Overweight and obesity present significant public health concerns because of the link with numerous chronic health conditions. Excess body weight is a result of an imbalance between energy intake and energy expenditure. Physical activity is the most variable component of energy expenditure and therefore has been the target of behavioral interventions to modify body weight. It appears that physical activity is an important component on long-term weight control, and therefore adequate levels of activity should be prescribed to combat the obesity epidemic. Although there is evidence that 30 min of moderate-intensity physical activity may improve health outcomes, the amount of physical activity that may be necessary to control body weight may be >30 min/d. There is a growing body of scientific literature suggesting that at least 60 min of moderate-intensity physical activity may be necessary to maximize weight loss and prevent significant weight regain. Moreover, adequate levels of physical activity appear to be important for the prevention of weight gain and the development of obesity. Physical activity also appears to have an independent effect on health-related outcomes when compared with body weight, suggesting that adequate levels of activity may counteract the negative influence of body weight on health outcomes. Thus, it is important to target intervention strategies to facilitate the adoption and maintenance of an adequate amount of physical activity to control body weight.
"Regular and adequate levels of physical activity – at least an hour a day – is important to keep a steady weight, or even reduce it, and to fight the obesity epidemic. Consequently, a healthy weight will have a positive effect on the health outcomes [23,41]. "
[Show abstract][Hide abstract] ABSTRACT: Background
Obesity is a major public health issue with increasing prevalence among adults. However, in Belgium the regional time trends (1997–2008) differed: the prevalence of obesity increased in the Flemish and Brussels Regions, but remained stable in the Walloon Region, the latter still showing the highest prevalence. The purpose of the present study is to explore if the different time trends of obesity prevalence in the three Belgian regions is associated with lifestyle changes.
We used data from four successive cross-sectional waves (1997, 2001, 2004 and 2008) of the Belgian Health Interview Survey. The study was restricted to the adult population, resulting in samples of respectively 8,071, 9,391, 10,319 and 8,831 individuals. In line with the WHO definition, obesity was defined as having a BMI ≥ 30. Differences in regional trends of obesity were investigated through stratified analyses. The association between obesity and survey year, adjusted for lifestyle factors (alcohol consumption, smoking, fruit and vegetables consumption and leisure time physical activity), was assessed via logistic regression models. Interactions were added to the models to explore if the association between lifestyle factors and obesity varied over time.
Obesity was associated with daily alcohol use in the Brussels (OR 0.66, 95% CI 0.50-0.88) and Walloon Regions (OR 0.8, 95% CI 0.6-0.9), with lower tendencies of being obese for daily drinkers. The probability of being obese was lower among smokers in the Flemish (OR 0.7, 95% CI 0.6-0.8) and Walloon Regions (OR 0.7, 95% CI 0.6-0.9) than among non-smokers. A lack of leisure time physical activity was associated with the probability of being obese in all regions (Brussels Region: OR 1.6, 95% CI 1.3-1.8; Flemish Region: OR 1.6, 95% CI 1.4-1.9; Walloon Region: OR 1.8, 95% CT 1.6-2.1). This association decreased significantly between 1997 and 2008 only in the Walloon Region.
The decreasing association between obesity and a lack of leisure time physical activity in the Walloon Region between 1997 and 2008 could indicate that there is an increasing awareness of risk factors for obesity in the Walloon population, which may have resulted in a more favourable evolution of the obesity epidemic.
"The benefit of physical activity in the management of obesity depends on the amount and the intensity of the intervention [45,46]. Clinical guidelines for the treatment of obesity recommend more than 225-300 min per week of moderate intensity physical activity [8,9]. "
[Show abstract][Hide abstract] ABSTRACT: To evaluate the clinical effectiveness of weight management interventions in adults with intellectual disabilities (ID) and obesity using recommendations from current clinical guidelines for the first line management of obesity in adults. Full papers on lifestyle modification interventions published between 1982 to 2011 were sought by searching the Medline, Embase, PsycINFO and CINAHL databases. Studies were evaluated based on 1) intervention components, 2) methodology, 3) attrition rate 4) reported weight loss and 5) duration of follow up. Twenty two studies met the inclusion criteria. The interventions were classified according to inclusion of the following components: behaviour change alone, behaviour change plus physical activity, dietary advice or physical activity alone, dietary plus physical activity advice and multi-component (all three components). The majority of the studies had the same methodological limitations: no sample size justification, small heterogeneous samples, no information on randomisation methodologies. Eight studies were classified as multi-component interventions, of which one study used a 600 kilocalorie (2510 kilojoule) daily energy deficit diet. Study durations were mostly below the duration recommended in clinical guidelines and varied widely. No study included an exercise program promoting 225--300 minutes or more of moderate intensity physical activity per week but the majority of the studies used the same behaviour change techniques. Three studies reported clinically significant weight loss (>= 5%) at six months post intervention. Current data indicate weight management interventions in those with ID differ from recommended practice and further studies to examine the effectiveness of multi-component weight management interventions for adults with ID and obesity are justified.
"This curve is derived from the crossover concept  which is a physiological theory of exercise explaining that at rest, as at low intensities of exercise, the substrate of energy that is preferentially oxidized is lipids whereas at the highest intensities, carbohydrates are preferentially oxidized. However, only a few studies have addressed this working hypothesis on exercise and obesity or diabetes, and the bulk of current literature does not take into account this concept  . Despite the fact that most of these studies involve a little number of subjects and are performed over a short duration of time, it was interesting to review them in a meta-analysis. "
[Show abstract][Hide abstract] ABSTRACT: Exercise is recognized as a part of the management of obesity and diabetes. Various protocols of exercise are proposed for the management of obesity, diabetes, and other metabolic diseases. One of the strategies proposed by several authors is low intensity endurance training targeted at the level of maximal oxidation. Large series using this technique are lacking. Addressing this issue, we performed a meta-analysis of the studies on anthropometric measurements. From a database of 433 articles, 15 were selected, including 279 subjects with 6 different populations. Studies duration ranged from 2 months to 12 months. Concerning weight loss, in the intervention versus control analysis, five studies with 185 participants were included with a significant effect size favors exercise (P = 0.02) without significant heterogeneity (I(2) = 0.0%, P = 0.83). Further randomized controlled trials for comparing it with other exercise protocols and defining its dose effectiveness on large samples are needed.
Journal of nutrition and metabolism 08/2012; 2012(4, part 1):285395. DOI:10.1155/2012/285395
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