Abstract
Cardiometabolic disease is a major cause of disability and death among older people. The scientific evidence purporting the cardiometabolic health benefits of moderate intensity, habitual physical activity among older adults has grown in recent years. Regular, moderate intensity physical activity is associated with lower resting blood pressure, less abdominal adiposity, improved blood lipids-lipoproteins and glucose homeostasis and reduced mortality and morbidity from coronary heart disease. Although more vigorous intensity exercise confers similar cardiometabolic health benefits, it predisposes older people to increased risk of injury and sudden death. Older adults prefer to engage in light to moderate intensity physical activities such as walking and activities of daily living. For these reasons, a cardiometabolic approach to exercise prescription is presented emphasising daily accumulated, familiar and enjoyable light to moderate intensity, aerobic physical activity supplemented by resistive exercise for the functionally able older adult.
Similar content being viewed by others
References
Pescatello LS, DiPietro L. Physical activity in older adults an overview of health benefits. Sports Med 1993; 15: 353–64
Fried LP, Kronmal RA, Newman AB, et al. Risk factors for 5-year mortality in older adults the cardiovascular health study. JAMA 1998; 279: 585–92
Gartside PS, Wang P, Glueck CJ. Prospective assessment of coronary heart disease risk factors: the NHANES I epidemiologic follow-up study (NHEFS) 16-year follow-up. JAmColl Nutr 1998; 17: 263–9
Hakim AA, Curb D, Petrovitch H, et al. Effects of walking on coronary heart disease in elderly men: the Honolulu Heart Program. Circulation 1999; 100: 9–13
Katzel LI, Bleecker ER, Colman EG, et al. Effects of weight loss vs aerobic exercise training on risk factors for coronary disease in healthy, obese, middle-aged and older men: a randomized controlled trial. JAMA 1995; 274: 1915–21
Mayer-Davis EJ, D’Agostino R, Karter AJ, et al. Intensity and amount of physical activity in relation to insulin sensitivity: the insulin resistance atherosclerosis study. JAMA1998; 279: 669–74
Pescatello LS, DiPietro L. Daily movement, adiposity and blood glucose among older adults of middle to lower socioeconomic status. Am J Public Health 1996; 86: 592–3
Pescatello LS, Murphy D. Lower intensity physical activity is advantageous for fat distribution and blood glucose among viscerally obese older adults. Med Sci Sports Exerc 1998; 30: 1408–13
Rodriguez BL, Curb D, Burchfiel CM, et al. Physical activity and 23-year incidence of coronary heart disease morbidity and mortality among middle-aged men: the Honolulu Heart Program Study. Circulation 1994; 89: 2540–4
Rosengren A, Wilhelmsen L. Physical activity protects against coronary death and deaths from all causes in middle-aged men: evidence from a 20-year follow up of the primary prevention study in Göteborg. Ann Epidemiol 1997; 7: 69–75
Stevenson ET, Davy KP, Seals DR. Hemostatic, metabolic, and androgenic risk factors for coronary heart disease in physically active and less active postmenopausal women. Arterioscler Thromb Vasc Biol 1995; 15: 669–77
Stevenson ET, DeSouza CA, Parker-Jones P, et al. Physically active women demonstrate less adverse age-related changes in plasma lipids and lipoproteins. Am J Cardiol 1997; 80: 1360–4
Wannamethee SG, Shaper AG, Walker M. Changes in physical activity, mortality, and incidence of coronary heart disease in older men. Lancet 1998; 351: 1603–8
American College of Sports Medicine Position Stand. Physical activity, physical fitness, and hypertension. Med Sci Sports Exerc 1993; 25: 1–10
American College of Sports Medicine and American Diabetes Association Joint Position Stand. Diabetes mellitus and exercise. Med Sci Sports Exerc 1997; 29: 1–6
American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in health adults. Med Sci Sports Exerc 1998; 30: 975–91
American College of Sports Medicine Position Stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 1998; 30: 992–1008
Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273: 402–7
US Department of Health and Human Services. Physical activity and health: a report of the surgeon general. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention, and National Center for Chronic Disease Prevention and Promotion, 1996
Leon AS, editor. National Institutes of Health. Physical activity and cardiovascular health: a national consensus. Champaign (IL): Human Kinetics, 1997
National Institutes of Health, National Heart, Lung and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Washington, DC: US Department of Health and Human Services, 1998
Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. Circulation 1998; 97: 2099–100
Després JP, Lamarche B, Mauriege P, et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med 1996; 334: 952–7
Després JP. Visceral obesity, insulin resistance, and dyslipidemia: contribution of endurance exercise training to the treatment of the plurimetabolic syndrome. Exp Sports Sci Rev 1997; 25: 271–300
Carey DG, Jenkins AB, Campbell LV, et al. Abdominal fat and insulin resistance in normal and overweight women: direct measurements reveal a strong relationship in subjects at both low and high risk of NIDDM. Diabetes 1996; 45: 633–8
Rexrode KM, Carey VJ, Hennekens CH, et al. Abdominal adiposity and coronary heart disease in women. JAMA 1998; 280: 1843–8
Wickelgren I. Obesity: how big a problem? Do ‘apples’ fare worse than ‘pears’? Science 1998; 280: 1364–7
Folsom AR, Kaye SA, Sellers TA, et al. Body fat distribution and 5-year risk of death in older women. JAMA 1993; 269: 483–7
Thune I, Njolstad I, Lochen ML, et al. Physical activity improves the metabolic risk profiles in men and women. Arch Intern Med 1998; 158: 1633–40
Pescatello LS. Exercise prescription and management for cardiometabolic health. ACSM Health Fitness J 1999; 3: 15–21
Bouchard C, Tremblay A, Nadeau A, et al. Long-term exercise training with constant energy intake. 1: effect on body composition and selected metabolic variables. Int J Obes 1990; 14: 57–73
Després JP, Pouliot MC, Morrjani S, et al. Loss of abdominal fat and metabolic response to exercise training in obese women. Am J Physiol 1991; 261: E159–67
Després JP, Lamarche B. Effects of diet and physical activity on adiposity and body fat distribution: implications for the prevention of cardiovascular disease. Nutr Res Rev 1993; 6: 137–59
Lamarche B, Després JP, Pouliot MC, et al. Is body fat loss a determinant factor in the improvement of carbohydrate and lipid metabolism following aerobic exercise training in obese women? Metabolism 1992; 41: 1249–56
Després JP, Lamarche B. Low-intensity endurance exercise training, plasma lipoproteins and the risk of coronary heart disease. J Intern Med 1994; 236: 7–22
Grundy SM. Small LDL, atherogenic dyslipidemia, and themetabolic syndrome. Circulation 1997; 95: 1–4
Haffner SM, Lehto S, Ronnemaa T, et al. Mortality from coronary heart disease in subjects with Type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339: 229–334
Superko RH. The most common cause of coronary heart disease can be successfully treated by the least expensive therapy: exercise. Certif News 1998; 8: 1–5
Grundy SM. Cholesterol management in patients with heart disease emphasizing secondary prevention to increase longevity. Postgrad Med 1997; 102: 81–90
DiPietro L. The epidemiology of physical activity and physical function in older people. Med Sci Sports Exerc 1996; 28: 596–600
Unger JB, Johnson CA, Marks G. Functional decline in the elderly: evidence for direct and stress-buffering protective effects of social interactions and physical activity. Ann Behav Med 1997; 19: 152–60
Davis JW, Ross PD, Preston SD, et al. Strength, physical activity, and body mass index: relationship to performance-based measures and activity of daily living among older Japanese women in Hawaii. J Am Geriatr Soc 1998; 46: 274–9
Spirduso WW. Physical dimensions of aging. Champaign (IL): Human Kinetics, 1995
Morey MC, Pieper CF, Cornoni-Huntley J. Is there a threshold between peak oxygen uptake and self-reported physical functioning in older adults? Med Sci Sports Exerc 1998; 30: 1223–9
Pescatello LS, Judge JO. The influence of physical activity and physical fitness on functional capacity in older adults. In: Spivack B, editor. Mobility and gait. New York (NY):Marcel Decker Inc., 1994: 325–39
Fitzgerald MG, Tanaka H, Tran ZV, et al. Age-related declines in maximal aerobic capacity in regularly exercising vs. sedentary women: a meta-analysis. J Appl Physiol 1997; 83: 160–5
Tanaka H, DeSouza CA, Jones PP, et al. Greater rate of decline in maximal aerobic capacity with age in physically active vs. sedentary healthy women. J Appl Physiol 1997; 83: 1947–53
Pereira MA, Kriska AM, Day RD, et al. A randomized walking trial in postmenopausal women effects on physical activity and health 10 years later. Arch InternMed 1998; 158: 1695–701
Bijnen FC, Feskens EJM, Caspersen CJ, et al. Age, period, and cohort effects on physical activity among elderly men during 10 years of follow-up: the Zutphen elderly study. J Gerontol 1998; 53A: M235–41
Caspersen CJ, Merritt RK. Physical activity trends among 26 states, 1986–1990. Med Sci Sports Exerc 1995; 27: 713–20
American Heart Association. 1998 heart and stroke statistical update. Dallas (TX): American Heart Association, 1997
Sherman SE, D’Agostino RB, Cobb JL, et al. Physical activity and mortality in women in the Framingham heart study. Am Heart J 1994; 128: 879–84
Regensteiner JG, Shetterly SM, Mayer EJ, et al. Relationship between habitual physical activity and insulin area among individuals with impaired glucose tolerance. Diabetes Care 1995; 18: 490–7
Tipton CM. Exercise, training, and hypertension: an update. Exerc Sport Sci Rev 1991; 19: 447–505
Bouchard C, Després JP. Physical activity and health: atherosclerotic, metabolic, and hypertensive diseases. Res Q Exerc Sport 1995; 68: 268–75
Hagberg JM. Physical activity, physical fitness, and blood pressure. In: Leon AS, editor. National Institutes of Health. Physical activity and cardiovascular health: a national consensus. Champaign (IL): Human Kinetics; 1997: 112–9
Williams PT. Relationships of heart disease risk factors to exercise quantity and intensity. Arch Intern Med 1998; 158: 237–45
Pescatello LS, Falkenham A, Leach Jr CN, et al. Short-term effect of dynamic exercise on arterial blood pressure. Circulation 1991; 83: 1557–61
Hagberg JM, Brown MD. Does exercise training play a role in the treatment of essential hypertension? J Cardiovasc Risk 1995; 2 (4): 296–302
Seals DR, Silverman HG, Reiling MJ, et al. Effect of regular aerobic exercise on elevated blood pressure in postmenopausal women. Am J Cardiol 1997; 80: 49–55
Young DR, Appel LJ, Lee S, et al. The effects of aerobic exercise and T’ai Chi on blood pressure in older people: results of a randomized trial. J Am Geriatr Soc 1999; 47: 277–84
Gueyffier F, Boutitie F, Boissel J-P. Effect of antihypertensive drug treatment on cardiovascular outcomes in women and men. Ann Intern Med 1997; 126: 761–7
Tucker LA, Friedman GM. Walking and serum cholesterol in adults. Am J Public Health 1990; 80: 1111–3
Giada F, Vigna GB, Vitale E, et al. Effect of age on the response of blood lipids, body composition, and aerobic power to physical conditioning and deconditioning. Metabolism 1995; 44: 161–5
Williams PT. Coronary heart disease risk factors of vigorously active sexagenarians and septuagenarians. J Am Geriatr Soc 1998; 46: 134–42
Costanzo D, Murphy D, Pescatello LS. Daily accumulated physical activity favorably alters lipoproteins among older adults [abstract]. Med Sci Sports Exerc 1998; 30: S172
Durstine JL, Haskell WL. Effects of exercise training on plasma lipids and lipoproteins. Exerc Sport Sci Rev 1994; 22: 477–521
Motoyama M, Sunami Y, Kinoshita F, et al. The effects of long-term low intensity aerobic training and detraining on serum lipid and lipoprotein concentrations in elderly men and women. Eur J Appl Physiol 1995; 70: 126–31
Duncan JE, Gordon NF, Scott CB. Women walking for health and fitness: how much is enough? JAMA 1991; 266: 3295–9
Mensink GBM, Heerstrass DW, Neppelenbroek SE, et al. Intensity, duration, and frequency of physical activity and coronary risk factors. Med Sci Sports Exerc 1997; 29: 1192–8
Hurley BF, Hagberg JM. Optimizing health in older persons: aerobic or strength training? Exerc Sport Sci Rev 1998; 26: 61–89
Hardman AE. Accumulation of physical activity for health gains: what is the evidence? Br J Sports Med 1999; 33: 87–92
Helmrich SP, Ragland DR, Leung RW, et al. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 1991; 325: 147–52
Manson JE, Rimm EB, Stampfer MJ, et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 1991; 333: 677–85
Manson JE, Nathan DM, Krolewsik AS, et al. A prospective study of exercise and incidence of diabetes among U.S. male physicians. JAMA 1992; 286: 63–7
Mourier A, Gautier JF, De Kerviler E, et al. Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM. Diabetes Care 1997; 20 (3): 385–91
Campbell AJ, Busby WJ, Horwath CC, et al. Relation of age, exercise, anthropometric measurements and diet with glucose and insulin levels in a population aged 70 years and over. Am J Epidemiol 1993; 138: 688–96
Kirwan JP, Kohrt WM, Wojta DM, et al. Endurance exercise training reduces glucose-stimulated insulin levels in 60- to 70-year-old men and women. J Gerontol 1993; 48: M84–90
Braun B, Zimmermann MB, Kretchmer N. Effects of exercise intensity on insulin sensitivity in women with non-insulin-dependent diabetes mellitus. J Appl Physiol 1995; 78 (1): 300–6
Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study. Diabetes Care 1997; 20: 537–44
Rankinen T, Suomeal-Markkanen T, Vaisanen S, et al. Relationship between changes in physical activity and plasma insulin during a 2.5-year follow-up study. Metabolism 1997; 46: 1418–23
Poehlman ET, Toth MJ, Bunyard LB, et al. Physiological predictors of increasing total and central adiposity in aging men and women. Arch Intern Med 1995; 155: 2443–8
DiPietro L, Seeman TE, Stanchenfeld NS, et al. Moderate intensity aerobic training improves glucose tolerance in aging independent of abdominal adiposity. J Am Geriatr Soc 1998; 46: 875–9
Tremblay A, Després JP, Leblanc C, et al. Effect of intensity of physical activity on body fatness and fat distribution. Am J Clin Nutr 1990; 51: 153–7
Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes 1992; 16: 397–415
Kirkendall DT, Garrett WE. The effects of aging and training on skeletal muscle. Am J Sports Med 1998; 26: 598–602
Rantanen T, Era P, Heikkinen E. Physical activity and the changes in maximal isometric strength in men and women from the age of 75 to 80 years. J Am Geriatr Soc 1997; 45: 1439–45
Evans WJ. Exercise training guidelines for the elderly. Med Sci Sports Exerc 1999; 31: 12–7
National Institute on Aging. Exercise: a guide. National Institute on Aging publication no. NIH 98–4258. Gaithersburg (MD): National Institute on Aging, 1998
Pollock ML, Carroll JF, Graves JE, et al. Injuries and adherence to walk/jog and resistance training programs in the elderly. Med Sci Sports Exerc 1991; 23: 1194–200
Shaper AG, Wannamethee G, Walker M. Physical activity, hypertension and risk of heart attack in men without evidence of ischaemic heart disease. J Hum Hypertens 1994; 8: 3–10
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pescatello, L.S. Physical Activity, Cardiometabolic Health and Older Adults. Sports Med 28, 315–323 (1999). https://doi.org/10.2165/00007256-199928050-00003
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-199928050-00003