Asikainen T-M, Miilunpalo S, Kukkonen-Harjula K, Nenonen A, Pasanen M, Rinne M, Uusi-Rasi K, Oja P, Vuori I
UKK Institute for Health Promotion Research, Tampere, Finland.
Scand J Med Sci Sports. 2003 Oct;13(5):284-92. doi: 10.1034/j.1600-0838.2003.00331.x.
We studied the fractionization of walking training and searched for the minimum dose to affect coronary risk factors in two randomized controlled trials. Altogether 134 (Study I) and 121 (Study II) healthy, sedentary postmenopausal women started the trials, and 130 (Study I) and 116 (Study II) completed them. In Study I the exercise intensity was 65% of the maximal aerobic power (VO2max) and a total of 300 kcal was expended in one (Group W1) or two (Group W2) daily walking bouts. In Study II the exercise was continuous, and the exercise intensity (% of VO2max) and energy expenditure (kcal session(-1)) were 55% and 300 kcal (Group W3), 45% and 300 kcal (Group W4), 55% and 200 kcal (Group W5) and 45% and 200 kcal (Group W6). All the subjects walked 5 days a week. The outcome measures were blood pressure, serum lipoproteins and blood glucose and plasma insulin in fasting state and also during 2-h oral glucose tolerance test in Study I. There was no change in diastolic pressure in the original study groups, but in the combined exercise group (W1+W2) in Study I, the mean diastolic pressure declined by -3.0 mmHg (95% con-fidence interval (CI) -5.5 to -0.4) (P=0.025) in comparison with that of the controls. The mean blood glucose declined by -0.21 mmol L(-1) (CI -0.33 to -0.09) in Group W1 and -0.13 mmol L(-1) (CI -0.25 to -0.01) in Group W2 compared to controls (P=0.03). Also the 2-h glucose concentration decreased in Groups W1 and W2 compared to controls. Systolic blood pressure, serum lipoproteins and insulin levels did not change in Study I or Study II. We conclude that our training program with the greatest exercise dose, exercise intensity 65% of VO2max and weekly expenditure of 1500 kcal had a minimal, positive effect on diastolic pressure and blood glucose, and the effect was similar in one or two daily exercise session groups. This exercise dose is probably close to the minimum to affect coronary risk factors in healthy postmenopausal women. To get a more pronounced and clinically relevant effect, a greater exercise dose is needed.
我们在两项随机对照试验中研究了步行训练的分次进行情况，并探寻影响冠心病危险因素的最小剂量。共有134名（研究I）和121名（研究II）健康、久坐的绝经后女性开始试验，130名（研究I）和116名（研究II）完成试验。在研究I中，运动强度为最大有氧能力（VO₂max）的65%，每日一次（W1组）或两次（W2组）步行消耗的总热量为300千卡。在研究II中，运动是持续进行的，运动强度（VO₂max的百分比）和能量消耗（千卡/次）分别为55%和300千卡（W3组）、45%和300千卡（W4组）、55%和200千卡（W5组）以及45%和200千卡（W6组）。所有受试者每周步行5天。观察指标包括血压、血清脂蛋白、空腹状态下以及研究I中2小时口服葡萄糖耐量试验期间的血糖和血浆胰岛素。在最初的研究组中舒张压没有变化，但在研究I的联合运动组（W1 + W2）中，与对照组相比，平均舒张压下降了 -3.0 mmHg（95%置信区间（CI）-5.5至-0.4）（P = 0.025）。与对照组相比，W1组平均血糖下降了 -0.21 mmol/L（CI -0.33至-0.09），W2组下降了 -0.13 mmol/L（CI -0.25至-0.01）（P = 0.03）。与对照组相比，W1组和W2组的2小时血糖浓度也降低了。研究I和研究II中的收缩压、血清脂蛋白和胰岛素水平均未改变。我们得出结论，我们的训练方案，即最大运动剂量、运动强度为VO₂max的65%且每周消耗1500千卡热量，对舒张压和血糖有最小的积极影响，并且在每日一次或两次运动组中的效果相似。这个运动剂量可能接近影响健康绝经后女性冠心病危险因素的最小剂量。为了获得更显著且具有临床意义的效果，则需要更大的运动剂量。
