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Exercise and Weight Control

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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  1. Exercise and Weight Control Dr. David L. Gee FCSN 446/PE 446 Nutrition, Weight Control, and Exercise

  2. Benefits of Exercise for Overweight Individuals • Weight Loss Related Benefits • Health Benefits Independent of Weight Loss • Psychological Benefits

  3. Why do Americans not exercise?

  4. 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

  5. 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

  6. 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

  7. 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!

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

  9. 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

  10. Lifestyle vs Structured Activity

  11. Lifestyle vs Structured Activity

  12. Lifestyle vs Structured Activity Conclusions: Lifestyle Programs have similar beneficial changes as Structured Exercise Programs

  13. 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.

  14. 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

  15. 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

  16. Active/highly active • > 10,000 steps/day • 20% men • 13% women • Sedentary lifestyle • < 5,000 steps/day • 32% men • 33% women

  17. Factors affecting steps/day • Age • Younger>older • Income • Low<high • Ethnicity NS • Marital status • Single/divorce>married • BMI • Obese<overweight<normal

  18. 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.”

  19. 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

  20. 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

  21. Considerations for the Overweight Exerciser • Many of those overweight: • are currently inactive • were never active • feel awkward exercising • have poor self image

  22. 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

  23. 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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