Exercise as a Treatment for Weight Loss and Well-BeingDavid Baron, DO

Physiologic effects of exercise well documented– Runner high(opioid)– Increased self-esteem– Caloric control improved– Effective treatment for Depression

Substantial evidence, retrospective, prospective, animal & human,

Exercise has a neuroprotective effect (Kramer,Erickson, Colcombe)

Delay the onset of cognitive decline, Alzheimer’s Proliferation of active capillary beds New dendritic connections Neuronal growth in hippocampus

Data demonstrated exercise several/week(Institute Brain Aging UCI)– Reduces rate of cognitive decline with age– Increases BDNF– Decreases B-amyloid

Gunstad J. in press Comprehensive Psychiatry– 408 subjects– 20-82 yo– Body mass index inversely related to

performance all cognitive tests Regular exercise improved cognitive

performance Overall sense of well-being

Diet and exercise represent the mainstays of obesity treatment. No systematic review has been conducted comparing the effect of dietary and exercise intervention in reducing metabolic risks in overweight children.

To compare the effects of diet-only intervention with those of diet plus exercise or exercise only on weight loss and metabolic risk reduction in overweight children.

Date of download: 3/4/2014Copyright © 2014 American Medical

Association. All rights reserved.

From: Impact of Dietary and Exercise Interventions on Weight Change and Metabolic Outcomes in Obese Children and Adolescents:  A Systematic Review and Meta-analysis of Randomized TrialsJAMA Pediatr. 2013;167(8):759-768. doi:10.1001/jamapediatrics.2013.1453

Flowchart for Identification of Trials for Inclusion in the Systematic Review and Meta-analyses

Obesity in children and adolescents is a major public health problem, with high or increasing prevalence reported in many countries

Diet and exercise represent the mainstays of obesity treatment

unclear whether diet plus exercise or exercise only is more effective than a diet-only intervention for improving weight status in overweight and obese children and adolescents

Fifteen studies were identified 1975-2010 Both diet-only and diet plus exercise

interventions resulted in weight loss and metabolic profile improvement.

Addition of exercise to dietary intervention led to greater improvements in – HDL– Fasting glucose, fasting insulin– triglycerides – Improved sense of well-being

Dietary interventions in conjunction with exercise interventions are effective in reducing metabolic risks, particularly HDL-C and fasting insulin levels, in overweight and obese children

How much is enough(exercise and weight loss) Must be enjoyable

– Reward– Negative reinforcement– Punishment

Aerobic vs anaerobic Effect throughout life-cycle (peds-gero)

– Gonadal steroid modulation Fad diets vs sound nutritional intake

– Many claims, limited data Supplements, herbs etc

All things in moderation

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