Randomised, controlled walking trials in postmenopausal women: the minimum dose to improve aerobic fitness?

Background: The American College of Sports Medicine recommends 20–60 minutes of aerobic exercise three to five days a week at an intensity of 40/50–85% of maximal aerobic power (VO2MAX) reserve, expending a total of 700–2000 kcal (2.93–8.36 MJ) a week to improve aerobic power and body composition. Objective: To ascertain the minimum effective dose of exercise. Methods: Voluntary, healthy, non-obese, sedentary, postmenopausal women (n = 121), 48–63 years of age, were randomised to four low dose walking groups or a control group; 116 subjects completed the study. The exercise groups walked five days a week for 24 weeks with the following intensity (% of VO2MAX) and energy expenditure (kcal/week): group W1, 55%/1500 kcal; group W2, 45%/1500 kcal; group W3, 55%/1000 kcal; group W4, 45%/1000 kcal. VO2MAX was measured in a direct maximal treadmill test. Submaximal aerobic fitness was estimated as heart rates at submaximal work levels corresponding to 65% and 75% of the baseline VO2MAX. The body mass index (BMI) was calculated and percentage of body fat (F%) estimated from skinfolds. Results: The net change (the differences between changes in each exercise group and the control group) in VO2MAX was 2.9 ml/min/kg (95% confidence interval (CI) 1.5 to 4.2) in group W1, 2.6 ml/min/kg (95% CI 1.3 to 4.0) in group W2, 2.4 ml/min/kg (95% CI 0.9 to 3.8) in group W3, and 2.2 ml/min/kg (95% CI 0.8 to 3.5) in group W4. The heart rates in standard submaximal work decreased 4 to 8 beats/min in all the groups. There was no change in BMI, but the F% decreased by about 1% unit in all the groups. Conclusions: Walking (for 24 weeks) at moderate intensity 45% to 55% of VO2MAX, with a total weekly energy expenditure of 1000–1500 kcal, improves VO2MAX and body composition of previously sedentary, non-obese, postmenopausal women. This dose of exercise apparently approaches the minimum effective dose.