Physical activity and the risk of becoming overweight or obese in middle-aged and older women.

Cardiovascular Division, Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA.
Obesity (Impact Factor: 4.39). 12/2011; 20(5):1096-103. DOI: 10.1038/oby.2011.359
Source: PubMed

ABSTRACT Although public health campaigns stress leisure time physical activity (LTPA) as essential for obesity prevention, few epidemiological studies have focused on the association of specific types and intensities of LTPA and the clinical endpoints of overweight and obesity. Therefore, we prospectively assessed whether moderate- and vigorous-intensity as well as total LTPA were associated with the risk of becoming either overweight or obese using a prospective cohort design of 19,003 women enrolled in the Women's Health Study (WHS). Women reported their participation in walking and LTPA at baseline. During a median follow-up of 11.6 years, 7,865 women became overweight or obese. In multivariable-adjusted models that included demographic, lifestyle, and dietary factors, both vigorous-intensity and total LTPA showed a modest inverse relationship with the development of overweight/obesity. The hazard ratios (HR) and 95% confidence interval (CI) for the highest categories of vigorous-intensity LTPA (>2,000 kcal/week) and total LTPA (>3,000 kcal/week) compared with no LTPA were 0.79 (0.71-0.89) and 0.87 (0.78-0.96), respectively. In addition, a greater percentage of total LTPA spent performing vigorous intensity activities was associated with a lower risk of overweight/obesity (multivariable HR 0.93, 95% CI 0.87-0.98 for performing >50% compared with <50% of activity as vigorous). In conclusion, higher amounts of total LTPA should be encouraged to prevent obesity. Among those willing to participate in vigorous LTPA, and for whom such activities are not contraindicated, vigorous LPTA should be encouraged.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Combating unhealthy weight gain is a major public health and clinical management issue. The extent of research into the etiology and pathophysiology of obesity has produced a wealth of evidence regarding the contributing factors. While aspects of the environment are ‘obesogenic’, weight gain is not inevitable for every individual. What then explains potentially unhealthy weight gain in individuals living within an environment where others remain lean? In this paper we explore the biological compensation that acts in response to a reduced energy intake by reducing energy needs, in order to defend against weight loss. We then examine the evidence that there is only a weak biological compensation to surplus energy supply, and that this allows behavior to drive weight gain. The extent to which biology impacts behavior is also considered.
    03/2013; 2(1). DOI:10.1007/s13679-012-0040-9
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Obesity represents an important public health concern and has negative health and social consequences. Epidemiological and observational studies have contributed to highlighting the multifactorial and complex etiology of obesity. Among the social components of the obesity epidemic the following appear to be the most relevant: assortative mating, parental age, socio-economical status and educational level, body dissatisfaction, sleep conditions, sedentary environments by build neighborhood, energy saving devices, work occupation and alcohol consumption. The assortative mating and parental traits (age, education level) have shown an important influence on the weight of children. In turn, sleep deprivation may reduce the energy expenditure and increase food intake, which can explain a relation with obesity. Body dissatisfaction in childhood and adolescence seems to increase the risk of obesity in adulthood. The low physical activity and spent sedentary time can be associated with unfavorably built environment, including low walk ability, unsafe playgrounds and pedestrian pathways. Moreover, the obesity per se, over time, may reduce physical activity level and social ability as well as influence in assortative mating, and subsequent intergenerational obesity condition. All findings together demonstrated that social components of obesity are as complex as itself. In summary, more studies concerning social, cultural and environment traits are needed in order to assess the effect of excessive adiposity in its own occurrence and chronicity. In addition, it is urgent to include obesity prevention as a relevant topic on the public health agenda in developing countries.
    03/2012; 2(1). DOI:10.1007/s13679-012-0043-6
  • [Show abstract] [Hide abstract]
    ABSTRACT: Physical activity (PA) reduces the risk for a number of chronic diseases including heart disease, hypertension, hyperlipidemia, and diabetes mellitus type 2. However, most Americans do not meet expert recommendations for exercise, and minorities and low-income persons are the most inactive. Community-based approaches to promoting PA include primary care exercise referral programs. This study examines patient characteristics associated with utilization of a community health center-based exercise referral program. Adult female patients of a community health center with an affiliated fitness center, in Boston, MA, were included in the study if they received a referral to the fitness center from their primary care provider. Demographic and medical information was abstracted from the medical chart, and fitness records were abstracted to measure activation of a fitness center membership (creation of an account denoting at least an initial visit) and utilization over time. Overall, 503 (40 %) of the 1,254 referred women in the study sample activated their membership. Black women were almost 60 % more likely to activate their membership (adjusted OR 1.6, 95 % CI 1.2-2.2), and women with higher co-morbidity counts were almost 45 % more likely to activate (adjusted OR 1.4, 95 % CI 1.0-2.0). Once activated, a minority of women participated at levels likely to improve cardiometabolic fitness. Of the 503 activations, 96 (19 %) had no participation, 359 (71 %) had low participation, and only 48 (10 %) had high participation. No independent predictors of participation were identified. These findings suggest that program design may benefit from developing activation, initial participation, and retention strategies that address population-specific barriers.
    Journal of Community Health 04/2014; 39(6). DOI:10.1007/s10900-014-9874-2 · 1.28 Impact Factor


1 Download
Available from