scholarly journals Role of physical activity in preventing and treating obesity

2005 ◽  
Vol 99 (2) ◽  
pp. 765-770 ◽  
Author(s):  
James O. Hill ◽  
Holly R. Wyatt

There is an inverse relationship between physical activity and weight gain. However, additional research is needed to quantify the amount of physical activity required to prevent weight gain in different populations, improve the way we convey physical activity recommendations to the public, and help the individuals increase their physical activity. Although physical activity does not appear to contribute significantly to weight loss, it is critical for maintenance of weight loss. Available data are consistent in that 60–90 min/day of moderate-intensity physical activity is required to maintain a significant weight loss. Although there is agreement about the need for high levels of physical activity to maintain weight loss, there is a need for more research to understand why physical activity is critical for weight loss maintenance. Finally, additional research is needed to determine whether there is an optimal level of physical activity below which it is difficult for most people to achieve a balance between energy intake and expenditure at a healthy body weight. The increasing prevalence of obesity may reflect the fact that the majority of the population has fallen below such a level of physical activity.

2021 ◽  
Author(s):  
Tainayah Thomas ◽  
Fei Xu ◽  
Sneha Sridhar ◽  
Tali Sedgwick ◽  
Linda Nkemere ◽  
...  

BACKGROUND Pregnant patients with overweight or obesity are at high risk of perinatal complications. Excess gestational weight gain further exacerbates this risk. Mobile health (mHealth) lifestyle interventions that leverage technology to facilitate self-monitoring and provide just-in-time feedback may motivate behavior change to reduce excess gestational weight gain, reduce intervention costs, and increase scalability by improving access. OBJECTIVE To test the acceptability and feasibility of a pilot mHealth lifestyle intervention for pregnant patients with overweight or obesity to promote moderate-intensity physical activity, encourage guideline-concordant gestational weight gain, and inform the design of a larger pragmatic cluster randomized controlled trial. METHODS We conducted a mixed-methods acceptability and feasibility randomized controlled trial among pregnant patients with a pre-pregnancy body mass index 25.0-40.0 kg/m2. Patients with singletons at 8–15 weeks’ gestation, and aged 21 years or older with Wi-Fi access were randomly assigned (1:1) to receive usual prenatal care or an mHealth lifestyle intervention. Participants in the intervention arm received wireless scales, access to an intervention website, activity trackers to receive automated feedback on weight gain and activity goals, and a monthly call from a lifestyle coach. Surveys and focus groups with intervention participants assessed intervention satisfaction and ways to improve the intervention. Physical activity outcomes were assessed using the Pregnancy Physical Activity Questionnaire and gestational weight gain was assessed using electronic health record data in both arms. RESULTS Thirty-three patients were randomly assigned to the intervention arm and 35 patients to the usual care arm. 100% of participants in the intervention arm weighed themselves at least once a week compared with 20% of participants in the usual care arm. Participants in the intervention arm wore the activity tracker 6.4 days/week, weighed themselves 5.3 times/week, and 87.9% rated the program “good to excellent.” Focus groups found participants desired more support related to nutrition to help them manage gestational weight gain and would have preferred an app instead of a website. Participants in the intervention arm had a 23.46 MET-hours greater change in total physical activity per week (95% CI:1.13, 45.8) and a 247.2-minute greater change in moderate intensity physical activity per week (95% CI: 36.2, 530.6) in unadjusted models, but these effects were attenuated in adjusted models (change in total physical activity: 15.55 MET-hours per week; 95% CI: -6.32, 37.42; change in moderate intensity physical activity: 199.6 minutes per week; 95% CI: -43.7, 442.9). We found no difference in total gestational weight gain (mean difference: 1.14 kg; 95% CI: -0.71, 3.00) compared to usual care. CONCLUSIONS A pilot mHealth lifestyle intervention was feasible, highly acceptable, and promoted self-monitoring. Refined interventions are needed to effectively impact physical activity and gestational weight gain among pregnant patients with overweight or obesity. CLINICALTRIAL ClinicalTrials.gov NCT03936283


2007 ◽  
Vol 103 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Elizabeth V. Menshikova ◽  
Vladimir B. Ritov ◽  
Robert E. Ferrell ◽  
Koichiro Azuma ◽  
Bret H. Goodpaster ◽  
...  

There are fewer mitochondria and a reduced oxidative capacity in skeletal muscle in obesity. Moderate-intensity physical activity combined with weight loss increase oxidative enzyme activity in obese sedentary adults; however, this adaptation occurs without a significant increase in mitochondrial DNA (mtDNA), which is unlike the classic pattern of mitochondrial biogenesis induced by vigorous activity. The objective of this study was to examine the hypothesis that the mitochondrial adaptation to moderate-intensity exercise and weight loss in obesity induces increased mitochondrial cristae despite a lack of mtDNA proliferation. Content of cardiolipin and mtDNA and enzymatic activities of the electron transport chain (ETC) and tricarboxylic acid cycle were measured in biopsy samples of vastus lateralis muscle obtained from sedentary obese men and women before and following a 4-mo walking intervention combined with weight loss. Cardiolipin increased by 60% from 47 ± 4 to 74 ± 8 μg/mU CK ( P < 0.01), but skeletal muscle mtDNA content did not change significantly (1,901 ± 363 to 2,169 ± 317 Rc, where Rc is relative copy number of mtDNA per diploid nuclear genome). Enzyme activity of the ETC increased ( P < 0.01); that for rotenone-sensitive NADH-oxidase (96 ± 1%) increased more than for ubiquinol-oxidase (48 ± 6%). Activities for citrate synthase and succinate dehydrogenase increased by 29 ± 9% and 40 ± 6%, respectively. In conclusion, moderate-intensity physical activity combined with weight loss induces skeletal muscle mitochondrial biogenesis in previously sedentary obese men and women, but this response occurs without mtDNA proliferation and may be characterized by an increase in mitochondrial cristae.


2014 ◽  
Vol 32 (21) ◽  
pp. 2231-2239 ◽  
Author(s):  
Pamela J. Goodwin ◽  
Roanne J. Segal ◽  
Michael Vallis ◽  
Jennifer A. Ligibel ◽  
Gregory R. Pond ◽  
...  

Purpose Obesity is associated with poor outcomes in women with operable breast cancer. Lifestyle interventions (LIs) that help women reduce their weight may improve outcomes. Patients and Methods We conducted a multicenter randomized trial comparing mail-based delivery of general health information alone or combined with a 24-month standardized, telephone-based LI that included diet (500 to 1,000 kcal per day deficit) and physical activity (150 to 200 minutes of moderate-intensity physical activity per week) goals to achieve weight loss (up to 10%). Women receiving adjuvant letrozole for T1-3N0-3M0 breast cancer with a body mass index (BMI) ≥ 24 kg/m2 were eligible. Weight was measured in the clinic, and self-report physical activity, quality-of-life (QOL), and diet questionnaires were completed. The primary outcome was disease-free survival. Accrual was terminated at 338 of 2,150 planned patients because of loss of funding. Results Mean weight loss was significantly (P < .001) greater in the LI arm versus the comparison arm (4.3 v 0.6 kg or 5.3% v 0.7% at 6 months and 3.1 v 0.3 kg or 3.6% v 0.4% at 24 months) and occurred consistently across strata (BMI 24 to < 30 v ≥ 30 kg/m2; prior v no prior adjuvant chemotherapy). Weight loss was greatest in those with higher baseline levels of moderate-intensity physical activity or improvement in QOL. Hospitalization rates and medical events were similar. Conclusion A telephone-based LI led to significant weight loss that was still evident at 24 months, without adverse effects on QOL, hospitalizations, or medical events. Adequately powered randomized trials with cancer end points are needed.


1999 ◽  
Vol 2 (3a) ◽  
pp. 383-390 ◽  
Author(s):  
Rainer Rauramaa ◽  
SB Väisänen

AbstractRegular moderate intensity physical activity and habitual diet providing no more than one third of energy from fats have been recommended for the prevention of atherosclerotic diseases. The background for these guidelines is the key role of plasma lipids. However, the importance of thrombogenesis in acute myocardial infarction has become obvious during the last decade. Hyperlipidaemia and excess of adipose tissue increase platelet aggregability and blood coagulation, and decrease fibrinolysis. Both regular physical activity and dietary fat reduction decrease blood lipids and body fat thereby diminishing the risk of thrombosis. Currently, data on interactions between physical activity and diet on haemostasis are scarce, and the few studies available have not demonstrated additional effects when these two lifestyle modifications have been combined. This paper is restricted only to studies using controlled randomized design. Regular moderate intensity physical activity as well as diet rich in omega-3 fatty acids decrease platelet aggregability. The effects of regular physical activity on plasma fibrinogen remain contradictory, while the impact of diet is even less clear. Plasminogen activator inhibitor-1, a possible link between insulin resistance syndrome and coronary heart disease, may decrease due to physical training or low fat diet. It can be hypothesized that moderation in physical activity and diet carries a more powerful impact on blood coagulation and fibrinolysis than either lifestyle modification alone. Studies focusing on the interactions of regular moderate physical activity and fat-modified diet are needed in efforts to optimize the preventive actions by lifestyle changes.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Joshua R Sparks ◽  
Xuewen F Wang

Background: Glucose concentrations in a fasted and during a glucose challenged state rely on different mechanisms for regulation. In a fasted state, hepatic regulation of glucose is important; while in a glucose challenged state, muscle glucose disposal becomes more important. Evidence suggests that physical activity of moderate or higher intensities can increase muscle glucose disposal during an insulin-stimulated state, but has less effect on hepatic insulin sensitivity. The purpose of this study was to examine the associations between glucose concentrations (fasting and after an oral glucose ingestion) and minutes of physical activity at moderate- and vigorous-intensity in a large population. Methods: The sample included 2,807 adults (47.4% male and 52.6% female) aged 18-80 years who participated in the National Health and Nutritional Examination Surveys (NHANES) from 2013-2014 and who did not take any diabetic medications. Minutes being physically active at moderate- and vigorous-intensities during work, and recreationally, were collected using the Physical Activity Questionnaire, which was based on the Global Physical Activity Questionnaire. Moderate-intensity physical activity was defined as any activity that caused a small increase in breathing or heart rate, while vigorous-intensity physical activity was defined as large increases in breathing or heart rate. Both intensities had to be performed for a minimum of 10 continuous minutes. Plasma glucose concentrations at fasting and 2 hours after consumption of a drink containing 75g glucose (2-hour glucose) were determined. Pearson product correlations were performed for analysis. Results: The population had 141±133 (mean±SD) minutes of moderate-intensity physical activity during work and 63±56 minutes recreationally, as well as 174±156 minutes of vigorous-intensity physical activity during work and 77±56 minutes recreationally. Minutes of vigorous-intensity physical activity performed during work was associated with 2-hour plasma glucose concentrations (r=0.15; p=0.045); this association was not affected after adjusting for age, race, and sex (p=0.049), but was no longer significant after BMI was also adjusted (p=0.059). Recreational or total minutes of vigorous-intensity physical activity, and moderate-intensity physical activity was not associated with 2-hour glucose (p>0.20). Additionally, none of the physical activity minutes was associated with fasting glucose (p>0.27). Conclusion: Self-reported vigorous-intensity physical activity during work was positively associated with 2-hour glucose, but not fasting glucose. The results are surprising. Further studies with objective physical activity measures are needed to examine the associations with fasting and 2-hour glucose.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joshua Z Willey ◽  
Jenna Voutsinas ◽  
Ayesha Sherzai ◽  
Sophia S Wang ◽  
Leslie Bernstein ◽  
...  

Introduction: Leisure time physical activity (LTPA) has been consistently associated with a lower risk of stroke across several populations. Less is known however about how changes over the life-time in physical activity may influence the risk of stroke. We examined the association of changes in engaging in moderate and strenuous physical activity with risk of stroke in the California Teachers Study. Methods: The California Teachers Study is a prospective cohort study established in 1995. Baseline LTPA was obtained using a questionnaire outlining time spent in moderate (brisk walking for example) and strenuous (swimming and running for example); the same questionnaire was repeated in 2005-6. We defined the exposure as engaging in any activity for at least 15 minutes per week (any) in the second questionnaire when not engaging in any on the first questionnaire, with the reference being no change or a decline in activity between both. Multi-variable Cox models were constructed to examine the association of the change in LTPA with risk of stroke. Separate models were created for moderate and strenuous activity. Results: There were a total of 61,256 participants with two LTPA questionnaires available separated by 10 years. A total of 3,111 participants increased their level of moderate activity, 11,744 remained active in both, 2,760 declined from the first to the second questionnaire, while 2,508 reported no activity in both. There were 987 (709 ischemic, 221 hemorrhagic, 247 deaths) strokes after the second questionnaires (mean follow up 6.5 years). In multi-variable models increasing any moderate intensity from none from the two questionnaires, versus no change or decline in activity, was associated with a lower risk of all stroke (adjusted HR 0.83, 95% CI 0.72-0.95). We found no associations of changes in strenuous LTPA with risk of stroke (adjusted HR 0.99, 95% CI 0.83-1.17). The associations were statistically significant for ischemic stroke (adjusted HR 0.75, 95% CI 0.64-0.89) but not hemorrhagic stroke (adjusted HR 0.94, 95% CI 0.72-1.25). Conclusion: Improving or maintaining moderate intensity physical activity is associated with a lower risk of stroke, while changes in strenuous activity is not.


2020 ◽  
pp. 089020702096230
Author(s):  
Zoë Francis ◽  
Jutta Mata ◽  
Lavinia Flückiger ◽  
Veronika Job

People may be more or less vulnerable to changes in self-control across the day, depending on whether they believe willpower is more or less limited. Limited willpower beliefs might be associated with steeper decreases in self-control across the day, which may result in less goal-consistent behaviour by the evening. Community members with health goals (Sample 1; N = 160; 1814 observations) and students (Sample 2; N = 162; 10,581 observations) completed five surveys per day for one to three weeks, reporting on their recent physical activity, snacking, subjective state, and health intentions. In both samples, more limited willpower beliefs were associated with less low- and moderate-intensity physical activity, particularly later in the day. Limited willpower beliefs were also associated with more snacking in the evenings (Sample 1) or overall (Sample 2). These behavioural patterns were mediated by differential changes in self-efficacy and intentions across the course of the day (in Sample 1), and the above patterns of low- and moderate-physical intensity held after controlling for related individual differences, including trait self-control and chronotype (in Sample 2). Overall, more limited willpower theories were associated with decreasing goal-consistent behaviour as the day progressed, alongside decreasing self-efficacy and weakening health-goal intentions.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S236-S236
Author(s):  
Marie Boltz

Abstract Many nurses, patients, and families continue to believe that physical activity increases the risk of falling. The purpose of this study was to test the hypothesis that residents who are exposed to Function Focused Care for Assisted Living (FFC-AL-EIT) and engage in moderate levels of physical activity would not be more likely to fall. This was a secondary data analysis using data from the first two cohorts of the FFC-AL-EIT study. The study included 508 residents the majority of whom were female (70%), white (97%), with a mean age of 87.72 (SD=7.47). Those who engaged in more moderate intensity physical activity were 1% less likely to fall (b = -.01, Wald =6.13, p =.01). There was no association between exposure to function focused care and falling (Beta =.41, Wald =2.35, p=.13). Further, engaging in moderate level physical activity was noted to be slightly protective of falling.


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