obesity among older women represents a serious public health problem and is strongly 
 associated with cardiovascular diseases ( cvds)1 . also , obesity was reduced parasympathetic activity both contribute 
 to coronary heart cvds4 . cvds remain the 
 biggest cause of deaths worldwide2 , and 
 atherosclerosis , a disease of the large arteries , is a major cause of heart disease3 . inflammation plays an essential role in the atherosclerotic process , and chemokines such as 
 monocyte chemoattractant protein-1 ( mcp-1)5 , soluble vascular cell adhesion molecule-1 ( svcam-1 ) and 
 se - selectin6 , seem to play a pivotal 
 role in the pathogenesis of atherosclerosis . also , increased plasma concentrations of mcp-1 
 were associated with several cardiovascular risk factors : older age , obesity , and higher 
 levels of c - reactive protein ( crp)7 . adipose tissue is metabolically active and secretes crp8 and various chemokines such as mcp-1 and adhesion molecules9 . although adipose tissue accumulation only 
 showed borderline significant associations with svcam-1 and se - selectin concentrations , and 
 some extent of the relationship between insulin resistance and endothelial 
 activation / dysfunction because significant association between fasting insulin as well as 
 the homa - ir and se - selectin levels10 . longitudinal study to demonstrate higher circulating inflammatory in the untrained state of 
 older women that had no increased in fat free mass . there have been a number of 
 longitudinal studies demonstrating the powerful effects of weight loss as a result of both 
 diet and exercise11 . exercise ( aerobic 
 and resistance exercise ) might be indices for evaluation of cardio function including 
 vo2max , which represents the oxygen - carrying capacity of the active muscles 
 during exercise12 . the purpose of this study was to investigate the effects of a healthy life exercise program 
 on arteriosclerosis adhesion molecules in elderly women with obesity . we hypothesized that a 
 regular healthy life exercise program for elderly obese women would prevent cardiovascular 
 diseases . we asked 
 them to complete simple questionnaires related to aspects of their current lifestyle , such 
 as physical activity , medication , alcohol consumption , and smoking , before the start of the 
 sessions . in this study , however , 10 participants were excluded from data analysis . the 
 reasons for exclusion included taking lipid- and/or glucose - lowering medication ( n = 4 ) , not 
 being able to start the exercise program due to their condition levels ( n = 3 ) , a history of 
 cardiovascular disease , and percentage of body fat < 30% . thus , twenty participants were 
 assigned into either the control ( n = 10 ) or supervised healthy life exercise program ( n = 
 10 ) group . the physical characteristics of the participants are shown in table 1table 1.physical characteristics of the participantsvariableexercise group(n=10)control group(n=10)age ( years)70.7  2.271.3  1.7body weight ( kg)62.8  4.864.9  3.1bmi ( kg / m)26.3  0.826.0  0.6percent body fat ( % ) 31.8  1.732.7  1.7sbp ( mmhg)129.4  12.7129.6  4.9dbp ( mmhg)80.8  6.777.0  4.3values are shown as the mean  sd . bmi : body mass index ; sbp : systolic blood 
 pressure ; dbp : diastolic blood pressure . bmi : body mass index ; sbp : systolic blood 
 pressure ; dbp : diastolic blood pressure physical and anthropometric variables were measured at baseline and after 12 weeks in both 
 groups . body mass and height were measured to the nearest 0.1  kg and 0.1  cm , respectively , 
 using a venus 5.5 body composition analyzer ( jawon medical , gyeongsan , republic of korea ) . body mass index was calculated as weight in kilograms divided by the square of the height in 
 meters . arterial blood pressure was measured with a mercury sphygmomanometer after the 
 participants had been seated at rest for 10 minutes . all participants were advised to avoid 
 physical activity for 48 hours prior to each measurement . the 12-week healthy life exercise program intervention consisted of 3 days of combined 
 aerobic exercise , resistance exercise , and traditional korean dance per week ( i.e. , monday , 
 wednesday , and friday ) . this program was modified from that in a previous study for obese 
 elderly women . each exercise session included 10 minutes of warm - up activities , 15 minutes 
 for the exercise program , and 10 minutes of cooldown activites ( i.e. , 45 minutes in total ) . aerobic exercise consisted of walking and the arm raise ; jumping and swinging arms ; side 
 walking ; the front , back , and side leg raise ; jumping and brining the knees up ; walking and 
 the leg raise ; and walking and jumping . resistance exercise consisted of arms fold and 
 spread , arms raise to front and side , turn shoulder , waist bending , waist bending to side , 
 twist trunk , knee up , stretch legs and raise to back and side . finally , traditional korean 
 dance consisted movements of the arms , legs , trunk , and whole body including jumping upward 
 and to the side and balance exercises such as one - leg standing and on - leg jumping . participants performed each exercise program for 15 minutes at 5060% of their maximum heart 
 rate during weeks 1 through 6 . after week 6 , the emphasis was placed on reaching and 
 maintaining an exercise intensity of approximately 6070% of their maximum heart rate for 15 
 minutes ( polar heart monitor ; rs400 , polar electro , kempele , finland ) . the healthy life 
 exercise program is shown in table 2table 2.healthy life exercise programwarm - upstretching ( arms , shoulder , hip , legs ) , breathingresistance exercisearms fold and spread , arms raise to front and side , turn shoulder 
 waist bending , waist bending to side , twist trunk , knee up , stretch legs and raise 
 to back and sideaerobic exercisewalking and the arm raise ; jumping and swinging the arms ; the 
 front , back , and side leg raise ; jumping and bringing the knees up ; walking and 
 the leg raise ; and walking and jumpingtraditional dancearms and legs : baechigy , yeo daji , gin - yeo daji , ban hwajang trunk : 
 yongteulim , jump up whole body : jump to side , kkaekkili , hwalgae chagi , ppulil 
 sawi balance : one - leg stand , one - leg jumpcooldownstretching ( arms , shoulder , hip , legs ) , breathing . fasting venous blood samples were collected from all participants at baseline and at 12 
 weeks . serum c - reactive protein ( crp ) , mcp-1 , 
 se - selectin , and svcam-1 were determined enzymatically using standard laboratory procedures . we determined blood sample levels in the serum using a sandwich - type enzyme - linked 
 immunosorbent assay ( elisa ) dueset kit from r&d systems ( minneapolis , mn , usa ) according 
 to the manufacturer s instructions as described previously . in each subject , the degree of 
 insulin resistance was assessed from the fasting glucose and insulin concentrations 
 according to homeostasis model assessment ( homa ) , the following formula : homa - ir = fasting 
 glucose ( mg / dl)/18  fasting insulin ( u / ml)/22.5 . the unpaired participations t - test was used 
 to assess group differences in baseline variables . a two - way analysis of variance ( anova ) 
 was used to determine interaction ( group  time ) effects for all outcome variables . all participants in the exercise group attended each healthy life exercise program session , 
 and no participants dropped out during the intervention . body mass , bmi , percent body fat , 
 sbp , and dbp , which were measured at baseline and after 12 weeks , are presented in table 3table 3.changes in body composition between the groups at baseline and after 12 
 weeksvariablegroupbaseline12 weeksbody mass ( kg)exercise62.8  1.661.2  1.5control64.9  1.064.8  0.9bmi ( kg / m)exercise26.3  0.825.6  1.0control26.0  0.625.7  0.6percent body fat ( % ) exercise31.6  1.831.1  1.9control31.5  2.833.7  4.1sbp ( mmhg)exercise129.4  12.7124.5  9.2control129.6  4.9129.5  4.7dbp ( mmhg)exercise80.8  6.778.1  6.7control77.0  4.377.9 bmi : body mass index ; sbp : systolic blood 
 pressure ; dbp : diastolic blood pressure . significant group  time interaction ( p<0.05 ) , * analyzed by paired 
 t - test ( p<0.05 ) . two - factor anova revealed group  time interaction for body mass ( p=0.019 ) 
 and dbp ( p=0.001 ) . within - group analyses showed that body mass , bmi , and percent body fat 
 were significantly decreased in the exercise group after 12 weeks relative to baseline 
 values ( p<0.05 ) , but no significant change were observed in the control group . insulin 
 resistance , crp , and adhesion molecules , which were measured at baseline and after 12 weeks , 
 are presented in table 4table 4.changes in insulin resistance , crp , and adhesion molecules between the groups at 
 baseline and after 12 weeksvariablegroupbaseline12 weeksglucose ( mg / dl)exercise80.3  3.179.0  3.1control92.2  6.692.1  5.6insulin ( u / ml)exercise8.13  0.767.91  0.67control9.28  1.189.55  0.80homa - irexercise1.6  0.21.5  0.1control2.1  0.32.2  0.2crp ( mg / l)exercise0.08  0.010.08  0.01control0.09 0.010.09  0.01mcp-1 ( pg / ml)exercise685.0  37.7673.66  33.6control655.9  64.3654.40  62.5se - selectin ( ng / ml)exercise55.5 4.354.6  4.0control48.7  4.049.0  3.9svcam-1 ( ng / ml)exercise515.0  21.7504.5  20.4control532.2  36.7538.7  40.2values are shown as the mean  sd . homa - ir : homeostasis model assessment ; crp : 
 high - sensitivity c - reactive protein ; mcp-1 : monocyte chemoattractant protein-1 ; 
 svcam-1 : soluble vascular cell adhesion molecules-1 . significant group  time interaction ( p<0.05 ) , * analyzed by 
 paired t - test ( p<0.05 ) , * * analyzed by paired t - test ( p<0.01 ) , * * * analyzed by 
 paired t - test ( p<0.001 ) . two - factor anova revealed group  time interaction for crp ( p=0.045 ) , 
 se - selectin ( p=0.043 ) , svcam-1 ( p=0.003 ) , insulin ( p=0.019 ) , and homa - ir ( p=0.038 ) . within - group analyses showed that glucose , insulin , homa - ir , mcp-1 , se - selectin and svcam-1 
 were significantly decreased in the exercise group after 12 weeks relative to the baseline 
 values ( p<0.01 , p<0.01 , p<0.001 , p<0.001 , p<0.05 , p<0.001 , respectively ) , 
 but no significant changes were observed in the control group . bmi : body mass index ; sbp : systolic blood 
 pressure ; dbp : diastolic blood pressure . data were analyzed by two - way anova . significant group  time interaction ( p<0.05 ) , * analyzed by paired 
 t - test ( p<0.05 ) values are shown as the mean  sd . homa - ir : homeostasis model assessment ; crp : 
 high - sensitivity c - reactive protein ; mcp-1 : monocyte chemoattractant protein-1 ; 
 svcam-1 : soluble vascular cell adhesion molecules-1 . significant group  time interaction ( p<0.05 ) , * analyzed by 
 paired t - test ( p<0.05 ) , * * analyzed by paired t - test ( p<0.01 ) , * * * analyzed by 
 paired t - test ( p<0.001 ) in this study , we investigated the effects of a 12-week healthy life exercise program on 
 arteriosclerosis adhesion molecules in elderly obese women . the exercises consisted of 
 combined aerobic exercise , resistance exercise , and traditional korean dance performed in 
 three sessions per week . each 45 minutes exercise program included 10 minutes of warm - up 
 activities and 10 minutes of cooldown activities and resulted in a decrease in mcp-1 and 
 arteriosclerosis adhesion molecules se - selectin and svcam-1 in elderly obese women who 
 exercised . strenuous exercise induces increased circulating levels of a number of cytokines , 
 macrophage inflammatory proteins , and chemokines including mcp-1 , se - selectin , and 
 svcam-113 . however , recent studies have 
 shown that increasing levels of exercise or physical activity are associated with reduced 
 levels of mcp-1 , se - selectin , and svcam-1 in healthy subjects14 . furthermore , in patients with cardiovascular disease who have 
 increased levels of chemokines and , adhesion molecules15 , it has been reported that moderate intensity exercise can reduce 
 mcp-1 , se - selectin , and svcam-116 . mcp-1 , 
 se - selectin , and svcam-1 were significantly decreased compared with baseline . a number of 
 studies have reported reduced chemokine and adhesion molecules concentrations in obese 
 adults following a combined with moderate physical exercise17 and lifestyle - modification program ( i.e. , diet , exercise sessions 
 and behavioral modification ) in obese women18 . also , previous studies have indicated that knockout mice lacking 
 receptors for mcp-1 exhibit significantly reduced progression of atherosclerosis19 and trigger the firm adhesion of monocytes 
 to vascular endothelium under flow conditions20 . a number of studies have provided support for the hypothesis that insulin resistance may be 
 associated with chronic subclinical inflammation21 . high glucose concentrations have been found to induce the release 
 of adhesion molecules in endothelial and smooth muscle cells , giving one possible 
 explanation for the link between hyperglycemia , inflammation , and atherosclerosis22 . adipose tissue is metabolically active , 
 and preadipocytes have been reported to secrete both mcp-1 and adhesion molecules9 . our finding of decreased glucose , insulin , 
 and homa - ir levels may be one component mediating the beneficial effect of the healthy life 
 exercise program in the elderly obese women . it is possible that the healthy life exercise 
 program consisting of aerobic and resistance exercise was associated with decreased levels 
 of markers of inflammation such as crp23 . in the present study , body mass , bmi , percent body fat , mcp-1 , se - selectin , svcam-1 , 
 glucose , and insulin were decreased after the 12-week healthy life exercise program in the 
 elderly obese women . these data may imply that even an aerobic and resistance exercise 
 program is effective in reducing reduce body composition ( i.e. , body mass , bmi , and percent 
 body fat ) , arteriosclerosis adhesion molecules , glucose , and insulin . combined exercise has 
 been previously shown to decrease body mass and fat mass24 , and glucose and insulin25 . moreover , traditional korean dance consists of movements of the 
 arms , legs , trunk , and whole body including jumping upward and to the side and balance 
 exercises such as one - leg standing and one - leg jumping . it might be beneficial effect 
 aerobic and resistance exercise and more safety other exercise program ( i.e. weight lifting 
 and not under the supervision ) nevertheless , although there is strong evidence that the healthy life exercise program 
 affected arteriosclerosis adhesion molecules in this population , the present study has some 
 limitations . cvd patients have various cvd risk factors , and they need exercise training 
 with a longer term rather than a higher exercise intensity to reduce the cvd risk 
 factors26 . also , the study period was 
 short , and our study subjects were not patients with cvd or atherosclerosis . therefore , more 
 longitudinal studies are require to investigate the effects of intermittent exercise on 
 patients with cvd or atherosclerosis . finally , the sample size was small , and further larger 
 populations studies required to confirm the relationships observed in this study . in conclusion , this study indicates that a healthy life exercise program is an effective 
 lifestyle intervention strategy for decreasing mcp-1 and adhesion molecules in elderly obese 
 women . in addition , continuation of the healthy life exercise program for 12 weeks led to 
 decreased glucose , insulin , and homa - ir levels . therefore , these finding provide preliminary 
 evidence indicating that a healthy life exercise program may represent an effective 
 intervention strategy for preventing atherosclerosis , leading to improved cardiovascular 
 health in elderly obese women .
[ purpose ] the aim of this study was to investigate the change in the arteriosclerosis 
 adhesion molecules after a healthy life exercise program that included aerobic training , 
 anaerobic training , and traditional korean dance . [ subjects ] the subjects were 20 elderly 
 women who were over 65  years of age and had 30% body fat . [ methods ] the experimental group 
 underwent a 12-week healthy life exercise program . to evaluate the effects of the healthy 
 life exercise program , 
 measurements were performed before and after the healthy life 
 exercise program in all the subjects . [ results ] after the healthy life exercise program , 
 mcp-1 and the arteriosclerosis adhesion molecules se - selectin and svcam-1 were 
 statistically significantly decreased . 
 [ conclusion ] the 12-week healthy life exercise 
 program reduced the levels of arteriosclerosis adhesion molecules 
 . therefore , the results 
 of our study suggest that a healthy life exercise program may be useful in preventing 
 arteriosclerosis and improving quality of life in elderly obese women .