By: Diane Brett, Mike Seidel and Mike Halbach

WHAT RESEARCH TELLS THE CLINICIAN REGARDING EXERCISE FOR OBESITY.

Authors: Yun Hee Lee, MD, Young Whan Song, MD, et al.

“THE EFFECTS OF AN EXERCISE PROGRAM ON ANTHROPOMETRIC, METABOLIC, AND CARDIOVASCULAR PARAMETERS IN OBESE CHILDREN.”

Korean Circulation Journal

Volume 40Pgs. 179-184

April 2010

Article #1

To compare cardiovascular and metabolic factors before

and after an exercise program on obese children

and to evaluate their physical fitness levels after.

PurposeArticle #1

54 obese children45 males, 9 femalesAges 12-1460 minutes sessions 3 times a week10 week exercise

program divided into 3 groups

1. Aerobic exercise: activities including soccer, basketball, football, jumping rope, etc.

2. Combined exercise: circuit weight training, aerobic activity, etc.

3. Control group

METHODSArticle #1

Increases

HDL levelsVO2 MaxGrip strengthLong jumpCurl ups

Decreases

Waist circumferenceSystolic BPLDL levelsI mile run times

RESULTSArticle #1

A regular exercise program which incorporates aerobic and anaerobic activities is shown to be the best combination to decrease BMI, weight and blood pressure in obese children.

Limitations to study:Short program- only 10 weeksSmall number of participants - only 54

DISCUSSIONSArticle #1

Incorporating an exercise program into a child’s routine at least 3 days per week can be effective in: Treating childhood obesity Decreasing the risk for metabolic syndrome in the

future.

CONCLUSIONSArticle #1

International Journal of Obesity

Volume 32Pgs. 837-844

2008

“VARIABILITY IN ADHERENCE TO AN UNSUPERVISED EXERCISE PRESCRIPTION IN OBESE WOMEN.”

Article #2

Authors: RC Colley, AP Hills, TM O’Moore-Sullivan, IJ Hickman, JB Prins and NM Byrne

To measure the consistency of a specific exercise

prescription (1500 kcal/week)

by subjecting unsupervised

exercise energy expenditure

(ExEE) in obese women.

PURPOSEArticle #2

Participants who had a body mass index of >30kg/m were placed into a hospital-based lifestyle intervention trial lasting for 16 weeks aimed to increase insulin sensitivity by weight loss and physical activity.

Heart rate monitors were used to track exercise compliance in the subjects.

Sub maximal treadmill protocols were used as well.

METHODSArticle #2

37 women were recruited; however, insuffi cient HR monitoring data in eight women- not included in analysis.

Compliance with using the HR monitors was 78%.

Two goals; change in body weight and in fat mass. 9 participants reached both goals 14 neither 6 reached weight loss goal without achieving the ExEE

goal.

RESULTSArticle #2

This study demonstrated that exercise is affi liated with both overall weight loss and fat mass loss in a group of obese women participating in an organized

lifestyle intervention program.

DISCUSSIONSArticle #2

The main finding of this study was that obese women have a highly variable and, on average, modest adherence to a prescription of 1500 kcal/week of unsupervised exercise.

In fact, the women in the present study achieved, on average, just over half of the prescribed dose.

CONCLUSIONSArticle #2

Journal Title: Research quarterly for Exercise and Sport

Volume 79

2008

p. 356-362

“CARDIOVASCULAR FITNESS IN OBESE VERSUS NON-OBESE 8-11-YEAR-OLD BOYS AND GIRLS.”

Article #3

Authors: M. Alysia Mastrangelo, Edward C. Chaloupka, and Peter Rattigan.

PURPOSE

The currency of obesity among children and

adolescents in the U.S. has nearly doubled in the past two decades, with 20-30%

of children and adolescents now classified as obese.

Article #3

All students asked to complete the MRW (mile run/walk) in as short a time as possible.

School nurses were asked to take height and weight measurements to compute BMI (kg/m^2) and to help with cardiovascular fitness calculations.

METHODSArticle #3

Non-obese boys and girls were able to perform the test better than the others that were classified as obese.

Non-obese boys finished the MRW 2 min 35s faster than obese boys.

Non-obese girls finished the MRW 1 min 29s faster than the obese girls.

RESULTSArticle #3

This test is shown to be easily administered and a cost and time effi cient

field test. Each participant’s time was

individually compared to the 50th percentile by

age and gender.

DISCUSSIONSArticle #3

Non-obese children performed better than obese children in assessing cardiovascular fitness. This indicates a lower susceptibility to obesity-related diseases in childhood and on to adulthood.

CONCLUSIONSArticle #3

Journal Title: PLoS Medicine

Volume 7

August 2010

“PHYSICAL ACTIVITY ATTENUATES THE GENETIC PREDISPOSITION TO OBESITY IN 20,000 MEN AND WOMEN IN EPIC-NORFOLK PROSPECTIVE STUDY.”

Article #4

Authors: Shengxu Li, Jing Hua Zhao, Jian’an Luan, Ulf Ekelund, Robert Luben, Kay-Tee Khaw, Nicholas Wareham and Ruth Loos

To assess the influence of a

physically active lifestyle on the

genetic predisposition to obesity in a large population based

study.

PURPOSEArticle #4

Assessed individuals with a genetic predisposition to see if increasing daily physical activity could modify the risk of becoming obese.

20,430 subjectsAges 39-79 years oldExamined 12 DNA characteristics that predisposed

people to becoming obese.A genetic predisposition score was given to each subject

which correlated to an increase in BMI.Each individual assessed their level of physical activity

(from occupational to leisure activities).There was an initial assessment and a final assessment

2 years later.

METHODSArticle #4

RESULTSPhysical activity

significantly modified the outcome of the genetic predisposition score on BMI.

The physical activity questionnaires placed participants into an active group and inactive group.

After 2 years, the active groups change in BMI did not change much, however the inactive groups average change in BMI was significant.

Article #4

Active vs. Inactive Change in BMI

Confounding Variables: questionnaire was not a true measure of physical

activity participants could have lied on questionnaire not every participant came to final assessment

(only 15,000 of 20,000)

DISCUSSIONSArticle #4

Having a physically active lifestyle can modify the genetic predisposition to obesity.

The genetic predisposition to obesity can be reduced by 40% by having a physically active lifestyle.

Individuals who are predisposed to obesity would benefit more from physical activity than genetically protected individuals.

CONCLUSIONSArticle #4

Journal of the American College of Sports Medicine

Volume 38

pg. 919-925

2006

“RISK OF OBESITY IN RELATION TO PHYSICAL ACTIVITY TRACKING FROM YOUTH TO ADULTHOOD.”

Article #5

Authors: Xiaolin Yang, Risto Telama, Jorma Viikari, and Olli T. Raitakari

1. To test the hypothesis that obesity in adults is related to physical activity as a child.

2. To test how changes in physical activity from youth to adulthood effects adulthood obesity.

PURPOSEArticle #5

Questionnaires and physical examinations were given to participants in both 1980 and 2001

A physical activity index was made to categorize the participants into active, moderately active, inactive groups.

Compared the PAI numbers from 1980 to 2001 to come up with 4 categories: persistently active increasingly active decreasing active persistently inactive

Used BMI, skin fold measurements, and waist circumference

METHODSArticle #5

Physical activity in youth is inversely associated with both measures of obesity in females, but only BMI in males.

In both sexes, participants that were persistently active or increasingly active had lower WC values than those who were decreasingly inactive.

Women who had been decreasingly active and persistently inactive had a higher probability of being overweight than women who were persistently active.

Both men and women who were decreasingly active were more likely to have mild and severe abdominal obesity in adulthood than those who were persistently active.

RESULTSArticle #5

Confounding variables: questions of education, occupation, residence, marital status, number of children, and smoking habits.

Physical activity over 21 years was significantly related to abdominal obesity in men and women.

Participants who reported that their physical activity level had decreased were at an increased risk of being obese in adulthood.

Being decreasingly inactive is a stronger risk factor for obesity than being persistently inactive.

Unexpected result: people who were persistently inactive were not at higher risk of obesity than people who were persistently active

Limitations: diet and perceived intensity diff erences in youths and adults

DISCUSSIONSArticle #5

Physical activity history over 21 years was significantly related to abdominal obesity in both men and women (more significantly in women).

Physical activity patterns are important in determining whether or not an adult will be obese.

Regular participation in physical activity from youth to adulthood could help to prevent obesity in adults.

CONCLUSIONSArticle #5

Each article provides evidence for the importance of physical activity in the determination of obesity.

Some find that adding exercise to a person’s daily routine will decrease risk for obesity and reduce BMI.

Other articles find that physical activity patterns throughout a persons life help determine the risk of obesity.

Although other factors are present, physical activity seems to be the most important factor in determining obesity.

For an obese person, it is important to put them on an exercise routine

For children, it is vital to be active in order to help prevent obesity in the future.

OVERALL CONCLUSIONS OF ARTICLES