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Fearing Physical Inactivity More Than Obesity . A New Perspective .

Fearing Physical Inactivity More Than Obesity . A New Perspective . . Cathy Roy, PhD, CSCS Associate Professor of Exercise Science HARK Department . Part I: the crusade against obesity.

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Fearing Physical Inactivity More Than Obesity . A New Perspective .

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  1. Fearing Physical Inactivity More Than Obesity. A New Perspective . Cathy Roy, PhD, CSCS Associate Professor of Exercise Science HARK Department

  2. Part I: the crusade against obesity It is clear from reading magazines or watching television that public derision and condemnation of fat people is one of the few remaining sanctioned social prejudices in this nation freely allowed against any group based solely on appearance. - Faith Fitzgerald, M.D. “The Problem of Obesity,” Annual Review of Medicine, 2009

  3. OBESITY - A KILLER DISEASE Definition • Excess body fat frequently resulting in a significant impairment of health • Overweight: BMI = 25-29.9 kg/m2 • Obese: BMI >30 kg/m2 Prevalence (CDC, 2009) • Adult obesity rates now exceed 25 percent in 31 states and exceed 20 percent in 49 states and Washington, D.C. • Two-thirds of American adults are either obese or overweight.

  4. OBESITY – A KILLER DISEASE • Atherosclerosis • High Blood Pressure • Insulin Resistance; Diabetes • Dyslipidemia • Osteoarthritis

  5. OBESITY – A KILLER DISEASE Etiology • Hypothalamic, endocrine, and genetic disorders • Diet and physical inactivity are the primary causes

  6. Part I1: exposing the myths It is suggested that, not only does advice on the subject of obesity need reappraisal, but that research into possible associated benefits of moderate obesity would be worthwhile. - Reubin Andres, M.D., National Institute on Aging International Journal of Obesity, 2007

  7. Weight and All-Cause Death Rates • Journal of the American Medical Association, 2003 • Men and women medically classified as “overweight” or “obese” who exercise regularly and are physically fit, yet remain above the ranges recommended by BMI charts, have lower all-cause death rates than thin men and women who do not exercise and are unfit.

  8. Weight and its relationship to Hypertension • New England Journal of Medicine, 1999 • “BPs in moderately hypertensive, overweight men and women could be reduced without weight loss, and, it should be emphasized, by an amount similar in magnitude to that observed with antihypertensive medications”

  9. Weight and Its Relationship to Diabetes • Journal of Clinical Endocrinology and Metabolism, 2005 • Both losers and gainers improved cardiovascular fitness by the same amount. • Subjects who gained body fat also improved their insulin sensitivity by the same amount as the subjects who lost weight. • Improvements in total cholesterol and HDL cholesterol were also similar, • Suggests that exercise, and not the fat loss, was the key to health and fitness improvements.

  10. Weight Loss and Health Benefits • American Journal of Clinical Nutrition, 2006 • Weight loss does not necessarily improve health or lengthen life. Dieters, especially yo-yo dieters, have a risk for cardiovascular disease and T2D that is up to twice that of “overweight” people who remain fat.

  11. Good Body Fat,Bad Body Fat • Body fat can actually be beneficial, depending on its location. Thigh and hip fat, for example, have been reported to be associated with lower risk of cardiovascular disease and possibly T2D

  12. Part 1II: The New approach to health Obesity may not be a direct cause of disease, but may serve as an imprecise marker for an imprudent lifestyle. Excessive consumption of alcohol, fat, and sugar, and inadequate exercise and dietary fiber all contribute to disease while promoting weight gain. If these lifestyle factors are the true culprits in obesity-related disease, then the current focus on weight reduction may be misplaced. - Paul Ernsberger and Paul Haskew, New England Journal of Medicine, 2006

  13. OBESITY and DIETING Prevalence of obesity & dieting is positively related • 1960’s, obesity was rare (<15%); now up over one-quarter • Every year 70 million people go on diets to attempt weight loss (compared to 52 million in the ‘60s) • Diet industry is a $35 Billion/year market

  14. The True Culprit – Physical Inactivity Prevalence (American Heart Association, 2008) • Recommended Moderate-to-Vigorous Physical Activity (MVPA): 40.8% • Insufficient MVPA: 42.7% • No MVPA 16.5%

  15. Metabolic Fitness • Fitness is not integrally related to weight • Real indicators of improved health and longevity • Insulin sensitivity • Blood pressure • Blood cholesterol levels

  16. The Bottom Line • The notion that we can predict our health, overall well-being, and mortality risk solely on the basis of a number on the scale is way oversold • There is not a single health problem that is associated with weight that cannot be handled fairly effectively with diet and exercise, independent of changes in weight • When you factor in fitness (in addition to body weight), it is a far better predictor of disease risk and mortality than weight itself.

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