Physical activity (PA) has numerous health benefits, particularly for those with diabetes. However, rates of long-term PA participation are often poor. PURPOSE: 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. METHODS: Data from 2,400 participants (age 59.3 +/- 6.9 yr, body mass index 36.1 +/- 5.9 kg/m2) 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. RESULTS: Despite no differences at baseline (ILI 93.4 +/- 152.7 versus 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 versus 87.5 +/- 145.1 min/wk, p < 0.0001) and year 4 (102.9 +/- 195.6 versus 73.9 +/- 267.5 min/wk, p < 0.001), and more ILI participants achieved >= 175 min/wk at year 1 (29.1% versus 16.3%, p < 0.001) and year 4 (18.3% versus 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. CONCLUSIONS: 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.

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