Generation 100 - GEN100

Contribution To Literature:

The Generation 100 study failed to show that supervised exercise training prevents cardiovascular events.


The goal of the trial was to evaluate high-intensity interval training compared with moderate-intensity continuous training among healthy, fit elderly individuals.

Study Design

  • Randomization
  • Parallel

Healthy and fit elderly individuals were randomized to high-intensity interval training (n = 400) versus moderate-intensity continuous training (n = 387) versus control (n = 780).

Exercise was supervised in the high-intensity interval training and moderate-intensity continuous training group. In the high-intensity interval training group, the target heart rate was ~90% of peak heart rate. In the moderate-intensity continuous training group, the target heart rate was ~70% of peak heart rate.

Participants in the control group were asked to participate in 30 minutes of moderate-intensity exercise most days per week.

  • Total number of enrollees: 1,567
  • Duration of follow-up: 5 years
  • Mean patient age: 73 years
  • Percentage female: 50%

Inclusion criteria:

  • Healthy and fit elderly individuals (aged 70-77 years)
  • Live in Trondheim, Norway

Principal Findings:

Continuous cardiovascular risk score was not significantly lower (-0.19, 99% confidence interval [CI] -0.46 to 0.07) and peak oxygen uptake (peak VO2) was not significantly higher (0.39 ml/kg/min, 99% CI -0.22 to 1.00) for combined exercise training versus control.


Among fit elderly individuals, supervised exercise training failed to improve a continuous cardiovascular risk score or improve peak VO2. Enrollment of healthy, fit individuals may have resulted in selection bias and limited the ability to detect a difference between groups.


Highlighted text has been updated as of June 7, 2022.

Letnes JM, Berglund I, Johnson KE, et al. Effect of 5 years of exercise training on the cardiovascular risk profile of older adults: the Generation 100 randomized trial. Eur Heart J 2022;43:2065-75.

Editorial Comment: Hellénius ML. Encouraging physical activity amongst older adults; where should we stand? Eur Heart J 2022;43:2076-7.

Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Prevention, Sports and Exercise Cardiology, Exercise

Keywords: Cardiorespiratory Fitness, Exercise, Geriatrics, Health Status, Heart Disease Risk Factors, Heart Rate, High-Intensity Interval Training, Primary Prevention, Risk Factors

< Back to Listings