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Exercise and Weight Control. Dr. David L. Gee FCSN 446/PE 446 Nutrition, Weight Control, and Exercise. Benefits of Exercise for Overweight Individuals. Weight Loss Related Benefits Health Benefits Independent of Weight Loss Psychological Benefits. Why do Americans not exercise?.

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Exercise and Weight Control

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Exercise and Weight Control

Dr. David L. Gee

FCSN 446/PE 446

Nutrition, Weight Control, and Exercise


Benefits of Exercise for Overweight Individuals

  • Weight Loss Related Benefits

  • Health Benefits Independent of Weight Loss

  • Psychological Benefits


Why do Americans not exercise?


Successful Approaches to Adopting and Maintaining a Physically Active Lifestyle

  • NIH Consensus Development Conference Statement, Dec. 1995

  • Perceives a net benefit

    • Chooses an enjoyable activity

    • Feels competent doing activity

    • Feels safe doing activity


Successful Approaches to Adopting and Maintaining a Physically Active Lifestyle

  • Easy access to activity

  • Activity fits into daily schedule

  • Financial and social costs acceptable

  • Minimum negative consequences

    • loss of time

    • negative peer pressure

    • problems with self esteem


Successful Approaches to Adopting and Maintaining a Physically Active Lifestyle

  • Able to successfully address issues of competing time demands

  • Balance labor saving devices and sedentary activities with activities that involve higher levels of physical exertion


Exercise for the Weight Loss: Intensity vs. Duration

  • Recommendations for overweight subjects who are sedentary

  • Begin with lower intensity exercises

  • Work on increasing duration first

  • Focus on regular program (5-7 days/week)

  • Gradually increase intensity once available time is limiting

  • Add weight training if time permits

  • Just do it!


OK, exercise is important.But, how important is “everyday/lifestyle” activity?


Lifestyle vs Structured Activity

  • JAMA (Jan. 1999)

  • Sedentary men (116) & women (119)

  • 6 months intensive intervention

    • lifestyle physical activity program

    • structured exercise program

  • 18 months maintenance intervention


Lifestyle vs Structured Activity


Lifestyle vs Structured Activity


Lifestyle vs Structured Activity

Conclusions: Lifestyle Programs have similar beneficial changes as Structured Exercise Programs


Training Effects of Short and Long Bouts of Brisk Walking in Sedentary Women. MSSE 30:152-157 (1998)

  • 47 women, @70-80% HRmax, 5X/wk, 10 weeks

    • Long walks: 30 min walking

    • Short walks: 3x10 min walking

  • Aerobic capacity increased equally in both walking groups

  • Decreases in BW was greater in short walk (1.7kg) than long walkers (0.9kg)

  • Waist circumference decreased greater in short walk (3cm) than long walkers (1.8cm)

  • Conclusion: accumulations of shorter walks at least as beneficial as single long walk.


Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness.JAMA 282:1554-1560

  • 148 obese women, 18 month weight loss program

    • home treadmill + 4-5 25-35min/wk walks

    • home treadmill + 10-14 15-20 min/wk walks

    • no equipment + 10-14 15-20 min/wk walks

  • Weight loss equal in first 6 months

    • (6-7kg)

  • Weight regain similar in last 12 months

    • 1.5-4kg, slightly higher in group w/o treadmill


Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness.JAMA 282:1554-1560

  • Dose-response relationship between weight loss/maintenance and weekly exercise time.

  • 150 min/wk:

    • 7kg loss @ 6 mo, 3.5 kg regain at 18 mo.

  • 150-200 min/wk

    • 10.5 kg loss @ 6 mo, 2 kg regain at 18 mo.

  • >200 min/wk

    • 12.5 kg loss @ 6 mo, no regain at 18 mo.

    • 200min/wk = 2-3 walks/day for 10-15min each


  • Active/highly active

    • > 10,000 steps/day

    • 20% men

    • 13% women

  • Sedentary lifestyle

    • < 5,000 steps/day

    • 32% men

    • 33% women


  • Factors affecting steps/day

  • Age

    • Younger>older

  • Income

    • Low<high

    • Ethnicity NS

  • Marital status

    • Single/divorce>married

  • BMI

    • Obese<overweight<normal


Conclusion:

  • “Increasing steps per day appears to be a good target to use in interventions to increase physical activity.”

  • “Even in Colorado, one of the leanest states, very low levels of physical activity are seen in much of the population.”


Exercise Recommendations

  • Old ACSM Recommendations (1990)

    • 3-5 days/week

    • 60-90% of max. HR

    • 20-60 min/session

  • ACSM 2002

    • 30 minutes of moderate exercise most days of the week

  • IOM – DRI Energy - 2002

    • 60 minutes of moderate exercise 7 days a week


Dr. Gee’s Recommendations for Exercise and Weight Loss

  • Priority 1

    • Emphasize active lifestyle every day

    • brainstorm ideas

    • Pedometers & 10,000 step programs

  • Priority 2

    • Include structured exercise most every day

    • focus first on endurance, second on intensity

  • Priority 3

    • Incorporate weight training 2-3x/week


Considerations for the Overweight Exerciser

  • Many of those overweight:

    • are currently inactive

    • were never active

    • feel awkward exercising

    • have poor self image


Considerations for the Overweight Exerciser

  • Very gradual introduction and progress

  • Appropriate types of exercise

  • group support

  • instructor support

  • low impact

  • heat intolerant

  • measure HR frequently


Considerations for the Overweight Exerciser

  • Make it a high priority (incentives)

  • Use as a substitute for problem behavior, not as a punishment

  • measure girth in addition to weight


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