.5 min·wk, P < 0.001), and more ILI participants achieved ≥175 min·wk at year 1 (29.1% vs 16.3%, P < 0.001) and year 4 (18.3% vs 10.0%, P < 0.001). Forty-one percent of ILI participants who achieved ≥175 min·wk at year 1 maintained this threshold of PA at year 4. However, the majority of ILI participants never achieved the ≥175 min·wk threshold.
  
  
  
  When measured objectively and compared with DSE, ILI engaged in significantly more bout-related MVPA for a 4-yr period. However, future intervention strategies should target the large percentage of individuals who fail to reach the MVPA goal as result of a lifestyle intervention.
authors.affiliation: 1Weight Control and Diabetes Research Center, The Miriam Hospital and Brown Medical School, Providence, RI; 2Wake Forest School of Medicine, Winston-Salem, NC; 3School of Medicine, University of Colorado, Denver, CO; 4Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA; 5Deparment of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy at the University of Gothenburg, Sweden; 6Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN; and 7Keck School of Medicine of the University of Southern California, Los Angeles, CA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Unick
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Gaussoin
authors.forename: James O
authors.initials: JO
authors.lastname: Hill
authors.forename: John M
authors.initials: JM
authors.lastname: Jakicic
authors.forename: Dale S
authors.initials: DS
authors.lastname: Bond
authors.forename: Margareta
authors.initials: M
authors.lastname: Hellgren
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.forename: Anne L
authors.initials: AL
authors.lastname: Peters
authors.forename: Mace
authors.initials: M
authors.lastname: Coday
authors.forename: Dalane W
authors.initials: DW
authors.lastname: Kitzman
authors.forename: Suzette
authors.initials: S
authors.lastname: Bossart
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
mesh_terms: D001521:Behavior Therapy; D015992:Body Mass Index; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D004038:Diet, Reducing; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic