Respiratory weight losses during exercise.

NASA Technical Reports Server (NTRS)

Mitchell, J. W.; Nadel, E. R.; Stolwijk, J. A. J.

1972-01-01

Evaporative water loss from the respiratory tract was determined over a wide range of exercise. The absolute humidity of the expired air was the same at all levels of exercise and equal to that measured at rest. The rate of respiratory water loss during exercise was found to be 0.019 of the oxygen uptake times (44 minus water vapor pressure). The rate of weight loss during exercise due to CO2-O2 exchange was calculated. For exercise at oxygen consumption rates exceeding 1.5 L/min in a dry environment with a water vapor pressure of 10 mm Hg, the total rate of weight loss via the respiratory tract is on the order of 2-5 g/min.

Effects of dietary and exercise intervention on weight loss and body composition in obese postmenopausal women: a systematic review and meta-analysis.

PubMed

Cheng, Chao-Chun; Hsu, Ching-Yun; Liu, Jen-Fang

2018-03-12

This study examined the effects of dietary and exercise interventions on weight loss and body composition in overweight/obese peri- and postmenopausal women. Medline, Central, Embase, and Google Scholar databases were searched for relevant trials conducted until December 31, 2016. Randomized controlled trials (RCTs) and prospective studies of overweight/obese peri- or postmenopausal women that examined the effects of dietary or exercise interventions, alone or combined, on weight loss were included. The primary outcome was percentage reduction in body weight. From 292 studies initially identified, 11 studies with 12 sets of participants were included. Both dietary and exercise intervention groups had significantly greater weight loss than control groups (diet vs control: difference in means = -6.55, 95% CI, -9.51 to -3.59, P < 0.001; exercise vs control: difference in means = -3.49, 95% CI, -6.96 to -0.02, P = 0.049). Combined dietary and exercise interventions resulted in greater weight loss than dietary interventions alone (diet plus exercise vs diet: difference in means = -1.22, 95% CI, -2.14 to -0.29, P = 0.010). Diet plus exercise resulted in greater fat loss (difference in means = -0.44, 95% CI, -0.67 to -0.20, P < 0.001) and greater lean mass loss (difference in means = -0.84, 95% CI, -1.13 to -0.55, P < 0.001) than diet alone. Dietary interventions reduced body weight and body composition profile parameters in peri- and postmenopausal women more than exercise alone. The addition of exercise reinforced the effect of dietary interventions on changing body weight and composition.

Short-term weight loss attenuates local tissue inflammation and improves insulin sensitivity without affecting adipose inflammation in obese mice.

PubMed

Jung, Dae Young; Ko, Hwi Jin; Lichtman, Eben I; Lee, Eunjung; Lawton, Elizabeth; Ong, Helena; Yu, Kristine; Azuma, Yoshihiro; Friedline, Randall H; Lee, Ki Won; Kim, Jason K

2013-05-01

Obesity is a major cause of insulin resistance, and weight loss is shown to improve glucose homeostasis. But the underlying mechanism and the role of inflammation remain unclear. Male C57BL/6 mice were fed a high-fat diet (HFD) for 12 wk. After HFD, weight loss was induced by changing to a low-fat diet (LFD) or exercise with continuous HFD. The weight loss effects on energy balance and insulin sensitivity were determined using metabolic cages and hyperinsulinemic euglycemic clamps in awake mice. Diet and exercise intervention for 3 wk caused a modest weight loss and improved glucose homeostasis. Weight loss dramatically reduced local inflammation in skeletal muscle, liver, and heart but not in adipose tissue. Exercise-mediated weight loss increased muscle glucose metabolism without affecting Akt phosphorylation or lipid levels. LFD-mediated weight loss reduced lipid levels and improved insulin sensitivity selectively in liver. Both weight loss interventions improved cardiac glucose metabolism. These results demonstrate that a short-term weight loss with exercise or diet intervention attenuates obesity-induced local inflammation and selectively improves insulin sensitivity in skeletal muscle and liver. Our findings suggest that local factors, not adipose tissue inflammation, are involved in the beneficial effects of weight loss on glucose homeostasis.

Weight Loss Behaviors Used by Active Duty Air Force Personnel to Maintain Compliance with Weight Control Standards

DTIC Science & Technology

1997-05-01

lose weight. The methods of weight loss reported were exercising , skipping meals, using diet pills, and self- induced vomiting. In each case, females...Restrictive Diet Popular Diet Self- induced Vomifing Laxatives Diuretics Diet Pills Exercise Other Note- N = frequency of resf were allowed to...Rate 69 Demographic Data 69 Exercise 70 Weight Loss Beliefs and Practices 71 Additional Data Collected 76 Implications for Military Health Care

Do more specific plans help you lose weight? Examining the relationship between plan specificity, weight loss goals, and plan content in the context of a weight management programme.

PubMed

Dombrowski, Stephan U; Endevelt, Ronit; Steinberg, David M; Benyamini, Yael

2016-11-01

The conditions under which planning for behaviour change is most effective are not fully understood. In the context of a weight management programme, we examined the interrelationship between plan specificity, type of behaviour planned (diet vs. exercise), and weight loss goals. Prospective design and content analysis of plans formed by participants of a 10-week weight management programme. Participants (n = 239) formulated two plans, for dietary and exercise behaviours, respectively. Plans were rated for specificity by examining the number of plan components. Weight loss goals were assessed by asking how much weight participants intend to lose. Weight was measured objectively each of the 10 weeks. Changes in body mass index (BMI) over time and the interactions between plan specificity and weight loss goals, for all plans and separately for diet and exercise, were estimated using linear mixed models. Plan specificity was unrelated to weight loss, but interacted with weight loss goals in predicting linear change in BMI (t = -2.48): More specific plans were associated with higher decreases in weight in participants with high weight loss goals. Separate interaction tests for plans formulated for diet and exercise change showed that more specific dietary plans, but not exercise plans, were associated with higher decreases in weight in participants with high weight loss goals (t = -2.21). Within a population that is highly motivated to lose weight, the combination of high weight loss goals and formulating detailed plans for changing dietary behaviours may be most effective in supporting weight loss. Statement of contribution What is already known on this subject? More specific plans are associated with increased performance of health-related behaviours. More motivated individuals form more specific plans. The interrelationship between plan specificity, plan content and behaviour-related goals in relation intervention effectiveness has not been explored to date. What does this study add? The effectiveness of forming specific plans may depend on the strength of behaviour-related goals as well as the behaviour selected for change. More detailed plans, in particular dietary plans, were related to greater weight loss, but only for participants with higher initial weight loss goals. Detailed exercise plans were not associated with weight loss, regardless of initial weight loss goals. © 2016 The British Psychological Society.

Exercise, appetite and weight management: understanding the compensatory responses in eating behaviour and how they contribute to variability in exercise-induced weight loss.

PubMed

King, N A; Horner, K; Hills, A P; Byrne, N M; Wood, R E; Bryant, E; Caudwell, P; Finlayson, G; Gibbons, C; Hopkins, M; Martins, C; Blundell, J E

2012-04-01

Does exercise promote weight loss? One of the key problems with studies assessing the efficacy of exercise as a method of weight management and obesity is that mean data are presented and the individual variability in response is overlooked. Recent data have highlighted the need to demonstrate and characterise the individual variability in response to exercise. Do people who exercise compensate for the increase in energy expenditure via compensatory increases in hunger and food intake? The authors address the physiological, psychological and behavioural factors potentially involved in the relationship between exercise and appetite, and identify the research questions that remain unanswered. A negative consequence of the phenomena of individual variability and compensatory responses has been the focus on those who lose little weight in response to exercise; this has been used unreasonably as evidence to suggest that exercise is a futile method of controlling weight and managing obesity. Most of the evidence suggests that exercise is useful for improving body composition and health. For example, when exercise-induced mean weight loss is <1.0 kg, significant improvements in aerobic capacity (+6.3 ml/kg/min), systolic (-6.00 mm Hg) and diastolic (-3.9 mm Hg) blood pressure, waist circumference (-3.7 cm) and positive mood still occur. However, people will vary in their responses to exercise; understanding and characterising this variability will help tailor weight loss strategies to suit individuals.

Factors that may impede the weight loss response to exercise-based interventions.

PubMed

Boutcher, S H; Dunn, S L

2009-11-01

The results of exercise programmes designed to reduce body fat are disappointing. However, the reporting of weight loss as mean values disguises those individuals who do lose significant amounts of fat. Why some participants produce significant exercise-induced fat loss whereas others lose little or increase fat stores is likely to be an outcome of a range of behavioural (e.g. sleep deprivation, caloric intake), inherited (e.g. muscle fibre type, gender) and physiological (e.g. hyperinsulinaemia, hypothyroidism) factors. The following review highlights possible factors involved in weight loss and discusses how individual differences may determine the extent of weight loss after an exercise intervention. Finally, implications for the treatment and prevention of obesity are discussed.

Separate and combined effects of exercise training and weight loss on exercise efficiency and substrate oxidation.

PubMed

Amati, Francesca; Dubé, John J; Shay, Chris; Goodpaster, Bret H

2008-09-01

Perturbations in body weight have been shown to affect energy expenditure and efficiency during physical activity. The separate effects of weight loss and exercise training on exercise efficiency or the proportion of energy derived from fat oxidation during physical activity, however, are not known. The purpose of this study was to determine the separate and combined effects of exercise training and weight loss on metabolic efficiency, economy (EC), and fat oxidation during steady-state moderate submaximal exercise. Sixty-four sedentary older (67 +/- 0.5 yr) overweight to obese (30.7 +/- 0.4 kg/m(2)) volunteers completed 4 mo of either diet-induced weight loss (WL; n = 11), exercise training (EX; n = 36), or the combination of both interventions (WLEX; n = 17). Energy expenditure, gross efficiency (GE), EC, and proportion of energy expended from fat (EF) were determined during a 1-h submaximal (50% of peak aerobic capacity) cycle ergometry exercise before the intervention and at the same absolute work rate after the intervention. We found that EX increased GE by 4.7 +/- 2.2%. EC was similarly increased by 4.2 +/- 2.1% by EX. The addition of concomitant WL to EX (WLEX) resulted in greater increases in GE (9.0 +/- 3.3%) compared with WL alone but not compared with EX alone. These effects remained after adjusting for changes in lean body mass. The proportion of energy derived from fat during the bout of moderate exercise increased with EX and WLEX but not with WL. From these findings, we conclude that exercise training, either alone or in combination with weight loss, increases both exercise efficiency and the utilization of fat during moderate physical activity in previously sedentary, obese older adults. Weight loss alone, however, significantly improves neither efficiency nor utilization of fat during exercise.

The Treatment of Obesity in Cardiac Rehabilitation

PubMed Central

Ades, Philip A.; Savage, Patrick D.; Harvey-Berino, Jean

2010-01-01

Obesity is an independent risk factor for the development of coronary heart disease (CHD). At entry into cardiac rehabilitation (CR) over 80% of patients are overweight and over 50% have the metabolic syndrome. Yet, CR programs do not generally include weight loss programs as a programmatic component and weight loss outcomes in CR have been abysmal. A recently published study outlines a template for weight reduction based upon a combination of behavioral weight loss counseling and an approach to exercise that maximized exercise-related caloric expenditure. This approach to exercise optimally includes walking as the primary exercise modality and eventually requires almost daily longer distance exercise to maximize caloric expenditure. Additionally, lifestyle exercise such as stair climbing and avoidance of energy-saving devices should be incorporated into the daily routine. Risk factor benefits of weight loss and exercise training in overweight patients with coronary heart disease are broad and compelling. Improvements in insulin resistance, lipid profiles, blood pressure, clotting abnormalities, endothelial-dependent vasodilatory capacity, and measures of inflammation such as C-reactive protein have all been demonstrated. CR/secondary prevention programs can no longer ignore the challenge of obesity management in patients with CHD. Individual programs need to develop clinically effective and culturally sensitive approaches to weight control. Finally, multicenter randomized clinical trials of weight loss in CHD patients with assessment of long-term clinical outcomes need to be performed. PMID:20436355

Exercise Training and Energy Expenditure following Weight Loss

PubMed Central

Hunter, Gary R.; Fisher, Gordon; Neumeier, William H.; Carter, Stephen J.; Plaisance, Eric P.

2015-01-01

Purpose Determine the effects of aerobic or resistance training on activity related energy expenditure (AEE, kcal/d) and physical activity index (ARTE) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by a decrease in AEE, ARTE, and non-training physical activity energy expenditure (NEAT) and that exercise training would prevent decreases in free living energy expenditure. Methods 140 pre-menopausal women underwent an average of 25 pound weight loss during an 800 kcal/day diet of furnished food. One group aerobically trained 3 times/wk (40 min/d), another resistance trained 3 times/wk (10 exercises/2 sets x10 repetitions) and the third group did not exercise. DXA was used to measure body composition, indirect calorimetry to measure resting (REE) and walking energy expenditure, and doubly labeled water to measure total energy expenditure (TEE). AEE, ARTE, and non-training physical activity energy expenditure (NEAT) were calculated. Results TEE, REE, and NEAT all decreased following weight loss for the no exercise group, but not for the aerobic and resistance trainers. Only REE decreased in the two exercise groups. The resistance trainers increased ARTE. Heart rate and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Conclusion Exercise training prevents a decrease in energy expenditure, including free living energy expenditure separate from the exercise training, following weight loss. Resistance training increased physical activity, while ease and economy in walking associates with increased TEE, AEE, NEAT, and ARTE. PMID:25606816

Balancing exercise and food intake with lactation to promote post-partum weight loss.

PubMed

Lovelady, Cheryl

2011-05-01

Excess weight gain during pregnancy and post-partum weight retention are risk factors for obesity. While many studies report average weight retained from pregnancy is only 0·5-3·0 kg; between 14 and 20% of women are 5 kg heavier at 6-18 months post-partum than they were before pregnancy. Among normal-weight women, lactation usually promotes weight loss to a moderate extent, but not among those with BMI≥35 kg/m2. While exercise and energy restriction may promote weight loss during lactation, their effect on milk volume and composition and, consequently, infant growth must be considered. The effect of exercise on lactation performance has been investigated. Moderate aerobic exercise of 45 min/d, 5 d/week improved cardiovascular fitness, plasma lipids and insulin response; however, it did not promote post-partum weight loss. Breast milk volume and composition were not affected. The effect of exercise with energy restriction in overweight women on the growth of their infants has also been studied. At 1 month post-partum, women restricted their energy intake by 2092 kJ/d and exercised 45 min/d, 4 d/week for 10 weeks. Women in the diet and exercise group lost more weight than the control group (4·8 (sd 1·7) kg v. 0·8 (sd 2·3) kg); however, there were no differences in infant growth. Based on the current evidence, it is recommended that once lactation is established, overweight women may restrict their energy intake by 2092 kJ/d and exercise aerobically 4 d/week to promote a weight loss of 0·5 kg/week.

Popular Weight Loss Strategies: a Review of Four Weight Loss Techniques.

PubMed

Obert, Jonathan; Pearlman, Michelle; Obert, Lois; Chapin, Sarah

2017-11-09

The purpose of this paper is to review the epidemiology of obesity and the most recent literature on popular fad diets and exercise regimens that are used for weight loss. The weight loss plans that will be discussed in this article include juicing or detoxification diets, intermittent fasting, the paleo diet, and high intensity training. Despite the growing popularity of fad diets and exercise plans for weight loss, there are limited studies that actually suggest these particular regimens are beneficial and lead to long-term weight loss. Juicing or detoxification diets tend to work because they lead to extremely low caloric intake for short periods of time, however tend to lead to weight gain once a normal diet is resumed. Both intermittent fasting and the paleo diet lead to weight loss because of overall decreased caloric intake as well. Lastly, studies on short bursts of high intensity training have shown remarkable weight loss and improvements in cardiovascular health. Review of the literature does suggest that some fad diets and exercise plans do lead to weight loss; however, the studies are quite limited and are all based on the concept of caloric restriction.

Calorie Restriction in Overweight SeniorS: Response of Older Adults to a Dieting Study: The CROSSROADS Randomized Controlled Clinical Trial

PubMed Central

Haas, Marilyn C.; Bodner, Eric V.; Brown, Cynthia J.; Bryan, David; Buys, David R.; Keita, Akilah Dulin; Flagg, Lee Anne; Goss, Amy; Gower, Barbara; Hovater, Martha; Hunter, Gary; Ritchie, Christine S.; Roth, David L.; Wingo, Brooks C.; Ard, Jamy; Locher, Julie L.

2014-01-01

We conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling, obese, older adults who were at increased risk for cardiometabolic disease. The CROSSROADS trial used a prospective randomized controlled design to compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition and adipose tissue deposition (Specific Aim #1: To compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition, namely visceral adipose tissue (VAT)), cardiometabolic disease risk (Specific Aim #2: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on cardiometabolic disease risk), functional status and quality of life (Specific Aim #3: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on functional status and quality of life). Participants were randomly assigned to one of three groups: Exercise Only (Control) Intervention, Exercise + Diet Quality + Weight Maintenance Intervention, or Exercise + Diet Quality + Weight Loss Intervention. CROSSROADS utilized a lifestyle intervention approach consisting of exercise, dietary, and behavioral components. The development and implementation of the CROSSROADS protocol, including a description of the methodology, detailing specific elements of the lifestyle intervention, assurances of treatment fidelity, and participant retention; outcome measures and adverse event monitoring; as well as unique data management features of the trial results, are presented in this article. PMID:25424512

Calorie restriction in overweight seniors: response of older adults to a dieting study: the CROSSROADS randomized controlled clinical trial.

PubMed

Haas, Marilyn C; Bodner, Eric V; Brown, Cynthia J; Bryan, David; Buys, David R; Keita, Akilah Dulin; Flagg, Lee Anne; Goss, Amy; Gower, Barbara; Hovater, Martha; Hunter, Gary; Ritchie, Christine S; Roth, David L; Wingo, Brooks C; Ard, Jamy; Locher, Julie L

2014-01-01

We conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling obese older adults who were at increased risk for cardiometabolic disease. The CROSSROADS trial used a prospective randomized controlled design to compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition and adipose tissue deposition (Specific Aim #1: To compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition, namely visceral adipose tissue), cardiometabolic disease risk (Specific Aim #2: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on cardiometabolic disease risk), and functional status and quality of life (Specific Aim #3: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on functional status and quality of life). Participants were randomly assigned to one of three groups: Exercise Only (Control) Intervention, Exercise + Diet Quality + Weight Maintenance Intervention, or Exercise + Diet Quality + Weight Loss Intervention. CROSSROADS utilized a lifestyle intervention approach consisting of exercise, dietary, and behavioral components. The development and implementation of the CROSSROADS protocol, including a description of the methodology, detailing specific elements of the lifestyle intervention, assurances of treatment fidelity, and participant retention; outcome measures and adverse event monitoring; as well as unique data management features of the trial results, are presented in this article.

Effect of Exercise on Pulmonary Function Tests in Obese Malaysian Patients.

PubMed

Christopher, L K S; Kosai, N R; Reynu, R; Levin, K B; Taher, M M; Sutton, P A; Sukor, N; Das, S

2015-01-01

Obesity has taken the 21st century by storm, posing negative effects on of the various facades of health, healthcare and global economy. With regards to pulmonary performance, numerous studies have proven the detrimental effects of obesity while reinstating the positive effects of weight loss on overall pulmonary function. However, effects of exercise on pulmonary function and correlation between changes in pulmonary function test with weight loss have yet to be described. We performed a prospective interventional study to determine the effects of regular exercise on Pulmonary Function Tests (PFT) and ascertain the relationship between weight loss and change in PFT in obese patients. Twenty-five obese patients were enrolled, giving an 80% power of study. Baseline weight and PFT consisting of FEV1, FVC, TLC, mean ERV and VC were recorded prior to commencement of the 8 week long Standard Exercise Regimen (SER). PFT and weight were recorded again at the end of 8 weeks. All parameters of the PFT studied improved significantly with exercise. The participants lost an average of 1kg of body weight post-exercise (p<0.0005). The correlations between mean changes in weight and PFT were negligible. A period of supervised regular exercise improves the pulmonary function of obese patients and this improvement is independent of the amount of weight loss. Hence, SER should be recommended to all obese patients, especially when bariatric surgery is desired.

Calorie Estimation in Adults Differing in Body Weight Class and Weight Loss Status.

PubMed

Brown, Ruth E; Canning, Karissa L; Fung, Michael; Jiandani, Dishay; Riddell, Michael C; Macpherson, Alison K; Kuk, Jennifer L

2016-03-01

Ability to accurately estimate calories is important for weight management, yet few studies have investigated whether individuals can accurately estimate calories during exercise or in a meal. The objective of this study was to determine if accuracy of estimation of moderate or vigorous exercise energy expenditure and calories in food is associated with body weight class or weight loss status. Fifty-eight adults who were either normal weight (NW) or overweight (OW), and either attempting (WL) or not attempting weight loss (noWL), exercised on a treadmill at a moderate (60% HRmax) and a vigorous intensity (75% HRmax) for 25 min. Subsequently, participants estimated the number of calories they expended through exercise and created a meal that they believed to be calorically equivalent to the exercise energy expenditure. The mean difference between estimated and measured calories in exercise and food did not differ within or between groups after moderate exercise. After vigorous exercise, OW-noWL overestimated energy expenditure by 72% and overestimated the calories in their food by 37% (P < 0.05). OW-noWL also significantly overestimated exercise energy expenditure compared with all other groups (P < 0.05) and significantly overestimated calories in food compared with both WL groups (P < 0.05). However, among all groups, there was a considerable range of overestimation and underestimation (-280 to +702 kcal), as reflected by the large and statistically significant absolute error in calorie estimation of exercise and food. There was a wide range of underestimation and overestimation of calories during exercise and in a meal. Error in calorie estimation may be greater in overweight adults who are not attempting weight loss.

Calorie Estimation in Adults Differing in Body Weight Class and Weight Loss Status

PubMed Central

Brown, Ruth E; Canning, Karissa L; Fung, Michael; Jiandani, Dishay; Riddell, Michael C; Macpherson, Alison K; Kuk, Jennifer L

2016-01-01

Purpose Ability to accurately estimate calories is important for weight management, yet few studies have investigated whether individuals can accurately estimate calories during exercise, or in a meal. The objective of this study was to determine if accuracy of estimation of moderate or vigorous exercise energy expenditure and calories in food is associated with body weight class or weight loss status. Methods Fifty-eight adults who were either normal weight (NW) or overweight (OW), and either attempting (WL) or not attempting weight loss (noWL), exercised on a treadmill at a moderate (60% HRmax) and a vigorous intensity (75% HRmax) for 25 minutes. Subsequently, participants estimated the number of calories they expended through exercise, and created a meal that they believed to be calorically equivalent to the exercise energy expenditure. Results The mean difference between estimated and measured calories in exercise and food did not differ within or between groups following moderate exercise. Following vigorous exercise, OW-noWL overestimated energy expenditure by 72%, and overestimated the calories in their food by 37% (P<0.05). OW-noWL also significantly overestimated exercise energy expenditure compared to all other groups (P<0.05), and significantly overestimated calories in food compared to both WL groups (P<0.05). However, among all groups there was a considerable range of over and underestimation (−280 kcal to +702 kcal), as reflected by the large and statistically significant absolute error in calorie estimation of exercise and food. Conclusion There was a wide range of under and overestimation of calories during exercise and in a meal. Error in calorie estimation may be greater in overweight adults who are not attempting weight loss. PMID:26469988

Exercise Training and Energy Expenditure following Weight Loss.

PubMed

Hunter, Gary R; Fisher, Gordon; Neumeier, William H; Carter, Stephen J; Plaisance, Eric P

2015-09-01

This study aims to determine the effects of aerobic or resistance training on activity-related energy expenditure (AEE; kcal·d(-1)) and physical activity index (activity-related time equivalent (ARTE)) following weight loss. It was hypothesized that weight loss without exercise training would be accompanied by decreases in AEE, ARTE, and nontraining physical activity energy expenditure (nonexercise activity thermogenesis (NEAT)) and that exercise training would prevent decreases in free-living energy expenditure. One hundred forty premenopausal women had an average weight loss of 25 lb during a diet (800 kcal·d(-1)) of furnished food. One group aerobically trained 3 times per week (40 min·d(-1)), another group resistance-trained 3 times per week (10 exercises/2 sets × 10 repetitions), and the third group did not exercise. Dual-energy x-ray absorptiometry was used to measure body composition, indirect calorimetry was used to measure resting energy expenditure (REE) and walking energy expenditure, and doubly labeled water was used to measure total energy expenditure (TEE). AEE, ARTE, and nontraining physical activity energy expenditure (NEAT) were calculated. TEE, REE, and NEAT all decreased following weight loss for the no-exercise group, but not for aerobic and resistance trainers. Only REE decreased in the two exercise groups. Resistance trainers increased ARTE. HR and oxygen uptake while walking on the flat and up a grade were consistently related to TEE, AEE, NEAT, and ARTE. Exercise training prevents a decrease in energy expenditure, including free-living energy expenditure separate from exercise training, following weight loss. Resistance training increases physical activity, whereas economy/ease of walking is associated with increased TEE, AEE, NEAT, and ARTE.

History of weight cycling does not impede future weight loss or metabolic improvements in postmenopausal women.

PubMed

Mason, Caitlin; Foster-Schubert, Karen E; Imayama, Ikuyo; Xiao, Liren; Kong, Angela; Campbell, Kristin L; Duggan, Catherine R; Wang, Ching-Yun; Alfano, Catherine M; Ulrich, Cornelia M; Blackburn, George L; McTiernan, Anne

2013-01-01

Given that the repetitive loss and regain of body weight, termed weight cycling, is a prevalent phenomenon that has been associated with negative physiological and psychological outcomes, the purpose of this study was to investigate weight change and physiological outcomes in women with a lifetime history of weight cycling enrolled in a 12-month diet and/or exercise intervention. 439 overweight, inactive, postmenopausal women were randomized to: i) dietary weight loss with a 10% weight loss goal (N=118); ii) moderate-to-vigorous intensity aerobic exercise for 45 min/day, 5 days/week (n=117); ii) both dietary weight loss and exercise (n=117); or iv) control (n=87). Women were categorized as non-, moderate- (≥3 losses of ≥4.5 kg), or severe-cyclers (≥3 losses of ≥9.1 kg). Trend tests and linear regression were used to compare adherence and changes in weight, body composition, blood pressure, insulin, C-peptide, glucose, insulin resistance (HOMA-IR), C-reactive protein, leptin, adiponectin, and interleukin-6 between cyclers and non-cyclers. Moderate (n=103) and severe (n=77) cyclers were heavier and had less favorable metabolic profiles than non-cyclers at baseline. There were, however, no significant differences in adherence to the lifestyle interventions. Weight-cyclers (combined) had a greater improvement in HOMA-IR compared to non-cyclers participating in the exercise only intervention (P=.03), but no differences were apparent in the other groups. A history of weight cycling does not impede successful participation in lifestyle interventions or alter the benefits of diet and/or exercise on body composition and metabolic outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

Aerobic exercise increases peripheral and hepatic insulin sensitivity in sedentary adolescents

USDA-ARS?s Scientific Manuscript database

Data are limited on the effects of controlled aerobic exercise programs (without weight loss) on insulin sensitivity and glucose metabolism in children and adolescents. To determine whether a controlled aerobic exercise program (without weight loss) improves peripheral and hepatic insulin sensitivi...

The effect of dietary and exercise interventions on body weight in prostate cancer patients: a systematic review.

PubMed

Mohamad, Hamdan; McNeill, Geraldine; Haseen, Farhana; N'Dow, James; Craig, Leone C A; Heys, Steven D

2015-01-01

Prostate cancer prognosis may therefore be improved by maintaining healthy weight through diet and physical activity. This systematic review looked at the effect of diet and exercise interventions on body weight among men treated for prostate cancer. MEDLINE, EMBASE, CINAHL, and Cochrane Library databases were searched from the earliest record to August 2013. Randomized controlled trials of diet and exercise interventions in prostate cancer patients that reported body weight or body composition changes were included. A total of 20 trials were included in the review. Because of the heterogeneity of intervention components, a narrative review was conducted. Interventions were categorized as diet (n = 6), exercise (n = 8), or a combination of both diet and exercise (n = 6). The sample size ranged from 8 to 155 and the duration from 3 wk to 4 yr. Four diet interventions and 1 combined diet and exercise intervention achieved significant weight loss with mean values ranging from 0.8 kg to 6.1 kg (median 4.5 kg). Exercise alone did not lead to weight loss, though most of these trials aimed to increase fitness and quality of life rather than decrease body weight. Diet intervention, alone or in combination with exercise, can lead to weight loss in men treated for prostate cancer.

Influence of diet, exercise and serum vitamin D on sarcopenia in post-menopausal women

PubMed Central

Mason, Caitlin; Xiao, Liren; Imayama, Ikuyo; Duggan, Catherine R.; Foster-Schubert, Karen E.; Kong, Angela; Campbell, Kristin L.; Wang, Ching-Yun; Villasenor, Adriana; Neuhouser, Marian L.; Alfano, Catherine M.; Blackburn, George L.; McTiernan, Anne

2012-01-01

Purpose To investigate the effects of 12 months of dietary weight loss and/or aerobic exercise on lean mass and the measurements defining sarcopenia in postmenopausal women, and to examine the potential moderating effect of serum 25-hydroxyvitamin D (25(OH)D) and age. Methods 439 overweight and obese postmenopausal women were randomized to: diet modification (N=118); exercise (N=117), diet+exercise (N=117), or control (N=87). The diet intervention was a group-based program with a 10% weight loss goal. The exercise intervention was 45 mins/day, 5 days/week of moderate-to-vigorous intensity aerobic activity. Total and appendicular lean mass were quantified by dual Xray absorptiometry (DXA) at baseline and 12 months. A skeletal muscle index (SMI=appendicular lean mass (kg)/m2) and the prevalence of sarcopenia (SMI<5.67 kg/m2) were calculated. Serum 25(OH)D was assayed using a competitive chemiluminescent immunoassay. Results Dietary weight loss resulted in a significant decrease in lean mass, and a borderline significant decrease in appendicular lean mass and SMI compared to controls. In contrast, aerobic exercise significantly preserved appendicular lean mass and SMI. Diet + exercise attenuated the loss of appendicular lean mass and SMI compared to diet alone, and did not result in significant loss of total- or appendicular lean mass compared to controls. Neither serum 25(OH)D nor age were significant moderators of the intervention effects. Conclusions Aerobic exercise added to dietary weight loss can attenuate the loss of appendicular lean mass during weight loss, and may be effective for the prevention and treatment of sarcopenia among overweight and obese postmenopausal women. PMID:23190588

Influence of diet, exercise, and serum vitamin d on sarcopenia in postmenopausal women.

PubMed

Mason, Caitlin; Xiao, Liren; Imayama, Ikuyo; Duggan, Catherine R; Foster-Schubert, Karen E; Kong, Angela; Campbell, Kristin L; Wang, Ching-Yun; Villasenor, Adriana; Neuhouser, Marian L; Alfano, Catherine M; Blackburn, George L; McTiernan, Anne

2013-04-01

The objective of this study is to investigate the effects of 12 months of dietary weight loss and/or aerobic exercise on lean mass and the measurements defining sarcopenia in postmenopausal women and to examine the potential moderating effect of serum 25-hydroxyvitamin D (25(OH)D) and age. Four hundred thirty-nine overweight and obese postmenopausal women were randomized to diet modification (N = 118), exercise (N = 117), diet + exercise (N = 117), or control (N = 87). The diet intervention was a group-based program with a 10% weight loss goal. The exercise intervention was 45 min·d, 5 d·wk, of moderate-to-vigorous intensity aerobic activity. Total and appendicular lean mass (ALM) were quantified by dual x-ray absorptiometry at baseline and 12 months. A skeletal muscle index (SMI = ALM (kg) / height (m)) and the prevalence of sarcopenia (SMI <5.67 kg·m) were calculated. Serum 25(OH)D was assayed using a competitive chemiluminescent immunoassay. Dietary weight loss resulted in a significant decrease in lean mass and a borderline significant decrease in ALM and SMI compared with controls. In contrast, aerobic exercise significantly preserved ALM and SMI. Diet + exercise attenuated the loss of ALM and SMI compared with diet alone and did not result in significant loss of total mass or ALM compared with controls. Neither serum 25(OH)D nor age was significant moderators of the intervention effects. Aerobic exercise added to dietary weight loss can attenuate the loss of ALM during weight loss and may be effective for the prevention and treatment of sarcopenia among overweight and obese postmenopausal women.

Physical activity profiles of U.S. adults trying to lose weight: NHIS 1998.

PubMed

Kruger, Judy; Galuska, Deborah A; Serdula, Mary K; Kohl, Harold W

2005-03-01

Physical activity is an integral part of weight control programs, but recommended amounts vary. The objectives of this study were to describe the prevalence and characteristics of those who reported using exercise as a weight loss strategy (N=14,716), and to determine the prevalence of meeting various institutionally recommended levels of physical activity (N=8538) among that population. Data were obtained from the 1998 National Health Interview Survey, a face-to-face nationally representative household interview. Questions on leisure-time physical activity were analyzed using SUDAAN. Among those who reported trying to lose weight, 55% reported using exercise as a weight loss strategy alone, and of those, 58% reported eating fewer calories. The prevalence of using exercise as a weight loss strategy was directly associated with education and inversely associated with age and body mass index. Among those who reported using exercise as a weight loss strategy, 57% met the minimal 1998 National Institutes of Health recommendation of >or=150 min.wk; 46% met the lower end of the 2001 American College of Sports Medicine recommendation of 200 min.wk; and 30% met the upper end for 300 min.wk. Only 19% met the 2002 Institute of Medicine recommendation of 420 min.wk. Despite the importance of physical activity in a weight loss program, only about half of the persons trying to lose weight reported using exercise. Even among those, only slightly more than half met the minimal recommendations for physical activity. Efforts are needed to aid those trying to lose weight to incorporate appropriate levels of physical activity into their weight loss strategy.

Behavioral and psychosocial correlates of adiposity and healthy lifestyle in Asian Indians.

PubMed

Weber, Mary Beth; Ranjani, Harish; Anjana, Ranjit Mohan; Mohan, Viswanathan; Narayan, K M Venkat; Gazmararian, Julie A

2015-12-01

Adiposity is an important diabetes risk factor, and Asian Indians have elevated diabetes risk. This analysis assessed the relationship between behavioral and psychosocial factors and adiposity among Asian Indians to better understand factors driving elevated weight/waist circumference in this population. This study used screening data (N=1285) from the D-CLIP study, a randomized controlled diabetes prevention trial in Chennai, India. Correlation tests and linear regression models were done to describe relationships among exposure variables (weight loss/exercise self-efficacy, fruit/vegetable intake, weekly exercise, past weight loss experience) and between these exposures and BMI or waist circumference. Exercise and weight loss self-efficacy were positively correlated with average minutes per week exercising (R=0.26, p<0.0001) and fruit (R=0.07, p<0.05) and vegetable intake (R=0.12, p<0.0001). Weekly fruit consumption, past weight loss experience, and weight loss self-efficacy, along with sex, age, and marital status, explained 13.6% and 25.9% in the variation in BMI and waist circumference, respectively. Low fruit consumption, unsuccessful past weight loss attempts, and low self-efficacy for weight loss are associated with higher BMI and waist circumference in this population. Understanding factors related to adiposity is important for preventing and treating weight gain. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Effect of Weight Loss with or without Exercise on Inflammatory Markers and Adipokines in Postmenopausal Women: The SHAPE-2 Trial, A Randomized Controlled Trial.

PubMed

van Gemert, Willemijn A; May, Anne M; Schuit, Albertine J; Oosterhof, Blanche Y M; Peeters, Petra H; Monninkhof, Evelyn M

2016-05-01

We investigated the effect of equivalent weight loss, by a hypocaloric diet or mainly exercise, on inflammatory markers and adipokines in overweight postmenopausal women. Women were randomized to a diet (n = 97), mainly exercise (n = 98), or control group (n = 48). Goal of both interventions was to lose 5 to 6 kg bodyweight by a hypocaloric diet or an exercise program (4 hours/week) combined with a small caloric intake restriction. Outcomes after 16 weeks included serum high-sensitive C-reactive protein (hsCRP), IL6, adiponectin, and leptin. Both intervention groups achieved the target weight loss. Controls remained weight stable. Compared with control, hsCRP decreased with mainly exercise [treatment effect ratio (TER) = 0.64] and borderline statistically significant with diet (TER = 0.77). There was a suggestively larger effect of exercise, directly compared with diet (TER = 0.83). Leptin decreased with both interventions: mainly exercise (TER = 0.55) and diet (TER = 0.59), versus control. Effects attenuated and lost significance after adjusting for change in body fat percentage, and to a lesser extent when adjusting for fitness. No effects were seen on IL6 and adiponectin. A 16-week randomized intervention inducing comparable weight loss by a hypocaloric diet or mainly exercise, resulted in favorable effects on serum hsCRP and leptin. We found a possible more beneficial effect on hsCRP with mainly exercise versus diet. These effects of exercise were established by changes in body fat percentage and physical fitness. A modest amount of weight loss in postmenopausal women reduces hsCRP and leptin levels which might be associated with a lower breast cancer risk. Cancer Epidemiol Biomarkers Prev; 25(5); 799-806. ©2016 AACR. ©2016 American Association for Cancer Research.

The independent and combined effects of intensive weight loss and exercise training on bone mineral density in overweight and obese, older adults with osteoarthritis

PubMed Central

Beavers, Daniel P.; Beavers, Kristen M.; Loeser, Richard F.; Walton, Nicole R.; Lyles, Mary F.; Nicklas, Barbara J.; Shapses, Sue A.; Newman, Jovita J.; Messier, Stephen P.

2014-01-01

Objective To determine the effects of dietary-induced weight loss (D) and weight loss plus exercise (D+E) compared to exercise alone (E) on bone mineral density (BMD) in older adults with knee osteoarthritis (OA). Design Data come from 284 older (66.0±6.2 years), overweight/obese (BMI 33.4±3.7 kg/m2), adults with knee OA enrolled in the Intensive Diet and Exercise for Arthritis (IDEA) study. Participants were randomized to 18 months of walking and strength training (E; n=95), dietary-induced weight loss targeting 10% of baseline weight (D; n=88) or a combination of the two (D+E; n=101). Body weight and composition (DXA), regional BMD, were obtained at baseline and 18 months. Results E, D, and D+E groups lost 1.3±4.5 kg, 9.1±8.6 kg and 10.4±8.0 kg, respectively (p<0.01). Significant treatment effects were observed for BMD in both hip and femoral neck regions, with the D and D+E groups showing similar relative losses compared to E (both p<0.01). Despite reduced BMD, fewer overall participants had T-scores indicative of osteoporosis after intervention (9 at 18 months vs. 10 at baseline). Within the D and D+E groups, changes in hip and femoral neck, but not spine, BMD correlated positively with changes in body weight (r=0.21 and 0.54 respectively, both p=<0.01). Conclusions Weight loss via an intensive dietary intervention, with or without exercise, results in bone loss at the hip and femoral neck in overweight and obese, older adults with OA. Although the exercise intervention did not attenuate weight loss associated reductions in BMD, classification of osteoporosis and osteopenia remained unchanged. PMID:24742955

Investigating the effects of negative-calorie diet compared with low-calorie diet under exercise conditions on weight loss and lipid profile in overweight/obese middle-aged and older men.

PubMed

Rezaeipour, Mohammadreza; Apanasenko, Gennady Leonidovich; Nychyporuk, Vladimir Ivanovich

2014-01-01

Negative-calorie diets (NCDs) are among the popular dieting guides for weight loss; however, there is still little knowledge about this method. The present study aimed to determine the effects of a NCD supplemented with exercise on weight loss and lipid profile, and to compare its efficiency with low-calorie diets (LCDs) with exercise among elderly adult men with abnormal weight gain. Participants included sedentary men (aged 45-75 years) who were overweight or obese (n = 37). They were randomly divided into 2 groups: a group with a NCD and exercise, and a group with a LCD with exercise. Of all 37 participants, 30 completed the treatment. Weight assessment parameters, including changes in weight and body composition and blood sample tests, were performed before and 3 months after intervention. All parameters decreased significantly in both groups. Elevation in high-density lipoprotein (HDL) cholesterol levels (P < 0.001) was different between the 2 groups. The decline in the total cholesterol to HDL cholesterol ratio was greater in the LCD than the NCD group. Contrary to expectations, both weight-loss diets were equally efficacious.

Few adults with functional limitations advised to exercise more or lose weight in NHANES 2011-14 seek health professional assistance: An opportunity for physical therapists.

PubMed

Kinslow, Brian; De Heer, Hendrik D; Warren, Meghan

2018-03-02

Functional limitations are associated with decreased physical activity and increased body mass index. The purpose of this study was to assess the prevalence of functional limitations among adults who reported receiving health professional advice to exercise more or lose weight, and to assess involvement of health professionals, including physical therapists, in weight loss efforts with these individuals. A cross-sectional analysis of U.S. adults from the 2011 to 2014 National Health and Nutrition Examination Survey (n = 5,480). Participant demographics, health history, and functional limitations were assessed via self-report and examination. Frequency distributions were calculated using SAS® analytical software, accounting for the complex survey design. Population estimates were calculated using the American Community Survey. 31.0% of individuals (n = 1,696), representing a population estimate of 35 million adults, advised to exercise more or lose weight by a health professional reported one or more functional limitation. Of the 31%, 57.6% attempted weight loss, and 40.1% used exercise for weight loss. Few sought health professional assistance. Physical therapists were not mentioned. Few individuals with functional limitations advised to lose weight or increase exercise seek health professional assistance for weight loss. Physical therapists have an opportunity to assist those with functional limitations with exercise prescription.

Consumption of whole-grain cereals during weight loss: effects on dietary quality, dietary fiber, magnesium, vitamin B-6, and obesity.

PubMed

Melanson, Kathleen J; Angelopoulos, Theodore J; Nguyen, Von T; Martini, Margaret; Zukley, Linda; Lowndes, Joshua; Dube, Thomas J; Fiutem, Justin J; Yount, Byron W; Rippe, James M

2006-09-01

While various weight-management approaches produce weight loss, they may differ in dietary quality. We monitored changes in nutrient intakes in overweight and obese subjects on three different weight-management programs. Randomized clinical trial (pilot study) with two 12-week phases: phase 1, weekly counseling; phase 2, monitoring only. One hundred eighty nonsmoking, sedentary overweight and obese adults began this outpatient study; 134 (body mass index [calculated as kg/m(2)]=30.9+/-2.4; age=42.3+/-1.2 years) were used in analyses. Twenty-four weeks of exercise only (control group), hypocaloric diet plus exercise, or hypocaloric diet with fiber-rich whole-grain cereals plus exercise. At weeks 0, 12, and 24, diet quality was assessed by 3-day food records and body weight was measured. Three-way analysis of variance with repeated measures. The hypocaloric diet with fiber-rich whole-grain cereals plus exercise decreased energy intake more than exercise only (P=0.032). By week 12, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise decreased total fat more than exercise only, which was sustained in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise at 24 weeks (P<0.001). At weeks 12 and 24, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise reduced saturated fat intake more than exercise only. The hypocaloric diet with fiber-rich whole-grain cereals plus exercise increased total fiber, insoluble fiber (both P<0.001), magnesium (P=0.004), and vitamin B-6 (P=0.002) intakes more than the hypocaloric diet plus exercise and exercise only. Calcium and vitamin E intakes were inadequate in all groups. Weight loss was similar in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise. Weight-reduction strategies may be associated with reduced intake of micronutrients, such as calcium and vitamin E. However, a hypocaloric diet with fiber-rich whole-grain cereal is effective for improving or maintaining other aspects of dietary quality during weight loss.

Energy balance and the composition of weight loss during prolonged space flight

NASA Technical Reports Server (NTRS)

Leonard, J. I.

1982-01-01

Integrated metabolic balance analysis, Skylab integrated metabolic balance analysis and computer simulation of fluid-electrolyte responses to zero-g, overall mission weight and tissue losses, energy balance, diet and exercise, continuous changes, electrolyte losses, caloric and exercise requirements, and body composition are discussed.

Discrepancy in Motivation for Weight Loss and Exercise in Rural Patients.

PubMed

Warren, Jacob C; Smalley, K Bryant; Barefoot, K Nikki

2017-11-01

We explored the extent to which discrepancy between motivation for weight loss and exercise is related to obesity among rural patients with chronic disease, and identified the psychosocial correlates of this discrepancy. 497 patients with diabetes and/or hypertension were recruited from a network of Federally Qualified Health Centers in the rural South and completed a battery of assessments. Most persons in the sample (83.1%) were overweight and 65.0% were obese. For motivation for change, 70.8% reported being in the Action stage or higher for weight loss, whereas only 24.9% reported being in the Action stage or higher for motivation for exercise. When controlling for age, education level, income, sex, and race/ethnicity, individuals who were motivated for weight loss but not exercise were twice as likely to be obese (p = .005). Race and sex were significantly associated with this discrepancy, with African-American patients 1.7 times as likely (p = .05) and women 2.3 times as likely to be discrepant (p = .001). Findings underscore the importance of focusing not simply on weight loss among rural patients with chronic disease, but rather to incorporate specific activities designed to build simultaneous motivation for engaging in exercise.

Diet and exercise for weight loss: a review of current issues.

PubMed

Volek, Jeff S; Vanheest, Jaci L; Forsythe, Cassandra E

2005-01-01

Obesity is a fast growing epidemic that is primarily due to environmental influences. Nutrition and exercise represent modifiable factors with a major impact on energy balance. Despite considerable research, there remains continued debate regarding the energy content and the optimal macronutrient distribution for promoting healthy and effective weight loss. Low-fat diets have been advised for many years to reduce obesity. However, their effectiveness has been recently challenged, partly because the prevalence of obesity continues to rise despite reductions in fat intake. There are also concerns regarding the methodology of clinical trials showing benefits of fat reduction on weight loss. Although often viewed as a fad diet, very low-carbohydrate (ketogenic) diets are very popular and several recent clinical trials indicate they are more effective at promoting short-term weight loss and improving characteristics of the metabolic syndrome than low-fat diets. However, there is a need to obtain long-term safety and efficacy data. Clearly, weight loss can be achieved with a variety of diet interventions but the effects on other health-related aspects also need to be considered and studied in more detail. Exercise can have positive effects on weight loss, weight control and overall general health, although debate exists concerning the most effective mode, duration and intensity of exercise required to achieve these effects. Importantly, any effective weight control treatment must consider a life-long plan or there will likely be weight regain. Perhaps the most challenging, but rewarding, question that faces researchers is how to predict individual responses to diet and exercise interventions.

Effect of weight loss, with or without exercise, on body composition and sex hormones in postmenopausal women: the SHAPE-2 trial.

PubMed

van Gemert, Willemijn A M; Schuit, Albertine J; van der Palen, Job; May, Anne M; Iestra, Jolein A; Wittink, Harriet; Peeters, Petra H; Monninkhof, Evelyn M

2015-09-02

Physical inactivity and overweight are risk factors for postmenopausal breast cancer. The effect of physical activity may be partially mediated by concordant weight loss. We studied the effect on serum sex hormones, which are known to be associated with postmenopausal breast cancer risk, that is attributable to exercise by comparing randomly obtained equivalent weight loss by following a hypocaloric diet only or mainly by exercise. Overweight, insufficiently active women were randomised to a diet (N = 97), mainly exercise (N = 98) or control group (N = 48). The goal of both interventions was to achieve 5-6 kg of weight loss by following a calorie-restricted diet or an intensive exercise programme combined with only a small caloric restriction. Primary outcomes after 16 weeks were serum sex hormones and sex hormone-binding globulin (SHBG). Body fat and lean mass were measured by dual-energy X-ray absorptiometry. Both the diet (-4.9 kg) and mainly exercise (-5.5 kg) groups achieved the target weight loss. Loss of body fat was significantly greater with exercise versus diet (difference -1.4 kg, P < 0.001). In the mainly exercise arm, the reduction in free testosterone was statistically significantly greater than that of the diet arm (treatment effect ratio [TER] 0.92, P = 0.043), and the results were suggestive of a difference for androstenedione (TER 0.90, P = 0.064) and SHBG (TER 1.05, P = 0.070). Compared with the control arm, beneficial effects were seen with both interventions, diet and mainly exercise, respectively, on oestradiol (TER 0.86, P = 0.025; TER 0.83, P = 0.007), free oestradiol (TER 0.80, P = 0.002; TER 0.77, P < 0.001), SHBG (TER 1.14; TER 1.21, both P < 0.001) and free testosterone (TER 0.91, P = 0.069; TER = 0.84, P = 0.001). After adjustment for changes in body fat, intervention effects attenuated or disappeared. Weight loss with both interventions resulted in favourable effects on serum sex hormones, which have been shown to be associated with a decrease in postmenopausal breast cancer risk. Weight loss induced mainly by exercise additionally resulted in maintenance of lean mass, greater fitness, greater fat loss and a larger effect on (some) sex hormones. The greater fat loss likely explains the observed larger effects on sex hormones. ClinicalTrials.gov identifier: NCT01511276 . Registered on 12 January 2012.

Noni-based nutritional supplementation and exercise interventions influence body composition

PubMed Central

Palu, Afa K.; West, Brett J.; Jensen, Jarakae

2011-01-01

Background: The prevalence of obesity and overweight in the Unites States has reached unprecedented levels, and so has the need for effective exercise and nutritional programs for prevention of unhealthy weight gain or safe weight loss. Aims: The present study was conducted in overweight men and women to assess the impact of noni-based nutritional supplementation and exercise interventions on body composition. Materials and Methods: Twenty two participants (16 women and 6 men), ages 18-65, were enrolled in a 12-week, open-label trial of a weight-loss program involving noni-based dietary supplements, gender-specific daily calorie restriction, and exercise interventions. Weight, percent body fat, and body mass index were measured before and after the trial. Results: All participants experienced weight loss. The average decrease in fat mass was highly significant (P < 0.0001), as were decreases in percent body fat and body mass index. Individual weight and fat mass losses were 17.55 ± 9.73 and 21.78 ± 8.34 lbs., respectively, and individual percent body fat and body mass index decreases were 8.91 ± 3.58 % and 2.6 ± 1.32, respectively. Conclusion: The nutritional and exercise interventions significantly influenced body composition among participants. PMID:22363077

Noni-based nutritional supplementation and exercise interventions influence body composition.

PubMed

Palu, Afa K; West, Brett J; Jensen, Jarakae

2011-12-01

The prevalence of obesity and overweight in the Unites States has reached unprecedented levels, and so has the need for effective exercise and nutritional programs for prevention of unhealthy weight gain or safe weight loss. The present study was conducted in overweight men and women to assess the impact of noni-based nutritional supplementation and exercise interventions on body composition. Twenty two participants (16 women and 6 men), ages 18-65, were enrolled in a 12-week, open-label trial of a weight-loss program involving noni-based dietary supplements, gender-specific daily calorie restriction, and exercise interventions. Weight, percent body fat, and body mass index were measured before and after the trial. All participants experienced weight loss. The average decrease in fat mass was highly significant (P < 0.0001), as were decreases in percent body fat and body mass index. Individual weight and fat mass losses were 17.55 ± 9.73 and 21.78 ± 8.34 lbs., respectively, and individual percent body fat and body mass index decreases were 8.91 ± 3.58 % and 2.6 ± 1.32, respectively. The nutritional and exercise interventions significantly influenced body composition among participants.

Reduced Reward-driven Eating Accounts for the Impact of a Mindfulness-Based Diet and Exercise Intervention on Weight Loss: Data from the SHINE Randomized Controlled Trial

PubMed Central

Mason, Ashley E.; Epel, Elissa S.; Aschbacher, Kirstin; Lustig, Robert H.; Acree, Michael; Kristeller, Jean; Cohn, Michael; Dallman, Mary; Moran, Patricia J.; Bacchetti, Peter; Laraia, Barbara; Hecht, Frederick M.; Daubenmier, Jennifer

2016-01-01

Many individuals with obesity report overeating despite intentions to maintain or lose weight. Two barriers to long-term weight loss are reward-driven eating, which is characterized by a lack of control over eating, a preoccupation with food, and a lack of satiety; and psychological stress. Mindfulness training may address these barriers by promoting awareness of hunger and satiety cues, self-regulatory control, and stress reduction. We examined these two barriers as potential mediators of weight loss in the Supporting Health by Integrating Nutrition and Exercise (SHINE) randomized controlled trial, which compared the effects of a 5.5-month diet and exercise intervention with or without mindfulness training on weight loss among adults with obesity. Intention-to-treat multiple mediation models tested whether post-intervention reward-driven eating and psychological stress mediated the impact of intervention arm on weight loss at 12-and 18-months post-baseline among 194 adults with obesity (BMI: 30–45). Mindfulness (relative to control) participants had significant reductions in reward-driven eating at 6 months (post-intervention), which, in turn, predicted weight loss at 12 months. Post-intervention reward-driven eating mediated 47.1% of the total intervention arm effect on weight loss at 12 months [β=-0.06, SE(β)=0.03, p=.030, 95% CI (−0.12, −0.01)]. This mediated effect was reduced when predicting weight loss at 18 months (p=.396), accounting for 23.0% of the total intervention effect, despite similar weight loss at 12 months. Psychological stress did not mediate the effect of intervention arm on weight loss at 12 or 18 months. In conclusion, reducing reward-driven eating, which can be achieved using a diet and exercise intervention that includes mindfulness training, may promote weight loss (clinicaltrials.gov registration: NCT00960414). PMID:26867697

Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial.

PubMed

Mason, Ashley E; Epel, Elissa S; Aschbacher, Kirstin; Lustig, Robert H; Acree, Michael; Kristeller, Jean; Cohn, Michael; Dallman, Mary; Moran, Patricia J; Bacchetti, Peter; Laraia, Barbara; Hecht, Frederick M; Daubenmier, Jennifer

2016-05-01

Many individuals with obesity report over eating despite intentions to maintain or lose weight. Two barriers to long-term weight loss are reward-driven eating, which is characterized by a lack of control over eating, a preoccupation with food, and a lack of satiety; and psychological stress. Mindfulness training may address these barriers by promoting awareness of hunger and satiety cues, self-regulatory control, and stress reduction. We examined these two barriers as potential mediators of weight loss in the Supporting Health by Integrating Nutrition and Exercise (SHINE) randomized controlled trial, which compared the effects of a 5.5-month diet and exercise intervention with or without mindfulness training on weight loss among adults with obesity. Intention-to-treat multiple mediation models tested whether post-intervention reward-driven eating and psychological stress mediated the impact of intervention arm on weight loss at 12- and 18-months post-baseline among 194 adults with obesity (BMI: 30-45). Mindfulness (relative to control) participants had significant reductions in reward-driven eating at 6 months (post-intervention), which, in turn, predicted weight loss at 12 months. Post-intervention reward-driven eating mediated 47.1% of the total intervention arm effect on weight loss at 12 months [β = -0.06, SE(β) = 0.03, p = .030, 95% CI (-0.12, -0.01)]. This mediated effect was reduced when predicting weight loss at 18 months (p = .396), accounting for 23.0% of the total intervention effect, despite similar weight loss at 12 months. Psychological stress did not mediate the effect of intervention arm on weight loss at 12 or 18 months. In conclusion, reducing reward-driven eating, which can be achieved using a diet and exercise intervention that includes mindfulness training, may promote weight loss (clinicaltrials.gov registration: NCT00960414). Published by Elsevier Ltd.

Early potential effects of resveratrol supplementation on skeletal muscle adaptation involved in exercise-induced weight loss in obese mice.

PubMed

Sun, Jingyu; Zhang, Chen; Kim, MinJeong; Su, Yajuan; Qin, Lili; Dong, Jingmei; Zhou, Yunhe; Ding, Shuzhe

2018-04-01

Exercise and resveratrol supplementation exhibit anti-obesity functions in the long term but have not been fully investigated yet in terms of their early potential effectiveness. Mice fed with high-fat diet were categorized into control (Cont), exercise (Ex), resveratrol supplementation (Res), and exercise combined with resveratrol supplementation (Ex ＋ Res) groups. In the four-week period of weight loss, exercise combined with resveratrol supplementation exerted no additional effects on body weight loss but significantly improved whole-body glucose and lipid homeostasis. The combined treatment significantly decreased intrahepatic lipid content but did not affect intramyocellular lipid content. Moreover, the treatment significantly increased the contents of mtDNA and cytochrome c, the expression levels of peroxisome proliferator-activated receptor gamma coactivator-1 alpha and its downstream transcription factors, and the activities of ATPase and citrate synthase. However, exercise, resveratrol, and their combination did not promote myofiber specification toward slow-twitch type. The effects of exercise combined with resveratrol supplementation on weight loss could be partly due to enhanced mitochondrial biogenesis and not to fiber-type shift in skeletal muscle tissues. [BMB Reports 2018; 51(4): 200-205].

Weight Loss and the Prevention of Weight Regain: Evaluation of a Treatment Model of Exercise Self-Regulation Generalizing to Controlled Eating.

PubMed

Annesi, James J; Johnson, Ping H; Tennant, Gisèle A; Porter, Kandice J; Mcewen, Kristin L

2016-01-01

For decades, behavioral weight-loss treatments have been unsuccessful beyond the short term. Development and testing of innovative, theoretically based methods that depart from current failed practices is a priority for behavioral medicine. To evaluate a new, theory-based protocol in which exercise support methods are employed to facilitate improvements in psychosocial predictors of controlled eating and sustained weight loss. Women with obesity were randomized into either a comparison treatment that incorporated a print manual plus telephone follow-ups (n = 55) or an experimental treatment of The Coach Approach exercise-support protocol followed after 2 months by group nutrition sessions focused on generalizing self-regulatory skills from an exercise support to a controlled eating context (n = 55). Repeated-measures analysis of variance contrasted group changes in weight, physical activity, fruit and vegetable intake, mood, and exercise- and eating-related self-regulation and self-efficacy over 24 months. Regression analyses determined salient interrelations of change scores over both the weight-loss phase (baseline-month 6) and weight-loss maintenance phase (month 6-month 24). Improvements in all psychological measures, physical activity, and fruit and vegetable intake were significantly greater in the experimental group where a mean weight loss of 5.7 kg (6.1% of initial body weight) occurred at month 6, and was largely maintained at a loss of 5.1 kg (5.4%) through the full 24 months of the study. After establishing temporal intervals for changes in self-regulation, self-efficacy, and mood that best predicted improvements in physical activity and eating, a consolidated multiple mediation model suggested that change in self-regulation best predicted weight loss, whereas change in self-efficacy best predicted maintenance of lost weight. Because for most participants loss of weight remained greater than that required for health benefits, and costs for treatment administration were comparatively low, the experimental protocol was considered successful. After sufficient replication, physician referral and applications within health promotion and wellness settings should be considered.

Weight Loss and the Prevention of Weight Regain: Evaluation of a Treatment Model of Exercise Self-Regulation Generalizing to Controlled Eating

PubMed Central

Annesi, James J; Johnson, Ping H; Tennant, Gisèle A; Porter, Kandice J; McEwen, Kristin L

2016-01-01

Context: For decades, behavioral weight-loss treatments have been unsuccessful beyond the short term. Development and testing of innovative, theoretically based methods that depart from current failed practices is a priority for behavioral medicine. Objective: To evaluate a new, theory-based protocol in which exercise support methods are employed to facilitate improvements in psychosocial predictors of controlled eating and sustained weight loss. Methods: Women with obesity were randomized into either a comparison treatment that incorporated a print manual plus telephone follow-ups (n = 55) or an experimental treatment of The Coach Approach exercise-support protocol followed after 2 months by group nutrition sessions focused on generalizing self-regulatory skills from an exercise support to a controlled eating context (n = 55). Repeated-measures analysis of variance contrasted group changes in weight, physical activity, fruit and vegetable intake, mood, and exercise- and eating-related self-regulation and self-efficacy over 24 months. Regression analyses determined salient interrelations of change scores over both the weight-loss phase (baseline-month 6) and weight-loss maintenance phase (month 6-month 24). Results: Improvements in all psychological measures, physical activity, and fruit and vegetable intake were significantly greater in the experimental group where a mean weight loss of 5.7 kg (6.1% of initial body weight) occurred at month 6, and was largely maintained at a loss of 5.1 kg (5.4%) through the full 24 months of the study. After establishing temporal intervals for changes in self-regulation, self-efficacy, and mood that best predicted improvements in physical activity and eating, a consolidated multiple mediation model suggested that change in self-regulation best predicted weight loss, whereas change in self-efficacy best predicted maintenance of lost weight. Conclusions: Because for most participants loss of weight remained greater than that required for health benefits, and costs for treatment administration were comparatively low, the experimental protocol was considered successful. After sufficient replication, physician referral and applications within health promotion and wellness settings should be considered. PMID:26901268

Skipping meals and alcohol consumption. The regulation of energy intake and expenditure among weight loss participants.

PubMed

Carels, Robert A; Young, Kathleen M; Coit, Carissa; Clayton, Anna Marie; Spencer, Alexis; Wagner, Marissa

2008-11-01

Research suggests that specific eating patterns (e.g., eating breakfast) may be related to favorable weight status. This investigation examined the relationship between eating patterns (i.e., skipping meals; consuming alcohol) and weight loss treatment outcomes (weight loss, energy intake, energy expenditure, and duration of exercise). Fifty-four overweight or obese adults (BMI> or =27 kg/m(2)) participated in a self-help or therapist-assisted weight loss program. Daily energy intake from breakfast, lunch, dinner, and alcoholic beverages, total daily energy intake, total daily energy expenditure, physical activity, and weekly weight loss were assessed. On days that breakfast or dinner was skipped, or alcoholic beverages were not consumed, less total daily energy was consumed compared to days that breakfast, dinner, or alcoholic beverages were consumed. On days that breakfast or alcohol was consumed, daily energy expenditure (breakfast only) and duration of exercise were higher compared to days that breakfast or alcohol was not consumed. Individuals who skipped dinner or lunch more often had lower energy expenditure and exercise duration than individuals who skipped dinner or lunch less often. Individuals who consumed alcohol more often had high daily energy expenditure than individuals who consumed alcohol less often. Skipping meals or consuming alcoholic beverages was not associated with weekly weight loss. In this investigation, weight loss program participants may have compensated for excess energy intake from alcoholic beverages and meals with greater daily energy expenditure and longer exercise duration.

Weight-loss and exercise for communities with arthritis in North Carolina (we-can): design and rationale of a pragmatic, assessor-blinded, randomized controlled trial.

PubMed

Messier, Stephen P; Callahan, Leigh F; Beavers, Daniel P; Queen, Kate; Mihalko, Shannon L; Miller, Gary D; Losina, Elena; Katz, Jeffrey N; Loeser, Richard F; Quandt, Sara A; DeVita, Paul; Hunter, David J; Lyles, Mary F; Newman, Jovita; Hackney, Betsy; Jordan, Joanne M

2017-02-22

Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown. Thus, the policy relevant and clinically important question is: Can we adapt this successful solution to a pervasive public health problem in real-world clinical and community settings? This study aims to develop a systematic, practical, cost-effective diet-induced weight loss and exercise intervention implemented in community settings and to determine its effectiveness in reducing pain and improving other clinical outcomes in persons with knee OA. This is a Phase III, pragmatic, assessor-blinded, randomized controlled trial. Participants will include 820 ambulatory, community-dwelling, overweight and obese (BMI ≥ 27 kg/m 2 ) men and women aged ≥ 50 years who meet the American College of Rheumatology clinical criteria for knee OA. The primary aim is to determine whether a community-based 18-month diet-induced weight loss and exercise intervention based on social cognitive theory and implemented in three North Carolina counties with diverse residential (from urban to rural) and socioeconomic composition significantly decreases knee pain in overweight and obese adults with knee OA relative to a nutrition and health attention control group. Secondary aims will determine whether this intervention improves self-reported function, health-related quality of life, mobility, and is cost-effective. Many physicians who treat people with knee OA have no practical means to implement weight loss and exercise treatments as recommended by numerous OA treatment guidelines. This study will establish the effectiveness of a community program that will serve as a blueprint and exemplar for clinicians and public health officials in urban and rural communities to implement a diet-induced weight loss and exercise program designed to reduce knee pain and improve other clinical outcomes in overweight and obese adults with knee OA. clinicaltrials.gov Identifier: NCT02577549 October 12, 2015.

Effect of an Exercise and Weight Control Curriculum: Views of Obesity among Exercise Science Students

ERIC Educational Resources Information Center

Richardson, Laura A.; Fister, Carrie L.; Ramlo, Susan E.

2015-01-01

Awareness of effective weight management strategies is necessary to prepare exercise science students for future work with obesity. Exercise science faculty members developed a course related to exercise as a therapeutic tool and options available for weight loss. The purpose of the present study was to investigate student views of weight…

Supported exercise improves controlled eating and weight through its effects on psychosocial factors: extending a systematic research program toward treatment development.

PubMed

Annesi, James J

2012-01-01

Behavioral weight-loss treatments have been overwhelmingly unsuccessful. Many inadequately address both behavioral theory and extant research--especially in regard to the lack of viability of simply educating individuals on improved eating and exercise behaviors. The aim was to synthesize research on associations of changes in exercise behaviors, psychosocial factors, eating behaviors, and weight; and then conduct further direct testing to inform the development of an improved treatment approach. A systematic program of health behavior-change research based on social cognitive theory, and extensions of that theory applied to exercise and weight loss, was first reviewed. Then, to extend this research toward treatment development and application, a field-based study of obese adults was conducted. Treatments incorporated a consistent component of cognitive-behaviorally supported exercise during 26 weeks that was paired with either standard nutrition education (n = 183) or cognitive-behavioral methods for controlled eating that emphasized self-regulatory methods such as goal setting and caloric tracking, cognitive restructuring, and eating cue awareness (n = 247). Both treatment conditions were associated with improved self-efficacy, self-regulation, mood, exercise, fruit and vegetable consumption, weight, and waist circumference; with improvements in self-regulation for eating, fruit and vegetable consumption, weight, and waist circumference significantly greater in the cognitive-behavioral nutrition condition. Changes in exercise- and eating-related self-efficacy and self-regulation were associated with changes in exercise and eating (R(2) = 0.40 and 0.17, respectively), with mood change increasing the explanatory power to R(2) = 0.43 and 0.20. Improved self-efficacy and self-regulation for exercise carried over to self-efficacy and self-regulation for controlled eating (β= 0.53 and 0.68, respectively). Development and longitudinal testing of a new and different approach to behavioral treatment for sustained weight loss that emphasizes exercise program-induced psychosocial changes preceding the facilitation of improved eating and weight loss should be guided by our present research.

Why even active people get fatter--the asymmetric effects ofincreasing and decreasing exercise

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, Paul T.

2006-01-06

Background: Public health policies for preventing obesityneed guidelines for active individuals who are at risk due to exerciserecidivism. Methods: Changes in adiposity were compared to the runningdistances at baseline and follow-up in men and women whose reportedexercise increased (N=4,632 and 1,953, respectively) or decreased (17,280and 5,970, respectively) during 7.7 years of follow-up. Results: PerDelta km/wk, decreases in running distance caused over four-fold greaterweight gain between 0-8 km/wk (slope+-SE, males: -0.068+ -0.005 kg/m2,females: -0.080+-0.01 kg/m2) than between 32-48 km/wk (-0.017+-0.002 and-0.010+-0.005 kg/m2, respectively). In contrast, increases in runningdistance produced the smallest weight losses between 0-8 km/wk andstatistically significant weight loss onlymore » above 16 km/wk in males and 32km/wk in females. Above 32 km/wk (30 kcal/kg) in men and 16 km/wk (15kcal/kg) in women, weight loss from increasing exercise was equal to orgreater than weight gained with decreasing exercise, otherwise weightgain exceeded weight loss. Substantial weight gain occurred in runnerswho quit running, which would be mostly retained with resumed activity.Conclusion: Public health recommendations should warn against the risksof irreversible weight gain with exercise cessation. Weight gained due toreductions in exercise below 30 kcal/kg in men and 15 kcal/kg in womenmay not be reversed by resuming prior activity. Current IOM guidelines(i.e., maintain total energy expenditure at 160 percent of basal) agreewith the men s exercise threshold for symmetric weight change withchanging exercise levels.« less

Rationale and design of REWARD (revving-up exercise for sustained weight loss by altering neurological reward and drive): a randomized trial in obese endometrial cancer survivors.

PubMed

Nock, Nora L; Dimitropoulos, Anastasia; Rao, Stephen M; Flask, Chris A; Schluchter, Mark; Zanotti, Kristine M; Rose, Peter G; Kirwan, John P; Alberts, Jay

2014-11-01

Obesity is a leading risk factor for endometrial cancer (EC), particularly Type I forms, which are increasing in the U.S. Although death rates from most cancers have been decreasing, overall mortality in EC is increasing in the U.S. EC survivors' poor fitness combined with their surgical treatments may make weight loss particularly challenging. High intensity exercise increases neurotrophins and neurological reward via altered striatal dopamine in animals, and, in humans, chronic high intensity exercise enhances meal-induced satiety and may reduce hedonic eating. "Assisted" exercise, a mode of exercise whereby a patient's voluntary exercise rate is augmented mechanically, may modulate brain dopamine levels in Parkinson's Disease patients but has not been previously evaluated as a treatment for obesity. We describe the rationale and design of the REWARD trial, which has the overarching goal of randomizing 120 obese EC survivors to "assisted" or voluntary rate cycling to evaluate the efficacy of "assisted" exercise in enhancing and sustaining weight loss. Patients in both arms will receive 3 days/week of supervised exercise and 1 day/week of a group dietary behavioral intervention for 16 weeks and, then, will be followed for 6 months. The primary outcome is weight loss. Secondary outcomes include measures for body composition, fitness, eating behavior, exercise motivation and, quality of life as well as cognition and food reward and motivation as assessed by functional magnetic resonance imaging (fMRI) tasks. If successful, the REWARD program could be extended to help sustain weight loss in obese cancer and non-cancer patients. Copyright © 2014 Elsevier Inc. All rights reserved.

A mixed methods comparison of perceived benefits and barriers to exercise between obese and nonobese women.

PubMed

Leone, Lucia Andrea; Ward, Dianne S

2013-05-01

Obese women have lower levels of physical activity than nonobese women, but it is unclear what drives these differences. Mixed methods were used to understand why obese women have lower physical activity levels. Findings from focus groups with obese white women age 50 and older (N = 19) were used to develop psychosocial items for an online survey of white women (N = 195). After examining the relationship between weight group (obese vs. nonobese) and exercise attitudes, associated items (P < .05) were tested for potential mediation of the relationship between weight and physical activity. Obese women were less likely than nonobese women to report that they enjoy exercise (OR = 0.4, 95% CI 0.2-0.8) and were more likely to agree their weight makes exercise difficult (OR = 10.6, 95% CI 4.2-27.1), and they only exercise when trying to lose weight (OR = 3.8, 95% CI 1.6-8.9). Enjoyment and exercise for weight loss were statistically significant mediators of the relationship between weight and physical activity. Exercise interventions for obese women may be improved by focusing on exercise enjoyment and the benefits of exercise that are independent of weight loss.

Exercise for the Overweight Patient.

ERIC Educational Resources Information Center

Work, Janis A.

1990-01-01

Exercise can help patients maintain lean body mass during weight loss. Although exercise is not extremely useful in shedding excess pounds, it helps keep off weight lost through calorie restriction. This article discusses the specifics of exercise prescription, types of exercise, motivation to exercise, and special problems such as diabetes. (SM)

Eccentric exercise training as a countermeasure to non-weight-bearing soleus muscle atrophy

NASA Technical Reports Server (NTRS)

Kirby, Christopher R.; Ryan, Mirelle J.; Booth, Frank W.

1992-01-01

This investigation tested whether eccentric resistance training could prevent soleus muscle atrophy during non-weight bearing. Adult female rats were randomly assigned to either weight bearing +/- intramuscular electrodes or non-weight bearing +/- intramuscular electrodes groups. Electrically stimulated maximal eccentric contractions were performed on anesthetized animals at 48-h intervals during the 10-day experiment. Non-weight bearing significantly reduced soleus muscle wet weight (28-31 percent) and noncollagenous protein content (30-31 percent) compared with controls. Eccentric exercise training during non-weight bearing attenuated but did not prevent the loss of soleus muscle wet weight and noncollagenous protein by 77 and 44 percent, respectively. The potential of eccentric exercise training as an effective and highly efficient counter-measure to non-weight-bearing atrophy is demonstrated in the 44 percent attenuation of soleus muscle noncollagenous protein loss by eccentric exercise during only 0.035 percent of the total non-weight-bearing time period.

Perceptions of Strategies for Successful Weight Loss in Persons with Serious Mental Illness Participating in a Behavioral Weight Loss Intervention: A Qualitative Study

PubMed Central

Vazin, Roza; McGinty, Emma E.; Dickerson, Faith; Dalcin, Arlene; Goldsholl, Stacy; Enriquez, Meghan Oefinger; Jerome, Gerald J.; Gennusa, Joseph V.; Daumit, Gail L.

2016-01-01

Objective The purpose of this study was to describe perceptions of weight loss strategies, benefits, and barriers among persons with serious mental illness who lost weight in the ACHIEVE behavioral weight loss intervention. Methods Semi-structured interviews with 20 ACHIEVE participants were conducted and analyzed using an inductive coding approach. Results Participants perceived tailored exercise sessions, social support, and dietary strategies taught in ACHIEVE – such as reducing portion sizes and avoiding sugar-sweetened beverages – as useful weight loss strategies. Health benefits, improved physical appearance, self-efficacy, and enhanced ability to perform activities of daily living were commonly cited benefits of intervention participation and weight loss. Some participants reported challenges with giving up snack food and reducing portion sizes, and barriers to exercise related to medical conditions. Conclusions and Implications for Practice There is emerging evidence that behavioral weight loss interventions can lead to clinically meaningful reductions in body weight among persons with serious mental illness. The perspective of persons with serious mental illness regarding strategies for, benefits of, and barriers to weight loss during participation in behavioral weight loss programs provide insight into which elements of multicomponent interventions such as ACHIEVE are most effective. The results of this study suggest that tailored exercise programs, social support, and emphasis on non-clinical benefits of intervention participation, such as improvements in self-efficacy and the ability to participate more actively in family and community activities, are promising facilitators of engagement and success in behavioral weight loss interventions for the population with serious mental illness. PMID:27054900

Integration of a physical training program in a weight loss plan for overweight pet dogs.

PubMed

Vitger, Anne D; Stallknecht, Bente M; Nielsen, Dorte H; Bjornvad, Charlotte R

2016-01-15

To investigate whether a controlled physical training plan for overweight dogs during a weight loss program would improve cardiorespiratory fitness and better preserve lean body mass, compared with results for dogs undergoing a weight loss program based on caloric restriction alone. Prospective, nonrandomized clinical study. 19 client-owned overweight or obese dogs. All dogs were fed the same calorie-restricted diet rationed to achieve a weight loss rate of 1% to 2%/wk for 12 weeks. The fitness-and-diet (FD) group participated in a training program that included underwater and land-based treadmill exercise 3 times/wk. The diet-only (DO) group had no change in exercise routines. Daily activity before and during the intervention was recorded by accelerometry. Before and after intervention, heart rate during exercise was recorded to assess cardiovascular fitness, and body composition was analyzed by dual-energy x-ray absorptiometry. Differences between groups were evaluated with t tests and multiple regression analysis. Mean weight loss was 13.9% and 12.9% for the FD and DO groups, respectively (n = 8 dogs/group that completed the study). Mean accelerometer counts during intervention were 13% higher than baseline counts for the FD group. Heart rate during exercise declined after intervention in both groups. Lean body mass was preserved in the FD group and lost in the DO group during intervention. The controlled exercise plan used with a dietary weight loss program prevented loss of lean body mass in dogs. This finding supports inclusion of controlled physical training for obesity management in dogs.

Insulin resistance influences weight loss in non-obese women who followed a home-based exercise program and slight caloric restriction.

PubMed

Mediano, Mauro Felippe Felix; Sichieri, Rosely

2011-06-01

This study aimed to evaluate the influence of insulin resistance status on weight changes in non-obese women who followed a home-based exercise program and slight caloric restriction over a period of 12 months. Middle-aged (25-45 year), non-obese (body mass index of 23-29.9 kg/m(2)) women were randomly assigned to control (CG) or home-based exercise group (HB). The HB group received a booklet explaining the physical exercises to be practiced at home at least three times per week (40 min/session). Both groups were required to follow a small energy restriction of 100-300 calories per day. For the analysis, women were stratified in two groups according to baseline insulin sensitivity: NIR (non-insulin resistant; n = 121) and IR (insulin resistant; n = 64). Women classified as IR at baseline had greater weight loss after 12 months of follow-up (-1.6 kg vs. -1.1 kg; p = 0.01), and HB exercise helped to reduce weight only among NIR women (-1.5 vs. -0.7; p = 0.04); no differences were observed between intervention groups for IR women (-1.5 vs. -1.7; p = 0.24). There were no differences between IR and NIR groups for lipid profile after adjustment for weight changes. Insulin resistance facilitated weight loss, and home-based exercise promoted greater weight loss only in non-insulin resistance women. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Immediate increase in food intake following exercise messages.

PubMed

Albarracin, Dolores; Wang, Wei; Leeper, Joshua

2009-07-01

Communications to stimulate weight loss include exercise-promotion messages that often produce unsatisfactory results due to compensatory behavioral and metabolic mechanisms triggered by physical activity. This research investigated potential automatic facilitation of eating immediately after exercise messages in the absence of actual exercise. Two controlled experiments demonstrated greater than control food intake following exposure to print messages typical of exercise campaigns as well as subliminal presentation of action words associated with exercise (e.g., "active"). These inadvertent effects may explain the limited efficacy of exercise-promotion programs for weight loss, particularly when systematic dietary guidelines are absent.

Resting and exercise energy metabolism in weight-reduced adults with severe obesity.

PubMed

Hames, Kazanna C; Coen, Paul M; King, Wendy C; Anthony, Steven J; Stefanovic-Racic, Maja; Toledo, Frederico G S; Lowery, Jolene B; Helbling, Nicole L; Dubé, John J; DeLany, James P; Jakicic, John M; Goodpaster, Bret H

2016-06-01

To determine effects of physical activity (PA) with diet-induced weight loss on energy metabolism in adults with severe obesity. Adults with severe obesity (n = 11) were studied across 6 months of intervention, then compared with controls with less severe obesity (n = 7) or normal weight (n = 9). Indirect calorimetry measured energy metabolism during exercise and rest. Markers of muscle oxidation were determined by immunohistochemistry. Data were presented as medians. The intervention induced 7% weight loss (P = 0.001) and increased vigorous PA by 24 min/wk (P = 0.02). During exercise, energy expenditure decreased, efficiency increased (P ≤ 0.03), and fatty acid oxidation (FAO) did not change. Succinate dehydrogenase increased (P = 0.001), but fiber type remained the same. Post-intervention subjects' resting metabolism remained similar to controls. Efficiency was lower in post-intervention subjects compared with normal-weight controls exercising at 25 W (P ≤ 0.002) and compared with all controls exercising at 60% VO2peak (P ≤ 0.019). Resting and exercise FAO of post-intervention subjects remained similar to adults with less severe obesity. Succinate dehydrogenase and fiber type were similar across all body weight statuses. While metabolic adaptations to PA during weight loss occur in adults with severe obesity, FAO does not change. Resulting FAO during rest and exercise remains similar to adults with less severe obesity. © 2016 The Obesity Society.

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial.

PubMed

Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

2011-01-01

Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Participants (N = 34) were generally healthy, obese, older adult women (age range 55-79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments.

Effects of a weight loss plus exercise program on physical function in overweight, older women: a randomized controlled trial

PubMed Central

Anton, Stephen D; Manini, Todd M; Milsom, Vanessa A; Dubyak, Pamela; Cesari, Matteo; Cheng, Jing; Daniels, Michael J; Marsiske, Michael; Pahor, Marco; Leeuwenburgh, Christiaan; Perri, Michael G

2011-01-01

Background: Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women. Methods: Participants (N = 34) were generally healthy, obese, older adult women (age range 55–79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength. Results: Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups. Conclusion: Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments. PMID:21753869

Postpartum weight loss: weight struggles, eating, exercise, and breast-feeding.

PubMed

Montgomery, Kristen S; Best, Melissa; Aniello, Tracy B; Phillips, Jennifer D; Hatmaker-Flanigan, Elizabeth

2013-06-01

Twenty-four women with children 5 years old or younger were interviewed regarding their experiences in losing weight during the postpartum period. Phenomenological interviews were conducted according to Husserl's perspective. Women who participated in the study revealed the issues related to postpartum weight loss: weight struggles, exercise, breast-feeding, eating, and pregnancy contributions to weight gain. The overall theme that resulted from these in-depth interviews was that women struggle to balance their successes and setbacks in losing weight during the postpartum period.

Exercise training and weight loss, not always a happy marriage: single blind exercise trials in females with diverse BMI.

PubMed

Jackson, Matthew; Fatahi, Fardin; Alabduljader, Kholoud; Jelleyman, Charlotte; Moore, Jonathan P; Kubis, Hans-Peter

2018-04-01

Individuals show high variability in body weight responses to exercise training. Expectations and motivation towards effects of exercise on body weight might influence eating behaviour and could conceal regulatory mechanisms. We conducted 2 single-blind exercise trials (4 weeks (study 1) and 8 weeks (study 2)) with concealed objectives and exclusion of individuals with weight loss intention. Circuit exercise training programs (3 times a week (45-90 min), intensity 50%-90% peak oxygen uptake for 4 and 8 weeks) were conducted. Thirty-four females finished the 4-week intervention and 36 females the 8-week intervention. Overweight/obese (OV/OB) and lean female participants' weight/body composition responses were assessed and fasting and postprandial appetite hormone levels (PYY, insulin, amylin, leptin, ghrelin) were measured before and after the intervention for understanding potential contribution to individuals' body weight response to exercise training (study 2). Exercise training in both studies did not lead to a significant reduction of weight/body mass index (BMI) in the participants' groups; however, lean participants gained muscle mass. Appetite hormones levels were significantly (p < 0.05) altered in the OV/OB group, affecting fasting (-24%) and postprandial amylin (-14%) levels. Investigation of individuals' BMI responses using multiple regression analysis revealed that levels of fasting leptin, postprandial amylin increase, and BMI were significant predictors of BMI change, explaining about 43% of the variance. In conclusion, tested exercise training did not lead to weight loss in female participants, while a considerable proportion of variance in body weight response to training could be explained by individuals' appetite hormone levels and BMI.

Preserving Healthy Muscle during Weight Loss123

PubMed Central

Cava, Edda; Yeat, Nai Chien; Mittendorfer, Bettina

2017-01-01

Weight loss is the cornerstone of therapy for people with obesity because it can ameliorate or completely resolve the metabolic risk factors for diabetes, coronary artery disease, and obesity-associated cancers. The potential health benefits of diet-induced weight loss are thought to be compromised by the weight-loss–associated loss of lean body mass, which could increase the risk of sarcopenia (low muscle mass and impaired muscle function). The objective of this review is to provide an overview of what is known about weight-loss–induced muscle loss and its implications for overall physical function (e.g., ability to lift items, walk, and climb stairs). The currently available data in the literature show the following: 1) compared with persons with normal weight, those with obesity have more muscle mass but poor muscle quality; 2) diet-induced weight loss reduces muscle mass without adversely affecting muscle strength; 3) weight loss improves global physical function, most likely because of reduced fat mass; 4) high protein intake helps preserve lean body and muscle mass during weight loss but does not improve muscle strength and could have adverse effects on metabolic function; 5) both endurance- and resistance-type exercise help preserve muscle mass during weight loss, and resistance-type exercise also improves muscle strength. We therefore conclude that weight-loss therapy, including a hypocaloric diet with adequate (but not excessive) protein intake and increased physical activity (particularly resistance-type exercise), should be promoted to maintain muscle mass and improve muscle strength and physical function in persons with obesity. PMID:28507015

Can exercise or physical activity help improve postnatal depression and weight loss? A systematic review.

PubMed

Saligheh, Maryam; Hackett, Daniel; Boyce, Philip; Cobley, Stephen

2017-10-01

Despite exercise or physical activity (PA) being effective on depression and weight management generally, its effectiveness remains uncertain during postpartum. This systematic review aimed to determine the efficacy of exercise or PA interventions on postnatal depression (PND) and weight loss, with a subsequent aim to identify more effective intervention approaches. Using PRISMA guidelines, data searches conducted across six databases. Nine studies fulfilled our inclusion criteria. Based on identified studies (some with high-quality RCT designs), there was inconsistency as to whether exercise or PA simultaneously reduced PND symptoms and assisted weight loss (or related body composition indices). Two (22.2%) identified changes in both outcomes with small effect sizes. Four studies (44.4%) reported changes in one outcome, typically PND with variable effect sizes, while three studies (33.3%) reported no effect. Studies implemented different exercise/PA modalities (commonly walking) and incorporated various support strategies to assist intervention participation and adherence. Studies identified as most likely to associate with PND and/or weight loss changes were those with supervision (1-1, group), structure (weekly frequency, scheduled durations and moderate intensity), which adhered to specific exercise/PA guidelines over an extended postpartum period (e.g. 12 weeks +) and were supplemented by several psycho-social support strategies (e.g. educational information, exercise/PA advice, and counselling). Future studies need to carefully address prior study methodological weaknesses (e.g. study design, inclusion criteria, measurement, reporting, assessing confounding factors), further examine proposed more beneficial exercise/PA intervention approaches, and consider how exercise/PA could be best delivered in practice to benefit women's postpartum health.

MicroRNAs associated with exercise and diet: a systematic review.

PubMed

Flowers, Elena; Won, Gloria Y; Fukuoka, Yoshimi

2015-01-01

MicroRNAs are posttranscriptional regulators of gene expression. MicroRNAs reflect individual biologic adaptation to exposures in the environment. As such, measurement of circulating microRNAs presents an opportunity to evaluate biologic changes associated with behavioral interventions (i.e., exercise, diet) for weight loss. The aim of this study was to perform a systematic review of the literature to summarize what is known about circulating microRNAs associated with exercise, diet, and weight loss. We performed a systematic review of three scientific databases. We included studies reporting on circulating microRNAs associated with exercise, diet, and weight loss in humans. Of 1,219 studies identified in our comprehensive database search, 14 were selected for inclusion. Twelve reported on microRNAs associated with exercise, and two reported on microRNAs associated with diet and weight loss. The majority of studies used a quasiexperimental, cross-sectional design. There were numerous differences in the type and intensity of exercise and dietary interventions, the biologic source of microRNAs, and the methodological approaches used quantitate microRNAs. Data from several studies support an association between circulating microRNAs and exercise. The evidence for an association between circulating microRNAs and diet is weaker because of a small number of studies. Additional research is needed to validate previous observations using methodologically rigorous approaches to microRNA quantitation to determine the specific circulating microRNA signatures associated with behavioral approaches to weight loss. Future directions include longitudinal studies to determine if circulating microRNAs are predictive of response to behavioral interventions. Copyright © 2015 the American Physiological Society.

Effect of a high protein diet and/or resistance exercise on the preservation of fat free mass during weight loss in overweight and obese older adults: a randomized controlled trial.

PubMed

Verreijen, Amely M; Engberink, Mariëlle F; Memelink, Robert G; van der Plas, Suzanne E; Visser, Marjolein; Weijs, Peter J M

2017-02-06

Intentional weight loss in obese older adults is a risk factor for accelerated muscle mass loss. We investigated whether a high protein diet and/or resistance exercise preserves fat free mass (FFM) during weight loss in overweight and obese older adults. We included 100 overweight and obese adults (55-80 year) in a randomized controlled trial (RCT) with a 2 × 2 factorial design and intention-to-treat analysis. During a 10-week weight loss program all subjects followed a hypocaloric diet. Subjects were randomly allocated to either a high protein (1.3 g/kg body weight) or normal protein diet (0.8 g/kg), with or without a resistance exercise program 3 times/week. FFM was assessed by air displacement plethysmography. At baseline, mean (±SD) BMI was 32 ± 4 kg/m 2 . During intervention, protein intake was 1.13 ± 0.35 g/kg in the high protein groups vs. 0.98 ± 0.29 in the normal protein groups, which reflects a 16.3 ± 5.2 g/d higher protein intake in the high protein groups. Both high protein diet and exercise did not significantly affect change in body weight, FFM and fat mass (FM). No significant protein*exercise interaction effect was observed for FFM. However, within-group analysis showed that high protein in combination with exercise significantly increased FFM (+0.6 ± 1.3 kg, p = 0.011). A high protein diet, though lower than targeted, did not significantly affect changes in FFM during modest weight loss in older overweight and obese adults. There was no significant interaction between the high protein diet and resistance exercise for change in FFM. However, only the group with the combined intervention of high protein diet and resistance exercise significantly increased in FFM. Dutch Trial Register, number NTR4556, date 05-01-2014.

Predictors of initial weight loss among women with abdominal obesity: a path model using self-efficacy and health-promoting behaviour.

PubMed

Choo, Jina; Kang, Hyuncheol

2015-05-01

To identify predictors of initial weight loss among women with abdominal obesity by using a path model. Successful weight loss in the initial stages of long-term weight management may promote weight loss maintenance. A longitudinal study design. Study participants were 75 women with abdominal obesity, who were enrolled in a 12-month Community-based Heart and Weight Management Trial and followed until a 6-month assessment. The Weight Efficacy Lifestyle, Exercise Self-Efficacy and Health Promoting Lifestyle Profile-II measured diet self-efficacy, exercise self-efficacy and health-promoting behaviour respectively. All endogenous and exogenous variables used in our path model were change variables from baseline to 6 months. Data were collected between May 2011-May 2012. Based on the path model, increases in both diet and exercise self-efficacy had significant effects on increases in health-promoting behaviour. Increases in diet self-efficacy had a significant indirect effect on initial weight loss via increases in health-promoting behaviour. Increases in health-promoting behaviour had a significant effect on initial weight loss. Among women with abdominal obesity, increased diet self-efficacy and health-promoting behaviour were predictors of initial weight loss. A mechanism by which increased diet self-efficacy predicts initial weight loss may be partially attributable to health-promoting behavioural change. However, more work is still needed to verify causality. Based on the current findings, intensive nursing strategies for increasing self-efficacy for weight control and health-promoting behaviour may be essential components for better weight loss in the initial stage of a weight management intervention. © 2015 John Wiley & Sons Ltd.

Adherence to a behavioral weight loss treatment program enhances weight loss and improvements in biomarkers

PubMed Central

Acharya, Sushama D; Elci, Okan U; Sereika, Susan M; Music, Edvin; Styn, Mindi A; Turk, Melanie Warziski; Burke, Lora E

2009-01-01

Objectives: To describe participants’ adherence to multiple components (attendance, energy intake, fat gram, exercise goals, and self-monitoring eating and exercise behaviors) of a standard behavioral treatment program (SBT) for weight loss and how adherence to these components may influence weight loss and biomarkers (triglycerides, low density lipoproteins [LDL], high density lipoprotein, and insulin) during the intensive and less-intensive intervention phases. Methods: A secondary analysis of a randomized clinical trial consisting of a SBT with either fat-restricted standard or lacto-ovo vegetarian diet. The 12-month intervention was delivered in 33 group sessions. The first six months reflected the intensive phase; the second six months, the less-intensive intervention phase. We conducted the analysis without regard to treatment assignment. Eligible participants included overweight/obese adults (N = 176; mean body mass index = 34.0 kg/m2). The sample was 86.9% female, 70.5% White, and 44.4 ± 8.6 years old. The outcome measures included weight and biomarkers. Results: There was a significant decline in adherence to each treatment component over time (P < 0.0001). In the first six months, adherence to attendance, self-monitoring and the energy goal were significantly associated with greater weight loss (P < 0.05). Adherence to attendance and exercise remained significantly associated with weight loss in the second six months (P < 0.05). Adherence to attendance, self-monitoring and exercise had indirect effects through weight loss on LDL, triglycerides, and insulin (P < 0.05). Conclusions: We observed a decline in adherence to each treatment component as the intervention intensity was reduced. Adherence to multiple treatment components was associated with greater weight loss and improvements in biomarkers. Future research needs to focus on improving and maintaining adherence to all components of the treatment protocol to promote weight loss and maintenance. PMID:19936157

Prevention of Weight Gain Following a Worksite Nutrition and Exercise Program

PubMed Central

Thorndike, Anne N.; Sonnenberg, Lillian; Healey, Erica; Myint-U, Khinlei; Kvedar, Joseph C.; Regan, Susan

2012-01-01

Background Many employers are now providing wellness programs to help employees make changes in diet and exercise behaviors. Improving health outcomes and reducing costs will depend on whether employees sustain lifestyle changes and maintain a healthy weight over time. Purpose To determine if a 9-month maintenance intervention immediately following a 10-week worksite exercise and nutrition program would prevent regain of the weight lost during the program. Design RCT. Setting/participants In 2008, a total of 330 employees from 24 teams completed a 10-week exercise and nutrition program at a large hospital worksite and were randomized by team to maintenance or control (usual care) for 9 months. Intervention Internet support with a website for goal-setting and self-monitoring of weight and exercise plus minimal personal support. Main outcome measures Weight loss, percentage weight loss, time spent in physical activity, and frequency of consumption of fruits/vegetables, fatty foods, and sugary foods at 1 year compared to baseline. One-year follow-up was completed in 2010, and data were analyzed in 2011. Results At 1 year, 238 subjects (72%) completed follow-up assessments. Mean baseline BMI was 27.6 and did not differ between intervention and control. Compared to baseline, both groups lost weight during the 10-week program and maintained 65% of weight loss at 1 year (p<0.001). There was no difference in weight loss between groups at end of the 10-week program (4.8 lbs vs 4.3 lbs, p=0.53 for group×time interaction) or end of maintenance at 1 year (3.4 lbs vs 2.5 lbs, p=0.40 for group×time interaction). All subjects had improvements in physical activity and nutrition (increased fruits/vegetables and decreased fat and sugar intake) at 1 year but did not differ by group. Conclusions An intensive 10-week team-based worksite exercise and nutrition program resulted in moderate weight loss and improvements in diet and exercise behaviors at 1 year, but an Internet-based maintenance program immediately following the 10-week program did not improve these outcomes. PMID:22704742

Impact of Diet and/or Exercise Intervention on Infrapatellar Fat Pad Morphology: Secondary Analysis from the Intensive Diet and Exercise for Arthritis (IDEA) Trial.

PubMed

Pogacnik Murillo, Aarón Leonardo; Eckstein, Felix; Wirth, Wolfgang; Beavers, Daniel; Loeser, Richard F; Nicklas, Barbara J; Mihalko, Shannon L; Miller, Gary D; Hunter, David J; Messier, Stephen P

2017-01-01

The infrapatellar fat pad (IPFP) represents intra-articular adipose tissue that may contribute to intra-articular inflammation and pain by secretion of proinflammatory cytokines. Here we examined the impact of weight loss by diet and/or exercise interventions on the IPFP volume. Intensive Diet and Exercise for Arthritis (IDEA) was a single-blinded, single-center, 18-month, prospective, randomized controlled trial that enrolled 454 overweight and obese older adults with knee pain and radiographic osteoarthritis. Participants were randomized to 1 of 3 groups: exercise-only control (E), diet-induced weight loss (D), and diet-induced weight loss + exercise (D+E). In a subsample (n = 106; E: n = 36, D: n = 35, and D+E: n = 35), magnetic resonance images were acquired at baseline and at the 18-month follow-up, from which we analyzed IPFP volume, surface areas, and thickness in this secondary analysis. The average weight loss amounted to 1.0% in the E group, 10.5% in the D group, and 13.0% in the D+E group. A significant (p < 0.01) reduction in IPFP volume was observed in the E (2.1%), D (4.0%), and D+E (5.2%) groups. The IPFP volume loss in the D+E group was significantly greater than that in the E group (p < 0.05) when not adjusting for parallel comparisons. Across intervention groups, there were significant correlations between IPFP volume change, individual weight loss (r = 0.40), and change in total body fat mass (dual-energy X-ray absorptiometry; r = 0.44, n = 88) and in subcutaneous thigh fat area (computed tomography; r = 0.32, n = 82). As a potential link between obesity and knee osteoarthritis, the IPFP was sensitive to intervention by diet and/or exercise, and its reduction was correlated with changes in weight and body fat. © 2017 S. Karger AG, Basel.

IMPACT OF DIET AND/OR EXERCISE INTERVENTION ON INFRAPATELLAR FAT PAD MORPHOLOGY - SECONDARY ANALYSIS FROM THE INTENSIVE DIET AND EXERCISE FOR ARTHRITIS (IDEA) TRIAL

PubMed Central

Murillo, A. Pogacnik; Eckstein, F.; Wirth, W.; Beavers, D.; Loeser, R. F.; Nicklas, B. J.; Mihalko, S.L.; Miller, G.D.; Hunter, D.J.; Messier, S. P.

2017-01-01

Objectives The infrapatellar fat pad (IPFP) represents intra-articular adipose tissue that may contribute to intra-articular inflammation and pain by secretion of pro-inflammatory cytokines. Here we examined the impact of weight loss by diet and/or exercise interventions on IPFP volume. Methods Intensive Diet and Exercise for Arthritis (IDEA) was a single-blinded, single-center, 18-month, prospective, randomized controlled trial that enrolled 454 overweight and obese older adults with knee pain and radiographic osteoarthritis. Participants were randomized to 1 of 3 groups: exercise only control (E), diet-induced weight loss (D), and diet-induced weight loss + exercise (D+E). In a subsample (n=106; E: n=36; D: n=35; D+E: n=35), magnetic resonance images were acquired at baseline and 18-month follow-up, from which we analyzed IPFP volume, surface areas and thickness in this secondary analysis. Results Average weight loss in each group amounted to 1.0% in E, 10.5% in D, and 13.0% in D+E. A significant (p< 0.01) reduction in IPFP volume was observed in E (2.1%), D (4.0%) and D+E (5.2%). The IPFP volume loss in D+E was significantly greater than that in E (p<0.05) when not adjusting for parallel comparisons. Across intervention groups, there were significant correlations between IPFP volume change, individual weight loss (r=0.40), and change in total body fat mass (DXA; r=0.44; n=88) and in subcutaneous thigh fat area (CT; r=0.32; n=82). Conclusions As a potential link between obesity and knee OA, the IPFP was sensitive to intervention by diet and/or exercise, and its reduction was correlated with change in weight and body fat. PMID:28222422

Lean Mass Loss Is Associated with Low Protein Intake during Dietary-Induced Weight Loss in Postmenopausal Women

PubMed Central

BOPP, MELANIE J.; HOUSTON, DENISE K.; LENCHIK, LEON; EASTER, LINDA; KRITCHEVSKY, STEPHEN B.; NICKLAS, BARBARA J.

2013-01-01

The health and quality-of-life implications of overweight and obesity span all ages in the United States. We investigated the association between dietary protein intake and loss of lean mass during weight loss in postmenopausal women through a retrospective analysis of a 20-week randomized, controlled diet and exercise intervention in women aged 50 to 70 years. Weight loss was achieved by differing levels of caloric restriction and exercise. The diet-only group reduced caloric intake by 2,800 kcal/week, and the exercise groups reduced caloric intake by 2,400 kcal/week and expended ~400 kcal/week through aerobic exercise. Total and appendicular lean mass was measured using dual energy x-ray absorptiometry. Linear regression analysis was used to examine the association between changes in lean mass and appendicular lean mass and dietary protein intake. Average weight loss was 10.8±4.0 kg, with an average of 32% of total weight lost as lean mass. Protein intake averaged 0.62 g/kg body weight/day (range=0.47 to 0.8 g/kg body weight/day). Participants who consumed higher amounts of dietary protein lost less lean mass and appendicular lean mass r(=0.3, P=0.01 and r=0.41, P<0.001, respectively). These associations remained significant after adjusting for intervention group and body size. Therefore, inadequate protein intake during caloric restriction may be associated with adverse body-composition changes in postmenopausal women. PMID:18589032

Exercise motivation, eating, and body image variables as predictors of weight control.

PubMed

Teixeira, Pedro J; Going, Scott B; Houtkooper, Linda B; Cussler, Ellen C; Metcalfe, Lauve L; Blew, Rob M; Sardinha, Luis B; Lohman, Timothy G

2006-01-01

This study investigated changes in psychosocial variables related to exercise, eating, and body image during a weight reduction program and evaluated their association with weight loss in middle-aged overweight and obese women up to 1 yr after intervention. The 136 participants (age, 48.1 +/- 4.4 yr; weight, 30.6 +/- 5.6 kg x m(-2)) who completed the 4-month lifestyle weight reduction program (86% retention), losing -6.2 +/- 4.6% (P < 0.001) of their initial weight, were followed up for 12 additional months. Of these, 82% completed 16-month assessments (weight change, -5.5 +/- 7.7%, P < 0.001). Psychosocial variables were assessed by validated instruments in standardized conditions at baseline and after the intervention (4 months). Compared with 4-month assessments, body weight did not change at 16 months (P > 0.09). Changes in eating restraint, disinhibition, and hunger; exercise, self-efficacy, and intrinsic motivation; body shape concerns; and physical self-worth were associated with weight change at 4 months (P < 0.001, except hunger, P < 0.05). Baseline-adjusted 4-month scores in all psychosocial variables also predicted weight change from baseline to 16 months (P < 0.01), except hunger (P > 0.05). After controlling for 4-month weight change and other covariates, increases in exercise intrinsic motivation remained predictive of weight loss at 16 months (P < 0.05). Multiple linear regression showed that eating variables were significant and independent correlates of short-term weight change, whereas changes in exercise variables were stronger predictors of longer term weight outcomes. Results highlight the importance of cognitive processes during weight control and support the notion that initial focus on diet is associated with short-term weight loss, while change in exercise-related motivational factors, with a special emphasis on intrinsic sources of motivation (e.g., interest and enjoyment in exercise), play a more important role in longer term weight management.

Exercise for Weight Loss: Calories Burned in One Hour

MedlinePlus

... values. Medicine & Science in Sports & Exercise. 2011;43:1575. 2008 Physical Activity Guidelines for Americans. U.S. Department ... values. Medicine & Science in Sports & Exercise. 2011;43:1575. Losing weight. Centers for Disease Control and Prevention. ...

Supported Exercise Improves Controlled Eating and Weight through Its Effects on Psychosocial Factors: Extending a Systematic Research Program Toward Treatment Development

PubMed Central

Annesi, James J

2012-01-01

Background: Behavioral weight-loss treatments have been overwhelmingly unsuccessful. Many inadequately address both behavioral theory and extant research—especially in regard to the lack of viability of simply educating individuals on improved eating and exercise behaviors. Objective: The aim was to synthesize research on associations of changes in exercise behaviors, psychosocial factors, eating behaviors, and weight; and then conduct further direct testing to inform the development of an improved treatment approach. Methods: A systematic program of health behavior-change research based on social cognitive theory, and extensions of that theory applied to exercise and weight loss, was first reviewed. Then, to extend this research toward treatment development and application, a field-based study of obese adults was conducted. Treatments incorporated a consistent component of cognitive-behaviorally supported exercise during 26 weeks that was paired with either standard nutrition education (n = 183) or cognitive-behavioral methods for controlled eating that emphasized self-regulatory methods such as goal setting and caloric tracking, cognitive restructuring, and eating cue awareness (n = 247). Results: Both treatment conditions were associated with improved self-efficacy, self-regulation, mood, exercise, fruit and vegetable consumption, weight, and waist circumference; with improvements in self-regulation for eating, fruit and vegetable consumption, weight, and waist circumference significantly greater in the cognitive-behavioral nutrition condition. Changes in exercise- and eating-related self-efficacy and self-regulation were associated with changes in exercise and eating (R2 = 0.40 and 0.17, respectively), with mood change increasing the explanatory power to R2 = 0.43 and 0.20. Improved self-efficacy and self-regulation for exercise carried over to self-efficacy and self-regulation for controlled eating (β= 0.53 and 0.68, respectively). Conclusions: Development and longitudinal testing of a new and different approach to behavioral treatment for sustained weight loss that emphasizes exercise program-induced psychosocial changes preceding the facilitation of improved eating and weight loss should be guided by our present research. PMID:22529754

The impact of supervised weight loss and intentional weight regain on sex hormone binding globulin and testosterone in premenopausal women.

PubMed

Aubuchon, Mira; Liu, Ying; Petroski, Gregory F; Thomas, Tom R; Polotsky, Alex J

2016-08-01

What is the impact of intentional weight loss and regain on serum androgens in women? We conducted an ancillary analysis of prospectively collected samples from a randomized controlled trial. The trial involved supervised 10% weight loss (8.5 kg on average) with diet and exercise over 4-6 months followed by supervised intentional regain of 50% of the lost weight (4.6 kg on average) over 4-6 months. Participants were randomized prior to the partial weight regain component to either continuation or cessation of endurance exercise. Analytic sample included 30 obese premenopausal women (mean age of 40 ± 5.9 years, mean baseline body mass index (BMI) of 32.9 ± 4.2 kg/m(2)) with metabolic syndrome. We evaluated sex hormone binding globulin (SHBG), total testosterone (T), free androgen index (FAI), and high molecular weight adiponectin (HMWAdp). Insulin, homeostasis model assessment (HOMA), and quantitative insulin sensitivity check index (QUICKI), and visceral adipose tissue (VAT) measured in the original trial were reanalyzed for the current analytic sample. Insulin, HOMA, and QUICKI improved with weight loss and were maintained despite weight regain. Log-transformed SHBG significantly increased from baseline to weight loss, and then significantly decreased with weight regain. LogFAI and logVAT decreased similarly and increased with weight loss followed by weight regain. No changes were found in logT and LogHMWAdp. There was no significant difference in any tested parameters by exercise between the groups. SHBG showed prominent sensitivity to body mass fluctuations, as reduction with controlled intentional weight regain showed an inverse relationship to VAT and occurred despite stable HMWAdp and sustained improvements with insulin resistance. FAI showed opposite changes to SHBG, while T did not change significantly with weight. Continued exercise during weight regain did not appear to impact these findings.

A weight-loss program adapted to the menstrual cycle increases weight loss in healthy, overweight, premenopausal women: a 6-mo randomized controlled trial.

PubMed

Geiker, Nina Rw; Ritz, Christian; Pedersen, Sue D; Larsen, Thomas M; Hill, James O; Astrup, Arne

2016-07-01

Hormonal fluctuations during the menstrual cycle influence energy intake and expenditure as well as eating preferences and behavior. We examined the effect in healthy, overweight, premenopausal women of a diet and exercise weight-loss program that was designed to target and moderate the effects of the menstrual cycle compared with the effect of simple energy restriction. A total of 60 healthy, overweight, premenopausal women were included in a 6-mo weight-loss program in which each subject consumed a diet of 1600 kcal/d. Subjects were randomly assigned to either a combined diet and exercise program that was tailored to metabolic changes of the menstrual cycle (Menstralean) or to undergo simple energy restriction (control). Thirty-one women (19 Menstralean and 12 control women) completed the study [mean ± SD body mass index (in kg/m(2)): 32.0 ± 5.2]. Both groups lost weight during the study. In an intention-to-treat analysis, the Menstralean group did not achieve a clinically significant weight loss compared with that of the control group (P = 0.61). In per-protocol analyses, a more-pronounced weight loss of 4.3 ± 1.4 kg (P = 0.002) was shown in adherent Menstralean subjects than in the control group. A differentiated diet and exercise program that is tailored to counteract food cravings and metabolic changes throughout the menstrual cycle may increase weight loss above that achieved with a traditional diet and exercise program in women who can comply with the program. This trial was registered at clinicaltrials.gov as NCT01622114. © 2016 American Society for Nutrition.

Do changes in energy intake and non-exercise physical activity affect exercise-induced weight loss? Midwest Exercise Trial-2

PubMed Central

Herrmann, Stephen D.; Willis, Erik A.; Honas, Jeffery J.; Lee, Jaehoon; Washburn, Richard A.; Donnelly, Joseph E.

2015-01-01

Objective To compare energy intake, total daily energy expenditure (TDEE), non-exercise energy expenditure (NEEx), resting metabolic rate (RMR), non-exercise physical activity (NEPA), and sedentary time between participants with weight loss <5% (non-responders) vs. ≥5% (responders) in response to exercise. Methods Overweight/obese (BMI 25–40 kg/m2), adults (18–30 yrs.) were randomized to exercise: 5 day/week, 400 or 600 kcal/session, 10 months. Results Forty participants responded and 34 did not respond to the exercise protocol. Non-responder energy intake was higher vs. responders, significant only in men (p=0.034). TDEE increased only in responders (p=0.001). NEEx increased in responders and decreased in non-responders, significant only in men (p=0.045). There were no within or between-group differences for change in RMR. NEPA increased in responders and decreased in non-responders (group-by-time interactions: total sample, p=0.049; men, p=0.016). Sedentary time decreased in both groups, significant only in men. Conclusion Men who did not lose weight in response to exercise (<5%) had higher energy intake and lower NEEx compared to men losing ≥5%. No significant differences in any parameters assessed were observed between women who lost <5% vs. those losing ≥5. Factors associated with the weight loss response to exercise in women warrant additional investigation. PMID:26193059

The impact of exercise training compared to caloric restriction on hepatic and peripheral insulin resistance in obesity.

PubMed

Coker, Robert H; Williams, Rick H; Yeo, Sophie E; Kortebein, Patrick M; Bodenner, Don L; Kern, Philip A; Evans, William J

2009-11-01

It has been difficult to distinguish the independent effects of caloric restriction versus exercise training on insulin resistance. Utilizing metabolic feeding and supervised exercise training, we examined the influence of caloric restriction vs. exercise training with and without weight loss on hepatic and peripheral insulin resistance. Thirty-four obese, older subjects were randomized to: caloric restriction with weight loss (CR), exercise training with weight loss (EWL), exercise training without weight loss (EX), or controls. Based on an equivalent caloric deficit in EWL and CR, we induced matched weight loss. Subjects in the EX group received caloric compensation. Combined with [6,6(2)H(2)]glucose, an octreotide, glucagon, multistage insulin infusion was performed to determine suppression of glucose production (SGP) and insulin-stimulated glucose disposal (ISGD). Computed tomography scans were performed to assess changes in fat distribution. Body weight decreased similarly in EWL and CR, and did not change in EX and controls. The reduction in visceral fat was significantly greater in EWL (-71 +/- 15 cm(2)) compared to CR and EX. The increase in SGP was also almost 3-fold greater (27 +/- 2%) in EWL. EWL and CR promoted similar improvements in ISGD [+2.5 +/- 0.4 and 2.4 +/- 0.9 mg x kg fat-free mass (FFM)(-1) x min(-1)], respectively. EWL promoted the most significant reduction in visceral fat and the greatest improvement in SGP. Equivalent increases in ISGD were noted in EWL and CR, whereas EX provided a modest improvement. Based on our results, EWL promoted the optimal intervention-based changes in body fat distribution and systemic insulin resistance.

The stigma of obesity surgery: negative evaluations based on weight loss history.

PubMed

Vartanian, Lenny R; Fardouly, Jasmine

2013-10-01

The present study investigated the stigma of obesity surgery by examining whether attitudes towards a lean person can change after learning that the person used to be obese but recently lost weight either through surgery or through diet and exercise. Participants (total N = 135) initially viewed an image of a lean woman or man and rated their impression of that individual on a variety of characteristics. Participants were then shown an image of the individual before she/he lost weight and were informed that the weight loss was achieved through surgery or through diet and exercise. Participants once again rated their impressions of that individual. After learning about the previous weight loss, participants rated the individual who lost weight through surgery as significantly more lazy and sloppy, less competent and sociable, less attractive, and having less healthy eating habits. The individual who lost weight through diet and exercise, in contrast, was not evaluated as harshly. Mediation analysis further showed that the difference between the two weight loss conditions in ratings of laziness, competence, and sociability was due to participants viewing surgery patients as less responsible for their weight loss. These findings suggest that learning about someone's weight history can negatively impact the way that person is seen by others. Furthermore, these findings suggest that the stigma may be strongest for people who lose weight through obesity surgery because those individuals are not seen as being responsible for their weight loss.

Smoking, weight loss intention and obesity-promoting behaviors in college students.

PubMed

Carroll, Shawna L; Lee, Rebecca E; Kaur, Harsohena; Harris, Kari J; Strother, Myra L; Huang, Terry T-K

2006-08-01

To examine whether college smoking was associated with trying to lose weight and other weight-related behaviors. We surveyed 300 students at the University of Kansas about smoking (ever, current, and amount), weight loss intention (y/n), weight-related attitudes, and eating and exercise behavior. Weight, height, and body fat were measured. About half the students (49%) self-identified as having ever smoked while 53 (17.6%) self-identified as current smokers. After controlling for sex, age, and ethnicity, ever smoking was not related to weight loss intention but was associated with greater pressure to maintain a healthy weight (p = 0.05), and having engaged in mild exercise on more days in the previous year (p = 0.05). Compared to nonsmokers, current smokers ate more at restaurants serving high calorie foods (p < 0.05) and ate more frequently in front of the TV (p < 0.01). Amount smoked was related to diminished use of exercise facilities (p = 0.03) and more frequent eating at restaurants serving high calorie foods (p < 0.05) and in front of the TV (p = 0.01). Current smoking among college students was related to weight loss intention. Despite wanting to lose weight, current smoking was concomitant with obesity-promoting behaviors such as eating higher calorie foods and eating in front of the TV. College-based interventions to prevent smoking initiation or promote smoking cessation should include a focus on healthy eating, exercise and healthful ways to lose or maintain weight.

Body composition changes after weight-loss interventions for overweight and obesity.

PubMed

Santarpia, Lidia; Contaldo, Franco; Pasanisi, Fabrizio

2013-04-01

Weight-loss interventions to correct overweight and obesity are very popular but often inappropriate and unsuccessful. In this review we evaluated studies on body composition changes during and after different medical and surgical interventions aimed at achieving stable weight loss in overweight and obese individuals. Most of the available literature and good clinical practice observations deal mainly with post-menopausal overweight and obese women, and, to a lesser extent adolescents and elderly, female and male, populations. These studies suggest that weight-loss maintenance interventions should have greater consideration and priority than simple weight-loss treatments. At a long term follow up (over one year), relatively high protein, moderately low calorie, low glycemic index diets, associated with a daily, moderate intensity, physical exercise (of at least 30 min), appear to be more successful in limiting long term relapse, maintaining fat free mass and achieving the highest fat loss. Diet alone or physical exercise alone does not produce similar results. Health professional training and practice also appear a challenging target. Adequate dietetic advice plus regular physical exercise avoid the fat-free-mass loss usually observed in the relapse of the weight cycling syndrome and prevent the onset of sarcopenic obesity. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Effects of Visfatin Gene Polymorphism RS4730153 on Exercise-induced Weight Loss of Obese Children and Adolescents of Han Chinese

PubMed Central

Lai, Aiping; Chen, Wenhe; Helm, Kelly

2013-01-01

Visfatin is a recently discovered adipokine that contributes to glucose and obesity-related conditions. This study investigates Visfatin RS4730153 polymorphism from the perspectives of its relations with glucose/lipid metabolism and its influence on the effects of exercise-induced weight loss. Eighty-eight obese Han Chinese children and adolescents were randomly selected from a 2008 Shanghai Weight Loss Summer Camp and were supervised to complete a 4 week aerobic exercise training program. Significant differences were observed in before-exercise TG value and exercise-induced HOMA-β change, with the AG group having a much higher TG value than the GG group (P ≤ 0.05), and the latter exhibiting a significantly larger before-and-after exercise HOMA-β change than the former (P ≤ 0.05). However, no significant difference was observed between the two groups in before exercise indices of body shape, function and quality, nor in exercise-induced changes of body shape, function, and quality. Findings suggest that Visfatin RS4730153 homozygous GG genotype may effect adjustment of glucose and lipid metabolism in obese children and adolescents by reducing TG levels and increasing insulin sensitivity to exercise. PMID:23289013

Effects of walking or resistance training on weight loss maintenance in obese, middle-aged men: a randomized trial.

PubMed

Borg, P; Kukkonen-Harjula, K; Fogelholm, M; Pasanen, M

2002-05-01

To investigate whether walking or resistance training improves weight maintenance after weight loss when added to dietary counselling. Two months' weight reduction with very-low-energy-diet (VLED) followed by randomization into three groups (control, walking, resistance training) for 6 months' weight maintenance (WM) program and 23 months' unsupervised follow-up. During VLED and WM all groups received similar dietary counselling. The main inclusion criteria were BMI >30 kg/m(2), waist>100 cm and physical inactivity (exercise < or = once a week). Ninety healthy, obese (mean BMI 32.9 kg/m(2) and waist 112.5 cm), 35-50 y-old men started the study and 68 were measured at the end of the study. Weight and body composition assessed by underwater weighing. Exercise diaries and dietary records to assess energy balance. During VLED the mean body weight decreased from 106.0 (s.d. 9.9) kg to 91.7 (9.4) kg. Weight was regained mostly during follow-up and in the end of the study the mean weight in groups was 99.9-102.0 kg. Exercise training did not improve short or long-term weight maintenance when compared to the control group. However, resistance training attenuated the regain of body fat mass during WM (P=0.0l), but not during follow-up. In the combined groups the estimated total energy expenditure (EE) of reported physical activity was associated with less weight regain during WM. EE of 10.1 MJ/week was associated with maintaining weight after weight loss. EE of physical activity tended to decrease after WM in exercise groups due to poor long-term adherence to prescribed exercise. Energy intake seemed to increase during follow-up. Exercise training of moderate dose did not seem to improve long-term weight maintenance because of poor adherence to prescribed exercise.

The importance of body weight and weight management for military personnel.

PubMed

Naghii, Mohammad Reza

2006-06-01

Weight or fat reduction and maintenance among military personnel and attainment of desired body composition and physical appearance are considered important. A high level of body fat has been shown to have an adverse effect on performance in a number of military activities. The effect of rapid weight loss on performance appears to depend on the method of weight loss, the magnitude of weight loss, and the type of exercise or activity performance test used. Personnel who undertake imprudent weight-loss strategies, that is, personnel who try to change their usual body size by chronically restricting their food and fluid intake, may suffer a number of problems. Overweight personnel and their military coaches are just as susceptible to false ideas about weight loss and dieting as the rest of the community. Inappropriate weight loss causes a loss of lean tissue and can reduce, rather than enhance, performance. The understanding and promotion of safe, effective, appropriate weight-loss and weight-maintenance strategies represent important functions of the military system and officials. The greatest likelihood of success requires an integrated program, both during and after the weight-loss phase, in which assessment, increased energy expenditure through exercise and other daily activities, energy intake reduction, nutrition education, lifestyle changes, environmental changes, and psychological support are all components.

Effects of a caloric restriction weight loss diet and exercise on inflammatory biomarkers in overweight/obese postmenopausal women: a randomized controlled trial

PubMed Central

Imayama, Ikuyo; Ulrich, Cornelia M.; Alfano, Catherine M.; Wang, Chiachi; Xiao, Liren; Wener, Mark H.; Campbell, Kristin L.; Duggan, Catherine; Foster-Schubert, Karen E.; Kong, Angela; Mason, Caitlin E.; Wang, Ching-Yun; Blackburn, George L.; Bain, Carolyn E.; Thompson, Henry J.; McTiernan, Anne

2012-01-01

Obese and sedentary persons have increased risk for cancer; inflammation is a hypothesized mechanism. We examined the effects of a caloric restriction weight loss diet and exercise on inflammatory biomarkers in 439 women. Overweight and obese postmenopausal women were randomized to 1-year: caloric restriction diet (goal of 10% weight loss, N=118), aerobic exercise (225 minutes/week of moderate-to-vigorous activity, N=117), combined diet+exercise (N=117) or control (N=87). Baseline and 1-year high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA), interleukin-6 (IL-6), leukocyte and neutrophil levels were measured by investigators blind to group. Inflammatory biomarker changes were compared using generalized estimating equations. Models were adjusted for baseline body mass index (BMI), race/ethnicity and age. 438 (N=1 in diet+exercise group was excluded) were analyzed. Relative to controls, hs-CRP decreased by geometric mean (95% confidence interval, p-value) 0.92mg/L (0.53–1.31, P<0.001) in the diet and 0.87mg/L (0.51–1.23, P<0.0001) in the diet+exercise groups. IL-6 decreased by 0.34pg/ml (0.13–0.55, P=0.001) in the diet and 0.32pg/ml (0.15–0.49, P<0.001) in the diet+exercise groups. Neutrophil counts decreased by 0.31×109/L (0.09–0.54, P=0.006) in the diet and 0.30×109/L (0.09–0.50, P=0.005) in the diet+exercise groups. Diet and diet+exercise participants with ≥5% weight loss reduced inflammatory biomarkers (hs-CRP, SAA, and IL-6) compared to controls. The diet and diet+exercise groups reduced hs-CRP in all subgroups of baseline BMI, waist circumference, CRP level, and fasting glucose. Our findings indicate that a caloric restriction weight loss diet with or without exercise reduces biomarkers of inflammation in postmenopausal women, with potential clinical significance for cancer risk reduction. PMID:22549948

Effects of a caloric restriction weight loss diet and exercise on inflammatory biomarkers in overweight/obese postmenopausal women: a randomized controlled trial.

PubMed

Imayama, Ikuyo; Ulrich, Cornelia M; Alfano, Catherine M; Wang, Chiachi; Xiao, Liren; Wener, Mark H; Campbell, Kristin L; Duggan, Catherine; Foster-Schubert, Karen E; Kong, Angela; Mason, Caitlin E; Wang, Ching-Yun; Blackburn, George L; Bain, Carolyn E; Thompson, Henry J; McTiernan, Anne

2012-05-01

Obese and sedentary persons have increased risk for cancer; inflammation is a hypothesized mechanism. We examined the effects of a caloric restriction weight loss diet and exercise on inflammatory biomarkers in 439 women. Overweight and obese postmenopausal women were randomized to 1-year: caloric restriction diet (goal of 10% weight loss, N = 118), aerobic exercise (225 min/wk of moderate-to-vigorous activity, N = 117), combined diet + exercise (N = 117), or control (N = 87). Baseline and 1-year high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA), interleukin-6 (IL-6), leukocyte, and neutrophil levels were measured by investigators blind to group. Inflammatory biomarker changes were compared using generalized estimating equations. Models were adjusted for baseline body mass index (BMI), race/ethnicity, and age. Four hundred and thirty-eight (N = 1 in diet + exercise group was excluded) were analyzed. Relative to controls, hs-CRP decreased by geometric mean (95% confidence interval, P value): 0.92 mg/L (0.53-1.31, P < 0.001) in the diet and 0.87 mg/L (0.51-1.23, P < 0.0001) in the diet + exercise groups. IL-6 decreased by 0.34 pg/mL (0.13-0.55, P = 0.001) in the diet and 0.32 pg/mL (0.15-0.49, P < 0.001) in the diet + exercise groups. Neutrophil counts decreased by 0.31 × 10(9)/L (0.09-0.54, P = 0.006) in the diet and 0.30 × 10(9)/L (0.09-0.50, P = 0.005) in the diet + exercise groups. Diet and diet + exercise participants with 5% or more weight loss reduced inflammatory biomarkers (hs-CRP, SAA, and IL-6) compared with controls. The diet and diet + exercise groups reduced hs-CRP in all subgroups of baseline BMI, waist circumference, CRP level, and fasting glucose. Our findings indicate that a caloric restriction weight loss diet with or without exercise reduces biomarkers of inflammation in postmenopausal women, with potential clinical significance for cancer risk reduction. ©2012 AACR

The Relationship Between Intuitive Eating and Postpartum Weight Loss.

PubMed

Leahy, Katie; Berlin, Kristoffer S; Banks, Gabrielle G; Bachman, Jessica

2017-08-01

Objective Postpartum weight loss is challenging for new mothers who report limited time and difficulties following traditional weight loss methods. Intuitive eating (IE) is a behavior that includes eating based on physical hunger and fullness and may have a role in encouraging weight loss. The purpose of this study was to examine the relationship between IE and postpartum weight loss. Methods Women 12-18 months postpartum completed a questionnaire regarding weight changes surrounding pregnancy, exercise, breastfeeding and intuitive eating using the Intuitive Eating Scale. Latent growth curve modeling was utilized to determine the relationship between IE, breastfeeding, weight gain during pregnancy, and postpartum weight trajectories. Results Participants (n = 50) were 28.5 ± 4.9 years old, had an average pre-pregnancy BMI of 26.4 ± 6.8 and the majority were married, and non-Hispanic white. The conditional model revealed that more intuitive eating practices predicted greater postpartum BMI decreases (Est. = -0.10, p < .05) when controlling for breastfeeding duration, exercise duration, and initial BMI and pregnancy BMI changes. Greater pregnancy BMI increases were associated with more rapid postpartum BMI decreases (Est. = -0.34, p < .001) while breastfeeding duration, exercise and initial BMI were not related. Conclusions for Practice Postpartum weight retention is a challenge for many women. Following a more intuitive eating approach to food consumption may encourage postpartum weight loss without the required weighing, measuring, recording and assessing dietary intake that is required of traditional weight loss programs. IE could offer an alternative approach that may be less arduous for new mothers.

Weight and metabolic effects of dietary weight loss and exercise interventions in postmenopausal antidepressant medication users and non-users: a randomized controlled trial.

PubMed

Imayama, Ikuyo; Alfano, Catherine M; Mason, Caitlin; Wang, Chiachi; Duggan, Catherine; Campbell, Kristin L; Kong, Angela; Foster-Schubert, Karen E; Blackburn, George L; Wang, Ching-Yun; McTiernan, Anne

2013-11-01

Antidepressants may attenuate the effects of diet and exercise programs. We compared adherence and changes in body measures and biomarkers of glucose metabolism and inflammation between antidepressant users and non-users in a 12-month randomized controlled trial. Overweight or obese, postmenopausal women were assigned to: diet (10% weight loss goal, N=118); moderate-to-vigorous aerobic exercise (225 min/week, N=117); diet+exercise (N=117); and control (N=87) in Seattle, WA 2005-2009. Women using antidepressants at baseline were classified as users (N=109). ANCOVA and generalized estimating equation approaches, respectively, were used to compare adherence (exercise amount, diet session attendance, and changes in percent calorie intake from fat, cardiopulmonary fitness, and pedometer steps) and changes in body measures (weight, waist and percent body fat) and serum biomarkers (glucose, insulin, homeostasis assessment-insulin resistance, and high-sensitivity C-reactive protein) between users and non-users. An interaction term (intervention×antidepressant use) tested effect modification. There were no differences in adherence except that diet session attendance was lower among users in the diet+exercise group (P<0.05 vs. non-users). Changes in body measures and serum biomarkers did not differ by antidepressant use (Pinteraction>0.05). Dietary weight loss and exercise improved body measures and biomarkers of glucose metabolism and inflammation independent of antidepressant use. © 2013.

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program.

PubMed

Befort, C A; Stewart, E E; Smith, B K; Gibson, C A; Sullivan, D K; Donnelly, J E

2008-03-01

To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers. Previous program participants (n=179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance. At 14.1+/-10.8 months following completion of treatment, survey respondents were on average 12.6+/-12.6 kg, or 11.3+/-10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management. Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.

Effects of weight changes in the autonomic nervous system: A systematic review and meta-analysis.

PubMed

Costa, João; Moreira, André; Moreira, Pedro; Delgado, Luís; Silva, Diana

2018-01-09

Obesity has been linked to autonomic dysfunction, which is thought to be one of the main contributors for hypertension, cardiac remodelling and death. Exercise and diet-based weight loss are the mainstay therapy for obesity, but there is a paucity of data regarding the effect of weight changes in autonomic nervous system (ANS) activity. To describe the impact of weight changes in autonomic nervous system. A systematic literature search of four biomedical databases was performed evaluating effects of weight changes, thorough diet and/or exercise-based interventions, in the following ANS outcomes: heart rate variability, namely low frequency (LF)/high frequency (HF) ratio (LF/HF ratio), normalized units of LF (LFnu) and HF (HFnu), muscle sympathetic nerve activity (MSNA), noradrenaline spillover rate (NA-SR), standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), baroreflex sensitivity and pupillometry. Quality appraisal was performed using the GRADE methodology and, where fitting, studies with comparable outcomes were pooled for meta-analysis. Twenty-seven studies - 7 controlled clinical trials and 20 observational studies - were included. Weight gain was reported in 4 studies and weight loss in all the other studies. Interventions inducing weight changes included: hypocaloric or hypercaloric diets, exercise (strength, endurance or aerobic training) and hypocaloric diet coupled with exercise programs. Most studies which resulted in weight loss reported decreases in LF/HF ratio, LFnu, MSNA burst frequency and incidence, NA-SR, and an increase of baroreflex sensitivity, HF, HFnu and RMSSD, pointing to a parasympathetic nervous system activation. Meta-analysis regarding weight loss interventions showed a significant pooled effect size (95% CI) with a decreased of MSNA burst frequency -5.09 (-8.42, -1.75), MSNA incidence -6.66 (-12.40, -0.62), however this was not significant for SDNN 14.32 (-4.31, 32.96). Weight gain was associated with an increase in LF/HF, LFnu, MSNA burst frequency and incidence. The weight loss effects were potentiated by the association of hypocaloric diet with exercise. Nevertheless, weight changes effects in these outcomes were based in low or very low quality of evidence. Diet and exercise based weight loss appears to increase parasympathetic and decrease sympathetic activity, the opposing effects being observed with weight gain. These findings are not uniformly reported in the literature, possibly due to differences in study design, methodology, characteristics of the participants and techniques used to estimate autonomic nervous activity. Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Cuidando El Corazon--a weight-reduction intervention for Mexican Americans.

PubMed

Foreyt, J P; Ramirez, A G; Cousins, J H

1991-06-01

Cuidando El Corazon (CEC; Taking Care of Your Heart) was designed to assess the effectiveness of a culturally adapted weight-reduction and exercise program for achieving long-term weight loss in Mexican Americans. CEC used a family-oriented approach to achieve lifestyle change in behavior. Participants were assigned to 1) a booklet-only comparison group that received a manual including behavior change, nutrition, and exercise information and traditional recipes modified in fat content; 2) an individual group that received the same manual and attended year-long classes; or 3) a family group that received a manual and attended classes that emphasized techniques for making changes in the family's eating and exercising habits. The family and individual groups had significantly greater weight losses than the information-only group. Weight loss was greatest in the family-involvement group and least in the information-only comparison group.

Effects of matched weight loss from calorie restriction, exercise, or both on cardiovascular disease risk factors: a randomized intervention trial.

PubMed

Weiss, Edward P; Albert, Stewart G; Reeds, Dominic N; Kress, Kathleen S; McDaniel, Jennifer L; Klein, Samuel; Villareal, Dennis T

2016-09-01

Weight loss from calorie restriction (CR) and/or endurance exercise training (EX) is cardioprotective. However CR and EX also have weight loss-independent benefits. We tested the hypothesis that weight loss from calorie restriction and exercise combined (CREX) improves cardiovascular disease (CVD) risk factors more so than similar weight loss from CR or EX alone. Overweight, sedentary men and women (n = 52; aged 45-65 y) were randomly assigned to undergo 6-8% weight loss by using CR, EX, or CREX. Outcomes were measured before and after weight loss and included maximal oxygen consumption (VO2max), resting blood pressure, fasting plasma lipids, glucose, C-reactive protein, and arterial stiffness [carotid-femoral pulse wave velocity (PWV) and carotid augmentation index (AI)]. Values are means ± SEs. Reductions in body weight (∼7%) were similar in all groups. VO2max changed in proportion to the amount of exercise performed (CR, -1% ± 3%; EX, +22% ± 3%; and CREX, +11% ± 3%). None of the changes in CVD risk factors differed between groups. For all groups combined, decreases were observed for systolic and diastolic blood pressure (-5 ± 1 and -4 ± 1 mm Hg, respectively; both P < 0.0008), total cholesterol (-17 ± 4 mg/dL; P < 0.0001), non-HDL cholesterol (-16 ± 3 mg/dL; P < 0.0001), triglycerides (-18 ± 8 mg/dL; P = 0.03), and glucose (-3 ± 1 mg/dL; P = 0.0003). No changes were observed for HDL cholesterol (P = 0.30), C-reactive protein (P = 0.10), PWV (P = 0.30), or AI (P = 0.84). These changes would be expected to decrease the lifetime risk of CVD from 46% to 36%. Matched weight losses from CR, EX, and CREX have substantial beneficial effects on CVD risk factors. However, the effects are not additive when weight loss is matched. This trial was registered at clinicaltrials.gov as NCT00777621. © 2016 American Society for Nutrition.

Prevention of weight gain following a worksite nutrition and exercise program: a randomized controlled trial.

PubMed

Thorndike, Anne N; Sonnenberg, Lillian; Healey, Erica; Myint-U, Khinlei; Kvedar, Joseph C; Regan, Susan

2012-07-01

Many employers are now providing wellness programs to help employees make changes in diet and exercise behaviors. Improving health outcomes and reducing costs will depend on whether employees sustain lifestyle changes and maintain a healthy weight over time. To determine if a 9-month maintenance intervention immediately following a 10-week worksite exercise and nutrition program would prevent regain of the weight lost during the program. RCT. In 2008, a total of 330 employees from 24 teams completed a 10-week exercise and nutrition program at a large hospital worksite and were randomized by team to maintenance or control (usual care) for 9 months. Internet support with a website for goal-setting and self-monitoring of weight and exercise plus minimal personal support. Weight loss, percentage weight loss, time spent in physical activity, and frequency of consumption of fruits/vegetables, fatty foods, and sugary foods at 1 year compared to baseline. One-year follow-up was completed in 2010, and data were analyzed in 2011. At 1 year, 238 subjects (72%) completed follow-up assessments. Mean baseline BMI was 27.6 and did not differ between intervention and control. Compared to baseline, both groups lost weight during the 10-week program and maintained 65% of weight loss at 1 year (p<0.001). There was no difference in weight loss between groups at the end of the 10-week program (4.8 lbs vs 4.3 lbs, p=0.53 for group X time interaction) or end of maintenance at 1 year (3.4 lbs vs 2.5 lbs, p=0.40 for group X time interaction). All subjects had improvements in physical activity and nutrition (increased fruits/vegetables and decreased fat and sugar intake) at 1 year but did not differ by group. An intensive 10-week team-based worksite exercise and nutrition program resulted in moderate weight loss and improvements in diet and exercise behaviors at 1 year, but an Internet-based maintenance program immediately following the 10-week program did not improve these outcomes. This study is registered at clinicaltrials.gov NCT00707577. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Comparative efficacy of CPAP, MADs, exercise-training, and dietary weight loss for sleep apnea: a network meta-analysis.

PubMed

Iftikhar, Imran H; Bittencourt, Lia; Youngstedt, Shawn D; Ayas, Najib; Cistulli, Peter; Schwab, Richard; Durkin, Martin W; Magalang, Ulysses J

2017-02-01

To synthesize evidence from available studies on the relative efficacies of continuous positive airway pressure (CPAP), mandibular advancement device (MAD), supervised aerobic exercise training, and dietary weight loss in patients with obstructive sleep apnea (OSA). Network meta-analysis of 80 randomized controlled trials (RCTs) short-listed from PubMed, SCOPUS, Web of science, and Cochrane register (inception - September 8, 2015). Individuals with OSA. CPAP, MADs, exercise training, and dietary weight loss. CPAP decreased apnea-hypopnea index (AHI) the most [by 25.27 events/hour (22.03-28.52)] followed by exercise training, MADs, and dietary weight loss. While the difference between exercise training and CPAP was non-significant [-8.04 (-17.00 to 0.92), a significant difference was found between CPAP and MADs on AHI and oxygen desaturation index (ODI) [-10.06 (-14.21 to -5.91) and -7.82 (-13.04 to -2.59), respectively]. Exercise training significantly improved Epworth sleepiness scores (ESS) [by 3.08 (0.68-5.48)], albeit with a non-significant difference compared to MADs and CPAP. CPAP is the most efficacious in complete resolution of sleep apnea and in improving the indices of saturation during sleep. While MADs offer a reasonable alternative to CPAP, exercise training which significantly improved daytime sleepiness (ESS) could be used as adjunctive to the former two. Copyright © 2016 Elsevier B.V. All rights reserved.

Multilevel Approach of a 1-Year Program of Dietary and Exercise Interventions on Bone Mineral Content and Density in Metabolic Syndrome--the RESOLVE Randomized Controlled Trial.

PubMed

Courteix, Daniel; Valente-dos-Santos, João; Ferry, Béatrice; Lac, Gérard; Lesourd, Bruno; Chapier, Robert; Naughton, Geraldine; Marceau, Geoffroy; João Coelho-e-Silva, Manuel; Vinet, Agnès; Walther, Guillaume; Obert, Philippe; Dutheil, Frédéric

2015-01-01

Weight loss is a public health concern in obesity-related diseases such as metabolic syndrome (MetS). However, restrictive diets might induce bone loss. The nature of exercise and whether exercise with weight loss programs can protect against potential bone mass deficits remains unclear. Moreover, compliance is essential in intervention programs. Thus, we aimed to investigate the effects that modality and exercise compliance have on bone mineral content (BMC) and density (BMD). We investigated 90 individuals with MetS who were recruited for the 1-year RESOLVE trial. Community-dwelling seniors with MetS were randomly assigned into three different modalities of exercise (intensive resistance, intensive endurance, moderate mixed) combined with a restrictive diet. They were compared to 44 healthy controls who did not undergo the intervention. This intensive lifestyle intervention (15-20 hours of training/week + restrictive diet) resulted in weight loss, body composition changes and health improvements. Baseline BMC and BMD for total body, lumbar spine and femoral neck did not differ between MetS groups and between MetS and controls. Despite changes over time, BMC or BMD did not differ between the three modalities of exercise and when compared with the controls. However, independent of exercise modality, compliant participants increased their BMC and BMD compared with their less compliant peers. Decreases in total body lean mass and negative energy balance significantly and independently contributed to decreases in lumbar spine BMC. After the one year intervention, differences relating to exercise modalities were not evident. However, compliance with an intensive exercise program resulted in a significantly higher bone mass during energy restriction than non-compliance. Exercise is therefore beneficial to bone in the context of a weight loss program. ClinicalTrials.gov NCT00917917.

Multilevel Approach of a 1-Year Program of Dietary and Exercise Interventions on Bone Mineral Content and Density in Metabolic Syndrome – the RESOLVE Randomized Controlled Trial

PubMed Central

Courteix, Daniel; Valente-dos-Santos, João; Ferry, Béatrice; Lac, Gérard; Lesourd, Bruno; Chapier, Robert; Naughton, Geraldine; Marceau, Geoffroy; João Coelho-e-Silva, Manuel; Vinet, Agnès; Walther, Guillaume; Obert, Philippe; Dutheil, Frédéric

2015-01-01

Background Weight loss is a public health concern in obesity-related diseases such as metabolic syndrome (MetS). However, restrictive diets might induce bone loss. The nature of exercise and whether exercise with weight loss programs can protect against potential bone mass deficits remains unclear. Moreover, compliance is essential in intervention programs. Thus, we aimed to investigate the effects that modality and exercise compliance have on bone mineral content (BMC) and density (BMD). Methods We investigated 90 individuals with MetS who were recruited for the 1-year RESOLVE trial. Community-dwelling seniors with MetS were randomly assigned into three different modalities of exercise (intensive resistance, intensive endurance, moderate mixed) combined with a restrictive diet. They were compared to 44 healthy controls who did not undergo the intervention. Results This intensive lifestyle intervention (15–20 hours of training/week + restrictive diet) resulted in weight loss, body composition changes and health improvements. Baseline BMC and BMD for total body, lumbar spine and femoral neck did not differ between MetS groups and between MetS and controls. Despite changes over time, BMC or BMD did not differ between the three modalities of exercise and when compared with the controls. However, independent of exercise modality, compliant participants increased their BMC and BMD compared with their less compliant peers. Decreases in total body lean mass and negative energy balance significantly and independently contributed to decreases in lumbar spine BMC. Conclusion After the one year intervention, differences relating to exercise modalities were not evident. However, compliance with an intensive exercise program resulted in a significantly higher bone mass during energy restriction than non-compliance. Exercise is therefore beneficial to bone in the context of a weight loss program. Trial Registration ClinicalTrials.gov NCT00917917 PMID:26376093

Current nutritional treatments of obesity.

PubMed

Greenwald, Ashli

2006-01-01

Obesity in our country is a growing concern. There are several different options for weight loss; however, individuals must be self-motivated and amendable to change in order to achieve success with their weight loss goals. Several strategies used by professionals in the US today to treat overweight and obesity, include diet therapy, exercise, behavior modification, pharmacotherapy, and surgery. The focus of the American Dietetic Association (ADA) Weight Management Position Statement is no longer just on weight loss but now on weight management. Reaching one's ideal body weight is recommended but not often realistic. Frequently, the goal of treatment shifts to maintenance of ones current weight or attempts at moderate weight loss. Lifestyle modification or behavioral modification interventions rely on analyzing behavior to identify events that are associated with appropriate vs. inappropriate eating, exercise, or thinking habits. Certain primary strategies that have been found to be useful for helping people change their behaviors so that they can lose weight and maintain their weight loss, include self-monitoring, stimulus control, cognitive restructuring, stress management, social support, physical activity, and relapse prevention. Weight loss programs should strive to combine a nutritionally balanced dietary regimen with exercise and lifestyle modifications at the lowest possible cost. There are several different methods used for dietary modifications; low calorie diets, very low calorie diets, fasting, formula diets and meal replacement programs, and popular diets. Bariatric surgery is gaining popularity as it has been an effective way to treat obesity. Following gastric bypass surgery, the patients must be prepared to modify their eating behaviors and dietary selections to assist with weight loss and prevent potential complications. Patients should be educated on the dietary guidelines extensively prior to surgery and again post-operatively.

Effectiveness of weight loss interventions – is there a difference between men and women: a systematic review

PubMed Central

Williams, R L; Wood, L G; Collins, C E; Callister, R

2015-01-01

Effective strategies are required to reduce the prevalence of overweight and obesity; however, the effectiveness of current weight loss programmes is variable. One contributing factor may be the difference in weight loss success between men and women. A systematic review was conducted to determine whether the effectiveness of weight loss interventions differs between men and women. Randomized controlled trials published up until March 2014 were included. Effect sizes (Hedges' g) were used to examine the difference in weight outcomes between men and women. A total of 58 studies met the eligibility criteria with 49 studies of higher quality included in the final data synthesis. Eleven studies that directly compared weight loss in men and women reported a significant sex difference. Ten of these reported that men lost more weight than women; however, women also lost a significant amount of weight. Analysis of effect sizes found small differences in weight loss favouring men for both diet (g = 0.489) and diet plus exercise (g = 0.240) interventions. There is little evidence from this review to indicate that men and women should adopt different weight loss strategies. Current evidence supports moderate energy restriction in combination with exercise for weight loss in both men and women. PMID:25494712

Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Johansson, Kari; Neovius, Martin; Hemmingsson, Erik

2014-01-01

Weight-loss maintenance remains a major challenge in obesity treatment. The objective was to evaluate the effects of anti-obesity drugs, diet, or exercise on weight-loss maintenance after an initial very-low-calorie diet (VLCD)/low-calorie diet (LCD) period (<1000 kcal/d). We conducted a systematic review by using MEDLINE, the Cochrane Controlled Trial Register, and EMBASE from January 1981 to February 2013. We included randomized controlled trials that evaluated weight-loss maintenance strategies after a VLCD/LCD period. Two authors performed independent data extraction by using a predefined data template. All pooled analyses were based on random-effects models. Twenty studies with a total of 27 intervention arms and 3017 participants were included with the following treatment categories: anti-obesity drugs (3 arms; n = 658), meal replacements (4 arms; n = 322), high-protein diets (6 arms; n = 865), dietary supplements (6 arms; n = 261), other diets (3 arms; n = 564), and exercise (5 arms; n = 347). During the VLCD/LCD period, the pooled mean weight change was -12.3 kg (median duration: 8 wk; range 3-16 wk). Compared with controls, anti-obesity drugs improved weight-loss maintenance by 3.5 kg [95% CI: 1.5, 5.5 kg; median duration: 18 mo (12-36 mo)], meal replacements by 3.9 kg [95% CI: 2.8, 5.0 kg; median duration: 12 mo (10-26 mo)], and high-protein diets by 1.5 kg [95% CI: 0.8, 2.1 kg; median duration: 5 mo (3-12 mo)]. Exercise [0.8 kg; 95% CI: -1.2, 2.8 kg; median duration: 10 mo (6-12 mo)] and dietary supplements [0.0 kg; 95% CI: -1.4, 1.4 kg; median duration: 3 mo (3-14 mo)] did not significantly improve weight-loss maintenance compared with control. Anti-obesity drugs, meal replacements, and high-protein diets were associated with improved weight-loss maintenance after a VLCD/LCD period, whereas no significant improvements were seen for dietary supplements and exercise.

A Retrospective Cross-sectional Analysis of Health Education Disparities in Patients With Diabetes Using Data From the National Ambulatory Medical Care Survey.

PubMed

Branoff, Janelle D; Jiroutek, Michael R; Kelly, Chloe R; Huma, Sadia; Sutton, Beth S

2017-02-01

Purpose The purpose of this study was to determine if there was an association between receipt of diet/nutrition, exercise, and weight loss education in adult patients with a primary diagnosis of diabetes with various demographic and socioeconomic variables using data from the National Ambulatory Medical Care Survey (NAMCS) for the years 2008 to 2011. Methods This retrospective, cross-sectional, observational study design included patients ≥ 18 years of age with diabetes in the NAMCS between 2008 and 2011, inclusive. A series of weighted multivariable logistic regression models was constructed to evaluate predictors of diet/nutrition, exercise, and weight loss education. Odds ratios and 95% confidence intervals were reported. Results Among patients included in this study (n = 3027), 35.6% received diet/nutrition education, 21.8% received exercise education, and 13.6% received weight loss education. From the multivariable analyses, visits using "other" payment type, visits with Medicaid, and visits occurring in non-Metropolitan Statistical Areas were significantly less likely to receive diet/nutrition education; visits using other payment type, visits in non-Metropolitan Statistical Areas, and visits by those ≥ 65 and 45-64 years of age were significantly less likely to receive exercise education. No significant disparities in the receipt of weight loss education were found. Conclusion These findings indicate that although only approximately one third or fewer patients diagnosed with diabetes were receiving diet/nutrition, exercise, or weight loss education, there appeared to be limited disparities among the groups studied. Education rates appear to be trending upward over time, to be slightly improved as compared with previous studies, and to include fewer disparities.

A comparison of hydration effect on body fluid and temperature regulation between Malaysian and Japanese males exercising at mild dehydration in humid heat.

PubMed

Wakabayashi, Hitoshi; Wijayanto, Titis; Lee, Joo-Young; Hashiguchi, Nobuko; Saat, Mohamed; Tochihara, Yutaka

2014-02-04

This study investigated the effect of hydration differences on body fluid and temperature regulation between tropical and temperate indigenes exercising in the heat. Ten Japanese and ten Malaysian males with matched physical characteristics (height, body weight, and peak oxygen consumption) participated in this study. Participants performed exercise for 60 min at 55% peak oxygen uptake followed by a 30-min recovery at 32°C and 70% relative air humidity with hydration (4 times each, 3 mL per kg body weight, 37°C) or without hydration. Rectal temperature, skin temperature, heart rate, skin blood flow, and blood pressure were measured continuously. The percentage of body weight loss and total sweat loss were calculated from body weight measurements. The percentage change in plasma volume was estimated from hemoglobin concentration and hematocrit. Malaysian participants had a significantly lower rectal temperature, a smaller reduction in plasma volume, and a lower heart rate in the hydrated condition than in the non-hydrated condition at the end of exercise (P <0.05), whereas Japanese participants showed no difference between the two hydration conditions. Hydration induced a greater total sweat loss in both groups (P <0.05), and the percentage of body weight loss in hydrated Malaysians was significantly less than in hydrated Japanese (P <0.05). A significant interaction between groups and hydration conditions was observed for the percentage of mean cutaneous vascular conductance during exercise relative to baseline (P <0.05). The smaller reduction in plasma volume and percentage body weight loss in hydrated Malaysians indicated an advantage in body fluid regulation. This may enable Malaysians to reserve more blood for circulation and heat dissipation and thereby maintain lower rectal temperatures in a hydrated condition.

Self-regulatory skills usage strengthens the relations of self-efficacy for improved eating, exercise, and weight in the severely obese: toward an explanatory model.

PubMed

Annesi, James J

2011-07-01

Lack of success with behavioral weight-management treatments indicates a need for a better understanding of modifiable psychological correlates. Adults with class 2 and 3 obesity (N = 183; Mean(BMI) = 42.0 kg/m(2)) volunteered for a 26-week nutrition and exercise treatment, based on social cognitive theory, that focused on self-efficacy and self-regulation applied to increasing cardiovascular exercise and fruit and vegetable consumption. Improved self-efficacy for controlled eating significantly predicted increased fruit and vegetable consumption (R(2) = .15). Improved self-efficacy for exercise significantly predicted increased exercise (R(2) = .46). When changes in self-regulatory skill usage were stepped into the 2 previous equations, the variances accounted for significantly increased. Increases in fruit and vegetable consumption and exercise significantly predicted weight loss (R(2) = .38). Findings suggest that behavioral theory should guide research on weight-loss treatment, and a focus on self-efficacy and self-regulatory skills applied to specific nutrition and exercise behaviors is warranted.

What is the effect of diet and/or exercise interventions on behavioural compensation in non-exercise physical activity and related energy expenditure of free-living adults? A systematic review.

PubMed

Silva, Analiza M; Júdice, Pedro B; Carraça, Eliana V; King, Neil; Teixeira, Pedro J; Sardinha, Luís B

2018-06-01

Non-exercise physical activity (NEPA) and/or non-exercise activity thermogenesis (NEAT) reductions may occur from diet and/or exercise-induced negative energy balance interventions, resulting in less-than-expected weight loss. This systematic review describes the effects of prescribed diet and/or physical activity (PA)/exercise on NEPA and/or NEAT in adults. Studies were identified from PubMed, web-of-knowledge, Embase, SPORTDiscus, ERIC and PsycINFO searches up to 1 March 2017. Eligibility criteria included randomised controlled trials (RCT), randomised trials (RT) and non-randomised trials (NRT); objective measures of PA and energy expenditure; data on NEPA, NEAT and spontaneous PA; ≥10 healthy male/female aged>18 years; and ≥7 d length. The trial is registered at PROSPERO-2017-CRD42017052635. In all, thirty-six articles (RCT-10, RT-9, NRT-17) with a total of seventy intervention arms (diet, exercise, combined diet/exercise), with a total of 1561 participants, were included. Compensation was observed in twenty-six out of seventy intervention arms (fifteen studies out of thirty-six reporting declines in NEAT (eight), NEPA (four) or both (three)) representing 63, 27 and 23 % of diet-only, combined diet/exercise, and exercise-only intervention arms, respectively. Weight loss observed in participants who decreased NEAT was double the weight loss found in those who did not compensate, suggesting that the energy imbalance degree may lead to energy conservation. Although these findings do not support the hypothesis that prescribed diet and/or exercise results in decreased NEAT and NEPA in healthy adults, the underpowered trial design and the lack of state-of-the-art methods may limit these conclusions. Future studies should explore the impact of weight-loss magnitude, energetic restriction degree, exercise dose and participant characteristics on NEAT and/or NEPA.

Influence of sibutramine in addition to diet and exercise on the relationship between weight loss and blood glucose changes.

PubMed

Kamil, Sadaf; Finer, Nicholas; James, William Philip T; Caterson, Ian D; Andersson, Charlotte; Torp-Pedersen, Christian

2017-07-01

Weight loss is expected to improve glycaemic control in patients with diabetes or at high risk hereof. Sibutramine causes weight loss and is associated with an increased risk of myocardial infarction and stroke in high-risk patients. We examined the impact of sibutramine-induced weight loss on glycaemic control. In total, 8192 obese patients with diabetes were randomized to sibutramine or placebo plus diet and exercise after a preliminary 6 weeks in which all patients received sibutramine. Patients were classified into four groups of weight change. A total of 1582 patients had a weight loss >5.7 kg; 2047 patients lost 3.7-5.7 kg; 2432 patients lost <3.7 kg, and 1875 patients gained weight. Patients on sibutramine lost slightly more weight than those on placebo (-0.2 kg on average, P < 0.0001). Mean blood glucose changes in the placebo group were -0.6 mmol/L (±3.1, P = 0.0002), -0.2  mmol/L (±2.7, P = 0.04), and -0.1  mmol/L (±3.0, P = 0.01) in the moderate, modest, and mild weight loss groups, respectively; in the weight gain group blood glucose levels increased by +0.2 mmol/L (±3.1, P = 0.003). Corresponding mean blood glucose changes in the sibutramine-treated patients were -0.4 mmol/L (±3.2, P = 0.0002), +0.1 mmol/L (±3.0, P = 0.04), +0.4 mmol/L (±2.8, P = 0.01), and +0.2 mmol/L (±3.4, P = 0.003). Mean values of HbA1c followed the same pattern though the HbA1c changes were smaller with weight loss and greater with weight gain in the sibutramine group. All results were statistically significant (P < 0.0001). Weight loss induced by sibutramine, diet, and exercise attenuates falls in blood glucose levels and HbA1c compared with similar weight loss with placebo, diet, and exercise. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: journals.permissions@oup.com.

"Exercise dependence"--a problem or natural result of high activity?

PubMed

Phelan, Suzanne; Bond, Dale S; Lang, Wei; Jordan, Dustin; Wing, Rena R

2011-11-01

To compare physical activity (PA) and exercise dependence (ED) in 267 weight-loss maintainers (WLM) and 213 normal-weight (NW) controls. PA and ED assessed via accelerometery and the Exercise Dependence Questionnaire. WLM had higher PA levels and ED scores than those of NW (P< 0.0001). WLM status (P=.006) and higher PA (P=.0001) were independently related to higher ED, although effect sizes were larger for PA. Exercising for weight control was the ED domain that most discriminated WLM from NW. WLM have higher ED scores than do NW, but this is mostly due to exercising for weight control.

Behavioral treatment of obesity in patients with Prader-Willi syndrome.

PubMed

Altman, K; Bondy, A; Hirsch, G

1978-12-01

Self-monitoring combined with contingency contracting resulted in weight loss, modification of dysfunctional eating habits, and increased or sustained exercise rates for two obese, mentally retarded adolescent females with Prader-Willi syndrome. Contingency contracting between clients and their parents/caregivers was used to specify consequences for daily self-monitoring, reduced caloric intake, weight loss, and exercise. Punishment for food stealing was also employed. Results suggest that contingency contracting is an effective technique for producing long-term weight loss in obese mentally retarded adolescents. Further, these techniques offer an alternative to the clinician considering solely dietary restriction or surgical intervention.

Weight loss and related behavior changes among lesbians.

PubMed

Fogel, Sarah; Young, Laura; Dietrich, Mary; Blakemore, Dana

2012-01-01

Overweight and obesity are known risk factors for several modifiable, if not preventable diseases. Growing evidence suggests that lesbians may have higher rates of obesity than other women. This study was designed to describe weight loss and behavior changes related to food choices and exercise habits among lesbians who participated in a predominantly lesbian, mainstream, commercial weight loss program. Behavioral changes were recorded in exercise, quality of food choices, and number of times dining out. Although there were several limitations based on sample size and heterogeneity, the impact of a lesbian-supportive environment for behavior change was upheld.

Effect of exercising while fasting on eating behaviors and food intake

PubMed Central

2013-01-01

Background Alternate day fasting combined with exercise is effective for weight loss. Objective The aim of this study was to examine the behavioral adaptations that occur when ADF is combined with exercise, and to determine how these changes affect weight loss. Design Obese subjects (n = 64) were randomized to 1 of 4 groups: 1) combination (ADF + endurance exercise), 2) ADF, 3) exercise, or 4) control, for 12 weeks. Results Body weight decreased (P < 0.05) in the combination group (6 ± 4 kg), ADF (3 ± 1 kg), exercise group (1 ± 0 kg), with no change in the control group (0 ± 0 kg). When given the choice, subjects chose to exercise the same amount (P = 0.790) on the fast days (48 ± 2%) as feed days (52 ± 2%). Percent of exercise sessions performed on fast day mornings (20 ± 6%) did not differ (P = 0.453) from fast day afternoons (28 ± 5%). Likeliness to cheat on the fast day was not higher if the subject exercised in the afternoon (17 ± 7%) versus the morning (10 ± 5%). Hunger decreased (P < 0.05) while satisfaction and fullness increased (P < 0.05) post-treatment in the ADF group only. Restrained eating increased (P < 0.05) and uncontrolled eating decreased (P < 0.05) in the combination and ADF groups. Conclusion These findings suggest that endurance exercise is an excellent adjunct therapy to ADF, as it leads to positive behavioral changes that may contribute to long-term steady weight loss. PMID:24176020

Less-than-expected weight loss in normal-weight women undergoing caloric restriction and exercise is accompanied by preservation of fat-free mass and metabolic adaptations.

PubMed

Koehler, K; De Souza, M J; Williams, N I

2017-03-01

Normal-weight women frequently restrict their caloric intake and exercise, but little is known about the effects on body weight, body composition and metabolic adaptations in this population. We conducted a secondary analysis of data from a randomized controlled trial in sedentary normal-weight women. Women were assigned to a severe energy deficit (SEV: -1062±80 kcal per day; n=9), a moderate energy deficit (MOD: -633±71 kcal per day; n=7) or energy balance (BAL; n=9) while exercising five times per week for 3 months. Outcome variables included changes in body weight, body composition, resting metabolic rate (RMR) and metabolic hormones associated with energy conservation. Weight loss occurred in SEV (-3.7±0.9 kg, P<0.001) and MOD (-2.7±0.8 kg; P=0.003), but weight loss was significantly less than predicted (SEV: -11.1±1.0 kg; MOD: -6.5±1.1 kg; both P<0.001 vs actual). Fat mass declined in SEV (P<0.001) and MOD (P=0.006), whereas fat-free mass remained unchanged in all groups (P>0.33). RMR decreased by -6±2% in MOD (P=0.020). In SEV, RMR did not change on a group level (P=0.66), but participants whose RMR declined lost more weight (P=0.020) and had a higher baseline RMR (P=0.026) than those whose RMR did not decrease. Characteristic changes in leptin (P=0.003), tri-iodothyronine (P=0.013), insulin-like growth factor-1 (P=0.016) and ghrelin (P=0.049) occurred only in SEV. The energy deficit and adaptive changes in RMR explained 54% of the observed weight loss. In normal-weight women, caloric restriction and exercise resulted in less-than-predicted weight loss. In contrast to previous literature, weight loss consisted almost exclusively of fat mass, whereas fat-free mass was preserved.

Challenging body weight: evidence from a community-based intervention on weight, behaviour and motivation.

PubMed

Blais, Louise T; Mack, Diane E; Wilson, Philip M; Blanchard, Chris M

2017-08-01

The objective of this study was to examine the effectiveness of a 12 week weight loss intervention within a commercial fitness centre on body weight, moderate to vigorous physical activity (MVPA), dietary intake, and behavioural regulations for exercise and healthy eating. Using a quasi-experimental design, the intervention group received weekly coaching sessions and bi-weekly seminars designed to increase MVPA and improve dietary intake. Outcome variables were assessed at three time points over a six month period. Results showed a significant interaction for body weight (p = .04) and dietary changes (p < .05) following the weight loss challenge but were not maintained across the six month period. Changes in behavioural regulations favoured the intervention condition. Results imply that a 12 week weight loss challenge within a commercial fitness centre may be effective at prompting short-term weight loss and support the internalization of behavioural regulations specific to healthy eating and exercise.

Does metabolic compensation explain the majority of less-than-expected weight loss in obese adults during a short-term severe diet and exercise intervention?

PubMed

Byrne, N M; Wood, R E; Schutz, Y; Hills, A P

2012-11-01

We investigated to what extent changes in metabolic rate and composition of weight loss explained the less-than-expected weight loss in obese men and women during a diet-plus-exercise intervention. In all, 16 obese men and women (41 ± 9 years; body mass index (BMI) 39 ± 6 kg m(-2)) were investigated in energy balance before, after and twice during a 12-week very-low-energy diet(565-650 kcal per day) plus exercise (aerobic plus resistance training) intervention. The relative energy deficit (EDef) from baseline requirements was severe (74%-87%). Body composition was measured by deuterium dilution and dual energy X-ray absorptiometry, and resting metabolic rate (RMR) was measured by indirect calorimetry. Fat mass (FM) and fat-free mass (FFM) were converted into energy equivalents using constants 9.45 kcal per g FM and 1.13 kcal per g FFM. Predicted weight loss was calculated from the EDef using the '7700 kcal kg(-1) rule'. Changes in weight (-18.6 ± 5.0 kg), FM (-15.5 ± 4.3 kg) and FFM (-3.1 ± 1.9 kg) did not differ between genders. Measured weight loss was on average 67% of the predicted value, but ranged from 39% to 94%. Relative EDef was correlated with the decrease in RMR (R=0.70, P<0.01), and the decrease in RMR correlated with the difference between actual and expected weight loss (R=0.51, P<0.01). Changes in metabolic rate explained on average 67% of the less-than-expected weight loss, and variability in the proportion of weight lost as FM accounted for a further 5%. On average, after adjustment for changes in metabolic rate and body composition of weight lost, actual weight loss reached 90% of the predicted values. Although weight loss was 33% lower than predicted at baseline from standard energy equivalents, the majority of this differential was explained by physiological variables. Although lower-than-expected weight loss is often attributed to incomplete adherence to prescribed interventions, the influence of baseline calculation errors and metabolic downregulation should not be discounted.

The effects of exercise training in a weight loss lifestyle intervention on asthma control, quality of life and psychosocial symptoms in adult obese asthmatics: protocol of a randomized controlled trial.

PubMed

Freitas, Patricia D; Ferreira, Palmira G; da Silva, Analuci; Trecco, Sonia; Stelmach, Rafael; Cukier, Alberto; Carvalho-Pinto, Regina; Salge, João Marcos; Fernandes, Frederico L A; Mancini, Marcio C; Martins, Milton A; Carvalho, Celso R F

2015-10-21

Asthma and obesity are public health problems with increasing prevalence worldwide. Clinical and epidemiologic studies have demonstrated that obese asthmatics have worse clinical control and health related quality of life (HRQL) despite an optimized medical treatment. Bariatric surgery is successful to weight-loss and improves asthma control; however, the benefits of nonsurgical interventions remain unknown. This is a randomized controlled trial with 2-arms parallel. Fifty-five moderate or severe asthmatics with grade II obesity (BMI ≥ 35 kg/m(2)) under optimized medication will be randomly assigned into either weight-loss program + sham (WL + S group) or weight-loss program + exercise (WL + E group). The weight loss program will be the same for both groups including nutrition and psychological therapies (every 15 days, total of 6 sessions, 60 min each). Exercise program will include aerobic and resistance muscle training while sham treatment will include a breathing and stretching program (both programs twice a week, 3 months, 60 min each session). The primary outcome variable will be asthma clinical control. Secondary outcomes include HRQL, levels of depression and anxiety, lung function, daily life physical activity, body composition, maximal aerobic capacity, strength muscle and sleep disorders. Potential mechanism (changes in lung mechanical and airway/systemic inflammation) will also be examined to explain the benefits in both groups. This study will bring a significant contribution to the literature evaluating the effects of exercise conditioning in a weight loss intervention in obese asthmatics as well as will evaluate possible involved mechanisms. NCT02188940.

Effects of Simultaneous or Sequential Weight Loss Diet and Aerobic Interval Training on Metabolic Syndrome.

PubMed

Mora-Rodriguez, R; Ortega, J F; Guio de Prada, V; Fernández-Elías, V E; Hamouti, N; Morales-Palomo, F; Martinez-Vizcaino, V; Nelson, R K

2016-04-01

Our purpose in this study was to investigate efficient and sustainable combinations of exercise and diet-induced weight loss (DIET), in order to combat obesity in metabolic syndrome (MetS) patients. We examined the impact of aerobic interval training (AIT), followed by or concurrent to a DIET on MetS components. 36 MetS patients (54±9 years old; 33±4 BMI; 27 males and 9 females) underwent 16 weeks of AIT followed by another 16 weeks without exercise from the fall of 2013 to the spring of 2014. Participants were randomized to AIT without DIET (E CON, n=12), AIT followed by DIET (E-then-D, n=12) or AIT concurrent with DIET (E+D, n=12) groups. Body weight decreased below E CON similarly in the E-then-D and E+D groups (~5%). Training improved blood pressure and cardiorespiratory fitness (VO2peak) in all groups with no additional effect of concurrent weight loss. However, E+D improved insulin sensitivity (HOMA) and lowered plasma triglycerides and blood cholesterol below E CON and E-then-D (all P<0.05). Weight loss in E-then-D in the 16 weeks without exercise lowered HOMA to the E+D levels and maintained blood pressure at trained levels. Our data suggest that a new lifestyle combination consisting of aerobic interval training followed by weight loss diet is similar, or even more effective on improving metabolic syndrome factors than concurrent exercise plus diet. © Georg Thieme Verlag KG Stuttgart · New York.

Meaningful weight loss in obese postmenopausal women: a pilot study of high-intensity interval training and wearable technology.

PubMed

Grossman, Joan A; Arigo, Danielle; Bachman, Jessica L

2018-04-01

Postmenopausal women cite lack of time as their primary barrier to exercise and related weight control behaviors. The purpose of this study was to address this barrier via testing the feasibility and initial outcomes of a short-duration/high-intensity interval training (HIIT)-based weight loss program among obese postmenopausal women, with descriptive comparison to an endurance-focused exercise program. A 16-week behavioral program incorporated (1) HIIT to limit time necessary to produce health benefits of exercise, and (2) wearable activity sensors to facilitate self-monitoring exercise. Participants (n = 11; MAge = 59 ± 5.33; MBMI = 32.0 ± 2.53 kg/m) were randomly assigned to HIIT or endurance exercise. Both groups followed a calorie-restricted diet, attended monthly in-person meetings, weekly weigh-ins and electronic check-ins to review behavioral skills, and monitored their exercise with a Fitbit ChargeHR. Adherence to exercise programs, assessed with the Fitbit sensor, was used to determine feasibility. Participants in the HIIT group (6/6) adhered to their program, whereas 3 of 5 adhered to the Endurance program. Participants in the HIIT group lost twice as much weight as those in the Endurance group (8.7% vs 4.3% of initial body weight), and lost an additional 6 in. of body mass. In addition, only the HIIT group significantly changed fat mass, body mass index, and fat-free mass (Ps < 0.04). These findings support the feasibility and potential effectiveness of HIIT for weight loss and body composition changes in obese postmenopausal women, and indicate that additional investigation of this approach is warranted to reduce postmenopausal chronic disease risk.

Exercise therapy in polycystic ovary syndrome.

PubMed

Hoeger, Kathleen M

2008-01-01

Women with polycystic ovary syndrome (PCOS) demonstrate a high prevalence of obesity across all populations studied. The role of decreased energy expenditure through reduced physical activity in contributing to obesity in PCOS is not well studied. The independent benefits of exercise in improving metabolic disease, cardiovascular health, and diabetes have been shown in the general population. Moderate activity incorporated into daily activities appears to be as effective in the reduction in diabetes risk and cardiovascular disease as that achieved with vigorous activity and may be more sustainable over the long-term. The role of physical activity in the management of the reproductive dysfunction of PCOS is less established, although lifestyle change incorporating increased physical activity with reduced caloric intake has shown benefit in small published trials. Studies of weight loss demonstrate an essential role for increased physical activity in maintenance of weight loss over the long-term although minimal effect in the achievement of weight loss with exercise alone. Further studies of the role for exercise in the management of reproductive dysfunction in PCOS as well as clarification of the type, frequency, and duration of exercise to achieve the best outcomes are needed.

Involving Support Partners in Obesity Treatment

ERIC Educational Resources Information Center

Gorin, Amy; Phelan, Suzanne; Tate, Deborah; Sherwood, Nancy; Jeffery, Robert; Wing, Rena

2005-01-01

In this study, the authors examined whether the number or success of weight loss partners influences participants' outcomes in behavioral weight loss treatment. Overweight participants (n=109) assigned to an exercise intensive group in a larger trial were encouraged to invite up to 3 partners to attend treatment. Weight losses at 6, 12, and 18…

The Efficacy of Weight-Loss Clinics: An Issue in Consumer Health Education.

ERIC Educational Resources Information Center

Thomas, Susan E.

1988-01-01

Weight loss clinics based on scientific fact and containing diet therapy, exercise therapy, and behavior modification components can be effective vehicles for weight loss among the mildly to moderately obese. Health educators are called on to disseminate the information necessary to establish scientifically based criteria and program evaluation…

Reciprocal effects of treatment-induced increases in exercise and improved eating, and their psychosocial correlates, in obese adults seeking weight loss: a field-based trial.

PubMed

Annesi, James J; Porter, Kandice J

2013-12-05

A better understanding of interrelations of exercise and improved eating, and their psychosocial correlates of self-efficacy, mood, and self-regulation, may be useful for the architecture of improved weight loss treatments. Theory-based research within field settings, with samples possessing high probabilities of health risks, might enable rapid application of useful findings. Adult volunteers with severe obesity (body mass index [BMI] 35-50 kg/m²; age = 43.0 ± 9.5 y; 83% female) were randomly assigned to six monthly cognitive-behavioral exercise support sessions paired with either group-based nutrition education (n = 145) or cognitive behavioral methods applied to improved eating (n = 149). After specification of mediation models using a bias-corrected bootstrapping procedure, a series of reciprocal effects analyses assessed: a) the reciprocal effects of changes in exercise and fruit and vegetable intake, resulting from the treatments, b) the reciprocal effects of changes in the three psychosocial variables tested (i.e. self-efficacy, mood, and self-regulation) and fruit and vegetable change, resulting from change in exercise volume, and c) the reciprocal effects of changes in the three psychosocial variables and exercise change, resulting from change in fruit and vegetable intake. Mediation analyses suggested a reciprocal effect between changes in exercise volume and fruit and vegetable intake. After inclusion of psychosocial variables, also found were reciprocal effects between change in fruit and vegetable intake and change in mood, self-efficacy for controlled eating, and self-regulation for eating; and change in exercise volume and change in mood and exercise-related self-regulation. Findings had implications for behavioral weight-loss theory and treatment. Specifically, results suggested that treatments should focus upon, and leverage, the transfer effects from each of the primary weight-loss behaviors (exercise and healthy eating) to the other. Findings on psychosocial correlates of these behavioral processes may also have practical applications.

Dietary Supplement Fact Sheets

MedlinePlus

... Primary Mitochondrial Disorders Weight Loss A Acai Aloe Vera Anabolic Steroids Antioxidants (see Exercise and Athletic Performance ) ... Pills (see Weight Loss ) Dietary Supplements Vitamin D E Echinacea Ephedra Essiac/Flor-Essence European Elder Evening ...

Valuing the benefits of weight loss programs: an application of the discrete choice experiment.

PubMed

Roux, Larissa; Ubach, Christina; Donaldson, Cam; Ryan, Mandy

2004-08-01

Obesity is a leading health threat. Determination of optimal therapies for long-term weight loss remains a challenge. Evidence suggests that successful weight loss depends on the compliance of weight loss program participants with their weight loss efforts. Despite this, little is known regarding the attributes influencing such compliance. The purpose of this study was to assess, using a discrete choice experiment (DCE), the relative importance of weight loss program attributes to its participants and to express these preferences in terms of their willingness to pay for them. A DCE survey explored the following weight loss program attributes in a sample of 165 overweight adults enrolled in community weight loss programs: cost, travel time required to attend, extent of physician involvement (e.g., none, monthly, every 2 weeks), components (e.g., diet, exercise, behavior change) emphasized, and focus (e.g., group, individual). The rate at which participants were willing to trade among attributes and the willingness to pay for different configurations of combined attributes were estimated using regression modeling. All attributes investigated appeared to be statistically significant. The most important unit change was "program components emphasized" (e.g., moving from diet only to diet and exercise). The majority of participants were willing to pay for weight loss programs that reflected their preferences. The DCE tool was useful in quantifying and understanding individual preferences in obesity management and provided information that could help to maximize the efficiency of existing weight loss programs or the design of new programs.

Weight Loss, Exercise, or Both and Cardiometabolic Risk Factors in Obese Older Adults: Results of a Randomized Controlled Trial

PubMed Central

Bouchonville, Matthew; Armamento-Villareal, Reina; Shah, Krupa; Napoli, Nicola; Sinacore, David R.; Qualls, Clifford; Villareal, Dennis T.

2013-01-01

Background Obesity exacerbates the age-related decline in insulin sensitivity and is associated with risk for cardiometabolic syndrome in older adults; however, the appropriate treatment for obese older adults is controversial. Objective To determine the independent and combined effects of weight loss and exercise on cardiometabolic risk factors in obese older adults. Design One-hundred-seven obese (BMI≥30 kg/m2) older (≥65 yrs) adults with physical frailty were randomized to control group, diet group, exercise group, and diet-exercise group for 1 year. Outcomes for this study included change in insulin sensitivity index (ISI), glucose tolerance, central obesity, adipocytokines, and cardiometabolic syndrome. Results Although similar increases in ISI occurred in the diet-exercise and diet groups at 6 months, the ISI improved more in the diet-exercise than in the diet group at 12 months (2.4 vs. 1.2; between-group difference, 1.2; 95% CI, 0.2-2.1); no changes in ISI occurred in both exercise and control groups. The diet-exercise and diet groups had similar improvements in insulin area under the curve (AUC) (−2.9 and −2.9 ×103mg.min/dl), glucose AUC (−1.4 and −2.2×103mg.min/dl), visceral fat (−787 and −561 cm3), tumor-necrosis factor (−17.0 and −12.8 pg/mL), adiponectin (5.0 and 4.0 ng/mL), waist circumference (−8.2 and −8.4 cm), triglyceride (−30.7 and −24.3 g/dL), and systolic/diastolic BP (−15.9 and −13.1/−4.9 and −6.7 mmHg), while no changes in these parameters occurred in both exercise and control groups. The cardiometabolic syndrome prevalence decreased by 40% in the diet-exercise and by 15% in the diet group. Body weight decreased similarly in the diet-exercise and diet groups (−8.6 and −9.7kg) but not in the exercise and control groups. Conclusions In frail, obese older adults, lifestyle interventions associated with weight loss improve insulin sensitivity and other cardiometabolic risk factors, but continued improvement in insulin sensitivity is only achieved when exercise training is added to weight loss. PMID:23823329

The effects of exercise-induced weight loss on appetite-related peptides and motivation to eat.

PubMed

Martins, C; Kulseng, B; King, N A; Holst, J J; Blundell, J E

2010-04-01

The magnitude of exercise-induced weight loss depends on the extent of compensatory responses. An increase in energy intake is likely to result from changes in the appetite control system toward an orexigenic environment; however, few studies have measured how exercise impacts on both orexigenic and anorexigenic peptides. The aim of the study was to investigate the effects of medium-term exercise on fasting/postprandial levels of appetite-related hormones and subjective appetite sensations in overweight/obese individuals. We conducted a longitudinal study in a university research center. Twenty-two sedentary overweight/obese individuals (age, 36.9 +/- 8.3 yr; body mass index, 31.3 +/- 3.3 kg/m(2)) took part in a 12-wk supervised exercise programme (five times per week, 75% maximal heart rate) and were requested not to change their food intake during the study. We measured changes in body weight and fasting/postprandial plasma levels of glucose, insulin, total ghrelin, acylated ghrelin (AG), peptide YY, and glucagon-like peptide-1 and feelings of appetite. Exercise resulted in a significant reduction in body weight and fasting insulin and an increase in AG plasma levels and fasting hunger sensations. A significant reduction in postprandial insulin plasma levels and a tendency toward an increase in the delayed release of glucagon-like peptide-1 (90-180 min) were also observed after exercise, as well as a significant increase (127%) in the suppression of AG postprandially. Exercise-induced weight loss is associated with physiological and biopsychological changes toward an increased drive to eat in the fasting state. However, this seems to be balanced by an improved satiety response to a meal and improved sensitivity of the appetite control system.

Correlates of Successful Response to a Behavioral Weight Control Clinic.

ERIC Educational Resources Information Center

And Others; Gormally, Jim

1980-01-01

Initial weight-loss success was correlated with two severity variables. Persons reporting frequent binge eating and histories of previous dieting weight loss lost the most weight. Persons who were successful at maintenance used frequent exercise. Those who relapsed reported high levels of stress during follow-up. (Author)

Effects of treatment differences on psychosocial predictors of exercise and improved eating in obese, middle-age adults.

PubMed

Annesi, James

2013-09-01

Behavioral interventions for weight-loss have been largely unsuccessful. Exercise is the strongest predictor of maintained weight loss and much of its effects may be from associated changes in psychosocial factors. Middle-aged, formerly sedentary adults with severe obesity were randomly selected to 6-month treatments of cognitive-behavioral exercise support paired with either standard nutrition education (n = 99) or nutrition change supported by cognitive-behavioral means with an emphasis on self-regulation (n = 101). Overall improvements in self-efficacy and self-regulation for both exercise and managed eating, and mood, were found, with significantly greater improvements associated with the cognitive-behavioral nutrition condition in self-regulation for eating and mood. Change scores trended toward being stronger predictors of increased exercise and fruit and vegetable intake than scores at treatment end. Multiple regression analyses indicated that significant portions of the variance in both increased volume of exercise (R2 = 0.45) and fruit and vegetable intake (R2 = 0.21) were explained by changes in self-regulatory skill usage, self-efficacy, and mood. Cognitive-behavioral methods for improved eating paired with behavioral support of exercise may improve weight loss through effects on the psychosocial factors of self-regulation, self-efficacy, and overall mood more than when standard nutrition education is incorporated.

Effects of anti-obesity drugs, diet, and exercise on weight-loss maintenance after a very-low-calorie diet or low-calorie diet: a systematic review and meta-analysis of randomized controlled trials123

PubMed Central

Neovius, Martin; Hemmingsson, Erik

2014-01-01

Background: Weight-loss maintenance remains a major challenge in obesity treatment. Objective: The objective was to evaluate the effects of anti-obesity drugs, diet, or exercise on weight-loss maintenance after an initial very-low-calorie diet (VLCD)/low-calorie diet (LCD) period (<1000 kcal/d). Design: We conducted a systematic review by using MEDLINE, the Cochrane Controlled Trial Register, and EMBASE from January 1981 to February 2013. We included randomized controlled trials that evaluated weight-loss maintenance strategies after a VLCD/LCD period. Two authors performed independent data extraction by using a predefined data template. All pooled analyses were based on random-effects models. Results: Twenty studies with a total of 27 intervention arms and 3017 participants were included with the following treatment categories: anti-obesity drugs (3 arms; n = 658), meal replacements (4 arms; n = 322), high-protein diets (6 arms; n = 865), dietary supplements (6 arms; n = 261), other diets (3 arms; n = 564), and exercise (5 arms; n = 347). During the VLCD/LCD period, the pooled mean weight change was −12.3 kg (median duration: 8 wk; range 3–16 wk). Compared with controls, anti-obesity drugs improved weight-loss maintenance by 3.5 kg [95% CI: 1.5, 5.5 kg; median duration: 18 mo (12–36 mo)], meal replacements by 3.9 kg [95% CI: 2.8, 5.0 kg; median duration: 12 mo (10–26 mo)], and high-protein diets by 1.5 kg [95% CI: 0.8, 2.1 kg; median duration: 5 mo (3–12 mo)]. Exercise [0.8 kg; 95% CI: −1.2, 2.8 kg; median duration: 10 mo (6–12 mo)] and dietary supplements [0.0 kg; 95% CI: −1.4, 1.4 kg; median duration: 3 mo (3–14 mo)] did not significantly improve weight-loss maintenance compared with control. Conclusion: Anti-obesity drugs, meal replacements, and high-protein diets were associated with improved weight-loss maintenance after a VLCD/LCD period, whereas no significant improvements were seen for dietary supplements and exercise. PMID:24172297

Avoiding Weight Gain in Cardiometabolic Disease: A Systematic Review

PubMed Central

Maruthur, Nisa M.; Fawole, Oluwakemi A.; Wilson, Renee F.; Lau, Brandyn D.; Anderson, Cheryl A. M.; Bleich, Sara N.; Segal, Jodi

2014-01-01

Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects. Even without weight loss, weight maintenance may be beneficial. We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify comparative studies of lifestyle interventions (self-management, diet, exercise, or their combination) without a weight loss focus in adults with or at risk for diabetes and cardiovascular disease. Weight, BMI, and waist circumference at ≥12 months were the primary outcomes. Of 24,870 citations, we included 12 trials (self-management, n = 2; diet, n = 2; exercise, n = 2; combination, n = 6) studying 4,206 participants. Self-management plus physical activity ± diet versus minimal/no intervention avoided meaningful weight (−0.65 to −1.3 kg) and BMI (−0.4 to −0.7 kg/m2) increases. Self-management and/or physical activity prevented meaningful waist circumference increases versus control (−2 to −4 cm). In patients with cardiometabolic disease, self-management plus exercise may prevent weight and BMI increases and self-management and/or exercise may prevent waist circumference increases versus minimal/no intervention. Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes. PMID:25610639

Gender-moderated links between urgency, binge drinking, and excessive exercise.

PubMed

Reilly, Erin E; Dmochowski, Sasha; Schaumberg, Katherine; Earleywine, Mitch; Anderson, Drew

2016-01-01

Exercise correlates with alcohol use, but the nature of this relation and the extent to which it is maladaptive remains unclear. Urgency and motives for engaging in drinking and exercise might indicate when these behaviors are problematic. The current study examined whether urgency moderated the association between exercise motivated by weight loss and drinking. College students (N = 589, 45.7% male) completed the study during the spring of 2012. Participants completed self-report assessment measures, including frequency/quantity of alcohol consumption, exercise for weight loss, and urgency, during a single session. Negative urgency moderated the relation between exercise and alcohol consumption in men but not women; the link between excessive exercise and alcohol use was stronger for men with higher levels of urgency. Further clarification of the mechanisms underlying alcohol use and physical activity-particularly maladaptive approaches to exercise-will inform health interventions among college students.

Nutrient Intake During Diet-Induced Weight Loss and Exercise Interventions in a Randomized Trial in Older Overweight and Obese Adults.

PubMed

Miller, G D; Beavers, D P; Hamm, D; Mihalko, S L; Messier, S P

2017-01-01

Dietary restriction in obese older adults undergoing weight loss may exacerbate nutrient deficiencies common in this group; the nutritional health of older adults is a factor in their quality of life, disability, and mortality. This study examined the effect of an 18-month weight loss program based in social cognitive theory incorporating partial meal replacements, on nutrient intake in older overweight and obese adults. The following analysis is from the Intensive Diet and Exercise for Arthritis (IDEA) trial, a single-blind, randomized controlled trial. Individuals were randomized into one of three 18-month interventions: exercise (E); intensive diet-induced weight loss (D); or intensive diet-induced weight loss plus exercise (D+E). The study setting was at a university research facility. Overweight and obese older adults (n=388; BMI=33.7±3.8 kg/m2; 65.8±6.1 years) were recruited. The D and D+E interventions (group mean goal of ≥10% loss by 18-months) utilized partial meal replacements (2 meal replacement shakes/day for 6-months). Exercise training for E and D+E was 3 days/week, 60 minutes/day. Three day food records were collected at baseline, 6-months, and 18-months and analyzed for total energy and macro- and micronutrient intake. Comparisons of dietary intake among treatment groups were performed at 6 and 18 months using mixed linear models. Weight loss at 18-months was 11.3±8.3% (D), 10.3±6.8% (D+E), and 1.2±4.2% (E). Meal replacements were used by more than 60% (6-months) and 50% (18-months) of D and D+E participants, compared to ≤15% for E. Both D and D+E consumed less energy and fat, and more carbohydrates and selected micronutrients than E during follow-up. More than 50% of all participants consumed less than the recommended intake of particular vitamins and minerals. The diet intervention improved intakes of several nutrients. However, inadequate intake of several vitamins and minerals of concern for older adults suggests they need further guidance to assure adequate intake.

Improvements in insulin sensitivity are blunted by subclinical hypothyroidism.

PubMed

Amati, Francesca; Dubé, John J; Stefanovic-Racic, Maja; Toledo, Frederico G; Goodpaster, Bret H

2009-02-01

Exercise- and weight loss-induced improvements in insulin resistance (IR) are variable; some individuals experience robust enhancements in insulin sensitivity, whereas others do not. Thyroid hormone status is related to IR, but it is not clear whether subclinical hypothyroidism may help to explain the variability in improvements in IR with diet and exercise. The purpose of this study was to examine whether thyroid hormone status is related to the improvement in insulin sensitivity and physical fitness after weight loss and exercise training. By retrospective nested case-control analysis, eight subclinical hypothyroid (sHT) subjects and eight matched euthyroid controls underwent a euglycemic hyperinsulinemic clamp and peak oxygen uptake test, before and after a 16-wk program of moderate aerobic exercise combined with diet-induced weight loss. All subjects were middle-aged (57.3 +/- 3.3 yr), were overweight to obese (body mass index = 33.1 +/- 0.8 kg m(-2)), and had impaired glucose tolerance. The improvement in insulin sensitivity was significantly lower (P < 0.05) in the sHT group than in the euthyroid group. Both groups performed similar amounts of regular exercise and lost a significant amount of body weight during the intervention. VO(2peak) tended to improve in the euthyroid group but not in the sHT group. Subclinical hypothyroidism may interfere with beneficial adaptations on muscle metabolism and physical fitness that typically occur with weight loss and increased physical activity. These results may have significant clinical implications because of the high prevalence of both hypothyroidism and insulin resistance in the aging population.

Cluster analysis of the national weight control registry to identify distinct subgroups maintaining successful weight loss.

PubMed

Ogden, Lorraine G; Stroebele, Nanette; Wyatt, Holly R; Catenacci, Victoria A; Peters, John C; Stuht, Jennifer; Wing, Rena R; Hill, James O

2012-10-01

The National Weight Control Registry (NWCR) is the largest ongoing study of individuals successful at maintaining weight loss; the registry enrolls individuals maintaining a weight loss of at least 13.6 kg (30 lb) for a minimum of 1 year. The current report uses multivariate latent class cluster analysis to identify unique clusters of individuals within the NWCR that have distinct experiences, strategies, and attitudes with respect to weight loss and weight loss maintenance. The cluster analysis considers weight and health history, weight control behaviors and strategies, effort and satisfaction with maintaining weight, and psychological and demographic characteristics. The analysis includes 2,228 participants enrolled between 1998 and 2002. Cluster 1 (50.5%) represents a weight-stable, healthy, exercise conscious group who are very satisfied with their current weight. Cluster 2 (26.9%) has continuously struggled with weight since childhood; they rely on the greatest number of resources and strategies to lose and maintain weight, and report higher levels of stress and depression. Cluster 3 (12.7%) represents a group successful at weight reduction on the first attempt; they were least likely to be overweight as children, are maintaining the longest duration of weight loss, and report the least difficulty maintaining weight. Cluster 4 (9.9%) represents a group less likely to use exercise to control weight; they tend to be older, eat fewer meals, and report more health problems. Further exploration of the unique characteristics of these clusters could be useful for tailoring future weight loss and weight maintenance programs to the specific characteristics of an individual.

Eating and Exercising: Nebraska Adolescents' Attitudes and Behaviors. Technical Report 25.

ERIC Educational Resources Information Center

Newman, Ian M.

This report describes selected eating and exercise patterns among a sample of 2,237 Nebraska youth in grades 9-12 selected from a random sample of 24 junior and senior high schools. The eating patterns reported cover food selection, body image, weight management, and weight loss methods. The exercise patterns relate to the frequency of…

Zonisamide-induced weight loss in schizophrenia: case series.

PubMed

Yang, Jaewon; Lee, Moon-Soo; Joe, Sook-Haeng; Jung, In-Kwa; Kim, Seung-Hyun

2010-01-01

Weight gain and metabolic disturbances constitute bothersome problems in schizophrenic patients treated with atypical antipsychotics. Several medications, exercise regimens, and lifestyle changes have been used in attempts to ameliorate these problems. We describe 3 patients with schizophrenia who manifested distinct weight loss and reduction in waist circumference during medication with zonisamide. This report suggests that zonisamide might be associated with weight loss in patients with schizophrenia.

What weight loss treatment options do geriatric patients with overweight and obesity want to consider?

PubMed

MacMillan, M; Cummins, K; Fujioka, K

2016-12-01

Since the 1990s, a number of weight loss medications have been removed from the USA and or European market because of adverse events associated with these medications. These medications include fenfluramine (heart valve thickening), sibutramine (cardiovascular risk) and rimonabant (depression). This history may affect a patient's desire to consider weight loss medications as an option for weight management. This descriptive study was designed to observe what treatment options the geriatric patient (age 65 or higher) seeking weight loss would like to consider, as well as the reasons they felt they struggled with overweight or obesity. A questionnaire was given to 102 geriatric patients with overweight or obesity before starting a weight loss programme at a weight management centre. The questionnaire asked the patient why they felt they were overweight or obese and what treatment options they wished to consider. The geriatric patients were matched with younger patients in body mass index and sex. The three most common perceptions that geriatric patients felt were causes of their increased weight were 'lack of exercise' (76.2%), 'poor food choices' (59.4%) and 'cravings' (47.5%). When geriatric patients were asked what treatment options they would like to discuss, the four most common options requested were 'diet and healthy eating' (67.3%), weight loss medications (57.4%), a request for a 'metabolic work up' (55.4%) and 'exercise' (53.5%). These responses were no different from their younger cohorts. When geriatric patients with a body mass index of 35 or higher were given bariatric surgery as a treatment option, 21.9% marked it as a treatment option they would like to consider. Over half of geriatric patients desired to discuss weight loss medications as a treatment option. Diet and exercise were also of strong interest, which is in line with current weight management guidelines.

Examining mindfulness as a predictor of weight loss - Findings from the DIABEGG study.

PubMed

Fuller, Nicholas R; Sainsbury, Amanda; Caterson, Ian D; Enarsson, Malin; Denyer, Gareth; Manns, Clare; Swinbourne, Jessica; Q da Luz, Felipe; Fong, Mackenzie; Markovic, Tania P

Identifying individuals who are less likely to respond to a weight loss intervention allows better allocation or focus of resources to achieve better weight loss results. The current study investigated whether baseline levels of mindfulness would predict weight loss during a 12-month diet and exercise intervention. The Five Facet Mindfulness Questionnaire (FFMQ) was administered and body weight measured, at baseline, three, six and 12 months in 140 participants with pre-diabetes or type 2 diabetes mellitus and a body mass index of ≥25kg/m 2 . 137 of 140 participants completed the FFMQ at baseline and were included in this study. There was no correlation between baseline mindfulness scores and weight loss. Mean baseline total FFMQ score was 112.2 [95% confidence interval: 109.4, 115.1] which did not change over the course of the study. Mean baseline body weight was 95.1kg (standard deviation (19.1kg)). There was a significant decrease in weight at month 12 (-3.8kg (±standard deviation 5.8kg)). This is comparable to the weight loss achieved by participants in other interventions of the same duration. The findings suggest that baseline dispositional mindfulness does not predict the amount of weight loss in a lifestyle (diet and exercise) intervention. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Estrogen or raloxifene during postmenopausal weight loss: adiposity and cardiometabolic outcomes.

PubMed

Van Pelt, R E; Gozansky, W S; Wolfe, P; Kittelson, J M; Jankowski, C M; Schwartz, R S; Kohrt, W M

2014-04-01

Estrogen-based hormone therapy (HT) attenuates abdominal fat gain after menopause, but whether HT improves abdominal fat loss during weight loss is unknown. It was hypothesized that HT or a selective estrogen receptor modulator (raloxifene) would augment reductions in abdominal visceral fat during weight loss when compared to placebo, potentially increasing improvements in glucose tolerance and lipid profile. Healthy postmenopausal women (n = 119; age 50-70 yr) underwent a 6-month weight-loss (primarily exercise) intervention with randomization to raloxifene (60 mg/d), HT (conjugated estrogens, 0.625 mg/d), or placebo. Outcomes were change in total and abdominal (visceral and subcutaneous) fat mass, lipid profile, and fasting and post-challenge glucose and insulin. Neither HT nor raloxifene augmented loss of total or abdominal fat mass during exercise-induced weight loss when compared with placebo. Weight loss-induced improvements in risk factors were similar among the three groups, except for a greater reduction in fasted glucose in the HT group (difference in change [95%CI] from placebo; -0.40 [-0.76, -0.05]) and greater reductions in LDL (-0.36 [-0.63, -0.09]) and increases in HDL (0.15 [0.07, 0.24]) in both treatment groups. Postmenopausal HT and raloxifene did not increase abdominal fat loss during weight loss, but did improve some cardiometabolic outcomes. Copyright © 2013 The Obesity Society.

The effect of weight training on bone mineral density and bone turnover in postmenopausal breast cancer survivors with bone loss: a 24-month randomized controlled trial.

PubMed

Waltman, N L; Twiss, J J; Ott, C D; Gross, G J; Lindsey, A M; Moore, T E; Berg, K; Kupzyk, K

2010-08-01

This study examined whether 24 months of weight training exercises enhanced the effectiveness of risedronate, calcium, and vitamin D in maintaining or improving bone mineral density (BMD) in 223 postmenopausal breast cancer survivors. Subjects who were > or =50% adherent to exercise had no improvement in BMD but were less likely to lose BMD. This study examined whether (1) postmenopausal breast cancer survivors (BCS) with bone loss taking 24 months of risedronate, calcium, and vitamin D had increased bone mineral density (BMD) at the total hip, femoral neck, L1-L4 spine, total radius and 33% radius, and decreased bone turnover; (2) subjects who also participated in strength/weight training (ST) exercises had greater increases in BMD and greater decreases in bone turnover; and (3) subjects who also exercised were more likely to preserve (at least maintain) BMD. Postmenopausal BCS (223) were randomly assigned to exercise plus medication or medication only groups. Both groups received 24 months of 1,200 mg of calcium and 400 IU of vitamin D daily and 35 mg of risedronate weekly, and the exercise group additionally had ST exercises twice weekly. After 24 months, women who took medications without exercising had significant improvements in BMD at the total hip (+1.81%) and spine (+2.85%) and significant decreases in Alkphase B (-8.7%) and serum NTx (-16.7%). Women who also exercised had additional increases in BMD at the femoral neck (+0.29%), total hip (+0.34%), spine (+0.23%), total radius (+0.30%), and additional decreases in Alkphase B (-2.4%) and Serum NTx (-6.5%). Additional changes in BMD and bone turnover with exercise were not significant. Subjects who were > or =50% adherent to exercise were less likely to lose BMD at the total hip (chi-square [1] = 4.66, p = 0.03) and femoral neck (chi-square [1] = 4.63, p = 0.03). Strength/weight training exercises may prevent loss of BMD in postmenopausal BCS at risk for bone loss.

Interservice/Industry Training, Simulation and Conference. Abstracts.

DTIC Science & Technology

1999-12-02

solutions in the areas of military training, exercises and planning. The resulting loss of the ’reality’ in conventional live exercises due to...view, such as that required for driver training or aerial combat. VR headsets have a distracting weight and inertia that makes them unsuitable for...exercises and planning. The resulting loss of the ’reality’ in conventional live exercises due to restrictions in the availability of supporting

A comparison of hydration effect on body fluid and temperature regulation between Malaysian and Japanese males exercising at mild dehydration in humid heat

PubMed Central

2014-01-01

Background This study investigated the effect of hydration differences on body fluid and temperature regulation between tropical and temperate indigenes exercising in the heat. Methods Ten Japanese and ten Malaysian males with matched physical characteristics (height, body weight, and peak oxygen consumption) participated in this study. Participants performed exercise for 60 min at 55% peak oxygen uptake followed by a 30-min recovery at 32°C and 70% relative air humidity with hydration (4 times each, 3 mL per kg body weight, 37°C) or without hydration. Rectal temperature, skin temperature, heart rate, skin blood flow, and blood pressure were measured continuously. The percentage of body weight loss and total sweat loss were calculated from body weight measurements. The percentage change in plasma volume was estimated from hemoglobin concentration and hematocrit. Results Malaysian participants had a significantly lower rectal temperature, a smaller reduction in plasma volume, and a lower heart rate in the hydrated condition than in the non-hydrated condition at the end of exercise (P <0.05), whereas Japanese participants showed no difference between the two hydration conditions. Hydration induced a greater total sweat loss in both groups (P <0.05), and the percentage of body weight loss in hydrated Malaysians was significantly less than in hydrated Japanese (P <0.05). A significant interaction between groups and hydration conditions was observed for the percentage of mean cutaneous vascular conductance during exercise relative to baseline (P <0.05). Conclusions The smaller reduction in plasma volume and percentage body weight loss in hydrated Malaysians indicated an advantage in body fluid regulation. This may enable Malaysians to reserve more blood for circulation and heat dissipation and thereby maintain lower rectal temperatures in a hydrated condition. PMID:24490869

Efficacy of a randomized trial examining commercial weight loss programs and exercise on metabolic syndrome in overweight and obese women.

PubMed

Baetge, Claire; Earnest, Conrad P; Lockard, Brittanie; Coletta, Adriana M; Galvan, Elfego; Rasmussen, Christopher; Levers, Kyle; Simbo, Sunday Y; Jung, Y Peter; Koozehchian, Majid; Oliver, Jonathan; Dalton, Ryan; Sanchez, Brittany; Byrd, Michael J; Khanna, Deepesh; Jagim, Andrew; Kresta, Julie; Greenwood, Mike; Kreider, Richard B

2017-02-01

While commercial dietary weight-loss programs typically advise exercise, few provide actual programing. The goal of this study was to compare the Curves Complete 90-day Challenge (CC, n = 29), which incorporates exercising and diet, to programs advocating exercise (Weight Watchers Points Plus (WW, n = 29), Jenny Craig At Home (JC, n = 27), and Nutrisystem Advance Select (NS, n = 28)) or control (n = 20) on metabolic syndrome (MetS) and weight loss. We randomized 133 sedentary, overweight women (age, 47 ± 11 years; body mass, 86 ± 14 kg; body mass index, 35 ± 6 kg/m 2 ) into respective treatment groups for 12 weeks. Data were analyzed using chi square and general linear models adjusted for age and respective baseline measures. Data are means ± SD or mean change ± 95% confidence intervals (CIs). We observed a significant trend for a reduction in energy intake for all treatment groups and significant weight loss for all groups except control: CC (-4.32 kg; 95% CI, -5.75, -2.88), WW (-4.31 kg; 95% CI, -5.82, -2.96), JC (-5.34 kg; 95% CI, -6.86, -3.90), NS (-5.03 kg; 95% CI, -6.49, -3.56), and control (0.16 kg, 95% CI, -1.56, 1.89). Reduced MetS prevalence was observed at follow-up for CC (35% vs. 14%, adjusted standardized residuals (adjres.) = 3.1), but not WW (31% vs. 28% adjres. = 0.5), JC (37% vs. 42%, adjres. = -0.7), NS (39% vs. 50% adjres. = -1.5), or control (45% vs. 55% adjres. = -1.7). While all groups improved relative fitness (mL·kg -1 ·min -1 ) because of weight loss, only the CC group improved absolute fitness (L/min). In conclusion, commercial programs offering concurrent diet and exercise programming appear to offer greater improvements in MetS prevalence and cardiovascular function after 12 weeks of intervention.

The moderating effect of gender on ideal-weight goals and exercise dependence symptoms.

PubMed

Cook, Brian; Hausenblas, Heather; Rossi, James

2013-03-01

Background and aims Exercise dependence is implicated in the development of eating disorders and muscle dysmorphic disorder. Although conceptually these disorders represent similar pathologies they largely affect different genders and result in opposite body composition, appearance, and ideal-weight goals (i.e., to gain or lose/maintain weight). Therefore, understanding individuals' ideal-weight goals related to engaging in exercise while simultaneously examining gender differences in exercise dependence symptoms may help to identify those whom may be most at-risk for eating disorders and muscle dysmorphic disorder. The purpose of our study was to examine the moderating effect of gender for exercise dependence symptoms in relation to weight gain, loss, or maintenance goals. Methods Self-reported exercise behavior and exercise dependence symptoms (i.e., Exercise Dependence Scale) were assessed in 513 undergraduate students. Results Our analysis revealed a moderating effect for gender on ideal-weight goals and a gender difference in exercise dependence symptoms. Specifically, men who were dissatisfied with their current weight reported more exercise dependence symptoms than women. Conclusions These results support a growing body of research and extend our understanding of the relationships among exercise dependence and gender specific body-focused psychiatric disorders.

The Seasonal Periodicity of Healthy Contemplations About Exercise and Weight Loss: Ecological Correlational Study.

PubMed

Madden, Kenneth Michael

2017-12-13

Lack of physical activity and weight gain are two of the biggest drivers of health care costs in the United States. Healthy contemplations are required before any changes in behavior, and a recent study has shown that they have underlying periodicities. The aim of this study was to examine seasonal variations in state-by-state interest in both weight loss and increasing physical activity, and how these variations were associated with geographic latitude using Google Trends search data for the United States. Internet search query data were obtained from Google Trends (2004-2016). Time series analysis (every 2 weeks) was performed to determine search volume (normalized to overall search intensity). Seasonality was determined both by the difference in search volumes between winter (December, January, and February) and summer (June, July, and August) months and by the amplitude of cosinor analysis. Exercise-related searches were highest during the winter months, whereas weight loss contemplations showed a biphasic pattern (peaking in the summer and winter months). The magnitude of the seasonal difference increased with increasing latitude for both exercise (R 2 =.45, F 1,49 =40.09, beta=-.671, standard deviation [SD]=0.106, P<.001) and weight loss (R 2 =.24, F 1,49 =15.79, beta=-.494, SD=0.124, P<.001) searches. Healthy contemplations follow specific seasonal patterns, with the highest contemplations surrounding exercise during the winter months, and weight loss contemplations peaking during both winter and summer seasons. Knowledge of seasonal variations in passive contemplations may potentially allow for more efficient use of public health campaign resources. ©Kenneth Michael Madden. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 13.12.2017.

Indirect effects of exercise on emotional eating through psychological predictors of weight loss in women.

PubMed

Annesi, James J; Mareno, Nicole

2015-12-01

An improved understanding of how weight-loss interventions might be tailored to improve emotional eating is required. This study aimed to assess mediation of the relationship between increased exercise and decreased emotional eating so that behavioral treatments might be optimized. After randomization, women with obesity (N = 108; mean age = 48 years) were assigned to either a previously tested treatment of manual-based self-help for nutrition and exercise plus brief phone follow-ups, or a new protocol of cognitive-behavioral methods of exercise support intended to carry-over psychological improvements to better controlled eating and weight loss. A community-based field setting was incorporated. Validated self-report measures were administered over 6 months. Significant overall improvements in exercise outputs, emotional eating, mood, and self-regulation and self-efficacy for controlled eating were found. The newly developed treatment protocol demonstrated significantly greater improvements in exercise outputs and self-regulation. In a multiple mediation analysis, changes in self-regulation, self-efficacy, and mood significantly mediated the relationship between changes in exercise and emotional eating. Changes in self-efficacy and mood were significant independent mediators. Within follow-up analyses, the substitution of emotional eating subscales that addressed specific moods, and a subscale of self-efficacy for controlled eating that addressed that factor specifically in the presence of negative emotions, yielded results generally consistent with those of the multiple mediation analysis. Results suggested a psychological pathway of exercise's association with emotional eating changes in women with obesity. Guided by the present findings, tailoring exercise support and leveraging it to induce specific psychological improvements might reduce emotional eating and improve weight-management outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effect of weight loss, exercise, or both on cognition and quality of life in obese older adults1234

PubMed Central

Napoli, Nicola; Shah, Krupa; Waters, Debra L; Sinacore, David R; Qualls, Clifford; Villareal, Dennis T

2014-01-01

Background: Obesity impairs cognition and health-related quality of life (HRQOL) in older adults; however, the appropriate treatment of obese older adults remains controversial. Objective: The objective was to determine the independent and combined effects of weight loss and exercise on cognition, mood, and HRQOL in obese older adults. Design: One hundred seven frail, obese older adults were randomly assigned to a control, weight-management (diet), exercise, or weight-management-plus-exercise (diet-exercise) group for 1 y. In this secondary analysis, main outcomes were Modified Mini-Mental State Examination (3MS) and total Impact of Weight on Quality of Life-Lite (IWQOL) scores. Other outcomes included Word Fluency Test, Trail Making Test Parts A and B, and Geriatric Depression Scale (GDS) scores. Results: Scores on the 3MS improved more in the diet (mean ± SE: 1.7 ± 0.4), exercise (2.8 ± 0.4), and diet-exercise (2.9 ± 0.4) groups than in the control group (0.1 ± 0.4) (between-group P = 0.0001–0.04); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. Scores on the Word Fluency Test improved more in the exercise (4.1 ± 0.8) and diet-exercise (4.2 ± 0.7) groups than in the control group (−0.8 ± 0.8; both P = 0.001). For the Trail Making Test Part A, scores in the diet-exercise group (−11.8 ± 1.9) improved more than in the control group (−0.8 ± 1.9) (P = 0.001); a similar finding was observed for the Trail Making Test Part B. Scores on the IWQOL improved more in the diet (7.6 ± 1.6), exercise (10.1 ± 1.6), and diet-exercise (14.0 ± 1.4) groups than in the control group (0.3 ± 1.6) (P = 0.0001–0.03); scores in the diet-exercise group improved more than in the diet group but not more than in the exercise group. In the diet-exercise group, peak oxygen consumption and strength changes were independent predictors of 3MS changes; weight and strength changes were independent predictors of IWQOL changes. GDS scores did not change. Conclusions: Weight loss and exercise each improve cognition and HRQOL, but their combination may provide benefits similar to exercise alone. These findings could inform practice guidelines with regard to optimal treatment strategies for obese older adults. This trial was registered atclinicaltrials.govas NCT00146107. PMID:24787497

Weight Loss Composition is One-Fourth Fat-Free Mass: A Critical Review and Critique of This Widely Cited Rule

PubMed Central

Heymsfield, Steven B.; Cristina Gonzalez, M. C.; Shen, Wei; Redman, Leanne; Thomas, Diana

2014-01-01

Maximizing fat loss while preserving lean tissue mass and function is a central goal of modern obesity treatments. A widely cited rule guiding expected loss of lean tissue as fat-free mass (FFM) states that approximately one-fourth of weight loss will be FFM (i.e., ΔFFM/ΔWeight = ~0.25) with the remaining three-fourths fat mass. This review examines the dynamic relations between FFM, fat mass, and weight changes that follow induction of negative energy balance with hypocaloric dieting and/or exercise. Historical developments in the field are traced with the “Quarter FFM Rule” used as a framework to examine evolving concepts on obesity tissue, excess weight, and what is often cited as “Forbes’ Rule”. Temporal effects in the fractional contribution of FFM to changes in body weight are examined as are lean tissue moderating effects such as aging, inactivity, and exercise that frequently accompany structured low-calorie diet weight loss protocols. Losses of lean tissue with dieting typically tend to be small, raising questions about study design, power, and applied measurement method reliability. Our review elicits important questions related to the fractional loss of lean tissues with dieting and provides a foundation for future research on this topic. PMID:24447775

A qualitative investigation of attitudes towards aerobic and resistance exercise amongst overweight and obese individuals.

PubMed

Guess, Nicola

2012-04-25

Most people are not meeting the minimal requirements for physical activity participation, particularly people who are overweight or obese. Numerous initiatives have been developed which aim to increase levels of physical activity in this group, yet little is known about their feelings towards different types of exercise. In particular, resistance exercise may offer unique benefits to people seeking to lose weight, yet no study to date has examined views of resistance exercise amongst the overweight and obese. This qualitative study examined the views and attitudes towards aerobic and resistance exercise amongst overweight and obese individuals engaged in a weight management clinic. 30 overweight and obese patients comprised of 25 females and 5 males, with a mean age of 40.7 years (SD = 15.2) and mean BMI of 33.8 kg/m2 (SD = 7.9) were recruited from a dietetic clinic to take part in baseline focus groups and interviews to assess their views on physical activity. After selecting and participating in a 12 week aerobic- or resistance-exercise program, the participants took part in follow-up interviews. Thematic analysis was then performed on the transcribed focus group and interview data. For the overweight and obese women in this study, weight loss was the primary motivation for physical activity participation. Subsequently, these women perceived a failure to lose weight as strongly affecting their motivation to continue or re-engage in physical activity. Only 3 participants selected the resistance exercise option. The view of resistance exercise as a masculine activity was a dominant theme amongst all participants. A lack of knowledge of how to perform certain exercises emerged as a barrier, but was seen by the participants as surmountable given appropriate instruction. The females in this study cited weight loss as a primary motivation for physical activity participation. This view must be reconciled with the existing knowledge base of physical activity requirements for successful weight loss and maintenance. Participants in this study had little awareness or experience of resistance exercise, and many were fearful of the potential risks.

"Exercise Dependence"--A Problem or Natural Result of High Activity?

ERIC Educational Resources Information Center

Phelan, Suzanne; Bond, Dale S.; Lang, Wei; Jordan, Dustin; Wing, Rena R.

2011-01-01

Objectives: To compare physical activity (PA) and exercise dependence (ED) in 267 weight-loss maintainers (WLM) and 213 normal-weight (NW) controls. Methods: PA and ED assessed via accelerometery and the Exercise Dependence Questionnaire. Results: WLM had higher PA levels and ED scores than those of NW (P less than 0.0001). WLM status (P = 0.006)…

Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial: A Behavioral Weight Loss Intervention in Overweight or Obese Breast Cancer Survivors

PubMed Central

Rock, Cheryl L.; Flatt, Shirley W.; Byers, Tim E.; Colditz, Graham A.; Demark-Wahnefried, Wendy; Ganz, Patricia A.; Wolin, Kathleen Y.; Elias, Anthony; Krontiras, Helen; Liu, Jingxia; Naughton, Michael; Pakiz, Bilgé; Parker, Barbara A.; Sedjo, Rebecca L.; Wyatt, Holly

2015-01-01

Purpose Obesity increases risk for all-cause and breast cancer mortality and comorbidities in women who have been diagnosed and treated for breast cancer. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is the largest weight loss intervention trial among survivors of breast cancer to date. Methods In this multicenter trial, 692 overweight/obese women who were, on average, 2 years since primary treatment for early-stage breast cancer were randomly assigned to either a group-based behavioral intervention, supplemented with telephone counseling and tailored newsletters, to support weight loss or a less intensive control intervention and observed for 2 years. Weight and blood pressure were measured at 6, 12, 18, and 24 months. Longitudinal mixed models were used to analyze change over time. Results At 12 months, mean weight loss was 6.0% of initial weight in the intervention group and 1.5% in the control group (P < .001). At 24 months, mean weight loss in the intervention and control groups was 3.7% and 1.3%, respectively (P < .001). Favorable effects of the intervention on physical activity and blood pressure were observed. The weight loss intervention was more effective among women older than 55 years than among younger women. Conclusion A behavioral weight loss intervention can lead to clinically meaningful weight loss in overweight/obese survivors of breast cancer. These findings support the need to conduct additional studies to test methods that support sustained weight loss and to examine the potential benefit of intentional weight loss on breast cancer recurrence and survival. PMID:26282657

Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial: A Behavioral Weight Loss Intervention in Overweight or Obese Breast Cancer Survivors.

PubMed

Rock, Cheryl L; Flatt, Shirley W; Byers, Tim E; Colditz, Graham A; Demark-Wahnefried, Wendy; Ganz, Patricia A; Wolin, Kathleen Y; Elias, Anthony; Krontiras, Helen; Liu, Jingxia; Naughton, Michael; Pakiz, Bilgé; Parker, Barbara A; Sedjo, Rebecca L; Wyatt, Holly

2015-10-01

Obesity increases risk for all-cause and breast cancer mortality and comorbidities in women who have been diagnosed and treated for breast cancer. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is the largest weight loss intervention trial among survivors of breast cancer to date. In this multicenter trial, 692 overweight/obese women who were, on average, 2 years since primary treatment for early-stage breast cancer were randomly assigned to either a group-based behavioral intervention, supplemented with telephone counseling and tailored newsletters, to support weight loss or a less intensive control intervention and observed for 2 years. Weight and blood pressure were measured at 6, 12, 18, and 24 months. Longitudinal mixed models were used to analyze change over time. At 12 months, mean weight loss was 6.0% of initial weight in the intervention group and 1.5% in the control group (P<.001). At 24 months, mean weight loss in the intervention and control groups was 3.7% and 1.3%, respectively (P<.001). Favorable effects of the intervention on physical activity and blood pressure were observed. The weight loss intervention was more effective among women older than 55 years than among younger women. A behavioral weight loss intervention can lead to clinically meaningful weight loss in overweight/obese survivors of breast cancer. These findings support the need to conduct additional studies to test methods that support sustained weight loss and to examine the potential benefit of intentional weight loss on breast cancer recurrence and survival. © 2015 by American Society of Clinical Oncology.

Childhood Obesity Demands New Approaches.

ERIC Educational Resources Information Center

Satter, Ellyn

1991-01-01

Health professionals suggest creating achievable goals in childhood obesity. The article recommends correcting factors that distort normal growth and providing positive eating and exercise management to slow weight gain. Rather than trying for weight loss, children must learn positive lifelong eating and exercise patterns and attitudes toward self…

The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss.

PubMed

Stiegler, Petra; Cunliffe, Adam

2006-01-01

The incidence of obesity is increasing rapidly. Research efforts for effective treatment strategies still focus on diet and exercise programmes, the individual components of which have been investigated in intervention trials in order to determine the most effective recommendations for sustained changes in bodyweight. The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss. Therefore, with respect to long-term effectiveness of weight-loss programmes, the loss of fat mass while maintaining FFM and RMR seems desirable. Diet intervention studies suggest spontaneous losses in bodyweight following low-fat diets, and current data on a reduction of the carbohydrate-to-protein ratio of the diet show promising outcomes. Exercise training is associated with an increase in energy expenditure, thus promoting changes in body composition and bodyweight while keeping dietary intake constant. The advantages of strength training may have greater implications than initially proposed with respect to decreasing percentage body fat and sustaining FFM. Research to date suggests that the addition of exercise programmes to dietary restriction can promote more favourable changes in body composition than diet or physical activity on its own. Moreover, recent research indicates that the macronutrient content of the energy-restricted diet may influence body compositional alterations following exercise regimens. Protein emerges as an important factor for the maintenance of or increase in FFM induced by exercise training. Changes in RMR can only partly be accounted for by alterations in respiring tissues, and other yet-undefined mechanisms have to be explored. These outcomes provide the scientific rationale to justify further randomised intervention trials on the synergies between diet and exercise approaches to yield favourable modifications in body composition.

Regular exercise coupled to diet regimen accelerates reduction of hepatic steatosis and associated pathological conditions in nonalcoholic fatty liver disease.

PubMed

Oh, Sechang; Tanaka, Kiyoji; Tsujimoto, Takehiko; So, Rina; Shida, Takashi; Shoda, Junichi

2014-06-01

A diet regimen focusing on weight loss is still the most efficient treatment for nonalcoholic fatty liver disease (NAFLD). Recently, specific benefits of exercise against NAFLD independent of weight loss have been reported. Hence, combining exercise with diet-induced weight loss can be expected to have an additive benefit for NAFLD management. We evaluated the effectiveness of diet in conjunction with exercise (DE) compared with that of diet alone (D) on hepatic steatosis and its underlying pathophysiology. Data obtained from 72 obese, middle-aged men with NAFLD who completed a 3-month program of DE or D in 2011 and 2012 were analyzed. Subjects went through a comprehensive parameters analysis for the pathophysiology of NAFLD. Subjects in the DE group, compared with those in the D group, elicited additive effects on the degree of hepatic steatosis (-82.6% vs. -60.0%) and body weight (-13.3% vs. -8.9%) accompanied by an improvement in serum marker levels: inflammation, ferritin (-16.1% vs. -2.1%); oxidative stress, lipid peroxidation (-31.8% vs. +4.8%); adipokine imbalance, adiponectin, and leptin (+27.4% vs. +2.6% and -74.4% vs. -30.2%). Consequently, subjects in the DE group achieved further attenuation of insulin resistance [homeostatsis model assessment of insulin resistance (HOMA-IR) (-63.6% vs. -40.0%)]. These observed additive benefits in the DE group were closely associated with the increased volume of physical activity. The addition of exercise to a diet regimen potentiates the benefits in NAFLD management through further improvement of hepatic steatosis, inflammatory and oxidative stress levels, and adipokine imbalance, thereby attenuating insulin resistance independent of detectable weight loss.

High genetic-risk individuals benefit less from resistance exercise intervention

PubMed Central

Klimentidis, Yann C.; Bea, Jennifer W.; Lohman, Timothy; Hsieh, Pei-Shan; Going, Scott; Chen, Zhao

2015-01-01

Background/Objectives Genetic factors play an important role in body mass index (BMI) variation, and also likely play a role in the weight-loss and body composition response to physical activity/exercise. With the recent identification of BMI–associated genetic variants, it is possible to investigate the interaction of these genetic factors with exercise on body composition outcomes. Subjects/Methods In a block-randomized clinical trial of resistance exercise among women (n=148), we examined whether the putative effect of exercise on weight and DXA-derived body composition measurements differs according to genetic risk for obesity. Approximately one-half of the sample was randomized to an intervention consisting of a supervised, intensive, resistance exercise program, lasting one year. Genetic risk for obesity was defined as a genetic risk score (GRS) comprised of 21 SNPs known to be associated with normal BMI variation. We examined the interaction of exercise intervention and the GRS on anthropometric and body composition measurements after one year of the exercise intervention. Results We found statistically significant interactions for body weight (p=0.01), body fat (p=0.01), body fat % (p=0.02), and abdominal fat (p=0.02), whereby the putative effect of exercise is greater among those with a lower level of genetic risk for obesity. No single SNP appears to be a major driver of these interactions. Conclusions The weight-loss response to resistance exercise, including changes in body composition, differs according to an individual’s genetic risk for obesity. PMID:25924711

Weight Loss Interventions in Older Adults with Obesity: A Systematic Review of Randomized Controlled Trials Since 2005

PubMed Central

Batsis, John A.; Gill, Lydia E.; Masutani, Rebecca; Adachi-Mejia, Anna M.; Blunt, Heather B.; Bagley, Pamela J.; Lopez-Jimenez, Francisco; Bartels, Stephen J.

2017-01-01

Objectives To identify geriatric obesity interventions that can guide clinical recommendations. Design Systematic review using Medline (PubMed), Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, EMBASE (Ovid), and PsycINFO (Proquest) from January 1, 2005, to October 12, 2015, to identify English-language randomized controlled trials. Participants Individuals aged 60 and older (mean age ≥65) and classified as having obesity (body mass index ≥30 kg/m2). Interventions Behavioral weight loss interventions not involving pharmacological or procedural therapies lasting 6 months or longer. Measurements Two investigators performed the systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria and achieved a high concordance rate (97.3%) in summarizing the primary outcomes. The three primary outcomes were weight loss, physical performance, and quality of life. Results Of 5,741 citations, 19 were included. (Six studies were unique, and the remaining 13 were based on the same study population.) Duration ranged from 6 to 18 months (n=405 participants, age range 66.7–71.1). Weight loss in the intervention groups ranged from 0.5 to 10.7 kg (0.1–9.3%). Five studies had a resistance exercise program accompanying a dietary component. Greater weight loss was observed in groups with a dietary component than those with exercise alone. Exercise alone led to better physical function but no significant weight loss. Combined dietary and exercise components led to the greatest improvement in physical performance measures and quality of life and mitigated reductions in muscle and bone mass observed in diet-only study arms. Heterogeneous outcomes were observed, which limited the ability to synthesize the data quantitatively. Conclusions The evidence supporting geriatric obesity interventions to improve physical function and quality of life is of low to moderate quality. Well-designed trials are needed in this population. PMID:27641543

Reciprocal effects of treatment-induced increases in exercise and improved eating, and their psychosocial correlates, in obese adults seeking weight loss: a field-based trial

PubMed Central

2013-01-01

Background A better understanding of interrelations of exercise and improved eating, and their psychosocial correlates of self-efficacy, mood, and self-regulation, may be useful for the architecture of improved weight loss treatments. Theory-based research within field settings, with samples possessing high probabilities of health risks, might enable rapid application of useful findings. Methods Adult volunteers with severe obesity (body mass index [BMI] 35–50 kg/m2; age = 43.0 ± 9.5 y; 83% female) were randomly assigned to six monthly cognitive-behavioral exercise support sessions paired with either group-based nutrition education (n = 145) or cognitive behavioral methods applied to improved eating (n = 149). After specification of mediation models using a bias-corrected bootstrapping procedure, a series of reciprocal effects analyses assessed: a) the reciprocal effects of changes in exercise and fruit and vegetable intake, resulting from the treatments, b) the reciprocal effects of changes in the three psychosocial variables tested (i.e. self-efficacy, mood, and self-regulation) and fruit and vegetable change, resulting from change in exercise volume, and c) the reciprocal effects of changes in the three psychosocial variables and exercise change, resulting from change in fruit and vegetable intake. Results Mediation analyses suggested a reciprocal effect between changes in exercise volume and fruit and vegetable intake. After inclusion of psychosocial variables, also found were reciprocal effects between change in fruit and vegetable intake and change in mood, self-efficacy for controlled eating, and self-regulation for eating; and change in exercise volume and change in mood and exercise-related self-regulation. Conclusion Findings had implications for behavioral weight-loss theory and treatment. Specifically, results suggested that treatments should focus upon, and leverage, the transfer effects from each of the primary weight-loss behaviors (exercise and healthy eating) to the other. Findings on psychosocial correlates of these behavioral processes may also have practical applications. PMID:24308572

Effects of omega-3 supplementation in combination with diet and exercise on weight loss and body composition.

PubMed

DeFina, Laura F; Marcoux, Lucille G; Devers, Susan M; Cleaver, Joseph P; Willis, Benjamin L

2011-02-01

In addition to the metabolic and cardiovascular benefits of omega-3 (n-3) fatty acids, several studies have suggested an added weight loss-enhancing benefit to this supplement. The objective was to assess whether supplemental omega-3 fatty acids in conjunction with diet and exercise augment weight loss over a 6-mo period. In a single-institution, placebo-controlled, randomized clinical trial, 128 individuals with a body mass index (in kg/m(2)) between 26 and 40 were assigned to receive 5 omega-3 [3.0 g eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) at a 5:1 ratio (EPA:DHA)] or placebo capsules daily in conjunction with lifestyle modification. The primary endpoint was weight loss; secondary endpoints included metabolic and psychometric variables. Analyses were by intention-to-treat. Overweight and obese individuals were assigned to the omega-3 arm (n = 64) or to the placebo arm (n = 64). Subjects in both arms received dietary and exercise counseling. Eighty-one individuals completed the 24-wk study, and the dropout rate was 27%. Subjects in both arms lost an average of >5% of their body weight. No significant differences in weight loss were observed between the omega-3 (-5.2 kg; 95% CI: -6.0, -4.4 kg) and placebo (-5.8 kg; 95% CI: -6.7, -5.1 kg) arms. The absolute mean (±SEM) change difference was 0.61 ± 0.58 kg (P = 0.29). In addition, no significant differences in the other factors assessed were observed. Omega-3 fatty acids were not effective as an adjunct for weight loss in this otherwise healthy, overweight population.

Exercise associated hormonal signals as powerful determinants of an effective fat mass loss.

PubMed

Bajer, B; Vlcek, M; Galusova, A; Imrich, R; Penesova, A

2015-07-01

Obesity management for achieving an effective weight loss includes dietary modification and exercise [resistance (strength), endurance (cardiovascular) or intervals training (high-intensity intermittent exercise)]. Regular exercise acutely increases fat oxidation, which induces loss of fat mass and increases energy expenditure. Moreover, it has a positive effect on the physical (improved insulin sensitivity, lipid profile, etc.) and mental health (mood, cognition, memory, sleep, etc.). Endocrine responses to muscle actions are affected by many factors, including the exercise muscle groups (lower and upper body), load/volume, time-under tension, and rest-period intervals between sets, training status, gender, and age. The aim of this review is to summarize, evaluate, and clarify the literature data focusing on the endocrine responses to different types of exercise, including the frequency, intensity, and type of movement with regard to the fat loss strategies. Many studies have investigated anabolic [growth hormone, insulin-like growth factor-1 (IGF-1), testosterone] and gluco- and appetite- regulatory (insulin, cortisol, ghrelin) hormone responses and adaptations of skeletal muscles to exercise. Muscle tissue is a critical endocrine organ, playing important role in the regulation of several physiological and metabolic events. Moreover, we are also describing the response of some other substances to exercise, such as myokines [irisin, apelin, brain-derived neurotrophic factor (BDNF), myostatin, and fibroblast growth factor 21 (FGF21)]. It is proposed that reducing intra-abdominal fat mass and increasing cardiorespiratory fitness through improving nutritional quality, reducing sedentary behavior, and increase the participation in physical activity/exercise, might be associated with clinical benefits, sometimes even in the absence of weight loss.

Impact of weight loss with or without exercise on abdominal fat and insulin resistance in obese individuals: a randomised clinical trial.

PubMed

Trussardi Fayh, Ana Paula; Lopes, André Luiz; Fernandes, Pablo Rober; Reischak-Oliveira, Alvaro; Friedman, Rogério

2013-08-28

Evidence supports an important contribution of abdominal obesity and inflammation to the development of insulin resistance (IR) and CVD. Weight loss in obese individuals can reduce inflammation and, consequently, IR, but the role of training remains unclear. The aim of this study was to evaluate the effects of body weight reduction with and without exercise over abdominal fat tissue (primary outcome) and IR. In this randomised clinical trial, forty-eight obese individuals (age 31·8 (SD 6·0) years, BMI 34·8 (SD 2·7) kg/m2) were randomised to either a diet-only group (DI) or a diet and exercise group (DI þ EXE). Treatment was maintained until 5% of the initial body weight was lost. At baseline and upon completion, the following parameters were analysed: biochemical parameters such as glycaemia and insulin for the determination of homeostasis model assessment of insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP) and abdominal computed tomography for the determination of visceral and subcutaneous adipose tissue. A total of thirteen individuals dropped out before completing the weight-loss intervention and did not repeat the tests. In both the DI (n 18) and DI þ EXE (n 17) groups, we observed significant and similar decreases of visceral adipose tissue (difference between means: 7·9 (95% CI 29·5, 25·2) cm2, P¼0·36), hs-CRP (difference between means: 20·06 (95% CI 20·19, 0·03) mg/l, P¼0·39) and HOMA (difference between means: 20·04 (95% CI 20·17, 0·08), P¼0·53). In the present study, 5% weight loss reduced abdominal fat and IR in obese individuals and exercise did not add to the effect of weight loss on the outcome variables.

Effects of low calorie diet-induced weight loss on post-exercise heart rate recovery in obese men.

PubMed

Kim, Maeng Kyu

2014-06-01

Heart Rate Recovery (HRR) after maximum exercise is a reactivation function of vagus nerve and an independent risk factor that predicts cardiovascular disease and mortality. Weight loss obtained through dietary programs has been employed as a therapy to reduce risks of cardiovascular disease and obesity. Eighteen subjects of middle aged obese men (age 44.8 ± 1.6 yrs, BMI 29.7 ± 0.5 kg/m(2)) were selected for this study. As a weight loss direction, the nutritional direction of low-calorie diet mainly consisted of carbohydrate, protein, and fat has been conducted for 3 months. Blood pressure was measured after overnight fasting, and blood samples were collected from the antecubital vein before and after weight loss program. All the pre- and post-exercise 'HRR decay constant's were assessed by using values of HRR (heart recovery rate; 2 minutes) and HR measured after reached to the maximal oxygen uptake (VO2max) exploited the bicycle ergometer. After the completion of weight loss program, body weight and BMI were significantly decreased, but the Heart Rate (HR) after maximum exercise and in steady state were not changed significantly (p > 0.05). The post-exercise HRR after the weight loss did not show significant changes in perspectives of 30 seconds (-16.6 ± 2.3 to -20.2 ± 2.1 beats/min, p > 0.05) and 60 seconds (-33.5 ± 3.4 to -34.6 ± 2.8 beats/min, p > 0.05) respectively but in perspectives of 90 seconds (-40.9 ± 2.6 to -48.1 ± 3.1 beats/min, p < 0.05) and 120 seconds (-48.6 ± 2.6 to -54.3 ± 3.5 beats/min, p < 0.05), they were decreased significantly. Pre-'HRR decay constant's of 0.294 ± 0.02 %/second were significantly increased to post-values of 0.342 ± 0.03 %/second (p = 0.026). Changes in 'HRR decay constant' were significantly correlated with changes in blood glucose (r = -0.471, p < 0.05) and maximal oxygen consumption (VO2max, r = 0.505, p < 0.05) respectively. The low-calorie diet directed to obese middle aged men for 3 months significantly improved the HRR after maximum exercise, and this improvement in cardiovascular autonomic nerve system was estimated to be involved with improvements in blood glucose and maximal oxygen consumption.

Impact of sleep, screen time, depression and stress on weight change in the intensive weight loss phase of the LIFE study.

PubMed

Elder, C R; Gullion, C M; Funk, K L; Debar, L L; Lindberg, N M; Stevens, V J

2012-01-01

The LIFE study is a two-phase randomized clinical trial comparing two approaches to maintaining weight loss following guided weight loss. Phase I provided a nonrandomized intensive 6-month behavioral weight loss intervention to 472 obese (body mass index 30-50) adult participants. Phase II is the randomized weight loss maintenance portion of the study. This paper focuses on Phase I measures of sleep, screen time, depression and stress. The Phase I intervention consisted of 22 group sessions led over 26 weeks by behavioral counselors. Recommendations included reducing dietary intake by 500 calories per day, adopting the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and increasing physical exercise to at least 180 min per week. Measures reported here are sleep time, insomnia, screen time, depression and stress at entry and post-weight loss intervention follow-up. The mean weight loss for all participants over the intensive Phase I weight loss intervention was 6.3 kg (s.d. 7.1). Sixty percent (N=285) of participants lost at least 4.5 kg (10 lbs) and were randomized into Phase II. Participants (N=472) attended a mean of 73.1% (s.d. 26.7) of sessions, completed 5.1 (s.d. 1.9) daily food records/week, and reported 195.1 min (s.d. 123.1) of exercise per week. Using logistic regression, sleep time (quadratic trend, P=0.030) and lower stress (P=0.024) at entry predicted success in the weight loss program, and lower stress predicted greater weight loss during Phase I (P=0.021). In addition, weight loss was significantly correlated with declines in stress (P=0.048) and depression (P=0.035). Results suggest that clinicians and investigators might consider targeting sleep, depression and stress as part of a behavioral weight loss intervention.

Dietary Weight Loss and Exercise Effects on Serum Biomarkers of Angiogenesis in Overweight Postmenopausal Women: A Randomized Controlled Trial.

PubMed

Duggan, Catherine; Tapsoba, Jean de Dieu; Wang, Ching-Yun; McTiernan, Anne

2016-07-15

Obese and sedentary persons have an increased risk for cancer, but underlying mechanisms are poorly understood. Angiogenesis is common to adipose tissue formation and remodeling, and to tumor vascularization. A total of 439 overweight/obese, healthy, postmenopausal women [body mass index (BMI) > 25 kg/m(2)] ages 50-75 years, recruited between 2005 and 2008 were randomized to a 4-arm 12-month randomized controlled trial, comparing a caloric restriction diet arm (goal: 10% weight loss, N = 118), aerobic exercise arm (225 minutes/week of moderate-to-vigorous activity, N = 117), a combined diet + exercise arm (N = 117), or control (N = 87) on circulating levels of angiogenic biomarkers. VEGF, plasminogen activator inhibitor-1 (PAI-1), and pigment epithelium-derived factor (PEDF) were measured by immunoassay at baseline and 12 months. Changes were compared using generalized estimating equations, adjusting for baseline BMI, age, and race/ethnicity. Participants randomized to the diet + exercise arms had statistically significantly greater reductions in PAI-1 at 12 months compared with controls (-19.3% vs. +3.48%, respectively, P < 0.0001). Participants randomized to the diet and diet + exercise arms had statistically significantly greater reductions in PEDF (-9.20%, -9.90%, respectively, both P < 0.0001) and VEGF (-8.25%, P = 0.0005; -9.98%, P < 0.0001, respectively) compared with controls. There were no differences in any of the analytes in participants randomized to the exercise arm compared with controls. Increasing weight loss was statistically significantly associated with linear trends of greater reductions in PAI-1, PEDF, and VEGF. Weight loss is significantly associated with reduced circulating VEGF, PEDF, and PAI-1, and could provide incentive for reducing weight as a cancer prevention method in overweight and obese individuals. Cancer Res; 76(14); 4226-35. ©2016 AACR. ©2016 American Association for Cancer Research.

Exercise and Fat Reduction.

ERIC Educational Resources Information Center

Clarke, H. Harrison, Ed.

1975-01-01

This document analyzes the problems encountered by the obese individual and the effects of regular exercise on weight loss and fat reduction. Part one compares the psychological traits of obese children with age groups of normal weight and discusses the organic disorders and social attitudes which plague the overweight individual. Part two states…

Green Tea Catechin Consumption Enhances Exercise-Induced Abdominal Fat Loss

USDA-ARS?s Scientific Manuscript database

Aim: This study evaluated the influence of a green tea catechin beverage on body composition and fat distribution in overweight and obese adults during exercised-induced weight loss. Methods: Participants (N=132) were randomly assigned to receive a 500 mL beverage containing approximately 625 mg of...

Subcutaneous fat loss is greater than visceral fat loss with diet and exercise, weight-loss promoting drugs and bariatric surgery: a critical review and meta-analysis.

PubMed

Merlotti, C; Ceriani, V; Morabito, A; Pontiroli, A E

2017-05-01

Aim of this review is to compare visceral and subcutaneous fat loss with all available strategies (diet and exercise, weight-loss promoting agents and bariatric surgery). Eighty-nine studies, all full papers, were analyzed to evaluate visceral and subcutaneous fat changes, measured through ultrasound, computerized tomography, magnetic resonance imaging and expressed as thickness, weight, area and volume. Studies were included in a meta-analysis (random-effects model). Intervention effect (absolute and percent changes of visceral and subcutaneous fat) was expressed as standardized mean differences, with 95% confidence intervals. Publication bias was formally assessed. The result was that subcutaneous fat was greater than visceral fat when measured as area, volume and weight, not as thickness; decrease of subcutaneous fat was greater than visceral fat when measured as area, volume and weight, not as thickness; percent decrease of visceral fat was always greater than percent decrease of subcutaneous fat, with no differences between different strategies. No intervention preferentially targets visceral fat. Basal visceral fat depots are smaller than basal subcutaneous fat depots. Visceral fat loss is linked to subcutaneous fat loss. With all strategies, percent decrease of visceral fat prevails on subcutaneous fat loss.

Randomized controlled trial of a comprehensive home environment-focused weight loss program for adults

PubMed Central

Gorin, Amy A.; Raynor, Hollie A.; Fava, Joseph; Maguire, Kimberly; Robichaud, Erica; Trautvetter, Jennifer; Crane, Melissa; Wing, Rena R.

2012-01-01

Objective Behavioral weight loss programs (BWL) provide limited instruction on how to change the environmental context of weight-regulating behaviors, perhaps contributing to regain. Drawing on social ecological models, this trial evaluated a comprehensive weight loss program that targeted both an individual’s behavior and their physical and social home environment. Methods Overweight and obese adults (N=201; 48.9±10.5 years; 78.1% women) were randomized to BWL or to BWL plus home environment changes (BWL+H). Groups met weekly for 6 months and bi-monthly for 12 months. BWL+H participants were given items to facilitate healthy choices in their homes (e.g., exercise equipment, portion plates) and attended treatment with a household partner. Weight loss at 6 and 18 months was the primary outcome. Results BWL+H changed many aspects of the home environment and produced better 6 month weight losses than BWL (p=.017). At 18 months, no weight loss differences were observed (p=.19) and rates of regain were equivalent (p=.30). Treatment response was moderated by gender (6 month p=.01; 18 month p=.006). Women lost more weight in BWL+H than BWL at 6 and 18 months, whereas men in BWL lost more weight than those in BWL+H at 18 months. Partners, regardless of gender, lost more weight in BWL+H than BWL at both time points (ps<.0001). Conclusion The home food and exercise environment is malleable and targeting this microenvironment appears to improve initial weight loss, and in women, 18-month outcomes. Research is needed to understand this gender difference and to develop home-focused strategies with more powerful and sustained weight loss effects. PMID:22309885

Validation of a personal fluid loss monitor.

PubMed

Wickwire, J; Bishop, P A; Green, J M; Richardson, M T; Lomax, R G; Casaru, C; Jones, E; Curtner-Smith, M

2008-02-01

Dehydration raises heat injury risk and reduces performance [ , , ]. The purpose was to validate the Hydra-Alert Jr (Acumen). The Hydra-Alert was tested in two exercise/clothing conditions. Participants wore it while wearing exercise clothing and exercising at a self-selected intensity (n = 8). Others wore the Hydra-Alert while wearing a ballistic-vest and performing an industrial-protocol (n = 8). For each condition, the Hydra-Alert was tested on two occasions (T1 and T2). The Hydra-Alert was tested against nude weight loss for both conditions. The Hydra-Alert had low test-retest reliability for both conditions (average absolute value of the error between Hydra-Alert outputs of T1 and T2 = 0.08 +/- 0.08 percentage points). With exercise-clothing, the Hydra-Alert evidenced low-moderate correlations between percent nude weight loss and Hydra-Alert output at 20 min (r = 0.59-T1, p = 0.13; r = 0.12-T2, p = 0.78), at 40 min (r = 0.93-T1, p = 0.001; r = 0.63-T2, p = 0.10), and at approximately 2 % weight loss (r = 0.21-T1 and T2, p = 0.61 and 0.62, respectively). The correlation at 40 min during T1 fell during T2 suggesting the Hydra-Alert was inconsistent. When wearing a ballistic-vest, the Hydra-Alert had poor validity (T1: r = - 0.29 [p = 0.48] for weight loss vs. monitor; T2: r = 0.11 [p = 0.80]). At the higher levels of dehydration ( approximately 2 %), the Hydra-Alert error was so high as to render its readings of little value. In some cases, the Hydra-Alert could lead to a false level of security if dehydrated. Therefore, the Hydra-Alert is of little use for those who want to measure their fluid loss while exercising in the heat.

Aerobic exercise training conserves insulin sensitivity for 1 yr following weight loss in overweight women.

PubMed

Fisher, Gordon; Hunter, Gary R; Gower, Barbara A

2012-02-01

The objectives of this study were to 1) identify the independent effects of exercise (aerobic or resistance training) and weight loss on whole body insulin sensitivity and 2) determine if aerobic or resistance training would be more successful for maintaining improved whole body insulin sensitivity 1 yr following weight loss. Subjects were 97 healthy, premenopausal women, body mass index (BMI) 27-30 kg/m(2). Following randomized assignment to one of three groups, diet only, diet + aerobic, or diet + resistance training until a BMI <25 kg/m(2) was achieved, body composition, fat distribution, and whole body insulin sensitivity were determined at baseline, in the weight reduced state, and at 1-yr follow up. The whole body insulin sensitivity index (S(I)) was determined using a frequently sampled intravenous glucose tolerance test. Results of repeated-measures ANOVA indicated a significant improvement in S(I) following weight loss. However, there were no group or group×time interactions. At 1-yr follow up, there were no significant time or group interactions for S(I;) however, there was a significant group×time interaction for S(I). Post hoc analysis revealed that women in the aerobic training group showed a significant increased S(I) from weight reduced to 1-yr follow up (P < 0.05), which was independent of intra-abdominal adipose tissue and %fat. No significant differences in S(I) from weight reduced to 1-yr follow up were observed for diet only or diet + resistance groups. Additionally, multiple linear regression analysis revealed that change in whole body insulin sensitivity from baseline to 1-yr follow up was independently associated with the change in Vo(2max) from baseline to 1-yr follow up (P < 0.05). These results suggest that long-term aerobic exercise training may conserve improvements in S(I) following weight loss and that maintaining cardiovascular fitness following weight loss may be important for maintaining improvements in S(I).

Intentional Weight Loss and Changes in Symptoms of Depression: A Systematic Review and Meta-Analysis

PubMed Central

Fabricatore, Anthony N.; Wadden, Thomas A.; Higginbotham, Allison J.; Faulconbridge, Lucy F.; Nguyen, Allison M.; Heymsfield, Steven B.; Faith, Myles S.

2011-01-01

Objective Obesity is related to increased risk of several health complications, including depression. Many studies have reported improvements in mood with weight loss, but results have been equivocal. The present meta-analysis examined changes in symptoms of depression that were reported in trials of weight loss interventions. Between-groups comparisons of different weight loss methods (e.g., lifestyle modification, diet alone, pharmacotherapy) were examined, as were within-group changes for each treatment type. Method MEDLINE was searched for articles published between 1950 and January 2009. Several obesity-related terms were intersected with terms related to depression. Results were filtered to return only studies of human subjects, published in English. Of 5971 articles, 394 were randomized controlled trials. Articles were excluded if they did not report mean changes in weight or symptoms of depression, included children or persons with psychiatric disorders (other than depression), or provided insufficient data for analysis. Thirty-one studies (n = 7937) were included. Two authors independently extracted a description of each study treatment, sample characteristics, assessment methods, and changes in weight and symptoms of depression. Treatments were categorized as: lifestyle modification, non-dieting, dietary counseling, diet-alone, exercise-alone, pharmacotherapy, placebo, or control interventions. Results Random effects models found that lifestyle modification was superior to control and non-dieting interventions for reducing symptoms of depression, and marginally better than dietary counseling and exercise-alone programs. Exercise-alone programs were superior to controls. No differences were found for comparisons of pharmacologic agents and placebos. Within-group analyses found significant reductions in symptoms of depression for nearly all active interventions. A meta-regression found no relationship between changes in weight and changes in symptoms of depression in lifestyle modification interventions. Conclusions On average, obese individuals in weight loss trials experienced reductions in symptoms of depression. Future studies should examine incidence and resolution of clinically significant depressive disorders with weight loss interventions. PMID:21343903

Local vibration enhanced the efficacy of passive exercise on mitigating bone loss in hindlimb unloading rats

NASA Astrophysics Data System (ADS)

Huang, Yunfei; Luan, Huiqin; Sun, Lianwen; Bi, Jingfang; Wang, Ying; Fan, Yubo

2017-08-01

Spaceflight induced bone loss is seriously affecting astronauts. Mechanical stimulation from exercise has been shown to restrain bone resorption as well as improve bone formation. Current exercise countermeasures in space cannot prevent it completely. Active exercise may convert to passive exercise in some ways because of the loss of gravity stimulus and inertia of exercise equipment. The aim of this study was to compare the efficacy of passive exercise or/and local vibration on counteracting the deterioration of the musculoskeletal system, including bone, muscle and tendons in tail-suspended rats. We hypothesized that local vibration could enhance the efficacy of passive exercise on countering bone loss. 40 Sprague Dawley rats were randomly distributed into five groups (n = 8, each): tail-suspension (TS), TS+35 Hz vibration (TSV), TS + passive exercise (TSP), TS + passive exercise coupled with 35 Hz vibration (TSPV) and control (CON). Passive exercise or/and local vibration was performed for 21 days. On day 0 and 21, bone mineral density (BMD) was observed by dual energy X-ray absorptiometry (DXA), and trabecular microstructure was evaluated by microcomputer tomography (μCT) analysis in vivo. Mechanical properties of tibia and tendon were determined by a mechanical testing system. Soleus and bone ash weight was tested by an electronic balance. Results showed that the passive exercise could not prevent the decrease of trabecular BMD, microstructure and bone ash weight induced by TS, whereas vibration and passive exercise coupled with local vibration (PV) could. Biomechanical properties of the tibia and tendon in TSPV group significantly increased compared with TS group. In summary, PV in this study was the best method in preventing weightlessness-induced bone loss. Consistent with our hypothesis, local vibration partly enhanced the effect of passive exercise. Furthermore, this study will be useful in improving countermeasure for astronauts, but also for the rehabilitation of disused or aged osteoporosis.

The role of exercise in the treatment of obesity.

PubMed

Laskowski, Edward R

2012-11-01

The United States is in the midst of a significant public health problem that relates to obesity and inactivity. This epidemic has far-ranging consequences for our workforce and our children and shows no signs of slowing in the near future. Significant research has been performed on the effects of exercise for the reduction of body weight; results of most studies indicate that exercise alone has a small effect on body-weight reduction independent of caloric restriction. However, when combined with dietary restriction, exercise has a synergistic effect and enhances weight loss beyond the effect of diet alone. In addition, exercise has been shown to have significant beneficial effects on cardiovascular and metabolic risk factors independent of actual weight loss, and losing just a small amount of weight can have a significant beneficial effect on these parameters. Genetic factors related to obesity have been found to be positively modified when persons incorporate physical activity into their lifestyle. Sitting time appears to be an independent risk factor for the development of metabolic risk factors; persons who spend more time sitting and watching television have worse metabolic profiles, even if they achieve the recommended amount of physical activity per week, than do those who move about throughout the day. Exercise also is essential for the prevention of weight gain over a life span, although the amount required to prevent weight gain may be closer to twice the amount of exercise recommended by the current Physical Activity Guidelines for Americans (www.health.gov/paguidelines). In many ways, the physiatrist is the most well prepared of all the specialists to address the complex, multidimensional problems of obesity and inactivity. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Effects of Moderate Aerobic Exercise Combined with Caloric Restriction on Circulating Estrogens and IGF-I in Premenopausal Women

DTIC Science & Technology

2005-08-01

reproductive status and stress hormones in breast cancer patients” ( Kinesiology ) 2004 Kelly Dougherty “No relation between leptin and exercise...associated reproductive disturbances in healthy normal weight young women” ( Kinesiology ) 2004 Brian Frye “Predictors of weight loss in a diet...and exercise intervention in young women” ( Kinesiology ) 2005 Sarah Giambuzzi ( Kinesiology – In Progress) 2005 Jennifer Ward (Physiology- In

Chronic Kidney Disease

MedlinePlus

... and Nutrition Healthy Food Choices Weight Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health ...

Caloric restriction and aerobic exercise in sarcopenic and non-sarcopenic obese women: an observational and retrospective study.

PubMed

Barbat-Artigas, Sébastien; Garnier, Sophie; Joffroy, Sandra; Riesco, Éléonor; Sanguignol, Frédéric; Vellas, Bruno; Rolland, Yves; Andrieu, Sandrine; Aubertin-Leheudre, Mylène; Mauriège, Pascale

2016-06-01

Sarcopenic obese (SO) individuals are a unique subset of subjects that combines obesity and sarcopenia. Traditional weight loss programmes including aerobic exercises may worsen their condition by further reducing their lean mass. The objective of this observational and retrospective study was to verify the effect of a mixed weight loss programme combining caloric restriction and exercise on body composition, and lipid-lipoprotein profile of obese women according to their sarcopenic status. One hundred and forty-six obese women (body mass index ≥ 30 kg/m(2) and fat mass ≥ 40%) participated to the 3 week usual and institutionalized weight-reducing programme combining a dietary plan (1400 ± 200 kcal/day) and aerobic exercise (1 h/day, 6 days/week) of a specialized medical institution. The lean body mass index (LMI; lean mass/height(2)) was calculated, and women in the lowest tertile of LMI were considered SO. At baseline, SO women were older, and their body weight and LMI were lower than non-sarcopenic obese (N-SO) women (p < 0.05). N-SO and SO women similarly lost fat mass and improved their lipid-lipoprotein profile (p < 0.05), while differences in LMI between groups persisted at the end of the weight-reducing programme. Indeed, N-SO women lost lean mass (p < 0.05) while SO did not. These findings suggest that a short weight loss programme combining caloric restriction and aerobic exercise may significantly reduce fat mass and improve lipid-lipoprotein profile in obese women, independently of their sarcopenic status. Such programmes may have deleterious effects on lean mass in N-SO subjects, only.

Obesity and the Unbalanced Energy Equation: Exercise versus Eating Habit Change.

ERIC Educational Resources Information Center

And Others; Dahlkoetter, JoAnn

1979-01-01

Compared relative effectiveness of exercise and eating habit change individually and in combination for weight loss and physical conditioning. Results indicated significant improvement for all treatment groups. Groups who exercised showed most improvement in physical fitness. Combining exercise and eating habit change yielded best results in…

Mechanisms of change of a novel weight loss programme provided by a third sector organisation: a qualitative interview study.

PubMed

McMahon, Naoimh E; Visram, Shelina; Connell, Louise A

2016-05-10

There is a need for theory-driven studies that explore the underlying mechanisms of change of complex weight loss programmes. Such studies will contribute to the existing evidence-base on how these programmes work and thus inform the future development and evaluation of tailored, effective interventions to tackle overweight and obesity. This study explored the mechanisms by which a novel weight loss programme triggered change amongst participants. The programme, delivered by a third sector organisation, addressed both diet and physical activity. Over a 26 week period participants engaged in three weekly sessions (education and exercise in a large group, exercise in a small group and a one-to-one education and exercise session). Novel aspects included the intensity and duration of the programme, a competitive selection process, milestone physical challenges (e.g. working up to a 5 K and 10 K walk/run during the programme), alumni support (face-to-face and online) and family attendance at exercise sessions. Data were collected through interviews with programme providers (n = 2) and focus groups with participants (n = 12). Discussions were audio-recorded, transcribed and analysed using NVivo10. Published behaviour change frameworks and behaviour change technique taxonomies were used to guide the coding process. Clients' interactions with components of the weight loss programme brought about a change in their commitment, knowledge, beliefs about capabilities and social and environmental contexts. Intervention components that generated these changes included the competitive selection process, group and online support, family involvement and overcoming milestone challenges over the 26 week programme. The mechanisms by which these components triggered change differed between participants. There is an urgent need to establish robust interventions that can support people who are overweight and obese to achieve a healthy weight and maintain this change. Third sector organisations may be a feasible alternative to private and public sector weight loss programmes. We have presented findings from one example of a novel community-based weight loss programme and identified how the programme components resulted in change amongst the participants. Further research is needed to robustly test the effectiveness, and cost-effectiveness, of this programme.

Examining behavioral processes through which lifestyle interventions promote weight loss: results from PREMIER.

PubMed

Fitzpatrick, Stephanie L; Bandeen-Roche, Karen; Stevens, Victor J; Coughlin, Janelle W; Rubin, Richard R; Brantley, Phillip J; Funk, Kristine L; Svetkey, Laura P; Jerome, Gerald J; Dalcin, Arlene; Charleston, Jeanne; Appel, Lawrence J

2014-04-01

To examine the behavioral processes through which lifestyle interventions impacted weight loss. The analyses were limited to overweight and obese Black and White adults randomized to a PREMIER lifestyle intervention (N = 501). Structural equation modeling was conducted to test the direct and indirect relationships of session attendance, days of self-monitoring diet and exercise, change in diet composition and exercise, and 6-month weight change. Greater session attendance was associated with increased self-monitoring, which was in turn significantly related to reduction in percent energy from total fat consumed. Change in percent energy from fat and self-monitoring was associated with 6-month percent change in weight. Both a decrease in fat intake and increase in self-monitoring are potential mediators of the relationship between attendance and weight change. The findings provide a reasonable model that suggests regular session attendance and use of behavioral strategies like self-monitoring are associated with improved behavioral outcomes that are associated with weight loss. Copyright © 2013 The Obesity Society.

4-containing GABA receptors at the hippocampal CA1 spines is a biomarker for resilience to food restriction-evoked excessive exercise and weight loss of adolescent female rats

PubMed Central

Aoki, Chiye; Wable, Gauri; Chowdhury, Tara G.; Sabaliauskas, Nicole A.; Laurino, Kevin; Barbarich-Marsteller, Nicole C.

2014-01-01

Anorexia nervosa (AN) is a psychiatric illness characterized by restricted eating and an intense fear of gaining weight. Most individuals with AN are females, diagnosed first during adolescence, 40% to 80% of whom exhibit excessive exercise, and an equally high number with a history of anxiety disorder. We sought to determine the cellular basis for individual differences in AN vulnerability by using an animal model, activity-based anorexia (ABA), that is induced by combining food restriction (FR) with access to a running wheel that allows voluntary exercise. Previously, we showed that by the 4th day of FR, the ABA group of adolescent female rats exhibit > 500% greater levels of non-synaptic α4βδ−GABAARs at the plasma membrane of hippocampal CA1 pyramidal cell spines, relative to the levels found in age-matched controls that are not FR and without wheel access. Here, we show that the ABA group exhibits individual differences in body weight loss, with some losing nearly 30%, while others lose only 15%. The individual differences in weight loss are ascribable to individual differences in wheel activity that both precedes and concurs with days of FR. Moreover, the increase in activity during FR correlates strongly and negatively with α4βδ−GABAAR levels (R= - 0.9, p<0.01). This negative correlation is evident within 2 days of FR, before body weight loss approaches life-threatening levels for any individual. These findings suggest that increased shunting inhibition by α4βδ−GABAARs in spines of CA1 pyramidal neurons may participate in the protection against the ABA-inducing environmental factors of severe weight loss by suppressing excitability of the CA1 pyramidal neurons which, in turn, is related indirectly to suppression of excessive exercise. The data also indicate that, although exercise has many health benefits, it can be maladaptive to individuals with low levels of α4βδ−GABAARs in the CA1, particularly when combined with FR. PMID:24444828

Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review.

PubMed

Gay, C; Chabaud, A; Guilley, E; Coudeyre, E

2016-06-01

Highlight the role of patient education about physical activity and exercise in the treatment of hip and knee osteoarthritis (OA). Systematic literature review from the Cochrane Library, PubMed and Wiley Online Library databases. A total of 125 items were identified, including 11 recommendations from learned societies interested in OA and 45 randomized controlled trials addressing treatment education and activity/exercise for the treatment of hip and knee osteoarthritis. In the end, 13 randomized controlled trials and 8 recommendations were reviewed (1b level of evidence). Based on the analysis, it was clear that education, exercise and weight loss are the pillars of non-pharmacological treatments. These treatments have proven to be effective but require changes in patient behaviour that are difficult to obtain. Exercise and weight loss improve function and reduce pain. Education potentiates compliance to exercise and weight loss programs, thereby improving their long-term benefits. Cost efficiency studies have found a reduction in medical visits and healthcare costs after 12 months because of self-management programs. Among non-surgical treatment options for hip and knee osteoarthritis, the most recent guidelines focus on non-pharmacological treatment. Self-management for general physical activity and exercise has a critical role. Programs must be personalized and adjusted to the patient's phenotype. This development should help every healthcare professional adapt the care they propose to each patient. Registration number for the systematic review: CRD42015032346. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project).

PubMed

Robertson, Clare; Avenell, Alison; Stewart, Fiona; Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Boyers, Dwayne

2017-07-01

Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials' registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m 2 (or ≥28 kg/m 2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program -3.2 kg, 95% confidence interval -4.8 to -1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was -4.9 kg, 95% confidence interval -5.9 to -4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.

Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project)

PubMed Central

Robertson, Clare; Avenell, Alison; Stewart, Fiona; Archibald, Daryll; Douglas, Flora; Hoddinott, Pat; van Teijlingen, Edwin; Boyers, Dwayne

2015-01-01

Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials’ registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2 (or ≥28 kg/m2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program −3.2 kg, 95% confidence interval −4.8 to −1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was −4.9 kg, 95% confidence interval −5.9 to −4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed. PMID:26130729

Physical Activity and Weight Loss Reduce the Risk of Breast Cancer: A Meta-analysis of 139 Prospective and Retrospective Studies.

PubMed

Hardefeldt, Prue J; Penninkilampi, Ross; Edirimanne, Senarath; Eslick, Guy D

2017-10-17

Physical activity and weight loss have been shown to reduce breast cancer incidence in numerous observational studies. The aim of this meta-analysis was to assess the effect of both physical activity and weight loss on breast cancer incidence. Specifically, we aimed to complete subgroup analyses by the intensity of physical activity and menopausal status at breast cancer diagnosis to further elucidate the relationship between physical activity, weight loss, and breast cancer incidence. Studies were obtained from a database search of MEDLINE, EMBASE, PubMed, Current Contents Connect, and Google Scholar through November 5, 2017. A random-effects model was used for pooled data. There were 139 studies included in the meta-analysis, including 236,955 cases and 3,963,367 controls. Physical activity significantly reduced the risk of breast cancer (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.76-0.81; P < .001), with high-intensity physical activity being slightly more protective (OR, 0.73; 95% CI, 0.65-0.81; P < .001) than low-intensity exercise (OR, 0.79; 95% CI, 0.72-0.86; P < .001). The effect size for general exercise was similar in both premenopausal (OR, 0.79; 95% CI, 0.73-0.87; P < .001) and postmenopausal (OR, 0.82; 95% CI, 0.78-0.86; P < .001) women. Additionally, weight loss reduced the risk of breast cancer incidence (OR, 0.82; 95% CI, 0.67-0.97). Physical activity and weight loss significantly reduce the risk of breast cancer, irrespective of the timing and intensity of the exercise. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Beneficial effects of training at the anaerobic threshold in addition to pharmacotherapy on weight loss, body composition, and exercise performance in women with obesity.

PubMed

Ozcelik, Oguz; Ozkan, Yusuf; Algul, Sermin; Colak, Ramis

2015-01-01

The aim of this study was to determine and compare the effects of weight loss achieved through orlistat therapy alone or a combination of orlistat and an aerobic exercise training program on aerobic fitness and body composition in obese females. Twenty-eight obese patients were randomly assigned to receive 12-week treatment with hypocaloric diet-orlistat or diet-orlistat-exercise. Each participant performed an incremental ramp exercise test every 4 weeks to measure aerobic fitness. Fourteen participants performed continuous exercise (approximately 45 minutes per session) at a work rate corresponding to the anaerobic threshold three times per week. A decrease in the fat mass to body weight ratio of 3.8% (P=0.006) was observed at the end of the 12 weeks in the orlistat group, while a decrease of 9.5% (P=0.001) was seen in the orlistat-exercise group. Maximal exercise capacity increased by 46.5% in the orlistat-exercise group and by 19.5% in the orlistat group. While orlistat therapy resulted in an improvement in body composition and aerobic fitness at the end of the 12-week period, its combination with exercise training provided improvements in the same parameters within the first 4 weeks of the study. These additional beneficial effects of combining aerobic exercise with orlistat therapy are important with regards to obesity-associated risk factors.

The role of weight loss and exercise in correcting skeletal muscle mitochondrial abnormalities in obesity, diabetes and aging.

PubMed

Toledo, Frederico G S; Goodpaster, Bret H

2013-10-15

Mitochondria within skeletal muscle have been implicated in insulin resistance of obesity and type 2 diabetes mellitus as well as impaired muscle function with normal aging. Evaluating the potential of interventions to improve mitochondria is clearly relevant to the prevention or treatment of metabolic diseases and age-related dysfunction. This review provides an overview and critical evaluation of the effects of weight loss and exercise interventions on skeletal muscle mitochondria, along with implications for insulin resistance, obesity, type 2 diabetes and aging. The available literature strongly suggests that the lower mitochondrial capacity associated with obesity, type 2 diabetes and aging is not an irreversible lesion. However, weight loss does not appear to affect this response, even when the weight loss is extreme. In contrast, increasing physical activity improves mitochondrial content and perhaps the function of individual mitochondrion. Despite the consistent effect of exercise to improve mitochondrial capacity, studies mechanistically linking mitochondria to insulin resistance, reductions in intramyocellular lipid or improvement in muscle function remain inconclusive. In summary, studies of diet and exercise training have advanced our understanding of the link between mitochondrial oxidative capacity and insulin resistance in obesity, type 2 diabetes and aging. Nevertheless, additional inquiry is necessary to establish the significance and clinical relevance of those perturbations, which could lead to targeted therapies for a myriad of conditions and diseases involving mitochondria. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Lower extremity muscle size and strength and aerobic capacity decrease with caloric restriction but not with exercise-induced weight loss

PubMed Central

Weiss, Edward P.; Racette, Susan B.; Villareal, Dennis T.; Fontana, Luigi; Steger-May, Karen; Schechtman, Kenneth B.; Klein, Samuel; Ehsani, Ali A.; Holloszy, John O.

2015-01-01

Caloric restriction (CR) results in fat loss; however, it may also result in loss of muscle and thereby reduce strength and aerobic capacity (V̇O2 max). These effects may not occur with exercise-induced weight loss (EX) because of the anabolic effects of exercise on heart and skeletal muscle. We tested the hypothesis that CR reduces muscle size and strength and V̇O2 max, whereas EX preserves or improves these parameters. Healthy 50- to 60-yr-old men and women (body mass index of 23.5–29.9 kg/m2) were studied before and after 12 mo of weight loss by CR (n = 18) or EX (n = 16). Lean mass was assessed by dual-energy X-ray absorptiometry, thigh muscle volume by MRI, isometric and isokinetic knee flexor strength by dynamometry, and treadmill V̇O2 max by indirect calorimetry. Both interventions caused significant decreases in body weight (CR: −10.7 ± 1.4%, EX: −9.5 ± 1.5%) and lean mass (CR: −3.5 ± 0.7%, EX: −2.2 ± 0.8%), with no significant differences between groups. Significant decreases in thigh muscle volume (−6.9 ± 0.8%) and composite knee flexion strength (−7.2 ± 3%) occurred in the CR group only. Absolute V̇O2 max decreased significantly in the CR group (−6.8 ± 2.3%), whereas the EX group had significant increases in both absolute (+15.5 ± 2.4%) and relative (+28.3 ± 3.0%) V̇O2 max. These data provide evidence that muscle mass and absolute physical work capacity decrease in response to 12 mo of CR but not in response to a similar weight loss induced by exercise. These findings suggest that, during EX, the body adapts to maintain or even enhance physical performance capacity. PMID:17095635

Lifestyle interventions for weight loss in adults with severe obesity: a systematic review.

PubMed

Hassan, Y; Head, V; Jacob, D; Bachmann, M O; Diu, S; Ford, J

2016-12-01

Severe obesity is an increasingly prevalent condition and is often associated with long-term comorbidities, reduced survival and higher healthcare costs. Non-surgical methods avoid the side effects, complications and costs of surgery, but it is unclear which non-surgical method is most effective. The objective of this article was to systematically review the effectiveness of lifestyle interventions compared to standard or minimal care for weight loss in adults with severe obesity. MEDLINE, EMBASE, CENTRAL, databases of on-going studies, reference lists of any relevant systematic reviews and the Cochrane Library database were searched from inception to February 2016 for relevant randomized controlled trials (RCTs). Inclusion criteria were participants with severe obesity (body mass index [BMI] > 40 kg/m 2 or BMI > 35 kg/m 2 with comorbidity) and interventions with a minimal duration of 12 weeks that were multi-component combinations of diet, exercise and behavioural therapy. Risk of bias was evaluated using the Cochrane risk of bias criteria. Meta-analysis was not possible because of methodological heterogeneity. Seventeen RCTs met the inclusion criteria. Weight change in kilograms of participants from baseline to follow-up was reported for 14 studies. Participants receiving the lifestyle intervention had a greater decrease in weight than participants in the control group for all studies (1.0-11.5 kg). Lifestyle interventions varied greatly between the studies. Overall lifestyle interventions with combined diet and exercise components achieved the greatest weight loss. Lifestyle interventions for weight loss in adults with severe obesity were found to result in increased weight loss when compared to minimal or standard care, especially those with combined diet and exercise components. © 2016 World Obesity Federation.

Interest in healthy diet and physical activity interventions peripartum among female partners of active duty military.

PubMed

Ostbye, Truls; McBride, Colleen; Demark-Wahnefried, Wendy; Bastian, Lori; Morey, Miriam; Krause, Katrina M; Brouwer, Rebecca; Turner, Barbara

2003-04-01

Overweight and obesity among soldiers and their dependents have increased over the last decade, mirroring rates in the general population. In general, few programs that result in sustained weight loss have been evaluated, although effective interventions could have clear health and cost benefits for the military. For women, the postpartum period represents a "teachable moment" to promote healthy diet and exercise behaviors related to weight loss, but the attitudes and preferences for weight-loss interventions in this population are unknown. With a view to developing a weight-loss intervention tailored to this population, we surveyed 161 peripartum women at a military base to assess their interests and preferences. Eighty-six percent were dependents. Despite their youth, more than one-third reported entering pregnancy overweight or obese. Interest was high for interventions that promote physical activity and facilitate social interaction. Based on these results, a postpartum exercise intervention is being designed for female partners of active duty soldiers.

A structured diet and exercise program promotes favorable changes in weight loss, body composition, and weight maintenance.

PubMed

Kreider, Richard B; Serra, Monica; Beavers, Kristen M; Moreillon, Jen; Kresta, Julie Y; Byrd, Mike; Oliver, Jonathan M; Gutierrez, Jean; Hudson, Geoffrey; Deike, Erika; Shelmadine, Brian; Leeke, Patricia; Rasmussen, Chris; Greenwood, Mike; Cooke, Matthew B; Kerksick, Chad; Campbell, Jessica K; Beiseigel, Jeannemarie; Jonnalagadda, Satya S

2011-06-01

A number of diet and exercise programs purport to help promote and maintain weight loss. However, few studies have compared the efficacy of different methods. To determine whether adherence to a meal-replacement-based diet program (MRP) with encouragement to increase physical activity is as effective as following a more structured meal-plan-based diet and supervised exercise program (SDE) in sedentary obese women. Randomized comparative effectiveness trial. From July 2007 to October 2008, 90 obese and apparently healthy women completed a 10-week university-based weight loss trial while 77 women from this cohort also completed a 24-week weight maintenance phase. Participants were matched and randomized to participate in an MRP or SDE program. Weight loss, health, and fitness-related data were assessed at 0 and 10 weeks on all subjects as well as at 14, 22, and 34 weeks on participants who completed the weight maintenance phase. Data were analyzed by multivariate analysis of variance for repeated measures. During the 10-week weight loss phase, moderate and vigorous physical activity levels were significantly higher in the SDE group with no differences observed between groups in daily energy intake. The SDE group lost more weight (-3.1 ± 3.7 vs -1.6 ± 2.5 kg; P = 0.03); fat mass (-2.3 ± 3.5 vs -0.9 ± 1.6 kg; P = 0.02); centimeters from the hips (-4.6 ± 7 vs -0.2 ± 6 cm; P = 0.002) and waist (-2.9 ± 6 vs -0.6 ± 5 cm; P = 0.05); and, experienced a greater increase in peak aerobic capacity than participants in the MRP group. During the 24-week maintenance phase, participants in the SDE group maintained greater moderate and vigorous physical activity levels, weight loss, fat loss, and saw greater improvement in maximal aerobic capacity and strength. In sedentary and obese women, an SDE-based program appears to be more efficacious in promoting and maintaining weight loss and improvements in markers of health and fitness compared to an MRP type program with encouragement to increase physical activity. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

An inpatient lifestyle-change programme improves heart rate recovery in overweight and obese children and adolescents (LOGIC Trial).

PubMed

Wilks, Désirée C; Rank, Melanie; Christle, Jeff; Langhof, Helmut; Siegrist, Monika; Halle, Martin

2014-07-01

Impaired heart rate recovery (HRR) is a strong predictor of overall mortality and cardio-metabolic risk. This study aimed at investigating (1) the effect of participation in a lifestyle-change programme for weight loss on HRR in overweight and obese children and (2) potential associations between the changes in one minute HRR (HRR1) and fitness, weight loss and cardio-metabolic risk. The analysis included 429 individuals (169 boys) aged 13.9 ± 2.3 years who participated in an inpatient weight loss programme for four to six weeks. At baseline and the end of the programme clinical investigations were performed, including blood analyses, blood pressure, anthropometry and maximal cycle ergometer exercise testing with continuous heart rate (HR) monitoring. HRR was calculated as the difference between the highest exercising HR and HR at one, three and five minutes post-exercise. Average body weight decreased from 90.7 ± 22.5 kg to 81.9 ± 20.0 kg and peak exercise capacity increased from 1.66 ± 0.38 W/kg to 2.05 ± 0.45 W/kg (p < 0.001). Cardio-metabolic risk factors improved (waist circumference, LDL-cholesterol, HOMA insulin ratio, blood pressure; p < 0.05). HDL-cholesterol and triglyceride levels remained unchanged. Compared with baseline, at follow-up the decline in HR was more pronounced (+32%, +18% and +11% for HRR1, HRR3 and HRR5; p < 0.001). Improvements in HRR1 were weakly correlated with changes in exercise capacity (p < 0.05; r < 0.13), but not with changes in body weight and cardio-metabolic risk factors. HRR considerably improved after an inpatient weight loss programme in overweight and obese children. This was not associated with improvements in body weight and cardio-metabolic risk; hence HRR would be a valuable addition to cardiovascular risk assessment in this group. © The European Society of Cardiology 2012.

New mothers' views of weight and exercise.

PubMed

Groth, Susan W; David, Tamala

2008-01-01

To describe the attitudes and preferences of ethnically diverse new mothers on weight and exercise. Exploratory, qualitative study. Forty-nine ethnically diverse women were interviewed during the first year following childbirth regarding beliefs about weight, choices of exercise, walking for exercise, perceived benefits, barriers, and facilitators of exercise. Content analysis techniques were used to analyze the data. Weight was a significant concern for women, although the importance varied by race. New mothers reported that they would like to weigh less, and they endorsed walking for exercise. Common barriers to exercise were children and time constraints; health problems were also seen as a barrier to walking as a form of exercise. Scheduling the walk and having a walking partner were factors that women said would facilitate walking for physical activity during the first year after childbirth. Because new mothers perceive walking as a good form of exercise, nurses can use this information to help them plan a daily walking schedule to aid in weight loss and control postpartum. Nurses should also encourage new mothers to look for a walking partner, especially another new mother or a friend, to help them continue their physical activity during the first year after childbirth.

An analysis of weight loss articles and advertisements in mainstream women's health and fitness magazines.

PubMed

Ethan, Danna; Basch, Corey H; Hillyer, Grace Clarke; Berdnik, Alyssa; Huynh, Mary

2016-01-01

Magazines are a commonly used source for health and fitness information. Little is known about the nature and extent of weight loss strategies and products presented in mainstream women's health and fitness magazines. This preliminary cross-sectional study evaluated the prevalence of articles and advertisements featuring weight loss content and products in mainstream US-based health and fitness magazines, as well as assessed weight loss themes presented. Thirty-one US health and fitness-focused magazine issues were coded. Prevalence of, product type, and themes related to weight loss in articles and advertisements were assessed. Among the 31 issues of the five US-based women's magazines examined, we identified 39 articles (4.8% [95% CI = 3.3% to 5.5%] of 819 articles) related to weight loss with 14 identified weight loss topics. The most prevalent article topics covered were exercising/workouts (32.0% [95% CI = 28.8% to 33.6%]) followed by dieting (18.6% [95% CI = 15.9% to 19.9%]).The most common product advertised was weight loss pills (46.0% [95% CI = 42.6% to 47.7%]). Fat burners were also frequently advertised (14.9% [95% CI = 12.5% to 16.1%]) followed by hunger reduction strategies (10.3% [95% CI = 8.2% to 11.3%]) and fat blockers (6.9% [95% CI= 5.2% to 7.8%]). Articles presented information about exercise and dieting whereas advertisements supported potentially harmful health beliefs and behaviors. As a well-utilized American media format, health and fitness-focused magazines have an opportunity to communicate frequent,accurate messaging about healthy weight reduction and limit advertisements that may include misleading claims.

An analysis of weight loss articles and advertisements in mainstream women’s health and fitness magazines

PubMed Central

Ethan, Danna; Basch, Corey H.; Hillyer, Grace Clarke; Berdnik, Alyssa; Huynh, Mary

2016-01-01

Background: Magazines are a commonly used source for health and fitness information. Little is known about the nature and extent of weight loss strategies and products presented in mainstream women’s health and fitness magazines. Methods: This preliminary cross-sectional study evaluated the prevalence of articles and advertisements featuring weight loss content and products in mainstream US-based health and fitness magazines, as well as assessed weight loss themes presented. Thirty-one US health and fitness-focused magazine issues were coded. Prevalence of, product type, and themes related to weight loss in articles and advertisements were assessed. Results: Among the 31 issues of the five US-based women’s magazines examined, we identified 39 articles (4.8% [95% CI = 3.3% to 5.5%] of 819 articles) related to weight loss with 14 identified weight loss topics. The most prevalent article topics covered were exercising/workouts (32.0% [95% CI = 28.8% to 33.6%]) followed by dieting (18.6% [95% CI = 15.9% to 19.9%]).The most common product advertised was weight loss pills (46.0% [95% CI = 42.6% to 47.7%]). Fat burners were also frequently advertised (14.9% [95% CI = 12.5% to 16.1%]) followed by hunger reduction strategies (10.3% [95% CI = 8.2% to 11.3%]) and fat blockers (6.9% [95% CI= 5.2% to 7.8%]). Conclusion: Articles presented information about exercise and dieting whereas advertisements supported potentially harmful health beliefs and behaviors. As a well-utilized American media format, health and fitness-focused magazines have an opportunity to communicate frequent,accurate messaging about healthy weight reduction and limit advertisements that may include misleading claims. PMID:27386422

Effect of Exercise and Calorie Restriction on Tissue Acylcarnitines, Tissue Desaturase Indices, and Fat Accumulation in Diet-Induced Obese Rats

PubMed Central

Gopalan, Venkatesh; Michael, Navin; Ishino, Seigo; Lee, Swee Shean; Yang, Adonsia Yating; Bhanu Prakash, K. N.; Yaligar, Jadegoud; Sadananthan, Suresh Anand; Kaneko, Manami; Zhou, Zhihong; Satomi, Yoshinori; Hirayama, Megumi; Kamiguchi, Hidenori; Zhu, Bin; Horiguchi, Takashi; Nishimoto, Tomoyuki; Velan, S. Sendhil

2016-01-01

Both exercise and calorie restriction interventions have been recommended for inducing weight-loss in obese states. However, there is conflicting evidence on their relative benefits for metabolic health and insulin sensitivity. This study seeks to evaluate the differential effects of the two interventions on fat mobilization, fat metabolism, and insulin sensitivity in diet-induced obese animal models. After 4 months of ad libitum high fat diet feeding, 35 male Fischer F344 rats were grouped (n = 7 per cohort) into sedentary control (CON), exercise once a day (EX1), exercise twice a day (EX2), 15% calorie restriction (CR1) and 30% calorie restriction (CR2) cohorts. Interventions were carried out over a 4-week period. We found elevated hepatic and muscle long chain acylcarnitines with both exercise and calorie restriction, and a positive association between hepatic long chain acylcarnitines and insulin sensitivity in the pooled cohort. Our result suggests that long chain acylcarnitines may not indicate incomplete fat oxidation in weight loss interventions. Calorie restriction was found to be more effective than exercise in reducing body weight. Exercise, on the other hand, was more effective in reducing adipose depots and muscle triglycerides, favorably altering muscle/liver desaturase activity and improving insulin sensitivity. PMID:27197769

The Effects of Exercise Training in Addition to Energy Restriction on Functional Capacities and Body Composition in Obese Adults during Weight Loss: A Systematic Review

PubMed Central

Miller, Clint T.; Fraser, Steve F.; Levinger, Itamar; Straznicky, Nora E.; Dixon, John B.; Reynolds, John; Selig, Steve E.

2013-01-01

Background Obesity is associated with impairments of physical function, cardiovascular fitness, muscle strength and the capacity to perform activities of daily living. This review examines the specific effects of exercise training in relation to body composition and physical function demonstrated by changes in cardiovascular fitness, and muscle strength when obese adults undergo energy restriction. Methods Electronic databases were searched for randomised controlled trials comparing energy restriction plus exercise training to energy restriction alone. Studies published to May 2013 were included if they used multi-component methods for analysing body composition and assessed measures of fitness in obese adults. Results Fourteen RCTs met the inclusion criteria. Heterogeneity of study characteristics prevented meta-analysis. Energy restriction plus exercise training was more effective than energy restriction alone for improving cardiovascular fitness, muscle strength, and increasing fat mass loss and preserving lean body mass, depending on the type of exercise training. Conclusion Adding exercise training to energy restriction for obese middle-aged and older individuals results in favourable changes to fitness and body composition. Whilst weight loss should be encouraged for obese individuals, exercise training should be included in lifestyle interventions as it offers additional benefits. PMID:24409219

Effects of Low-Fat Diets Differing in Protein and Carbohydrate Content on Cardiometabolic Risk Factors during Weight Loss and Weight Maintenance in Obese Adults with Type 2 Diabetes.

PubMed

Watson, Nerylee; Dyer, Kathryn; Buckley, Jonathan; Brinkworth, Grant; Coates, Alison; Parfitt, Gaynor; Howe, Peter; Noakes, Manny; Murphy, Karen

2016-05-12

Despite evidence for the benefits of higher-protein (HP) diets in weight loss, their role in type 2 diabetes mellitus (T2DM) management and weight maintenance is not clear. This randomised study compared the effects of a HP diet (38% carbohydrate, 30% protein, 29% fat) to a isocaloric higher-carbohydrate diet (HC: 53%:21%:23%) on cardiometabolic risk factors for 12 weeks in energy restriction (~30% reduction) followed by 12 weeks of energy balance whilst performing regular exercise. Outcomes were measured at baseline and the end of each phase. Sixty-one overweight/obese adults (BMI (body mass index) 34.3 ± 5.1 kg/m², aged 55 ± 8 years) with T2DM who commenced the study were included in the intention-to-treat analysis including the 17 participants (HP n = 9, HC n = 8) who withdrew. Following weight loss (M ± SEM: -7.8 ± 0.6 kg), there were significant reductions in HbA1c (-1.4% ± 0.1%, p < 0.001) and several cardiometabolic health risk factors. Improvements were sustained for 12 weeks when weight was stabilised and weight loss maintained. Both the HP and HC dietary patterns with concurrent exercise may be effective strategies for weight loss and weight maintenance in T2DM although further studies are needed to determine the longer term effects of weight maintenance.

Effects of Low-Fat Diets Differing in Protein and Carbohydrate Content on Cardiometabolic Risk Factors during Weight Loss and Weight Maintenance in Obese Adults with Type 2 Diabetes

PubMed Central

Watson, Nerylee; Dyer, Kathryn; Buckley, Jonathan; Brinkworth, Grant; Coates, Alison; Parfitt, Gaynor; Howe, Peter; Noakes, Manny; Murphy, Karen

2016-01-01

Despite evidence for the benefits of higher-protein (HP) diets in weight loss, their role in type 2 diabetes mellitus (T2DM) management and weight maintenance is not clear. This randomised study compared the effects of a HP diet (38% carbohydrate, 30% protein, 29% fat) to a isocaloric higher-carbohydrate diet (HC: 53%:21%:23%) on cardiometabolic risk factors for 12 weeks in energy restriction (~30% reduction) followed by 12 weeks of energy balance whilst performing regular exercise. Outcomes were measured at baseline and the end of each phase. Sixty-one overweight/obese adults (BMI (body mass index) 34.3 ± 5.1 kg/m2, aged 55 ± 8 years) with T2DM who commenced the study were included in the intention-to-treat analysis including the 17 participants (HP n = 9, HC n = 8) who withdrew. Following weight loss (M ± SEM: −7.8 ± 0.6 kg), there were significant reductions in HbA1c (−1.4% ± 0.1%, p < 0.001) and several cardiometabolic health risk factors. Improvements were sustained for 12 weeks when weight was stabilised and weight loss maintained. Both the HP and HC dietary patterns with concurrent exercise may be effective strategies for weight loss and weight maintenance in T2DM although further studies are needed to determine the longer term effects of weight maintenance. PMID:27187457

Effects of a parallel arm randomized controlled weight loss pilot study on biological and psychosocial parameters of overweight and obese breast cancer survivors

USDA-ARS?s Scientific Manuscript database

Background: Weight gain often occurs after breast cancer (BC) diagnosis, and obesity along with sedentary behavior, are associated with increased risk of BC recurrence and mortality. The purpose of this study was to examine effects of weight loss and exercise on body composition, fitness, cancer-rel...

Instrumentalization of Eating Improves Weight Loss Maintenance in Obesity.

PubMed

Christensen, Bodil Just; Iepsen, Eva Winning; Lundgren, Julie; Holm, Lotte; Madsbad, Sten; Holst, Jens Juul; Torekov, Signe Sørensen

2017-01-01

The purpose of this study was to identify psychosocial determinants for maintaining weight loss. 42 obese individuals who achieved a 12% weight loss before entering a 52-week weight maintenance program were interviewed qualitatively. Psychosocial factors related to weight loss maintenance were identified in two contrasting groups: weight reducers and weight regainers. Groups were defined by health-relevant weight maintenance (additional weight loss > 3% at week 52, n = 9 versus weight gain > 3%, at week 52, n = 20). Weight reducers reported structured meal patterns (p = 0.008), no comfort eating (p = 0.016) and less psychosocial stress (p = 0.04) compared to weight regainers. The ability to instrumentalize eating behavior emerged as an important factor (p = 0.007). Nutritional knowledge, motivation or exercise level did not differ between groups (p > 0.05). Successful weight loss maintenance was associated with an interplay between behavioral, affective and contextual changes. 'Instrumentalization of eating behavior' seems to be an important element in long-term weight maintenance. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Effective weight-loss using an e-health delivered physical activity and dietary intervention: A federal credit union pilot study.

PubMed

Gregoski, Mathew J; Newton, Janis; Ling, Catherine G; Blaylock, Kathleen; Smith, Sheila A O; Paguntalan, John; Treiber, Frank A

2016-04-06

This pilot study investigated the effectiveness of a distance-based e-health program delivered across multiple rural Federal Credit Union worksites that focused on physical activity and dietary education. Program design and implementation were based on the premises of Social Impact Theory (SIT). A sample of fifty-four participants (47 white. 7 black) aged 24 to 58 across different worksite locations completed 10 weeks of e-health delivered physical activity and dietary intervention. Pre to post weight changes were examined as a primary outcome. The findings showed that regardless of worksite location, participants on average reduced their weight by 10.13 lbs if they completed both the exercise and lunch and learn components of the study compared to a decrease of 2.73 lbs for participants who chose not to engage in the exercise related activities. Participant dropout from either group was less than four percent. The results of this study show the beneficial influence of physical activity integration using SIT upon distance programs targeting weight loss. In addition, the high adherence and weight loss success show promise and demonstrates the potential for e-health delivered exercise and lifestyle interventions. Further replication of results via additional randomized controlled trials is needed.

Motivational "spill-over" during weight control: increased self-determination and exercise intrinsic motivation predict eating self-regulation.

PubMed

Mata, Jutta; Silva, Marlene N; Vieira, Paulo N; Carraça, Eliana V; Andrade, Ana M; Coutinho, Sílvia R; Sardinha, Luis B; Teixeira, Pedro J

2009-11-01

Successful weight management relies on at least two health behaviors, eating and exercise. However, little is known about their interaction on a motivational and behavioral level. Based on the Hierarchical Model of Motivation the authors examined whether exercise-specific motivation can transfer to eating regulation during a lifestyle weight control program. The authors further investigated whether general, treatment-related, and exercise motivation underlie the relation between increased exercise and improved eating regulation. Overweight/obese women participated in a 1-year randomized controlled trial (N = 239). The intervention focused on promoting physical activity and internal motivation for exercise and weight loss, following Self-Determination Theory. The control group received general health education. General and exercise specific self-determination, eating self-regulation variables, and physical activity behavior. General self-determination and more autonomous exercise motivation predicted eating self-regulation over 12 months. Additionally, general and exercise self-determination fully mediated the relation between physical activity and eating self-regulation. Increased general self-determination and exercise motivation seem to facilitate improvements in eating self-regulation during weight control in women. These motivational mechanisms also underlie the relationship between improvements in exercise behavior and eating regulation. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Increased Skin Blood Flow and Enhanced Heat Loss in Humans after Niacin Ingestion

DTIC Science & Technology

1994-06-01

vessels near the skin through a prostaglandin-mediated mechanism, as the flush can be inhibited by pre -treatment with sodium salicylate or other inhibitors...as the change in body weight from pre - to post-exercise. Heart rate (HR) was measured from the EKG record. Upright Exercise and Clothing Study Four...sweating was determined as the change in body weight from pre - to post-exercise. Oxygen consumption was measured by an automated method (SensorMedics

Thalassemia

MedlinePlus

... Crisis Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health ...

Shoulder Pain

MedlinePlus

... Crisis Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health ...

Diet and exercise weight-loss trial in lactating overweight and obese women.

PubMed

Bertz, Fredrik; Brekke, Hilde K; Ellegård, Lars; Rasmussen, Kathleen M; Wennergren, Margareta; Winkvist, Anna

2012-10-01

Current evidence suggests a combined treatment of postpartum weight loss of diet and exercise. However, to our knowledge, neither their separate and interactive effects nor long-term outcomes have been evaluated. We evaluated whether a 12-wk dietary behavior modification (D) treatment to decrease energy intake, physical exercise behavior modification (E) treatment to implement moderate aerobic exercise, or combined dietary and physical exercise behavior modification (DE) treatment compared with control (usual care) (C) reduces body weight in lactating women measured at the end of treatment and at a 1-y follow-up 9 mo after treatment termination. At 10-14 wk postpartum, 68 lactating Swedish women with a prepregnancy BMI (in kg/m²) of 25-35 were randomly assigned to D, E, DE, or C groups. Measurements were made at baseline, after the intervention, and again at a 1-y follow-up 9 mo later. A 2 × 2 factorial approach was used to analyze main and interaction effects of treatments. Weight changes after the intervention and 1-y follow-up were -8.3 ± 4.2 and -10.2 ± 5.7 kg, respectively, in the D group; -2.4 ± 3.2 and -2.7 ± 5.9 kg, respectively, in the E group; -6.9 ± 3.0 and -7.3 ± 6.3 kg, respectively, in the DE group; and -0.8 ± 3.0 and -0.9 ± 6.6 kg, respectively, in the C group. The main effects of D treatment, but not of E treatment, on weight were significant at both times (P < 0.001). Dietary treatment provided clinically relevant weight loss in lactating postpartum women, which was sustained at 9 mo after treatment. The combined treatment did not yield significant weight or body-composition changes beyond those of dietary treatment alone.

Perceptions relating to body size, weight loss and weight-loss interventions in black South African women: a qualitative study.

PubMed

Draper, Catherine E; Davidowitz, Kesiah J; Goedecke, Julia H

2016-02-01

A higher tolerance for a larger body size has been associated with obesity in black South African (SA) women. The aim of the present study was to explore perceptions regarding body size and weight loss in a sample of black women from a low-income community in Cape Town, SA. Qualitative pilot study including five focus groups. Data were analysed using thematic analysis. Khayelitsha, Cape Town, SA. Twenty-one black SA women. The majority of participants had positive perceptions of overweight/obesity, which were influenced by community and cultural perceptions, but some inconsistencies were observed as overweight/obesity was also associated with ill health. Participants identified many benefits to weight loss, but due to the association with sickness, they were concerned about being stigmatised in their community. Although participants had knowledge about healthy eating, the main barrier to eating healthily included the perceived higher cost of healthier food and food insecurity. All participants saw exercise as a strategy to lose weight and improve health, and were interested in participating in a community-based exercise intervention, but negative community perceptions and conflicting views regarding who should lead the intervention were identified as barriers. These findings highlight the complexities surrounding participants' perceptions regarding body size, weight loss and weight-loss interventions, and emphasise low socio-economic status as a barrier to change. The study also highlights the strong influence of cultural ideals and community perceptions on personal perceptions. These findings underscore the necessity for culturally appropriate weight-loss interventions in low-income, transitioning communities.

Altered gut and adipose tissue hormones in overweight and obese individuals: cause or consequence?

PubMed Central

Lean, M E J; Malkova, D

2016-01-01

The aim of this article is to review the research into the main peripheral appetite signals altered in human obesity, together with their modifications after body weight loss with diet and exercise and after bariatric surgery, which may be relevant to strategies for obesity treatment. Body weight homeostasis involves the gut–brain axis, a complex and highly coordinated system of peripheral appetite hormones and centrally mediated neuronal regulation. The list of peripheral anorexigenic and orexigenic physiological factors in both animals and humans is intimidating and expanding, but anorexigenic glucagon-like peptide 1 (GLP-1), cholecystokinin (CCK), peptide YY (PYY) and orexigenic ghrelin from the gastrointestinal tract, pancreatic polypeptide (PP) from the pancreas and anorexigenic leptin from adiposites remain the most widely studied hormones. Homeostatic control of food intake occurs in humans, although its relative importance for eating behaviour is uncertain, compared with social and environmental influences. There are perturbations in the gut–brain axis in obese compared with lean individuals, as well as in weight-reduced obese individuals. Fasting and postprandial levels of gut hormones change when obese individuals lose weight, either with surgical or with dietary and/or exercise interventions. Diet-induced weight loss results in long-term changes in appetite gut hormones, postulated to favour increased appetite and weight regain while exercise programmes modify responses in a direction expected to enhance satiety and permit weight loss and/or maintenance. Sustained weight loss achieved by bariatric surgery may in part be mediated via favourable changes to gut hormones. Future work will be necessary to fully elucidate the role of each element of the axis, and whether modifying these signals can reduce the risk of obesity. PMID:26499438

Altered gut and adipose tissue hormones in overweight and obese individuals: cause or consequence?

PubMed

Lean, M E J; Malkova, D

2016-04-01

The aim of this article is to review the research into the main peripheral appetite signals altered in human obesity, together with their modifications after body weight loss with diet and exercise and after bariatric surgery, which may be relevant to strategies for obesity treatment. Body weight homeostasis involves the gut-brain axis, a complex and highly coordinated system of peripheral appetite hormones and centrally mediated neuronal regulation. The list of peripheral anorexigenic and orexigenic physiological factors in both animals and humans is intimidating and expanding, but anorexigenic glucagon-like peptide 1 (GLP-1), cholecystokinin (CCK), peptide YY (PYY) and orexigenic ghrelin from the gastrointestinal tract, pancreatic polypeptide (PP) from the pancreas and anorexigenic leptin from adiposites remain the most widely studied hormones. Homeostatic control of food intake occurs in humans, although its relative importance for eating behaviour is uncertain, compared with social and environmental influences. There are perturbations in the gut-brain axis in obese compared with lean individuals, as well as in weight-reduced obese individuals. Fasting and postprandial levels of gut hormones change when obese individuals lose weight, either with surgical or with dietary and/or exercise interventions. Diet-induced weight loss results in long-term changes in appetite gut hormones, postulated to favour increased appetite and weight regain while exercise programmes modify responses in a direction expected to enhance satiety and permit weight loss and/or maintenance. Sustained weight loss achieved by bariatric surgery may in part be mediated via favourable changes to gut hormones. Future work will be necessary to fully elucidate the role of each element of the axis, and whether modifying these signals can reduce the risk of obesity.

Exercise, appetite and appetite-regulating hormones: implications for food intake and weight control.

PubMed

Stensel, David

2010-01-01

Knowledge about the relationship between exercise and appetite is important both for athletes wishing to optimise performance and for those interested in maintaining a healthy body weight. A variety of hormones are involved in appetite regulation including both episodic hormones, which are responsive to episodes of feeding, and tonic hormones, which are important regulators of energy storage over the longer term (e.g. insulin and leptin). Notable among the episodic appetite-regulating hormones is ghrelin, which plays a unique role in stimulating appetite and energy intake. Many studies have demonstrated that acute bouts of moderately vigorous exercise transiently suppress appetite and this has been termed 'exercise-induced anorexia'. The mechanisms by which acute exercise suppresses appetite are not fully understood but may involve lowered concentrations of ghrelin and increased concentrations of satiety hormones, notably peptide YY and glucagon-like peptide 1. Evidence suggests that chronic exercise training typically causes a partial but incomplete compensation in energy intake perhaps due to beneficial changes in appetite-regulating hormones. The lack of a full compensatory response of appetite to exercise may facilitate the development of a negative energy balance and weight loss although there is individual variability in the response to exercise. From a practical standpoint athletes should not feel concerned that exercise will cause overeating as there is limited evidence to support this. For those desiring weight loss there may be some merit in performing exercise in the postprandial period as a means of enhancing the satiating effect of a meal but additional evidence is required to confirm the effectiveness of this strategy. Copyright © 2011 S. Karger AG, Basel.

Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk

PubMed Central

Dobrosielski, Devon A.; Papandreou, Christopher; Patil, Susheel P.; Salas-Salvadó, Jordi

2017-01-01

Obstructive sleep apnoea (OSA) is associated with increased cardiovascular disease (CVD) morbidity and mortality. It is accepted that OSA and obesity commonly coexist. The American Academy of Sleep Medicine recommends dietary-induced weight loss and exercise as lifestyle treatment options for OSA. However, most clinical trials upon which this recommendation is based have focused on establishing the effectiveness of calorie-restricted, often low-fat diets for improving OSA severity, whereas less attention has been given to the means through which weight loss is achieved (e.g. altered dietary quality) or whether diet or exercise mediates the associations between reduced weight, improved OSA severity and the CVD substrate. The current evidence suggests that the benefits of a low-carbohydrate or Mediterranean diet in overweight and obese individuals go beyond the recognised benefits of weight reduction. In addition, exercise has an independent protective effect on vascular health, which may counter the increased oxidative stress, inflammation and sympathetic activation that occur in OSA patients. This review aims to expand our understanding of the effects of diet and exercise on OSA and associated CVD complications, and sets the stage for continued research designed to explore optimal lifestyle strategies for reducing the CVD burden in OSA patients. PMID:28659501

Diet and exercise in the management of obstructive sleep apnoea and cardiovascular disease risk.

PubMed

Dobrosielski, Devon A; Papandreou, Christopher; Patil, Susheel P; Salas-Salvadó, Jordi

2017-06-30

Obstructive sleep apnoea (OSA) is associated with increased cardiovascular disease (CVD) morbidity and mortality. It is accepted that OSA and obesity commonly coexist. The American Academy of Sleep Medicine recommends dietary-induced weight loss and exercise as lifestyle treatment options for OSA. However, most clinical trials upon which this recommendation is based have focused on establishing the effectiveness of calorie-restricted, often low-fat diets for improving OSA severity, whereas less attention has been given to the means through which weight loss is achieved ( e.g. altered dietary quality) or whether diet or exercise mediates the associations between reduced weight, improved OSA severity and the CVD substrate. The current evidence suggests that the benefits of a low-carbohydrate or Mediterranean diet in overweight and obese individuals go beyond the recognised benefits of weight reduction. In addition, exercise has an independent protective effect on vascular health, which may counter the increased oxidative stress, inflammation and sympathetic activation that occur in OSA patients. This review aims to expand our understanding of the effects of diet and exercise on OSA and associated CVD complications, and sets the stage for continued research designed to explore optimal lifestyle strategies for reducing the CVD burden in OSA patients. Copyright ©ERS 2017.

Copenhagen study of overweight patients with coronary artery disease undergoing low energy diet or interval training: the randomized CUT-IT trial protocol.

PubMed

Pedersen, Lene Rørholm; Olsen, Rasmus Huan; Frederiksen, Marianne; Astrup, Arne; Chabanova, Elizaveta; Hasbak, Philip; Holst, Jens Juul; Kjær, Andreas; Newman, John W; Walzem, Rosemary; Wisløff, Ulrik; Sajadieh, Ahmad; Haugaard, Steen Bendix; Prescott, Eva

2013-11-19

Coronary artery disease (CAD) is accountable for more than 7 million deaths each year according to the World Health Organization (WHO). In a European population 80% of patients diagnosed with CAD are overweight and 31% are obese. Physical inactivity and overweight are major risk factors in CAD, thus central strategies in secondary prevention are increased physical activity and weight loss. In a randomized controlled trial 70 participants with stable CAD, age 45-75, body mass index 28-40 kg/m2 and no diabetes are randomized (1:1) to 12 weeks of intensive exercise or weight loss both succeeded by a 40-week follow-up. The exercise protocol consist of supervised aerobic interval training (AIT) at 85-90% of VO2peak 3 times weekly for 12 weeks followed by supervised AIT twice weekly for 40 weeks. In the weight loss arm dieticians instruct the participants in a low energy diet (800-1000 kcal/day) for 12 weeks, followed by 40 weeks of weight maintenance combined with supervised AIT twice weekly. The primary endpoint of the study is change in coronary flow reserve after the first 12 weeks' intervention. Secondary endpoints include cardiovascular, metabolic, inflammatory and anthropometric measures. The study will compare the short and long-term effects of a protocol consisting of AIT alone or a rapid weight loss followed by AIT. Additionally, it will provide new insight in mechanisms behind the benefits of exercise and weight loss. We wish to contribute to the creation of effective secondary prevention and sustainable rehabilitation strategies in the large population of overweight and obese patients diagnosed with CAD. ClinicalTrials.gov: NCT01724567.

Impact of lorcaserin on glycemic control in overweight and obese patients with type 2 diabetes: analysis of week 52 responders and nonresponders.

PubMed

Pi-Sunyer, Xavier; Shanahan, William; Fain, Randi; Ma, Tony; Garvey, W Timothy

2016-08-01

Treatment guidelines for type 2 diabetes mellitus (T2DM) suggest weight loss as a means to maintain glycemic control. Lorcaserin has been approved for chronic weight management in the United States as an adjunct to a reduced-calorie diet and exercise, and the previous phase 3 Behavioral Modification and Lorcaserin for Obesity and Overweight Management in Diabetes Mellitus (BLOOM-DM) study has shown that, in addition to weight loss, lorcaserin is associated with improvements in glycemic parameters. In this post hoc analysis of the BLOOM-DM trial, the relationship between responder status (patients achieving ≥5% weight loss at Week 52) and glycemic and cardiometabolic parameters is evaluated. Data are presented for patients receiving lorcaserin 10 mg twice daily or placebo for 52 weeks. More than twice as many patients receiving lorcaserin plus diet and exercise counseling were classified as Week 52 responders compared to those receiving diet and exercise counseling alone (37.5% vs. 16.1%, respectively; p < 0.001), and lorcaserin Week 52 responders had greater improvements vs. placebo Week 52 responders in FPG (-38.1 mg/dL vs. -26.0 mg/dL) and HbA1c (-1.3% vs. -1.0%). Furthermore, more lorcaserin-treated Week 52 responders decreased the number of concomitant oral antidiabetic medications (OADs) used, and fewer increased the number of OADs used, compared to placebo. Unexpectedly, lorcaserin Week 52 nonresponders also had substantial reductions in glycemic levels, despite very modest weight loss. These data support lorcaserin use in overweight and obese patients with T2DM to promote weight loss and facilitate glycemic control. www.clinicaltrials.gov identifier is NCT00603291.

Strength exercise improves muscle mass and hepatic insulin sensitivity in obese youth

USDA-ARS?s Scientific Manuscript database

Data on the metabolic effects of resistance exercise (strength training) in adolescents are limited. The objective of this study was to determine whether a controlled resistance exercise program without dietary intervention or weight loss reduces body fat accumulation, increases lean body mass, and ...

A Pilot Randomized Controlled Trial of a Commercial Diet and Exercise Weight Loss Program in Minority Breast Cancer Survivors

PubMed Central

Greenlee, Heather A.; Crew, Katherine D.; Mata, Jennie M.; McKinley, Paula S.; Rundle, Andrew G.; Zhang, Wenfei; Liao, Yuyan; Tsai, Wei Y.; Hershman, Dawn L.

2015-01-01

Objective Obesity is associated with poorer breast cancer outcomes and losing weight postdiagnosis may improve survival. As Hispanic and black women have poorer breast cancer prognosis than non-Hispanic whites diagnosed at similar age and stage, and have higher rates of obesity, effective weight loss strategies are needed. We piloted a randomized, waitlist-controlled, crossover study to examine the effects and feasibility of the commercial Curves weight loss program among Hispanic, African American and Afro-Caribbean breast cancer survivors. Design and Methods Women with stage 0– IIIa breast cancer ≥6 months posttreatment, sedentary, and BMI ≥25 kg/m2 were randomized to the immediate arm (IA): 6 months of the Curves program followed by 6 months of observation; or the waitlist control arm (WCA): 6 months of observation followed by 6 months of the Curves program. The Curves program uses a 30-min exercise circuit and a high-vegetable/low-fat/calorie-restricted diet. Results A total of 42 women enrolled (79% Hispanic, 21% black), mean age 51 (range 32–69) and mean BMI 33.2(±5.9) kg/m2; 91% were retained at month 12. At month 6, women in the IA lost an average 3.3% (±3.5%) of body weight (range: 1.7% gain to 10.6% loss), as compared with 1.8% (±2.9%) weight loss in the WCA (P = 0.04). At month 12, on average women in the IA regained some but not all of the weight lost during the first 6 months (P = 0.02). Conclusions Minority breast cancer survivors were recruited and retained in a weight loss study. Six months of the Curves program resulted in moderate weight loss, but weight loss was not maintained postintervention. Future interventions should identify methods to increase uptake and maintenance of weight loss behaviors. PMID:23505170

A pilot randomized controlled trial of a commercial diet and exercise weight loss program in minority breast cancer survivors.

PubMed

Greenlee, Heather A; Crew, Katherine D; Mata, Jennie M; McKinley, Paula S; Rundle, Andrew G; Zhang, Wenfei; Liao, Yuyan; Tsai, Wei Y; Hershman, Dawn L

2013-01-01

Obesity is associated with poorer breast cancer outcomes and losing weight postdiagnosis may improve survival. As Hispanic and black women have poorer breast cancer prognosis than non-Hispanic whites diagnosed at similar age and stage, and have higher rates of obesity, effective weight loss strategies are needed. We piloted a randomized, waitlist-controlled, crossover study to examine the effects and feasibility of the commercial Curves weight loss program among Hispanic, African American and Afro-Caribbean breast cancer survivors. Women with stage 0-IIIa breast cancer ≥ 6 months posttreatment, sedentary, and BMI ≥ 25 kg/m(2) were randomized to the immediate arm (IA): 6 months of the Curves program followed by 6 months of observation; or the waitlist control arm (WCA): 6 months of observation followed by 6 months of the Curves program. The Curves program uses a 30-min exercise circuit and a high-vegetable/low-fat/calorie-restricted diet. A total of 42 women enrolled (79% Hispanic, 21% black), mean age 51 (range 32-69) and mean BMI 33.2(± 5.9) kg/m(2); 91% were retained at month 12. At month 6, women in the IA lost an average 3.3% (± 3.5%) of body weight (range: 1.7% gain to 10.6% loss), as compared with 1.8% (± 2.9%) weight loss in the WCA (P = 0.04). At month 12, on average women in the IA regained some but not all of the weight lost during the first 6 months (P = 0.02). Minority breast cancer survivors were recruited and retained in a weight loss study. Six months of the Curves program resulted in moderate weight loss, but weight loss was not maintained postintervention. Future interventions should identify methods to increase uptake and maintenance of weight loss behaviors. Copyright © 2013 The Obesity Society.

Diet and nutrition in polycystic ovary syndrome (PCOS): pointers for nutritional management.

PubMed

Farshchi, H; Rane, A; Love, A; Kennedy, R L

2007-11-01

PCOS patients are not always markedly overweight but PCOS is strongly associated with abdominal obesity and insulin resistance. Effective approaches to nutrition and exercise improve endocrine features, reproductive function and cardiometabolic risk profile--even without marked weight loss. Recent studies allow us to make recommendations on macronutrient intake. Fat should be restricted to < or =30% of total calories with a low proportion of saturated fat. High intake of low GI carbohydrate contributes to dyslipidaemia and weight gain and also stimulates hunger and carbohydrate craving. Diet and exercise need to be tailored to the individual's needs and preferences. Calorie intake should be distributed between several meals per day with low intake from snacks and drinks. Use of drugs to either improve insulin sensitivity or to promote weight loss are justified as a short-term measure, and are most likely to be beneficial when used early in combination with diet and exercise.

Effect of Exercise Training on Non-Exercise Physical Activity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

PubMed

Fedewa, Michael V; Hathaway, Elizabeth D; Williams, Tyler D; Schmidt, Michael D

2017-06-01

Many overweight and obese individuals use exercise when attempting to lose weight. However, the improvements in weight and body composition are often far less than expected. Levels of physical activity outside of the structured exercise program are believed to change and may be responsible for the unsuccessful weight loss. The purpose of this meta-analysis was to provide a quantitative estimate of the change in non-exercise physical activity (NEPA) during exercise interventions. All studies included in the meta-analysis were peer-reviewed and published in English. Participants were randomized to a non-exercise comparison group or exercise training group with an intervention lasting ≥2 weeks. NEPA was measured at baseline and at various times during the study. Hedges' d effect size (ES) was used to adjust for small sample bias, and random-effects models were used to calculate the mean ES and explore potential moderators. The cumulative results of 44 effects gathered from ten studies published between 1997 and 2015 indicated that NEPA did not change significantly during exercise training (ES = 0.02, 95% confidence interval [CI] -0.09 to 0.13; p = 0.723). Duration of the exercise session (β = -0.0039), intervention length (β = 0.0543), and an age × sex (β = -0.0005) interaction indicated that the increase in NEPA may be attenuated in older women during exercise training and during shorter exercise interventions with longer sessions (all p < 0.005). On average, no statistically or clinically significant mean change in NEPA occurs during exercise training. However, session duration and intervention length, age, and sex should be accounted for when designing exercise programs to improve long-term sustainability and improve the likelihood of weight loss success, as the initial decrease in NEPA appears to dissipate with continued training.

Water exercise prevents femur density loss associated with ovariectomy in the retired breeder rat.

PubMed

Melton, Sheri A; Hegsted, Maren; Keenan, Michael J; Morris, G Stephen; O'Neil, Carol E; Zablah-Pimentel, Erika M

2004-08-01

The effect of non-weight-bearing exercise on skeletal bone remains controversial. The objective of this pilot study was to examine the effects of water exercise training on femur density and serum alkaline phosphatase activity in ovariectomized and sham-operated (ovaries left intact) retired breeder rats. Exercised animals swam at progressively increasing duration from 5 minutes to 75 min.d(-1), 5 d.wk(-1), for a 6-week conditioning period. Exercised rats had greater (p < 0.02) soleus muscle citrate synthase activity than sedentary rats, confirming an aerobic training effect. Femur density (g.cm(-3)) was greater (p < 0.0007) for exercised rats than sedentary rats but lower (p < 0.01) for ovariectomized rats compared to sham rats. Serum alkaline phosphatase activity tended (p < 0.06) to be greater for exercised rats compared to sedentary rats. These results indicate that dynamic water-flotation exercise prevents the femur bone loss associated with ovariectomy in rats. We conclude that this form of exercise could be beneficial in maintaining bone density in hormone-deficient postmenopausal women, especially the elderly who may not be able to perform weight-bearing activities.

An Integrated Musculoskeletal Countermeasure Battery for Long-Duration Lunar Missions

NASA Technical Reports Server (NTRS)

Lang, T. F.; Streeper, T. S.; Cavanagh, P. R.; Saeed, I. H.; Carpenter, R. D.; Frassetto, L. A.; Lee, S. M. C.; Grodsinsky, C. M.; Funk, J.; Hanson, A. M.;

Preferential reductions in intermuscular and visceral adipose tissue with exercise-induced weight loss compared with calorie restriction

PubMed Central

Murphy, Joan C.; McDaniel, Jennifer L.; Mora, Katherine; Villareal, Dennis T.; Fontana, Luigi

2012-01-01

Intermuscular adipose tissue (IMAT) and visceral adipose tissue (VAT) are associated with insulin resistance. We sought to determine whether exercise-induced weight loss (EX) results in greater reductions in IMAT and VAT compared with similar weight loss induced by calorie restriction (CR) and whether these changes are associated with improvements in glucoregulation. Sedentary men and women (50–60 yr; body mass index of 23.5–29.9 kg/m2) were randomized to 1 yr of CR (n = 17), EX (n = 16), or a control group (CON; n = 6). Bilateral thigh IMAT and VAT volumes were quantified using multi-slice magnetic resonance imaging. Insulin sensitivity index (ISI) was determined from oral glucose tolerance test glucose and insulin levels. Weight loss was comparable (P = 0.25) in the CR (−10.8 ± 1.4%) and EX groups (−8.3 ± 1.5%) and greater than in the control group (−2.0 ± 2.4%; P < 0.05). IMAT and VAT reductions were larger in the CR and EX groups than in the CON group (P ≤ 0.05). After controlling for differences in total fat mass change between the CR and EX groups, IMAT and VAT reductions were nearly twofold greater (P ≤ 0.05) in the EX group than in the CR group (IMAT: −45 ±5 vs. −25 ± 5 ml; VAT: −490 ± 64 vs. −267 ± 61 ml). In the EX group, the reductions in IMAT were correlated with increases in ISI (r = −0.71; P = 0.003), whereas in the CR group, VAT reductions were correlated with increases in ISI (r = −0.64; P = 0.006). In conclusion, calorie restriction and exercise-induced weight loss both decrease IMAT and VAT volumes. However, exercise appears to result in preferential reductions in these fat depots. PMID:22016371

H1N1 Influenza

MedlinePlus

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The Intensive Diet and Exercise for Arthritis (IDEA) trial: 18-month radiographic and MRI outcomes.

PubMed

Hunter, D J; Beavers, D P; Eckstein, F; Guermazi, A; Loeser, R F; Nicklas, B J; Mihalko, S L; Miller, G D; Lyles, M; DeVita, P; Legault, C; Carr, J J; Williamson, J D; Messier, S P

2015-07-01

Report the radiographic and magnetic resonance imaging (MRI) structural outcomes of an 18-month study of diet-induced weight loss, with or without exercise, compared to exercise alone in older, overweight and obese adults with symptomatic knee osteoarthritis (OA). Prospective, single-blind, randomized controlled trial that enrolled 454 overweight and obese (body mass index, BMI = 27-41 kg m(-2)) older (age ≥ 55 yrs) adults with knee pain and radiographic evidence of femorotibial OA. Participants were randomized to one of three 18-month interventions: diet-induced weight loss only (D); diet-induced weight loss plus exercise (D + E); or exercise-only control (E). X-rays (N = 325) and MRIs (N = 105) were acquired at baseline and 18 months follow-up. X-ray and MRI (cartilage thickness and semi-quantitative (SQ)) results were analyzed to compare change between groups at 18-month follow-up using analysis of covariance (ANCOVA) adjusted for baseline values, baseline BMI, and gender. Mean baseline descriptive characteristics of the cohort included: age, 65.6 yrs; BMI 33.6 kg m(-2); 72% female; 81% white. There was no significant difference between groups in joint space width (JSW) loss; D -0.07 (SE 0.22) mm, D + E -0.27 (SE 0.22) mm and E -0.16 (SE 0.24) mm (P = 0.79). There was also no significant difference in MRI cartilage loss between groups; D -0.10(0.05) mm, D + E -0.13(0.04) mm and E -0.05(0.04) mm (P = 0.42). Despite the potent effects of weight loss in this study on symptoms as well as mechanistic outcomes (such as joint compressive force and markers of inflammation), there was no statistically significant difference between the three active interventions on the rate of structural progression either on X-ray or MRI over 18-months. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Circulating MicroRNA Responses between 'High' and 'Low' Responders to a 16-Wk Diet and Exercise Weight Loss Intervention.

PubMed

Parr, Evelyn B; Camera, Donny M; Burke, Louise M; Phillips, Stuart M; Coffey, Vernon G; Hawley, John A

2016-01-01

Interactions between diet, physical activity and genetic predisposition contribute to variable body mass changes observed in response to weight loss interventions. Circulating microRNAs (c-miRNAs) may act as 'biomarkers' that are associated with the rate of change in weight loss, and/or play a role in regulating the biological variation, in response to energy restriction. To quantify targeted c-miRNAs with putative roles in energy metabolism and exercise adaptations following a 16 wk diet and exercise intervention in individuals with large (high responders; HiRes) versus small (low responders; LoRes) losses in body mass. From 89 male and female overweight/obese participants who completed the intervention (energy restriction from diet, 250 kcal/d, and exercise, 250 kcal/d), subgroups of HiRes (>10% body mass loss, n = 22) and LoRes (<5% body mass loss, n = 18) were identified. From resting plasma samples collected after an overnight fast pre and post intervention, RNA was extracted, quantified and reverse transcribed. Thirteen c-miRNA selected a priori were analysed using a customised 96-well miScript miRNA PCR Array. Loss of body mass (-11.0 ± 2.3 kg vs. -3.0 ± 1.3 kg; P<0.01) and fat mass (-11.1 ± 2.6 kg vs. -3.9 ± 1.6 kg; P<0.01) was greater for HiRes than LoRes (P<0.001). Expression of c-miR-935 was higher in LoRes compared to HiRes pre- (~47%; P = 0.025) and post- (~100%; P<0.01) intervention and was the only c-miRNA differentially expressed at baseline between groups. The abundance of c-miR-221-3p and -223-3p increased pre- to post-intervention in both groups (~57-69% and ~25-90%, P<0.05). There was a post-intervention increase in c-miR-140 only in LoRes compared to HiRes (~23%, P = 0.016). The differential expression and responses of selected c-miRNAs in overweight/obese individuals to an exercise and diet intervention suggests a putative role for these 'biomarkers' in the prediction or detection of individual variability to weight loss interventions.

Circulating MicroRNA Responses between ‘High’ and ‘Low’ Responders to a 16-Wk Diet and Exercise Weight Loss Intervention

PubMed Central

Parr, Evelyn B.; Camera, Donny M.; Burke, Louise M.; Phillips, Stuart M.; Coffey, Vernon G.; Hawley, John A.

2016-01-01

Background Interactions between diet, physical activity and genetic predisposition contribute to variable body mass changes observed in response to weight loss interventions. Circulating microRNAs (c-miRNAs) may act as ‘biomarkers’ that are associated with the rate of change in weight loss, and/or play a role in regulating the biological variation, in response to energy restriction. Objective To quantify targeted c-miRNAs with putative roles in energy metabolism and exercise adaptations following a 16 wk diet and exercise intervention in individuals with large (high responders; HiRes) versus small (low responders; LoRes) losses in body mass. Methods From 89 male and female overweight/obese participants who completed the intervention (energy restriction from diet, 250 kcal/d, and exercise, 250 kcal/d), subgroups of HiRes (>10% body mass loss, n = 22) and LoRes (<5% body mass loss, n = 18) were identified. From resting plasma samples collected after an overnight fast pre and post intervention, RNA was extracted, quantified and reverse transcribed. Thirteen c-miRNA selected a priori were analysed using a customised 96-well miScript miRNA PCR Array. Results Loss of body mass (-11.0 ± 2.3 kg vs. -3.0 ± 1.3 kg; P<0.01) and fat mass (-11.1 ± 2.6 kg vs. -3.9 ± 1.6 kg; P<0.01) was greater for HiRes than LoRes (P<0.001). Expression of c-miR-935 was higher in LoRes compared to HiRes pre- (~47%; P = 0.025) and post- (~100%; P<0.01) intervention and was the only c-miRNA differentially expressed at baseline between groups. The abundance of c-miR-221-3p and -223-3p increased pre- to post-intervention in both groups (~57–69% and ~25–90%, P<0.05). There was a post-intervention increase in c-miR-140 only in LoRes compared to HiRes (~23%, P = 0.016). Conclusion The differential expression and responses of selected c-miRNAs in overweight/obese individuals to an exercise and diet intervention suggests a putative role for these ‘biomarkers’ in the prediction or detection of individual variability to weight loss interventions. PMID:27101373

Self-monitoring of spontaneous physical activity and sedentary behavior to prevent weight regain in older adults.

PubMed

Nicklas, Barbara J; Gaukstern, Jill E; Beavers, Kristen M; Newman, Jill C; Leng, Xiaoyan; Rejeski, W Jack

2014-06-01

The objective was to determine whether adding a self-regulatory intervention (SRI) focused on self-monitoring of spontaneous physical activity (SPA) and sedentary behavior to a standard weight loss intervention improved maintenance of lost weight. Older (65-79 years), obese (BMI = 30-40 kg/m(2) ) adults (n = 48) were randomized to a 5-month weight loss intervention involving a hypocaloric diet (DIET) and aerobic exercise (EX) with or without the SRI to promote SPA and decrease sedentary behavior (SRI + DIET + EX compared with DIET + EX). Following the weight loss phase, both groups transitioned to self-selected diet and exercise behavior during a 5-month follow-up. Throughout the 10-months, the SRI + DIET + EX group utilized real-time accelerometer feedback for self-monitoring. There was an overall group by time effect of the SRI (P < 0.01); DIET + EX lost less weight and regained more weight than SRI + DIET + EX. The average weight regain during follow-up was 1.3 kg less in the SRI + DIET + EX group. Individuals in this group maintained approximately 10% lower weight than baseline compared with those in the DIET + EX group whom maintained approximately 5% lower weight than baseline. Addition of a SRI, designed to increase SPA and decrease sedentary behavior, to a standard weight loss intervention enhanced successful maintenance of lost weight. Copyright © 2014 The Obesity Society.

Weight loss and bone mineral density.

PubMed

Hunter, Gary R; Plaisance, Eric P; Fisher, Gordon

2014-10-01

Despite evidence that energy deficit produces multiple physiological and metabolic benefits, clinicians are often reluctant to prescribe weight loss in older individuals or those with low bone mineral density (BMD), fearing BMD will be decreased. Confusion exists concerning the effects that weight loss has on bone health. Bone density is more closely associated with lean mass than total body mass and fat mass. Although rapid or large weight loss is often associated with loss of bone density, slower or smaller weight loss is much less apt to adversely affect BMD, especially when it is accompanied with high intensity resistance and/or impact loading training. Maintenance of calcium and vitamin D intake seems to positively affect BMD during weight loss. Although dual energy X-ray absorptiometry is normally used to evaluate bone density, it may overestimate BMD loss following massive weight loss. Volumetric quantitative computed tomography may be more accurate for tracking bone density changes following large weight loss. Moderate weight loss does not necessarily compromise bone health, especially when exercise training is involved. Training strategies that include heavy resistance training and high impact loading that occur with jump training may be especially productive in maintaining, or even increasing bone density with weight loss.

The effect of diet and exercise on markers of endothelial function in overweight and obese women with polycystic ovary syndrome.

PubMed

Thomson, R L; Brinkworth, G D; Noakes, M; Clifton, P M; Norman, R J; Buckley, J D

2012-07-01

Women with polycystic ovary syndrome (PCOS) present with vascular abnormalities, including elevated markers of endothelial dysfunction. There is limited evidence for the effect of lifestyle modification and weight loss on these markers. The aim of this study was to determine if 20 weeks of a high-protein energy-restricted diet with or without exercise in women with PCOS could improve endothelial function. This is a secondary analysis of a subset of 50 overweight/obese women with PCOS (age: 30.3 ± 6.3 years; BMI: 36.5 ± 5.7 kg/m(2)) from a previous study. Participants were randomly assigned by computer generation to one of three 20-week interventions: diet only (DO; n = 14, ≈ 6000 kJ/day), diet and aerobic exercise (DA; n = 16, ≈ 6000 kJ/day and five walking sessions/week) and diet and combined aerobic-resistance exercise (DC; n = 20, ≈ 6000 kJ/day, three walking and two strength sessions/week). At Weeks 0 and 20, weight, markers of endothelial function [vascular cell adhesion molecule-1 (sVCAM-1), inter-cellular adhesion molecule-1 (sICAM-1), plasminogen activator inhibitor-1 (PAI-1) and asymmetric dimethylarginine (ADMA)], insulin resistance and hormonal profile were assessed. All three treatments resulted in significant weight loss (DO 7.9 ± 1.2%, DA 11.0 ± 1.6%, DC 8.8 ± 1.1; P < 0.001 for time; P = 0.6 time × treatment). sVCAM-1, sICAM-1 and PAI-1 levels decreased with weight loss (P≤ 0.01), with no differences between treatments (P ≥ 0.4). ADMA levels did not change significantly (P = 0.06). Testosterone, sex hormone-binding globulin and the free androgen index (FAI) and insulin resistance also improved (P < 0.001) with no differences between treatments (P ≥ 0.2). Reductions in sVCAM-1 were correlated to reductions in testosterone (r = 0.32, P = 0.03) and FAI (r = 0.33, P = 0.02) as well as weight loss (r= 0.44, P = 0.002). Weight loss was also associated with reductions in sICAM-1 (r= 0.37, P = 0.008). Exercise training provided no additional benefit to following a high-protein, hypocaloric diet on markers of endothelial function in overweight/obese women with PCOS.

A novel prescription pedometer-assisted walking intervention and weight management for Chinese occupational population.

PubMed

Yu, Yingxiang; Lv, Yiran; Yao, Bin; Duan, Liguang; Zhang, Xiaoyuan; Xie, Lan; Chang, Cuiqing

2018-01-01

Information technology has been previously used for the research and practice of health promotion. Appropriate and effective health promotion methods used by professional groups remain to be investigated. This study aimed to assess the feasibility and effectiveness of a weight management program among the Chinese occupational population using and a novel information technology exercise prescription. A 3-month open, self-monitored intervention trial, involving individualized pedometer-assisted exercise prescription and a one-time targeted dietary guidance prior to exercise was conducted on the Chinese occupational population aged 18-65 years in China from 2015 to 2016. Data were collected from March 2015 to May 2016 and analyzed from June 2016 to August 2016. Participants were also asked to synchronize exercise data of the pedometer to the Internet-based Health System Center daily (at least weekly), by connecting to the personal computer (PC) using a USB cable or via Bluetooth. Eligible participants included 802 Chinese occupational persons, and 718 of them followed exercise interventions with 89.5% (718/802) adherence to the exercise programs. Of them, 688 participants completed the program with 85.8% (688/802) adherence to the exercise program and their data were analyzed. Weight decreased by 2.2% among all overweight/obese participants, with 1.8% reduction in waist circumference and 3.3% reduction in body fat percentage (p< 0.001). Weight and body fat percentage in normal-weight individuals decreased by 0.7% and 2.5%, respectively (p < 0.01). A weight gain of 1.0% was observed in all underweight participants (p< 0.05), and 68.2% (208/305) of overweight/obese participants experienced weight loss, with an average reduction of 3.5%, with 20.2% (42/208) of them achieving weight loss ≥5%. Blood pressure and fasting serum glucose decreased significantly in both the overweight/obese and the normal-weight individuals (p < 0.05). The incidence of hypertension was significantly lower and lifestyle behavior significantly improved (p < 0.05). The prescription pedometer-assisted walking intervention can effectively improve exercise adherence and manage weight. This approach was also effective in controlling the risk factors of weight-related chronic diseases. Chinese Clinical Trial Registry (ChiCTR) ChiCTR-OOh-16010229.

U.S. health professionals' views on obesity care, training, and self-efficacy.

PubMed

Bleich, Sara N; Bandara, Sachini; Bennett, Wendy L; Cooper, Lisa A; Gudzune, Kimberly A

2015-04-01

Despite emphasis of recent guidelines on multidisciplinary teams for collaborative weight management, little is known about non-physician health professionals' perspectives on obesity, their weight management training, and self-efficacy for obesity care. To evaluate differences in health professionals' perspectives on (1) the causes of obesity; (2) training in weight management; and (3) self-efficacy for providing obesity care. Data were obtained from a cross-sectional Internet-based survey of 500 U.S. health professionals from nutrition, nursing, behavioral/mental health, exercise, and pharmacy (collected from January 20 through February 5, 2014). Inferences were derived using logistic regression adjusting for age and education (analyzed in 2014). Nearly all non-physician health professionals, regardless of specialty, cited individual-level factors, such as overconsumption of food (97%), as important causes of obesity. Nutrition professionals were significantly more likely to report high-quality training in weight management (78%) than the other professionals (nursing, 53%; behavioral/mental health, 32%; exercise, 50%; pharmacy, 47%; p<0.05). Nutrition professionals were significantly more likely to report high confidence in helping obese patients achieve clinically significant weight loss (88%) than the other professionals (nursing, 61%; behavioral/mental health, 51%; exercise, 52%; pharmacy, 61%; p<0.05), and more likely to perceive success in helping patients with obesity achieve clinically significant weight loss (nutrition, 81%; nursing, behavioral/mental health, exercise, and pharmacy, all <50%; p<0.05). Nursing, behavioral/mental health, exercise, and pharmacy professionals may need additional training in weight management and obesity care to effectively participate in collaborative weight management models. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Exercise improves adiponectin concentrations irrespective of the adiponectin gene polymorphisms SNP45 and the SNP276 in obese Korean women.

PubMed

Lee, Kyoung-Young; Kang, Hyun-Sik; Shin, Yun-A

2013-03-10

The effects of exercise on adiponectin levels have been reported to be variable and may be attributable to an interaction between environmental and genetic factors. The single nucleotide polymorphisms (SNP) 45 (T>G) and SNP276 (G>T) of the adiponectin gene are associated with metabolic risk factors including adiponectin levels. We examined whether SNP45 and SNP276 would differentially influence the effect of exercise training in middle-aged women with uncomplicated obesity. We conducted a prospective study in the general community that included 90 Korean women (age 47.0±5.1 years) with uncomplicated obesity. The intervention was aerobic exercise training for 3 months. Body composition, adiponectin levels, and other metabolic risk factors were measured. Prior to exercise training, only body weight differed among the SNP276 genotypes. Exercise training improved body composition, systolic blood pressure, maximal oxygen consumption, high-density lipoprotein cholesterol, and leptin levels. In addition, exercise improved adiponectin levels irrespective of weight gain or loss. However, after adjustments for age, BMI, body fat (%), and waist circumference, no differences were found in obesity-related characteristics (e.g., adiponectin) following exercise training among the SNP45 and the 276 genotypes. Our findings suggest that aerobic exercise affects adiponectin levels regardless of weight loss and this effect would not be influenced by SNP45 and SNP276 in the adiponectin gene. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

Information needs of cancer patients and survivors regarding diet, exercise and weight management: a qualitative study.

PubMed

James-Martin, G; Koczwara, B; Smith, E L; Miller, M D

2014-05-01

While advanced cancer is often associated with weight loss, curative cancer treatment is often associated with weight gain. Weight gain during treatment may be associated with greater risk of cancer recurrence and development of lifestyle diseases. Currently, limited resources are available to cancer patients focussed on weight control. This study assessed the information needs of patients undergoing curative chemotherapy regarding diet, exercise and weight management for the purpose of developing weight management resources. Focus groups were held with oncology practitioners, patients and survivors to determine current information provision and needs. Focus groups highlighted a perception that information provision regarding diet, exercise and weight management is insufficient and no routine assessment of weight occurs during chemotherapy. Barriers to information provision described included lack of resources and time, and practitioners' uncertainty regarding appropriate messages to provide. Patients wanted more information regarding diet, exercise and weight during treatment time. The findings of this study suggest an increase in provision of diet, exercise and weight management information is needed. This information should be evidence-based and delivered at an appropriate time by the preferred health care professional. It would also be beneficial to implement protocols regarding assessment of weight during treatment. © 2013 John Wiley & Sons Ltd.

Physical activity counseling intervention to promote weight loss in overweight rural women.

PubMed

Peterson, Jane Anthony; Cheng, An-Lin

2013-07-01

To identify key behavioral factors that contribute to physical activity and weight management in overweight, rural women and determine the degree to which social support, stage of behavior change, and self-efficacy for physical activity and depressive symptoms are linked to physical activity, body weight, and body mass index (BMI). Twenty-five overweight or obese rural women completed self-report scales and height and weight measurements; BMI was calculated. Self-report scales included the International Physical Activity Questionnaire (physical activity level), Social Support for Exercise and Social Support Questionnaire (social support), Stage of Exercise Adoption (stage of behavior change), Self-efficacy for Exercise (self-efficacy), and the Patient Health Questionnaire (depressive symptoms). Higher levels of physical activity were associated with greater self-efficacy and the self-esteem domain of social support. Rural women reported more depressive symptoms over the year. Women did not significantly increase physical activity and gained weight during the 1-year study. Rural women have limited resources available to increase physical activity to facilitate weight loss. Routine screening and treatment for depression in rural women may need to be initiated concurrently with interventions to promote health behavior changes. ©2012 The Author(s) ©2012 American Association of Nurse Practitioners.

Weight Control: Attitudes of Dieters and Change Agents.

ERIC Educational Resources Information Center

Parham, Ellen S.; And Others

1991-01-01

Survey explores attitudes toward weight loss/weight control among 2 groups of change agents--40 dietitians and 42 fitness instructors--and among 96 people trying to lose weight. Significant differences were found in terms of importance in weight control of diet, drugs, exercise, religion, and will power; in importance of being of normal weight;…

Making Healthy Choices at Fast Food Restaurants

MedlinePlus

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Evidence Supports the Use of Soy Protein to Promote Cardiometabolic Health and Muscle Development.

PubMed

Paul, Greg; Mendelson, Garry J

2015-01-01

Consumption of adequate amounts of dietary protein can help individuals maintain a healthy body composition, especially when combined with resistance exercise and during weight loss. It is well established that dietary protein intake supports muscle development and helps reduce loss of lean body mass during weight loss. Numerous studies have demonstrated the efficacy of soy protein intake for promoting fat loss while preserving muscle mass and supporting lean body mass gains. In fact, soy protein and animal-based proteins both support weight loss and weight maintenance equally as part of an energy-restricted diet; however, soy protein offers additional cardiometabolic advantages. Key teaching points: Soy protein is a high-quality, plant-based protein that can be consumed throughout the life span. More human clinical studies have been conducted to assess the cholesterol-lowering effects of soy protein than any other cholesterol-lowering food ingredient. Ingestion of proteins with unique and complementary characteristics like soy, whey, and casein helps resistance-trained individuals achieve significant muscle growth. Recent research supports the efficacy of consuming a combination of soy, whey, and casein after resistance exercise to extend the time period that muscle building occurs.

Weight loss is associated with plasma free amino acid alterations in subjects with metabolic syndrome

PubMed Central

Tochikubo, O; Nakamura, H; Jinzu, H; Nagao, K; Yoshida, H; Kageyama, N; Miyano, H

2016-01-01

Objectives: The prevalence of metabolic syndrome is increasing worldwide, especially in Asian populations. Early detection and effective intervention are vital. Plasma free amino acid profile is a potential biomarker for the early detection for lifestyle-related diseases. However, little is known about whether the altered plasma free amino acid profiles in subjects with metabolic syndrome are related to the effectiveness of dietary and exercise interventions. Methods: Eighty-five Japanese subjects who fulfilled the Japanese diagnostic criteria for metabolic syndrome were enrolled in a 3-month diet and exercise intervention. The plasma free amino acid concentrations and metabolic variables were measured, and the relationships between plasma free amino acid profiles, metabolic variables and the extent of body weight reduction were investigated. Those who lost more than 3% of body weight were compared with those who lost less than 3%. Results: Baseline levels of most amino acids in the subset that went on to lose <3% body weight were markedly lower compared with the counterpart, although both groups showed similar proportional pattern of plasma amino acid profiles. The weight loss induced by the diet and exercise intervention normalized plasma free amino acid profiles. For those with a high degree of weight loss, those changes were also associated with improvement in blood pressure, triglyceride and hemoglobin A1c levels. Conclusions: These data suggest that among Japanese adults meeting the criteria for metabolic syndrome, baseline plasma free amino acid profiles may differ in ways that predict who will be more vs less beneficially responsive to a standard diet and exercise program. Plasma free amino acid profiles may also be useful as markers for monitoring the risks of developing lifestyle-related diseases and measuring improvement in physiological states. PMID:26926588

Blogging for weight loss: personal accountability, writing selves, and the weight-loss blogosphere.

PubMed

Leggatt-Cook, Chez; Chamberlain, Kerry

2012-09-01

Body weight is a key concern in contemporary society, with large proportions of the population attempting to control their weight. However, losing weight and maintaining weight loss is notoriously difficult, and new strategies for weight loss attract significant interest. Writing about experiences of weight loss in online journals, or blogging, has recently expanded rapidly. Weight-loss bloggers typically write about daily successes and failures, report calorie consumption and exercise output, and post photographs of their changing bodies. Many bloggers openly court the surveillance of blog readers as a motivation for accountability to their weight-loss goals. Drawing from a sample of weight-loss blogs authored by women, we explore three issues arising from this practice of disclosing a conventionally private activity within an online public domain. First, we examine motivations for blogging, focusing on accountability. Secondly, we consider the online construction of self, exploring how weight-loss bloggers negotiate discourses around fatness, and rework selves as their bodies transform. Finally, we consider the communities of interest that form around weight-loss blogs. This 'blogosphere' provides mutual support for weight loss. However, participating in online social spaces is complicated and bloggers must carefully manage issues of privacy and disclosure. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Resistance exercise attenuates skeletal muscle oxidative stress, systemic pro-inflammatory state, and cachexia in Walker-256 tumor-bearing rats.

PubMed

Padilha, Camila Souza; Borges, Fernando Henrique; Costa Mendes da Silva, Lilian Eslaine; Frajacomo, Fernando Tadeu Trevisan; Jordao, Alceu Afonso; Duarte, José Alberto; Cecchini, Rubens; Guarnier, Flávia Alessandra; Deminice, Rafael

2017-09-01

The aim of this study was to investigate the effects of resistance exercise training (RET) on oxidative stress, systemic inflammatory markers, and muscle wasting in Walker-256 tumor-bearing rats. Male (Wistar) rats were divided into 4 groups: sedentary controls (n = 9), tumor-bearing (n = 9), exercised (n = 9), and tumor-bearing exercised (n = 10). Exercised and tumor-bearing exercised rats were exposed to resistance exercise of climbing a ladder apparatus with weights tied to their tails for 6 weeks. The physical activity of control and tumor-bearing rats was confined to the space of the cage. After this period, tumor-bearing and tumor-bearing exercised animals were inoculated subcutaneously with Walker-256 tumor cells (11.0 × 10 7 cells in 0.5 mL of phosphate-buffered saline) while control and exercised rats were injected with vehicle. Following inoculation, rats maintained resistance exercise training (exercised and tumor-bearing exercised) or sedentary behavior (control and tumor-bearing) for 12 more days, after which they were euthanized. Results showed muscle wasting in the tumor-bearing group, with body weight loss, increased systemic leukocytes, and inflammatory interleukins as well as muscular oxidative stress and reduced mTOR signaling. In contrast, RET in the tumor-bearing exercised group was able to mitigate the reduced body weight and muscle wasting with the attenuation of muscle oxidative stress and systemic inflammatory markers. RET also prevented loss of muscle strength associated with tumor development. RET, however, did not prevent the muscle proteolysis signaling via FBXO32 gene messenger RNA expression in the tumor-bearing group. In conclusion, RET performed prior tumor implantation prevents cachexia development by attenuating tumor-induced systemic pro-inflammatory condition with muscle oxidative stress and muscle damage.

Inverse relationship between changes of maximal aerobic capacity and changes in walking economy after weight loss.

PubMed

Borges, Juliano H; Carter, Stephen J; Singh, Harshvardhan; Hunter, Gary R

2018-05-16

The aims of this study were to: (1) determine the relationships between maximum oxygen uptake ([Formula: see text]O 2max ) and walking economy during non-graded and graded walking among overweight women and (2) examine potential differences in [Formula: see text]O 2max and walking economy before and after weight loss. One-hundred and twenty-four premenopausal women with a body mass index (BMI) between 27 and 30 kg/m 2 were randomly assigned to one of three groups: (a) diet only; (b) diet and aerobic exercise training; and (c) diet and resistance exercise training. All were furnished with standard, very-low calorie diet to reduce BMI to < 25 kg/m 2 . [Formula: see text]O 2max was measured using a modified-Bruce protocol while walking economy (1-net [Formula: see text]O 2 ) was obtained during fixed-speed (4.8 k·h -1 ), steady-state treadmill walking at 0% grade and 2.5% grade. Assessments were conducted before and after achieving target BMI. Prior to weight loss, [Formula: see text]O 2max was inversely related (P < 0.05) with non-graded and graded walking economy (r = - 0.28 to - 0.35). Similar results were also observed following weight loss (r = - 0.22 to - 0.28). Additionally, we also detected a significant inverse relationship (P < 0.05) between the changes (∆, after weight loss) in ∆[Formula: see text]O 2max , adjusted for fat-free mass, with non-graded and graded ∆walking economy (r = - 0.37 to - 0.41). Our results demonstrate [Formula: see text]O 2max and walking economy are inversely related (cross-sectional) before and after weight loss. Importantly though, ∆[Formula: see text]O 2max and ∆walking economy were also found to be inversely related, suggesting a strong synchrony between maximal aerobic capacity and metabolic cost of exercise.

Becoming active: more to exercise than weight loss for indigenous men.

PubMed

Warbrick, Isaac; Wilson, Denise; Griffith, Derek

2018-03-27

To understand what motivates sedentary indigenous and ethnic minority men to become more physically active. We use thematic analysis to present data from a qualitative study exploring 23 sedentary indigenous Māori (New Zealand) men's experiences of completing a 12-week exercise intervention to improve their metabolic health. Four themes emerged: The Bros - having fellowship and mutual motivation; Being better informed about exercise; Impacting overall wellbeing; and Disseminating the findings beyond the study Exercise interventions informed by indigenous Māori cultural values and knowledge increased its relevance to their daily lives. The motivation for these indigenous men was more culturally-based external factors than an inherent desire to lose weight. Indigenous and minority men in many developed countries have high morbidity and premature mortality related to sedentary lifestyles. The low uptake of physical activities possibly relates to focusing more on outcomes such as weight loss which lacks cultural relevance. When offering health promotion interventions for marginalized populations these findings highlight the importance of culturally tailoring interventions to the unique sources of motivation for each group to increase activity to improve their efficacy.

Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study.

PubMed

Wadden, T A; Hollander, P; Klein, S; Niswender, K; Woo, V; Hale, P M; Aronne, L

2013-11-01

Liraglutide, a once-daily human glucagon-like peptide-1 analog, induced clinically meaningful weight loss in a phase 2 study in obese individuals without diabetes. The present randomized phase 3 trial assessed the efficacy of liraglutide in maintaining weight loss achieved with a low-calorie diet (LCD). Obese/overweight participants (≥18 years, body mass index ≥30 kg m(-2) or ≥27 kg m(-2) with comorbidities) who lost ≥5% of initial weight during a LCD run-in were randomly assigned to liraglutide 3.0 mg per day or placebo (subcutaneous administration) for 56 weeks. Diet and exercise counseling were provided throughout the trial. Co-primary end points were percentage weight change from randomization, the proportion of participants that maintained the initial ≥5% weight loss, and the proportion that lost ≥5% of randomization weight (intention-to-treat analysis). ClinicalTrials.gov identifier: NCT00781937. Participants (n=422) lost a mean 6.0% (s.d. 0.9) of screening weight during run-in. From randomization to week 56, weight decreased an additional mean 6.2% (s.d. 7.3) with liraglutide and 0.2% (s.d. 7.0) with placebo (estimated difference -6.1% (95% class intervals -7.5 to -4.6), P<0.0001). More participants receiving liraglutide (81.4%) maintained the ≥5% run-in weight loss, compared with those receiving placebo (48.9%) (estimated odds ratio 4.8 (3.0; 7.7), P<0.0001), and 50.5% versus 21.8% of participants lost ≥5% of randomization weight (estimated odds ratio 3.9 (2.4; 6.1), P<0.0001). Liraglutide produced small but statistically significant improvements in several cardiometabolic risk factors compared with placebo. Gastrointestinal (GI) disorders were reported more frequently with liraglutide than placebo, but most events were transient, and mild or moderate in severity. Liraglutide, with diet and exercise, maintained weight loss achieved by caloric restriction and induced further weight loss over 56 weeks. Improvements in some cardiovascular disease-risk factors were also observed. Liraglutide, prescribed as 3.0 mg per day, holds promise for improving the maintenance of lost weight.

Effect of body weight gain on insulin sensitivity after retirement from exercise training

NASA Technical Reports Server (NTRS)

Dolkas, Constantine B.; Rodnick, Kenneth J.; Mondon, Carl E.

1990-01-01

The effect of the body-weight gain after retirement from an exercise-training program on the retained increase in insulin sensitivity elicited by the training was investigated in exercise-trained (ET) rats. Insulin sensitivity was assessed by oral glucose tolerance and insulin suppression tests immediately after training and during retirement. Results show that, compared with sedentary controls, exercise training enhanced insulin-induced glucose uptake, but the enhanced sensitivity was gradually lost with the end of running activity until after seven days of retirement, when it became equal to that of controls. This loss of enhanced sensitivity to insulin was associated with an accelerated gain in body weight beginning one day after the start of retirement. However, those animals that gained weight only at rates similar to those of control rats, retained their enhanced sensitivity to insulin.

Lifestyle intervention improves heart rate recovery from exercise in adults with type 2 diabetes: results from the Look AHEAD study.

PubMed

Ribisl, Paul M; Gaussoin, Sarah A; Lang, Wei; Bahnson, Judy; Connelly, Stephanie A; Horton, Edward S; Jakicic, John M; Killean, Tina; Kitzman, Dalane W; Knowler, William C; Stewart, Kerry J

2012-01-01

The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined effects of weight loss and fitness changes upon HRR. In 4503 participants (45-76 years) who completed 1 year of intervention, HRR was measured after a submaximal GXT to compare the influence of (ILI) with (DSE) upon HRR. Participants assigned to ILI lost an average 8.6% of their initial weight versus 0.7% in DSE group (P < 0.001) while mean fitness increased in ILI by 20.9% versus 5.8% in DSE (P < 0.001). At Year 1, all exercise and HRR variables in ILI improved (P < 0.0001) versus DSE: heart rate (HR) at rest was lower (72.8 ± 11.4 versus 77.7 ± 11.7 b/min), HR range was greater (57.7 ± 12.1 versus 53.1 ± 12.4 b/min), HR at 2 minutes was lower (89.3 ± 21.8 versus 93.0 ± 12.1 b/min), and HRR was greater (41.25 ± 22.0 versus 37.8 ± 12.5 b/min). Weight loss and fitness gain produced significant separate and independent improvements in HRR.

Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.

PubMed

White, Andrea M; Johnston, Carol S; Swan, Pamela D; Tjonn, Sherrie L; Sears, Barry

2007-10-01

Ketogenic diets have been associated with reductions in free-living physical activity, a response that can be counterproductive in individuals trying to lose weight. To explore whether popular low-carbohydrate diets might impact the desire to exercise by raising blood ketone concentrations, fatigue and perceived effort during exercise were compared in untrained, overweight adults adhering to a ketogenic low-carbohydrate diet or to a control diet low in carbohydrate, but not ketogenic (5%, 65%, and 30% or 40%, 30%, and 30% of energy from carbohydrate, fat, and protein, respectively). In this prospective, randomized, 2-week pilot study, all meals and snacks were provided to subjects, and energy intake was strictly controlled to provide approximately 70% of that needed for weight maintenance. At baseline and at the end of week 2, exercise testing was conducted in fasting participants. Weight loss and the reductions in fat mass did not differ by group during the trial. At week 2, blood beta-hydroxybutyrate concentrations were 3.6-fold greater for the ketogenic vs nonketogenic group (P=0.018) and correlated significantly with perceived exercise effort (r2=0.22, P=0.049). Blood beta-hydroxybutyrate was also significantly correlated to feelings of "fatigue" (r=0.458, P=0.049) and to "total mood disturbance" (r=0.551, P=0.015) while exercising. These pilot data indicate that ketogenic, low-carbohydrate diets enhance fatigability and can reduce the desire to exercise in free-living individuals.

The PPET Study: people and pets exercising together.

PubMed

Kushner, Robert F; Blatner, Dawn Jackson; Jewell, Dennis E; Rudloff, Kimberly

2006-10-01

Obesity is a significant public health problem that is affecting people and their pets. The human-companion animal bond and the role of pets in providing social support provides a rationale framework for studying the effectiveness of a combined people and pets (PP) exercising together (PPET) weight loss program. Thirty-six pairs of overweight or obese people with an obese pet (PP) and 56 overweight or obese people only (PO) participated in a 1-year prospective controlled weight loss study. In a group format, people received dietary and physical activity counseling, and dogs were fed a calorie-controlled prescription diet. Physical activity was recorded using the physical activity recall questionnaire. Completion rates at 1 year were 61% for the PP group and 58% for the PO group. Mean weight losses at 12 months using last observation carried forward were 4.7% (PP) and 5.2% (PO). Mean weight loss among the dogs was 15%. Time spent in physical activity increased in both groups to 3.9 (PP) and 3.5 (PO) h/wk. Two-thirds of total physical activity in the PP group was spent with the dogs. The PPET study is the first program to demonstrate the effectiveness of a combined PP weight loss program. This fresh approach to the dual obesity epidemic builds on the human-companion animal bond. Consideration of social support for weight loss of family members, friends, and coworkers should be extended to include pets.

Behavior Modification for Obesity: The Evaluation of Exercise, Contingency Management, and Program Adherence.

ERIC Educational Resources Information Center

And Others; Stalonas, Peter M., Jr.

1978-01-01

Investigated behavioral programs for obesity. Exercise and self-managed contingency components were compared using obese subjects who were evaluated after treatment and follow-up. Significant weight loss was observed at termination. The influence of exercise at follow-up was noticeable. Subjects engaged in behaviors, yet behaviors were not related…

Modulation of leptin, insulin, and growth hormone in obese pony mares under chronic nutritional restriction and supplementation with ractopamine hydrochloride.

PubMed

Buff, Preston R; Johnson, Philip J; Wiedmeyer, Charles E; Ganjam, Venkataseshu K; Messer Iv, Nat T; Keisler, Duane H

2006-01-01

Horses fed beyond their nutritional requirement and that are physically inactive will develop obesity, which is often accompanied by insulin resistance and heightened risk of laminitis. The use of pharmacologic agents in combination with nutritional restriction may promote weight loss in obese horses unable to exercise because of laminitic pain. This study shows that reducing feed intake of brome grass hay to 75% of ad libitum intake in obese pony mares reduces body weight without induced exercise. Additional supplementation of ractopamine hydrochloride for 6 weeks resulted in a tendency for increased weight loss. Subsequent modulation of obesity-associated hormones, leptin and insulin, as a result of caloric restriction was observed.

Increased consumption of dairy foods and protein during diet- and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women.

PubMed

Josse, Andrea R; Atkinson, Stephanie A; Tarnopolsky, Mark A; Phillips, Stuart M

2011-09-01

Weight loss can have substantial health benefits for overweight or obese persons; however, the ratio of fat:lean tissue loss may be more important. We aimed to determine how daily exercise (resistance and/or aerobic) and a hypoenergetic diet varying in protein and calcium content from dairy foods would affect the composition of weight lost in otherwise healthy, premenopausal, overweight, and obese women. Ninety participants were randomized to 3 groups (n = 30/group): high protein, high dairy (HPHD), adequate protein, medium dairy (APMD), and adequate protein, low dairy (APLD) differing in the quantity of total dietary protein and dairy food-source protein consumed: 30 and 15%, 15 and 7.5%, or 15 and <2% of energy, respectively. Body composition was measured by DXA at 0, 8, and 16 wk and MRI (n = 39) to assess visceral adipose tissue (VAT) volume at 0 and 16 wk. All groups lost body weight (P < 0.05) and fat (P < 0.01); however, fat loss during wk 8-16 was greater in the HPHD group than in the APMD and APLD groups (P < 0.05). The HPHD group gained lean tissue with a greater increase during 8-16 wk than the APMD group, which maintained lean mass and the APLD group, which lost lean mass (P < 0.05). The HPHD group also lost more VAT as assessed by MRI (P < 0.05) and trunk fat as assessed by DXA (P < 0.005) than the APLD group. The reduction in VAT in all groups was correlated with intakes of calcium (r = 0.40; P < 0.05) and protein (r = 0.32; P < 0.05). Therefore, diet- and exercise-induced weight loss with higher protein and increased dairy product intakes promotes more favorable body composition changes in women characterized by greater total and visceral fat loss and lean mass gain.

Bone, body weight, and weight reduction: what are the concerns?

PubMed

Shapses, Sue A; Riedt, Claudia S

2006-06-01

Of the U.S. population, 65% is either overweight or obese, and weight loss is recommended to reduce co-morbid conditions. However, bone mobilization and loss may also occur with weight loss. The risk for bone loss depends on initial body weight, age, gender, physical activity, and conditions of dieting such as the extent of energy restriction and specific levels of nutrient intake. Older populations are more prone to bone loss with weight loss; in women, this is due at least in part to a reduced dietary Ca intake and/or efficiency of absorption. Potential hormonal mechanisms regulating bone loss during weight loss are discussed, including decreases in estrogen, leptin, glucagon-like peptide-2, growth hormone, and insulin-like growth factor-1, or an increase in cortisol. In contrast, the rise in adiponectin and ghrelin with weight reduction should not be detrimental to bone. Combining energy restriction with exercise does not necessarily prevent bone loss, but may attenuate loss as was shown with additional Ca intake or osteoporosis medications. Future controlled weight loss trials should be designed to further address mechanisms influencing the density and quality of bone sites vulnerable to fracture, in the prevention of osteoporosis.

Effects of a popular exercise and weight loss program on weight loss, body composition, energy expenditure and health in obese women

PubMed Central

Kerksick, Chad; Thomas, Ashli; Campbell, Bill; Taylor, Lem; Wilborn, Colin; Marcello, Brandon; Roberts, Mike; Pfau, Emily; Grimstvedt, Megan; Opusunju, Jasmine; Magrans-Courtney, Teresa; Rasmussen, Christopher; Wilson, Ron; Kreider, Richard B

2009-01-01

Objective To determine the safety and efficacy of altering the ratio of carbohydrate and protein in low-energy diets in conjunction with a popular exercise program in obese women. Design Matched, prospective clinical intervention study to assess efficacy of varying ratios of carbohydrate and protein intake in conjunction with a regular exercise program. Participants One-hundred sixty one sedentary, obese, pre-menopausal women (38.5 ± 8.5 yrs, 164.2 ± 6.7 cm, 94.2 ± 18.8 kg, 34.9 ± 6.4 kg·m-2, 43.8 ± 4.2%) participated in this study. Participants were weight stable and not participating in additional weight loss programs. Methods Participants were assigned to either a no exercise + no diet control (CON), a no diet + exercise group (ND), or one of four diet + exercise groups (presented as kcals; % carbohydrate: protein: fat): 1) a high energy, high carbohydrate, low protein diet (HED) [2,600; 55:15:30%], 2) a very low carbohydrate, high protein diet (VLCHP) [1,200 kcals; 63:7:30%], 3) a low carbohydrate, moderate protein diet (LCMP) [1,200 kcals; 50:20:30%] and 4) a high carbohydrate, low protein diet (HCLP) [1,200 kcals; 55:15:30%]. Participants in exercise groups (all but CON) performed a pneumatic resistance-based, circuit training program under supervision three times per week. Measurements Anthropometric, body composition, resting energy expenditure (REE), fasting blood samples and muscular fitness assessments were examined at baseline and weeks 2, 10 and 14. Results All groups except CON experienced significant reductions (P < 0.05 – 0.001) in waist circumference over 14 weeks. VLCHP, LCHP and LPHC participants experienced similar but significant (P < 0.05 – 0.001) reductions in body mass when compared to other groups. Delta responses indicated that fat loss after 14 weeks was significantly greatest in VLCHP (95% CI: -5.2, -3.2 kg), LCMP (-4.0, -1.9 kg) and HCLP (-3.8, -2.1 kg) when compared to other groups. Subsequent reductions in % body fat were significantly greater in VLCHP, LCMP and HCLP participants. Initial dieting decreased (P < 0.05) relative REE similarly in all groups. All exercise groups significantly (P < 0.05) improved in muscular fitness, but these improvements were not different among groups. Favorable but non-significant mean changes occurred in lipid panels, glucose and HOMA-IR. Leptin levels decreased (P < 0.05) in all groups, except for CON, after two weeks of dieting and remained lower throughout the 14 week program. Exercise participation resulted in significant improvements in quality of life and body image. Conclusion Exercise alone (ND) appears to have minimal impact on measured outcomes with positive outcomes apparent when exercise is combined with a hypoenergetic diet. Greater improvements in waist circumference and body composition occurred when carbohydrate is replaced in the diet with protein. Weight loss in all diet groups (VLCHP, LCMP and HCLP) was primarily fat and stimulated improvements in markers of cardiovascular disease risk, body composition, energy expenditure and psychosocial parameters. PMID:19442301

A lifestyle program of exercise and weight loss is effective in preventing and treating type 2 diabetes mellitus: Why are programs not more available?

PubMed

Ades, Philip A

2015-11-01

There is substantial evidence that type 2 diabetes mellitus (T2DM) can be prevented in high-risk individuals by a lifestyle program of regular exercise and weight reduction. Additionally, there is emerging evidence that new onset T2DM (<1year) can go into remission after weight loss and exercise in a majority of motivated individuals, obviating a need for glucose lowering medications. Yet, lifestyle programs to support such behavior change are not widely available. Moreover, health care insurance companies generally do not provide coverage for behavioral weight loss programs to prevent or treat T2DM. Consequently, physicians caring for individuals with T2DM may find it much easier to start a chronic glucose lowering medication rather than attempting to motivate and support patients through long-term behavior change. The cardiac rehabilitation model of disease management, with a network of over 2000 programs in the U.S., is well suited to deliver medically-supervised lifestyle programs. National organizations such as the American Diabetes Association and the American Association of Cardiovascular and Pulmonary Rehabilitation should support greater availability and use of lifestyle programs for T2DM treatment and prevention. Copyright © 2015 Elsevier Inc. All rights reserved.

Dramatic weight loss associated with commencing clozapine.

PubMed

Lally, John; McDonald, Colm

2011-11-08

The authors report the case of a 44-year-old man with a long history of chronic enduring schizophrenia who experienced dramatic weight loss after commencing treatment with clozapine, an antipsychotic medication characteristically associated with the greatest degree of weight gain among medical treatments for schizophrenia. He was obese with a body mass index (BMI) of 41.5 kg/m(2), but after commencing clozapine therapy he experienced an improvement in psychotic symptoms and 40% loss of his body weight attained through an altered diet and exercise regime, which resulted in him attaining a normal BMI of 24.8 kg/m(2).

Current concepts in the pharmacological management of obesity.

PubMed

Carek, P J; Dickerson, L M

1999-06-01

The pharmacological management of obesity has gained increasing attention as new weight loss treatments are approved and a significant proportion of the public strives to lose weight. Obesity is associated with a high mortality rate, multiple chronic medical conditions, and carries an enormous financial burden. Obesity is a multifactorial condition, most often due to an imbalance in energy intake and expenditure. Despite the greater focus on management of obesity, weight loss remains a difficult goal to achieve. Obesity is a chronic medical condition that may require long term treatment, therefore the risks and benefits of all pharmacological agents must be carefully considered. Noradrenergic appetite suppressants (ie. phenyl-propanolamine, phentermine) result in weight loss but stimulatory effects limit their use. The serotonergic agents (fenfluramine, dexfenfluramine) were effective weight loss drugs, but were voluntarily withdrawn from the US market last year because of cardiovascular and pulmonary complications. The combination noradrenergic/serotonergic agent sibutramine is indicated for the management of obesity, particularly in the presence of other cardiovascular risk factors. Modest weight loss is achieved with sibutramine, although weight gain is significant after discontinuation. In addition, long term safety data are not yet available. The thermogenic combination of ephedrine plus caffeine is minimally effective, and adverse effects are usually transient. Other thermogenic agents, such as beta3-agonists, are still under investigation. Agents may alter digestion through lipase inhibition (orlistat) or fat substitution (olestra). Orlistat decreases systemic absorption of dietary fat, decreasing body weight and cholesterol. Olestra is a fat substitute that has been incorporated into snack foods. Olestra substitution for dietary fat has not been studied as a weight loss strategy, although olestra has no caloric value and may be beneficial. The use of orlistat and olestra may be limited by gastrointestinal adverse effects. Finally, the manipulation of leptin and neuropeptide Y are under investigation for the treatment of obesity. Pharmacological agents should be used as an aid to a structured diet and exercise regimen in the treatment of obesity. Weight loss agents may result in initial weight loss, but sustained weight loss is not always achieved even with continuation of treatment. The effect of weight loss obtained while using pharmacotherapeutic agents on morbidity and mortality has not been established. Therefore, diet and exercise should be the focus of any weight loss programme. There is a continued need for safe and effective pharmacotherapeutic agents for the treatment of obesity.

Exercise training improves obesity‐related lymphatic dysfunction

PubMed Central

Hespe, Geoffrey E.; Kataru, Raghu P.; Savetsky, Ira L.; García Nores, Gabriela D.; Torrisi, Jeremy S.; Nitti, Matthew D.; Gardenier, Jason C.; Zhou, Jie; Yu, Jessie Z.; Jones, Lee W.

2016-01-01

Key points Obesity results in perilymphatic inflammation and lymphatic dysfunction.Lymphatic dysfunction in obesity is characterized by decreased lymphatic vessel density, decreased collecting lymphatic vessel pumping frequency, decreased lymphatic trafficking of immune cells, increased lymphatic vessel leakiness and changes in the gene expression patterns of lymphatic endothelial cells.Aerobic exercise, independent of weight loss, decreases perilymphatic inflammatory cell accumulation, improves lymphatic function and reverses pathological changes in gene expression in lymphatic endothelial cells. Abstract Although previous studies have shown that obesity markedly decreases lymphatic function, the cellular mechanisms that regulate this response remain unknown. In addition, it is unclear whether the pathological effects of obesity on the lymphatic system are reversible with behavioural modifications. The purpose of this study, therefore, was to analyse lymphatic vascular changes in obese mice and to determine whether these pathological effects are reversible with aerobic exercise. We randomized obese mice to either aerobic exercise (treadmill running for 30 min per day, 5 days a week, for 6 weeks) or a sedentary group that was not exercised and analysed lymphatic function using a variety of outcomes. We found that sedentary obese mice had markedly decreased collecting lymphatic vessel pumping capacity, decreased lymphatic vessel density, decreased lymphatic migration of immune cells, increased lymphatic vessel leakiness and decreased expression of lymphatic specific markers compared with lean mice (all P < 0.01). Aerobic exercise did not cause weight loss but markedly improved lymphatic function compared with sedentary obese mice. Exercise had a significant anti‐inflammatory effect, resulting in decreased perilymphatic accumulation of inflammatory cells and inducible nitric oxide synthase expression. In addition, exercise normalized isolated lymphatic endothelial cell gene expression of lymphatic specific genes, including VEGFR‐3 and Prox1. Taken together, our findings suggest that obesity impairs lymphatic function via multiple mechanisms and that these pathological changes can be reversed, in part, with aerobic exercise, independent of weight loss. In addition, our study shows that obesity‐induced lymphatic endothelial cell gene expression changes are reversible with behavioural modifications. PMID:26931178

Self-Monitoring in Weight Loss: A Systematic Review of the Literature

PubMed Central

Wang, Jing; Sevick, Mary Ann

2011-01-01

Self-monitoring is the centerpiece of behavioral weight loss intervention programs. This article presents a systematic review of the literature on three components of self-monitoring in behavioral weight loss studies: diet, exercise and self-weighing. This review included articles that were published between 1993 and 2009 that reported on the relationship between weight loss and these self-monitoring strategies. Of the 22 studies identified, 14 focused on dietary self-monitoring, one on self-monitoring exercise and six on self-weighing. A wide array of methods was used to perform self-monitoring; the paper diary was used most often. Adherence to self-monitoring was reported most frequently as the number of diaries completed or the frequency of log-ins or reported weights. The use of technology, which included the Internet, personal digital assistants and electronic digital scales were reported in five studies. Descriptive designs were used in the earlier studies while more recent reports involved prospective studies and randomized trials that examined the effect of self-monitoring on weight loss. A significant association between self-monitoring and weight loss was consistently found; however, the level of evidence was weak because of methodological limitations. The most significant limitations of the reviewed studies were the homogenous samples and reliance on self-report. In all but two studies, the samples were predominantly White and female. This review highlights the need for studies in more diverse populations, for objective measures of adherence to self-monitoring, and for studies that establish the required dose of self-monitoring for successful outcomes. PMID:21185970

Genetic variants influencing effectiveness of weight loss strategies.

PubMed

Deram, Sophie; Villares, Sandra M F

2009-03-01

Body weight excess has an increasingly high prevalence in the world. Obesity is a complex disease of multifactorial origin with a polygenic condition affected by environmental factors. Weight loss is a primary strategy to treat obesity and its morbidities. Weight changes through life depend on the interaction of environmental, behavioral and genetic factors. Interindividual variation of weight loss in response to different types of interventions (behavioral, caloric restriction, exercise, drug or surgery) has been observed. In this article, currently available data on the role of candidate gene polymorphisms in weight loss are reviewed. Even though control of weight loss by genotype was described in twin and family studies, it is premature to recommend use of genotyping in the design of therapeutic diets or drug treatment. Future studies will have to be large in order to assess the effects of multiple polymorphisms, and will have to control factors other than diet.

Reduction in obesity and coronary risk factors after high caloric exercise training in overweight coronary patients.

PubMed

Savage, Patrick D; Brochu, Martin; Poehlman, Eric T; Ades, Philip A

2003-08-01

The majority of patients with coronary heart disease (CHD) are overweight. However, little weight loss occurs with participation in a standard cardiac rehabilitation (CR) program. Fifteen overweight patients (average body mass index of 31.0 kg/m2) with CHD completed a 4-month exercise training program in a CR program. The exercise program consisted primarily of walking long duration (60-90 minutes per session) 5 to 7 days per week at a relatively low intensity of 50% to 60% of peak VO2. Measures of body composition by dual-energy x-ray absorptiometry, body fat distribution by computed tomography, plasma lipid-lipoprotein, glucose and insulin concentrations, and peak VO2 were obtained before and after the exercise intervention. Patients maintained an isocaloric diet throughout the study. Patients had reductions in total body weight (-4.6 kg), fat mass (-3.6 kg), percent body fat (-2.9%), and waist circumference (-5.6 cm) (all P <.001) while maintaining fat-free mass. Subcutaneous adipose tissue was reduced by 12% (P <.001) and visceral adipose tissue was lowered by 14% (P <.001). There were favorable changes in the lipid-metabolic profile with reductions in triglyceride levels (-23.7%), total cholesterol/HDL-C ratio (-14.3%), and fasting insulin levels (-22.3%) (all P <.05). Peak VO2 increased by 21.2% (P <.001). The present pilot study results suggest that a high caloric training exercise training program in the CR setting may be effective in promoting weight loss and improving coronary risk factors in overweight coronary patients. Although additional research with randomized control patients is needed, this alternative to traditional CR may be considered to maximize weight loss as part of a secondary prevention program.

Weight loss reduces breast ductal fluid estrogens in obese postmenopausal women: a single arm intervention pilot study.

PubMed

Carpenter, Catherine L; Duvall, Karen; Jardack, Patricia; Li, Luyi; Henning, Susanne M; Li, Zhaoping; Heber, David

2012-12-05

Accumulation of excess body fat increases breast cancer risk after menopause. Whether the localized breast is differently influenced by adipose tissue compared to the rest of the body, has not been well studied. Our purpose was to demonstrate feasibility and preliminarily evaluate serum-based and localized breast biomarker changes resulting from a weight loss intervention among obese postmenopausal women. We conducted a 12-week pilot controlled dietary and exercise intervention among healthy obese postmenopausal women, collected serum and breast ductal fluid before and after the intervention, and estimated the association with systemic and localized biomarker changes. We recruited 7 obese (mean body mass index = 33.6 kg/m2) postmenopausal women. We collected samples at baseline and the 12th week for: anthropometry; phlebotomy; dual-energy x-ray absorptiometry (lean and fat mass); exercise fitness (maximum oxygen consumption (VO2Max); 1-repetition strength maximum); and breast ductal lavage. Changes from baseline occurred in body composition and exercise performance including fat mass loss (14% average drop), VO2Max (+36% increase) and strength improvement (+26%). Breast ductal fluid markers declined from baseline with estradiol showing a 24% reduction and IL-6 a 20% reduction. We also observed serum biomarker reductions from baseline including leptin (36% decline), estrone sulfate (-10%), estradiol (-25%), and Il-6 (-33%). Conduct of the diet and exercise intervention, collection of ductal fluid, and measurement of hormones and cytokines contained in the ductal fluid were all feasible. We preliminarily demonstrated estradiol and IL-6 reductions from baseline in both serum and breast ductal fluid among obese postmenopausal women who participated in the 12-week weight loss diet and exercise intervention.

Perceived Self-Efficacy and Financial Incentives: Factors Affecting Health Behaviors and Weight Loss in a Workplace Weight Loss Intervention.

PubMed

Faghri, Pouran D; Simon, Julia; Huedo-Medina, Tania; Gorin, Amy

2017-05-01

To evaluate if self-efficacy (SE) and financial incentives (FI) mediate the effect of health behavior on weight loss in a group of overweight and obese nursing-home employees participating in a 16-week weight-loss intervention with 12-week follow-up. Ninety nine overweight/obese (body mass index [BMI] > 25) employees from four nursing-homes participated, with a mean age of 46.98 years and BMI of 35.33. Nursing-homes were randomized to receiving an incentive-based intervention (n = 51) and no incentive (n = 48). Participants' health behaviors and eating and exercise self-efficacy (Ex-SE) were assessed at week 1, 16, and 28 using a self-reported questionnaire. Mediation and moderated mediation analysis assessed relationships among these variables. Eating self-efficacy (Eat-SE) and Ex-SE were significant mediators between health behaviors and weight loss (P < 0.05). Incentives significantly moderated the effects of self-efficacy (P = 0.00) on weight loss. Self-efficacy and FI may affect weight loss and play a role in weight-loss interventions.

Effect of exercise on the maternal outcome in pregnancy of spontaneously hypertensive rats.

PubMed

Rocha, Renato; Peraçoli, José Carlos; Volpato, Gustavo Tadeu; Damasceno, Débora Cristina; Campos, Kleber Eduardo de

2014-09-01

To evaluate the effect of exercise (swimming) on pregnancy in spontaneously hypertensive rats (SHR). Thirty three pregnant female SHR were distributed into three groups (n=11 animals/group): SHR Control=non-exercised (sedentary); SHR Ex0 = exercised from day zero to day 20 of pregnancy; and SHR Ex7 = exercised from day 7 to 20 of pregnancy. Body weight and systolic blood pressure were indirectly measured during pregnancy. On gestational day 21, the rats were anaesthetized and uterine content was withdrawn for analysis of maternal reproductive outcome parameters and fetal development. The reduced blood pressure percentage was higher in SHR Ex0 and SHR Ex7 compared to SHR Control group. Weight gain was present in all pregnancy periods, but it was lower in SHR Ex7 than in SHR Control dams. The exercise increased the pre-implantation loss rate. The post-implantation loss rate was lower in SHR Ex0 group. SHR Ex7 group showed a significantly higher percentage of fetuses classified as small for gestational age as compared to others groups. The exercise contributed to lowering gestational blood pressure in SHR rats, but had a negative impact on the developing embryo.

Reducing breast cancer recurrence with weight loss, a vanguard trial: the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial.

PubMed

Rock, Cheryl L; Byers, Tim E; Colditz, Graham A; Demark-Wahnefried, Wendy; Ganz, Patricia A; Wolin, Kathleen Y; Elias, Anthony; Krontiras, Helen; Liu, Jingxia; Naughton, Michael; Pakiz, Bilgé; Parker, Barbara A; Sedjo, Rebecca L; Wyatt, Holly

2013-03-01

Breast cancer is the most common invasive cancer among women in developed countries. Obesity is a major risk factor for breast cancer recurrence and mortality in both pre- and postmenopausal women. Co-morbid medical conditions are common among breast cancer survivors. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is a 4-year randomized clinical trial of 693 overweight/obese women aged ≥21years diagnosed with any early stage breast cancer (stages I[≥1cm]-III) within the previous five years, designed to demonstrate the feasibility of achieving sustained weight loss and to examine the impact of weight loss on quality of life and co-morbidities, and to enable future exploration of biochemical mechanisms linking obesity to lower likelihood of disease-free survival. This trial is strategically designed as a vanguard for a fully-powered trial of women who will be evaluated for breast cancer recurrence and disease-free survival. Participants were recruited between 2010 and 2012 at four sites, had completed initial therapies, and had a body mass index between 25 and 45kg/m(2). The intervention featured a group-based cognitive-behavioral weight loss program with telephone counseling and tailored newsletters to support initial weight loss and subsequent maintenance, with the goal of 7% weight loss at two years. This study has high potential to have a major impact on clinical management and outcomes after a breast cancer diagnosis. This trial initiates the effort to establish weight loss support for overweight or obese breast cancer survivors as a new standard of clinical care. Copyright © 2012 Elsevier Inc. All rights reserved.

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults

PubMed Central

Villareal, Dennis T.; Aguirre, Lina; Gurney, A. Burke; Waters, Debra L.; Sinacore, David R.; Colombo, Elizabeth; Armamento-Villareal, Reina; Qualls, Clifford

2017-01-01

BACKGROUND Obesity causes frailty in older adults; however, weight loss might accelerate age-related loss of muscle and bone mass and resultant sarcopenia and osteopenia. METHODS In this clinical trial involving 160 obese older adults, we evaluated the effectiveness of several exercise modes in reversing frailty and preventing reduction in muscle and bone mass induced by weight loss. Participants were randomly assigned to a weight-management program plus one of three exercise programs — aerobic training, resistance training, or combined aerobic and resistance training — or to a control group (no weight-management or exercise program). The primary outcome was the change in Physical Performance Test score from baseline to 6 months (scores range from 0 to 36 points; higher scores indicate better performance). Secondary outcomes included changes in other frailty measures, body composition, bone mineral density, and physical functions. RESULTS A total of 141 participants completed the study. The Physical Performance Test score increased more in the combination group than in the aerobic and resistance groups (27.9 to 33.4 points [21% increase] vs. 29.3 to 33.2 points [14% increase] and 28.8 to 32.7 points [14% increase], respectively; P=0.01 and P=0.02 after Bonferroni correction); the scores increased more in all exercise groups than in the control group (P<0.001 for between-group comparisons). Peak oxygen consumption (milliliters per kilogram of body weight per minute) increased more in the combination and aerobic groups (17.2 to 20.3 [17% increase] and 17.6 to 20.9 [18% increase], respectively) than in the resistance group (17.0 to 18.3 [8% increase]) (P<0.001 for both comparisons). Strength increased more in the combination and resistance groups (272 to 320 kg [18% increase] and 288 to 337 kg [19% increase], respectively) than in the aerobic group (265 to 270 kg [4% increase]) (P<0.001 for both comparisons). Body weight decreased by 9% in all exercise groups but did not change significantly in the control group. Lean mass decreased less in the combination and resistance groups than in the aerobic group (56.5 to 54.8 kg [3% decrease] and 58.1 to 57.1 kg [2% decrease], respectively, vs. 55.0 to 52.3 kg [5% decrease]), as did bone mineral density at the total hip (grams per square centimeter; 1.010 to 0.996 [1% decrease] and 1.047 to 1.041 [0.5% decrease], respectively, vs. 1.018 to 0.991 [3% decrease]) (P<0.05 for all comparisons). Exercise-related adverse events included musculoskeletal injuries. CONCLUSIONS Of the methods tested, weight loss plus combined aerobic and resistance exercise was the most effective in improving functional status of obese older adults. (Funded by the National Institutes of Health; LITOE ClinicalTrials.gov number, NCT01065636.) PMID:28514618

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults.

PubMed

Villareal, Dennis T; Aguirre, Lina; Gurney, A Burke; Waters, Debra L; Sinacore, David R; Colombo, Elizabeth; Armamento-Villareal, Reina; Qualls, Clifford

2017-05-18

Obesity causes frailty in older adults; however, weight loss might accelerate age-related loss of muscle and bone mass and resultant sarcopenia and osteopenia. In this clinical trial involving 160 obese older adults, we evaluated the effectiveness of several exercise modes in reversing frailty and preventing reduction in muscle and bone mass induced by weight loss. Participants were randomly assigned to a weight-management program plus one of three exercise programs - aerobic training, resistance training, or combined aerobic and resistance training - or to a control group (no weight-management or exercise program). The primary outcome was the change in Physical Performance Test score from baseline to 6 months (scores range from 0 to 36 points; higher scores indicate better performance). Secondary outcomes included changes in other frailty measures, body composition, bone mineral density, and physical functions. A total of 141 participants completed the study. The Physical Performance Test score increased more in the combination group than in the aerobic and resistance groups (27.9 to 33.4 points [21% increase] vs. 29.3 to 33.2 points [14% increase] and 28.8 to 32.7 points [14% increase], respectively; P=0.01 and P=0.02 after Bonferroni correction); the scores increased more in all exercise groups than in the control group (P<0.001 for between-group comparisons). Peak oxygen consumption (milliliters per kilogram of body weight per minute) increased more in the combination and aerobic groups (17.2 to 20.3 [17% increase] and 17.6 to 20.9 [18% increase], respectively) than in the resistance group (17.0 to 18.3 [8% increase]) (P<0.001 for both comparisons). Strength increased more in the combination and resistance groups (272 to 320 kg [18% increase] and 288 to 337 kg [19% increase], respectively) than in the aerobic group (265 to 270 kg [4% increase]) (P<0.001 for both comparisons). Body weight decreased by 9% in all exercise groups but did not change significantly in the control group. Lean mass decreased less in the combination and resistance groups than in the aerobic group (56.5 to 54.8 kg [3% decrease] and 58.1 to 57.1 kg [2% decrease], respectively, vs. 55.0 to 52.3 kg [5% decrease]), as did bone mineral density at the total hip (grams per square centimeter; 1.010 to 0.996 [1% decrease] and 1.047 to 1.041 [0.5% decrease], respectively, vs. 1.018 to 0.991 [3% decrease]) (P<0.05 for all comparisons). Exercise-related adverse events included musculoskeletal injuries. Of the methods tested, weight loss plus combined aerobic and resistance exercise was the most effective in improving functional status of obese older adults. (Funded by the National Institutes of Health; LITOE ClinicalTrials.gov number, NCT01065636 .).

A Clinical Trial on Weight Loss among Truck Drivers.

PubMed

Thiese, M S; Effiong, A C; Ott, U; Passey, D G; Arnold, Z C; Ronna, B B; Muthe, P A; Wood, E M; Murtaugh, M A

2015-04-01

The high prevalence of obesity among commercial truck drivers may be related to sedentary nature of the job, lack of healthy eating choices, and lack of exercise. There may be a link between obesity and crash risk, therefore an intervention to reduce obesity in this population is needed. To assess feasibility of a 12-week weight loss intervention for truck drivers with a weight loss goal of 10% of initial body weight. Drivers were selected based on age (≥21 years) and body mass index (≥30 kg/m^2). The drivers participated in a before-after clinical trial. The intervention included a 12-week program that provided information on healthy diet and increasing exercise, and telephone-based coaching using SMART goals. Outcomes included change from baseline in reported energy intake, measured weight, waist, hip, and neck circumference, blood pressure, and point of care capillary blood lipids and hemoglobin A1c. Exit interviews were conducted to gain insight into driver opinions on the program features and usefulness. This study was registered with the NIH Clinical Trials Registry, number NCT02348983. 12 of 13 drivers completed the study. Weight loss was statistically significant (p=0.03). Reported energy (p=0.005), total fat consumption (p=0.04), and saturated fat consumption (p=0.02) intake were also lower after the 12-week intervention. Drivers attributed their weight loss to health coaching and suggested a longer intervention so that they could reach their goal and become accustomed to the changes. This weight loss intervention is feasible for this difficult population. Additional research is needed to compare this intervention with a control group.

Lifestyle intervention improves heart rate recovery from exercise in adults with Type 2 diabetes: Results from the Look AHEAD Study

USDA-ARS?s Scientific Manuscript database

The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined ...

Lifestyle intervention improves heart rate recovery from exercise in adults with type 2 diabetes: Results from the Look AHEAD study

USDA-ARS?s Scientific Manuscript database

The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT), and (2) to determine the independent and combined...

Quality of life outcomes from the Exercise and Nutrition Enhance Recovery and Good Health for You (ENERGY)-randomized weight loss trial among breast cancer survivors

PubMed Central

Colditz, Graham A.; Rock, Cheryl L.; Sedjo, Rebecca L.; Liu, Jingxia; Wolin, Kathleen Y.; Krontiras, Helen; Byers, Tim; Pakiz, Bilgé; Parker, Barbara A.; Naughton, Michael; Elias, Anthony; Ganz, Patricia A.

2015-01-01

Obesity is a poor prognostic factor and is negatively related to quality of life (QOL) in breast cancer survivors. Exercise and Nutrition to Enhance Recovery and Good Health for You is the largest weight loss trial completed among cancer survivors. Percent losses in body weight with an intensive group-based intervention versus an attention control were 6.0 versus 1.5 % (p < 0.0001) and 3.7 versus 1.3 % (p<0.0001) at 12 and 24 months, respectively. ENERGY also was designed to answer the research question: Does weight loss significantly improve vitality and physical function (key components of QOL)? 692 breast cancer survivors (BMI: 25–45 kg/m2) at 4 US sites were randomized to a year-long intensive intervention of 52 group sessions and telephone counseling contacts versus a non-intensive (control) of two in-person counseling sessions. Weight, self-reported QOL, and symptoms were measured semi-annually for two years. Significant decreases in physical function and increases in symptoms were observed among controls from baseline to 6 months, but not in the intervention arm, −3.45 (95 % Confidence Interval [CI] −6.10, –0.79, p = 0.0109) and 0.10 (95 %CI 0.04, 0.16, p = 0.0021), respectively. Improvements in vitality were seen in both arms but trended toward greater improvement in the intervention arm −2.72 (95 % CI −5.45, 0.01, p = 0.0508). These differences diminished over time; however, depressive symptoms increased in the intervention versus control arms and became significant at 24 months, −1.64 (95 % CI −3.13, –0.15, p = 0.0308). Increased QOL has been reported in shorter term diet and exercise trials among cancer survivors. These longer term data suggest that diet and exercise interventions improve some aspects of QOL, but these benefits may diminish over time. PMID:26518022

Aerobic Exercise and Weight Loss Reduce Vascular Markers of Inflammation and Improve Insulin Sensitivity in Obese Women

PubMed Central

Ryan, Alice S.; Ge, Shealinna; Blumenthal, Jacob B.; Serra, Monica C.; Prior, Steven J.; Goldberg, Andrew P.

2014-01-01

Background/Objectives To examine the relationships of plasma and tissue markers of systemic and vascular inflammation to obesity and insulin resistance and determine the effects of aerobic exercise training+weight loss (AEX+WL) and weight loss (WL) on these biomarkers. Design Prospective controlled study. Participants Seventy-seven overweight and obese sedentary postmenopausal women. Interventions Six months, 3d/wk AEX+WL (n=37) or WL (n=40). Measurements Total body dual-energy x-ray absorptiometry, abdominal computed tomography scans, hyperinsulinemic-euglycemic clamps, adipose tissue biopsies (n=28), and blood for Homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule (sICAM-1) and vascular CAM-1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA). Results Body weight, %fat, visceral fat, triglyceride levels and systolic blood pressure decreased comparably after WL and AEX+WL (P<0.05). VO2max increased 16% after AEX+WL (P<0.001). Insulin resistance decreased in both groups (P<0.01). Glucose utilization increased 10% (P< 0.05) after AEX+WL and 8% with WL (P=0.07). AEX+WL and WL decreased CRP by 29% and 21%, (P<0.05). SAA levels decreased two-fold more after AEX+WL (−19%, P<0.05) than with WL (−9%, P=0.08). Plasma sICAM-1 and sVCAM-1 levels did not change; however, women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose, insulin and insulin resistance (P<0.05). Gluteal ICAM mRNA levels decreased 27% after AEX+WL (P<0.05) and did not change after WL. Conclusion Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP and SAA and tissue ICAM decrease with exercise and weight loss, suggesting that exercise training is a necessary component of lifestyle modification in obese postmenopausal women. PMID:24635342

Exercise coupled with dietary restriction reduces oxidative stress in male adolescents with obesity.

PubMed

Li, Chunyan; Feng, Feihu; Xiong, Xiaoling; Li, Rui; Chen, Ning

2017-04-01

The increased oxidative stress is usually observed in obese population, but the control of body weight by calorie restriction and/or exercise training can ameliorate oxidative stress. In order to evaluate oxidative stress in response to exercise and dietary restriction in obese adolescents, a total of 20 obese volunteers were enrolled in a 4-week intervention program including exercise training and dietary restriction. Body compositions and blood samples were analysed before and after 4-week intervention, and biomarkers associated with oxidative stress were examined. After 4-week exercise training coupled with dietary restriction, physical composition parameters including body mass, body mass index (BMI), lean body mass, body fat mass and fat mass ratio had obvious reduction by 12.43%, 13.51%, 5.83%, 25.05% and 14.52%, respectively. In addition, the activities of antioxidant enzymes, such as superoxide dismutase (SOD) and glutathione peroxidase (GPx) revealed a remarkable enhancement. On the other hand, protein carbonyls (PC) exhibited an obvious reduction. Moreover, total thiols and nitrites with respect to baseline revealed a reducing trend although no significant difference was observed. Therefore, the 4-week exercise intervention coupled with dietary restriction is benefit for the loss of body weight and the mitigation of oxidative stress in obese population so that it can be a recommendable intervention prescription for the loss of body weight.

Yerba Maté (Ilex paraguariensis) Metabolic, Satiety, and Mood State Effects at Rest and during Prolonged Exercise.

PubMed

Alkhatib, Ahmad; Atcheson, Roisin

2017-08-15

Yerba Maté (YM), has become a popular herb ingested for enhancing metabolic health and weight-loss outcomes. No studies have tested the combined metabolic, satiety, and psychomotor effects of YM during exercise. We tested whether YM ingestion affects fatty acid oxidation (FAO), profile of mood state score (POMS), and subjective appetite scale (VAS), during prolonged moderate exercise. Twelve healthy active females were randomized to ingest either 2 g of YM or placebo (PLC) in a repeated-measures design. Participants rested for 120 min before performing a 30-min cycling exercise corresponding to individuals' crossover point intensity (COP). FAO, determined using indirect calorimetry, was significantly higher during the 30-min exercise in YM vs. PLC (0.21 ± 0.07 vs. 0.17 ± 0.06 g/min, p < 0.05). VAS scores for hunger, prospective eating, and desire to eat were all reduced ( p < 0.05). Whereas, POMS measures of focus, energy, and concentration were all increased ( p < 0.05). There was no significant time-effect for any of the measured variables, nor was there any interaction effects between YM treatment and time. Combining YM intake with prolonged exercise at targeted "fat-loss"' intensities augments FAO and improves measures of satiety and mood state. Such positive combined metabolic, satiety, and psychomotor effects may provide an important role for designing future fat and weight-loss lifestyle interventions.

Postpartum Care and Contraception in Obese Women.

PubMed

Maclean, Courtney C; Thompson, Ivana S

2016-03-01

Postpartum obese women have an increased risk of breastfeeding difficulties and depression. Retaining the pregnancy weight at 6 months postpartum predicts long-term obesity. Risks for weight retention include excessive gestational weight gain, ethnicity, socioeconomic status, diet, exercise, depression, and duration of breastfeeding. Exercise and reducing total caloric intake promote postpartum weight loss. Intrauterine devices and contraceptive implants are the most effective contraceptives for obese women. Contraceptive pills, patches, and vaginal rings are effective options; however, obese women should be made aware of a potential increased risk of venous thromboembolism. Vasectomy and hysteroscopic sterilization carry the least surgical risk for obese women.

Comparing Weight Loss-Maintenance Outcomes of a Worksite-Based Lifestyle Program Delivered via DVD and Face-to-Face: A Randomized Trial.

PubMed

Ing, Claire Townsend; Miyamoto, Robin E S; Fang, Rui; Antonio, Mapuana; Paloma, Diane; Braun, Kathryn L; Kaholokula, Joseph Keawe'aimoku

2018-03-01

Native Hawaiians and other Pacific Islanders have high rates of overweight and obesity compared with other ethnic groups in Hawai'i. Effective weight loss and weight loss-maintenance programs are needed to address obesity and obesity-related health inequities for this group. Compare the effectiveness of a 9-month, worksite-based, weight loss-maintenance intervention delivered via DVD versus face-to-face in continued weight reduction and weight loss maintenance beyond the initial weight loss phase. We tested DVD versus face-to-face delivery of the PILI@Work Program's 9-month, weight loss-maintenance phase in Native Hawaiian-serving organizations. After completing the 3-month weight loss phase, participants ( n = 217) were randomized to receive the weight loss-maintenance phase delivered via trained peer facilitators or DVDs. Participant assessments at randomization and postintervention included weight, height, blood pressure, physical functioning, exercise frequency, and fat intake. Eighty-three face-to-face participants were retained at 12 months (74.1%) compared with 73 DVD participants (69.5%). There was no significant difference between groups in weight loss or weight loss maintenance. The number of lessons attended in Phase 1 of the intervention (β = 0.358, p = .022) and baseline systolic blood pressure (β = -0.038, p = .048) predicted percent weight loss at 12 months. Weight loss maintenance was similar across groups. This suggests that low-cost delivery methods for worksite-based interventions targeting at-risk populations can help address obesity and obesity-related disparities. Additionally, attendance during the weight loss phase and lower baseline systolic blood pressure predicted greater percent weight loss during the weight loss-maintenance phase, suggesting that early engagement and initial physical functioning improve long-term weight loss outcomes.

Hardware Evaluation of the Horizontal Exercise Fixture with Weight Stack

NASA Technical Reports Server (NTRS)

Newby, Nate; Leach, Mark; Fincke, Renita; Sharp, Carwyn

2009-01-01

HEF with weight stack seems to be a very sturdy and reliable exercise device that should function well in a bed rest training setting. A few improvements should be made to both the hardware and software to improve usage efficiency, but largely, this evaluation has demonstrated HEF's robustness. The hardware offers loading to muscles, bones, and joints, potentially sufficient to mitigate the loss of muscle mass and bone mineral density during long-duration bed rest campaigns. With some minor modifications, the HEF with weight stack equipment provides the best currently available means of performing squat, heel raise, prone row, bench press, and hip flexion/extension exercise in a supine orientation.

Issues in the Assessment and Treatment of Obesity.

ERIC Educational Resources Information Center

Foreyt, John P.

1987-01-01

Summarizes recent developments in assessment and treatment of obesity. Reviews studies on genetics and weight cycling, which demonstrate the heterogeneous etiology of obesity and help explain difficulty in losing weight or maintaining weight loss. Describes the newer treatment programs which emphasize the development of exercise behaviors,…

Deal with Diets

MedlinePlus

... las dietas? High-protein diets. Low-fat diets. Vegetarian diets. No-carb diets. With all the focus on ... Detox Diets Safe? Should I Go on a Diet? Staying at a Healthy Weight Therapy and Weight Management Weight Loss Surgery Compulsive Exercise Becoming a Vegetarian Body Image and Self-Esteem How Can I ...

My student body: effects of an internet-based prevention program to decrease obesity among college students.

PubMed

Lachausse, Robert G

2012-01-01

To determine the impact of My Student Body (MSB)-Nutrition, an Internet-based obesity prevention program for college students. Three hundred and twenty ethnically diverse undergraduate students were randomly assigned to 1 of 3 conditions: MSB-Nutrition program, an on-campus weight management course, and a comparison group. Students completed baseline and follow-up surveys regarding their nutrition and physical activity behaviors, self-efficacy, stress, attitudes, and body weight. Compared with the on-campus course and a comparison group, the MSB-Nutrition program increased fruit and vegetable consumption, reduced stress, and increased fruit and vegetable self-efficacy but had no significant effect on students' exercise self-efficacy, exercise behavior, or weight loss. The MSB-Nutrition program was effective in changing students' nutrition behaviors but had no effect on physical activity behaviors or weight loss. Suggestions for improving Internet-based interventions aimed at decreasing obesity rates among college students are offered.

[Contraindications to weight reduction].

PubMed

Heini, A

2000-08-01

It is relatively well accepted that weight gain, even within the range of normal weight, is detrimental for health. The claimed long-term benefit of intentional weight loss is mainly based on a few observational trials, confounding intentional and non-intentional weight loss. The few data on obesity-related diseases prevented by intentional weight reduction have not been replicated. Thus, for lack of level-one evidence it is to date doubtful whether voluntary weight loss should be intensively recommended to obese individuals rather than other lifestyle-interventions, e.g. exercise training. The aim of this overview is to discuss some of the contraindications to intentional weight loss often ignored in recent debates. There is no intention to question the increased risk of overweight on morbidity and the need for preventing weight gain in our population. Besides well-known consequences secondary to rapid weight loss, e.g. gallstones and electrolyte disorders, some new aspects or more debated issues are discussed. Recent compelling data indicate a significant bone density loss after weight loss of a few kilograms. Knowledge on the impact of weight cycling mainly relies on cross-sectional data. So far there is no concluding evidence of adverse pathophysiological effects from weight cycling. Repeated dieting has been associated with eating disorders, although the cause-effect relationship has not been well established. At least on an empirical basis there seems to be a tolerance effect after repeated weight losing efforts. Pharmacotherapy tends more and more to be part of weight loss interventions. Although the currently available drugs are designed for long-term treatment, in practice they are rarely used longer than a few months, and therefore their use can be entirely questioned. Nonetheless, if employed properly for weight loss and weight maintenance, i.e. "for life", additional data on long-term effects on health are needed. Such risks can then be weighed against the risk of remaining obese. Even a limited detrimental effect on blood pressure, such as known for sibutramine, could compromise the beneficial effect of the drug on weight loss and maintenance. Further, the financial burden of weight loss is not to be underestimated. Besides diets and weight loss programs being a multi billion dollar business, the cost of patient care in cases of surgery for gallstones has, among other economic implications, to be considered. Finally, with the example of the recently investigated impact of fitness level on health, exercise training may be an alternative to weight loss. Whether obese or not, cardiovascular fitness is a strong, independent predictor of cardiovascular mortality and overall mortality. Most obese being unfit, a greater preventive impact might come from becoming more fit than from losing weight. This should only illustrate that there is still a long way to go until we have sufficient scientific data to be able to tell whether in the management of obesity weight loss or other interventions are of higher priority. In part, current recommendations to lose weight are biased by societal pressure, which overrules simple scientific evidence.

Menstrual Cycle: What's Normal, What's Not

MedlinePlus

... loss or excessive exercising. Eating disorders — such as anorexia nervosa — extreme weight loss and increased physical activity can ... Treatment for any underlying problems, such as an eating disorder, also might help. However, some menstrual irregularities can' ...

Diet or exercise, or both, for weight reduction in women after childbirth.

PubMed

Amorim Adegboye, Amanda R; Linne, Yvonne M

2013-07-23

Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. The objectives of this review were to evaluate the effect of diet, exercise or both for weight reduction in women after childbirth, and to assess the impact of these interventions on maternal body composition, cardiorespiratory fitness, breastfeeding performance and other child and maternal outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2012) and LILACS (31 January 2012). We scanned secondary references and contacted experts in the field. We updated the search of the Cochrane Pregnancy and Childbirth Group's Trials Register on 30 April 2013 and added the results to the awaiting classification section of the review. All published and unpublished randomised controlled trials (RCTs) and quasi-randomised trials of diet or exercise or both, among women during the postpartum period. Both review authors independently assessed trial quality and extracted data. Results are presented using risk ratio (RR) for categorical data and mean difference (MD) for continuous data. Data were analysed with a fixed-effect model. A random-effects model was used in the presence of heterogeneity. Fourteen trials were included, but only 12 trials involving 910 women contributed data to outcome analysis. Women who exercised did not lose significantly more weight than women in the usual care group (two trials; n = 53; MD -0.10 kg; 95% confidence interval (CI) -1.90 to 1.71). Women who took part in a diet (one trial; n = 45; MD -1.70 kg; 95% CI -2.08 to -1.32), or diet plus exercise programme (seven trials; n = 573; MD -1.93 kg; 95% CI -2.96 to -0.89; random-effects, T² = 1.09, I² = 71%), lost significantly more weight than women in the usual care group. There was no difference in the magnitude of weight loss between diet alone and diet plus exercise group (one trial; n = 43; MD 0.30 kg; 95% CI -0.06 to 0.66). The interventions seemed not to affect breastfeeding performance adversely. Evidence from this review suggests that both diet and exercise together and diet alone help women to lose weight after childbirth. Nevertheless, it may be preferable to lose weight through a combination of diet and exercise as this improves maternal cardiorespiratory fitness and preserves fat-free mass, while diet alone reduces fat-free mass. This needs confirmation in large trials of high methodological quality. For women who are breastfeeding, more evidence is required to confirm whether diet or exercise, or both, is not detrimental for either mother or baby.

Pre-Training Muscle Characteristics of Subjects Who Are Obese Determine How Well Exercise Training Will Improve Their Insulin Responsiveness

PubMed Central

Stuart, Charles A.; Lee, Michelle L.; South, Mark A.; Howell, Mary E.A.; Cartwright, Brian M.; Ramsey, Michael W.; Stone, Michael H.

2016-01-01

Only half of pre-diabetic, subjects who are obese who underwent exercise training without weight loss increased their insulin responsiveness. We hypothesized that those who improved their insulin responsiveness might have pre-training characteristics favoring a positive response to exercise training. Thirty non-diabetic, subjects who are obese volunteered for eight weeks of either strength training or endurance training. During training, subjects increased their caloric intake to prevent weight loss. Insulin responsiveness by euglycemic clamps and muscle fiber composition and expression of muscle key biochemical pathways were quantified. Positive responders initially had 52% higher intermediate muscle fibers (fiber type IIa) with 27% lower slow twitch fibers (type I) and 23% lower expression of muscle insulin receptors. Whether after weight training or stationary bike training, positive responders' fiber type shifted away from type I and type IIa fibers to an increased proportion of type IIx fibers (fast twitch). Muscle insulin receptor expression and GLUT4 expression increased in all trained subjects, but these moderate changes did not consistently translate to improvement in whole body insulin responsiveness. Exercise training of previously sedentary subjects who are obese can result in muscle remodeling and increased expression of key elements of the insulin pathway, but in the absence of weight loss, insulin sensitivity improvement was modest and limited to about half of the participants. Our data suggest rather than responders being more fit, they may have been less fit, only catching up to the other half of subjects who are obese whose insulin responsiveness did not increase beyond their pre-training baseline. PMID:27379957

Impact of Physician BMI on Obesity Care and Beliefs

PubMed Central

Bleich, Sara N.; Bennett, Wendy L.; Gudzune, Kimberly A.; Cooper, Lisa A.

2013-01-01

Using a national cross-sectional survey of 500 primary care physicians conducted between 9 February and 1 March 2011, the objective of this study was to assess the impact of physician BMI on obesity care, physician self-efficacy, perceptions of role-modeling weight-related health behaviors, and perceptions of patient trust in weight loss advice. We found that physicians with normal BMI were more likely to engage their obese patients in weight loss discussions as compared to overweight/obese physicians (30% vs. 18%, P = 0.010). Physicians with normal BMI had greater confidence in their ability to provide diet (53% vs. 37%, P = 0.002) and exercise counseling (56% vs. 38%, P = 0.001) to their obese patients. A higher percentage of normal BMI physicians believed that overweight/obese patients would be less likely to trust weight loss advice from overweight/obese doctors (80% vs. 69%, P = 0.02). Physicians in the normal BMI category were more likely to believe that physicians should model healthy weight-related behaviors—maintaining a healthy weight (72% vs. 56%, P = 0.002) and exercising regularly (73% vs. 57%, P = 0.001). The probability of a physician recording an obesity diagnosis (93% vs. 7%, P < 0.001) or initiating a weight loss conversation (89% vs. 11%, P ≤ 0.001) with their obese patients was higher when the physicians’ perception of the patients’ body weight met or exceeded their own personal body weight. These results suggest that more normal weight physicians provided recommended obesity care to their patients and felt confident doing so. PMID:22262162

Behavioral Intervention in the Overweight and Obese Employee: The Challenge of Promoting Weight Loss and Physical Activity

PubMed Central

Maniwa, Rumi; Iwamoto, Mamiko; Nogi, Akiko; Yamasaki, Masayuki; Yang, Jian-jun; Hanaoka, Hideaki; Shiwaku, Kuninori

2012-01-01

Effects of gender and employment situation on weight loss and lifestyle modification were assessed in a 3-month intervention study done for overweight and obesity. A total of 384 individuals in Izumo City Japan, participated from 2000 to 2006. Lifestyle modifications were quantitatively evaluated by calculating calories of energy intake and expenditure. Eleven men and 15 women failed to complete the intervention; they were significantly younger in both genders, and the women had a higher rate of employment than the completing group (91 men and 267 women). Intervention induced a weight loss of 1.9 kg for men and 1.6 kg for women, with no significant differences by gender. Significant differences were found in changes in energy intake and expenditure in both genders, but these disappeared after adjusting for weight. There were significant decreases in weight (1.6 kg in unemployed, 2.5 kg in employed) in men. Increases in walking and exercise for the employed were smaller than those for the unemployed. The relationship between changes in weight and energy balance by employment status was independently significant using multiple regression analysis. Employment is associated with difficulty in losing weight due to limited exercise time in behavioral intervention. PMID:25648082

'Now I care': a qualitative study of how overweight adolescents managed their weight in the transition to adulthood.

PubMed

Sweeting, Helen; Smith, Emily; Neary, Joanne; Wright, Charlotte

2016-11-02

A qualitative study of recalled experiences of early adolescent overweight/obesity revealed low levels of weight-related concern. This further analysis aimed to explore weight-related concern and weight-loss efforts as participants transitioned into adulthood. Participants were 35 young adults from a population-based cohort study who had body mass index (BMI) >95th centile between ages 11 and 15 and participated in semistructured interviews aged 24. At age 24, they were categorised as: 'slimmers' (N=13) who had lower BMI Z-scores at 24 than their adolescent peak and were not obese (BMI<30 kg/m 2 ); 'relapsers' (N=8, of whom 2 were morbidly obese (BMI>35 kg/m 2 ) at age 24); 'stable' (N=3, of whom 1 morbidly obese); and 'gainers' (N=11, of whom 5 morbidly obese). Themes were identified and coded using NVivo qualitative data analysis software, blind to participants' current weight status. Contrasting with the lack of concern recalled in respect of earlier adolescence, weight-related concerns and/or desire to lose weight generally increased around the time of school leaving and almost all participants described some form of exercise (formal/informal) and dietary weight-control strategies. Among 'slimmers', there was some (subtle) evidence of more consistent use of exercise, self-monitoring of diet and exercise and of lifestyle changes becoming habitual and/or part of identity. Few participants had accessed professional support. Diet clubs seemed to have been used most by 'gainers', some only recently. Labour-market and housing transitions were strong influences, described as facilitating weight losses by some, but increases by others. For some participants, it appeared that weight loss was simply a by-product of these transitions. In contrast to earlier adolescence, even the heaviest participants tended to show actual weight loss action or preparation for action. The transition to adulthood could thus be a key life stage for interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

‘Now I care’: a qualitative study of how overweight adolescents managed their weight in the transition to adulthood

PubMed Central

Sweeting, Helen; Smith, Emily; Neary, Joanne; Wright, Charlotte

2016-01-01

Objectives A qualitative study of recalled experiences of early adolescent overweight/obesity revealed low levels of weight-related concern. This further analysis aimed to explore weight-related concern and weight-loss efforts as participants transitioned into adulthood. Design, participants and methods Participants were 35 young adults from a population-based cohort study who had body mass index (BMI) >95th centile between ages 11 and 15 and participated in semistructured interviews aged 24. At age 24, they were categorised as: ‘slimmers’ (N=13) who had lower BMI Z-scores at 24 than their adolescent peak and were not obese (BMI<30 kg/m2); ‘relapsers’ (N=8, of whom 2 were morbidly obese (BMI>35 kg/m2) at age 24); ‘stable’ (N=3, of whom 1 morbidly obese); and ‘gainers’ (N=11, of whom 5 morbidly obese). Themes were identified and coded using NVivo qualitative data analysis software, blind to participants’ current weight status. Results Contrasting with the lack of concern recalled in respect of earlier adolescence, weight-related concerns and/or desire to lose weight generally increased around the time of school leaving and almost all participants described some form of exercise (formal/informal) and dietary weight-control strategies. Among ‘slimmers’, there was some (subtle) evidence of more consistent use of exercise, self-monitoring of diet and exercise and of lifestyle changes becoming habitual and/or part of identity. Few participants had accessed professional support. Diet clubs seemed to have been used most by ‘gainers’, some only recently. Labour-market and housing transitions were strong influences, described as facilitating weight losses by some, but increases by others. For some participants, it appeared that weight loss was simply a by-product of these transitions. Conclusions In contrast to earlier adolescence, even the heaviest participants tended to show actual weight loss action or preparation for action. The transition to adulthood could thus be a key life stage for interventions. PMID:27807079

Effects of dietary weight loss with and without exercise on interstitial matrix turnover and tissue inflammation biomarkers in adults with knee osteoarthritis: the Intensive Diet and Exercise for Arthritis trial (IDEA).

PubMed

Loeser, R F; Beavers, D P; Bay-Jensen, A C; Karsdal, M A; Nicklas, B J; Guermazi, A; Hunter, D J; Messier, S P

2017-11-01

To examine the effects of dietary weight loss, with and without exercise, on selected soluble biomarkers in overweight and obese older adults with symptomatic knee osteoarthritis (OA). Blood samples were analyzed from 429 participants in the Intensive Diet and Exercise for Arthritis (IDEA) trial randomized to either an 18 month exercise control group (E), weight loss diet (D), or D + E. C1M, C2M, C3M and CRPM biomarkers and interleukin-6 (IL-6) were quantitated using ELISAs. Radiographic progression was defined as a decrease in joint space width of ≥0.7 mm. Statistical modeling of group means and associations used mixed models adjusted for visit, baseline body mass index (BMI), gender, and baseline values of the outcome. Compared to the E control group, C1M was significantly lower in the D and D + E groups at both 6 and 18 months while C3M was significantly lower in D and D + E at 6 months and in D + E at 18 months. C2M did not change in any group. Using data from all groups, change in C1M (P < 0.0001), C3M (P < 0.0001), as well as CRPM (P = 0.0004) from baseline to 18 months was positively associated with change in weight. No marker was associated with change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain or radiographic progression. C3M (P = 0.008) and CRPM (P = 0.028) were positively associated with change in WOMAC function. Change in IL-6 was positively associated with change in C1M, C3M, and CRPM. Overweight and obese adults with knee OA who lost weight from diet and diet plus exercise reduced serum markers of interstitial matrix turnover and inflammation but not type II collagen degradation. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences.

PubMed

Nicol, Ginger; Worsham, Elizabeth; Haire-Joshu, Debra; Duncan, Alexis; Schweiger, Julia; Yingling, Michael; Lenze, Eric

2016-02-01

Mentally ill youth are at risk for developing obesity, especially when they require antipsychotic treatment; moreover, they may face unique challenges in adhering to behavioral weight loss interventions. The aims of this project were to characterize the challenges families of youth with psychiatric disorders face when engaging in weight loss treatment and to gather information on attitudes and preferences for weight management interventions in this population. We devised a telephone survey to evaluate caregiver-perceived barriers/challenges to and preferences for behavioral weight loss treatment in overweight or obese mentally ill youth ages 6-18 treated with an antipsychotic agent in an outpatient setting. A total of 26 parents or primary caregivers completed the survey. The most commonly cited barriers to participation in physical activity (PA) and maintaining a healthy diet were child's dislike of PA and child's preference for energy-dense foods, respectively, which were impacted by psychiatric symptoms. Preferences for weight loss treatment included individualized, prescribed meal plans and shopping lists, and exercise support/demonstration, with a preference for Internet or cell phone applications to help with monitoring food intake and exercise. These results suggest that targets for obesity treatment in this population include individualized, specific support that takes into account the child's motivation, which is effected by psychiatric symptoms. Tools for providing support may include the use of telehealth visits and mobile device applications for self-monitoring.

Effect of exercise intensity on abdominal fat loss during calorie restriction in overweight and obese postmenopausal women: a randomized, controlled trial1234

PubMed Central

Nicklas, Barbara J; Wang, Xuewen; You, Tongjian; Lyles, Mary F; Demons, Jamehl; Easter, Linda; Berry, Michael J; Lenchik, Leon; Carr, J Jeffrey

2009-01-01

Background: Exercise intensity may affect the selective loss of abdominal adipose tissue. Objective: This study showed whether aerobic exercise intensity affects the loss of abdominal fat and improvement in cardiovascular disease risk factors under conditions of equal energy deficit in women with abdominal obesity. Design: This was a randomized trial in 112 overweight and obese [body mass index (in kg/m2): 25–40; waist circumference >88 cm], postmenopausal women assigned to one of three 20-wk interventions of equal energy deficit: calorie restriction (CR only), CR plus moderate-intensity aerobic exercise (CR + moderate-intensity), or CR plus vigorous-intensity exercise (CR + vigorous-intensity). The diet was a controlled program of underfeeding during which meals were provided at individual calorie levels (≈400 kcal/d). Exercise (3 d/wk) involved treadmill walking at an intensity of 45–50% (moderate-intensity) or 70–75% (vigorous-intensity) of heart rate reserve. The primary outcome was abdominal visceral fat volume. Results: Average weight loss for the 95 women who completed the study was 12.1 kg (±4.5 kg) and was not significantly different across groups. Maximal oxygen uptake (O2max) increased more in the CR + vigorous-intensity group than in either of the other groups (P < 0.05). The CR-only group lost relatively more lean mass than did either exercise group (P < 0.05). All groups showed similar decreases in abdominal visceral fat (≈25%; P < 0.001 for all). However, changes in visceral fat were inversely related to increases in O2max (P < 0.01). Changes in lipids, fasting glucose or insulin, and 2-h glucose and insulin areas during the oral-glucose-tolerance test were similar across treatment groups. Conclusion: With a similar amount of total weight loss, lean mass is preserved, but there is not a preferential loss of abdominal fat when either moderate- or vigorous-intensity aerobic exercise is performed during caloric restriction. This trial was registered at clinicaltrials.gov as NCT00664729. PMID:19211823

An aggregate urine analysis tool to detect acute dehydration.

PubMed

Hahn, Robert G; Waldréus, Nana

2013-08-01

Urine sampling has previously been evaluated for detecting dehydration in young male athletes. The present study investigated whether urine analysis can serve as a measure of dehydration in men and women of a wide age span. Urine sampling and body weight measurement were undertaken before and after recreational physical exercise (median time: 90 min) in 57 volunteers age 17-69 years (mean age: 42). Urine analysis included urine color, osmolality, specific gravity, and creatinine. The volunteers' body weight decreased 1.1% (mean) while they exercised. There were strong correlations between all 4 urinary markers of dehydration (r = .73-.84, p < .001). Researchers constructed a composite dehydration index graded from 1 to 6 based on these markers. This index changed from 2.70 before exercising to 3.55 after exercising, which corresponded to dehydration of 1.0% as given by a preliminary reference curve based on seven previous studies in athletes. Men were slightly dehydrated at baseline (mean: 1.9%) compared with women (mean: 0.7%; p < .001), though age had no influence on the results. A final reference curve that considered both the present results and the 7 previous studies was constructed in which exercise-induced weight loss (x) was predicted by the exponential equation x = 0.20 dehydration index1.86. Urine sampling can be used to estimate weight loss due to dehydration in adults up to age 70. A robust dehydration index based on four indicators reduces the influence of confounders.

Effects of The Coach Approach Intervention on Adherence to Exercise in Obese Women: Assessing Mediation of Social Cognitive Theory Factors

ERIC Educational Resources Information Center

Annesi, James J.; Unruh, Jennifer L.; Marti, C. Nathan; Gorjala, Srinivasa; Tennant, Gisele

2011-01-01

The link between physical activity and weight loss has precipitated interest in interventions to foster adherence to exercise. It has been suggested that treatment effects, when significant, should be analyzed to determine theory-based mediators. This research assessed possible mediation of changes in Physical Self-Concept, Exercise Self-Efficacy,…

Overweight in polycystic ovary syndrome. An update on evidence based advice on diet, exercise and metformin use for weight loss.

PubMed

Ravn, P; Haugen, A G; Glintborg, D

2013-03-01

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in premenopausal women affecting 5-10%. Nearly 50% are overweight or obese, which result in a more severe phenotype of PCOS. Weight loss is therefore considered the first line treatment in overweight women with PCOS. The aim of this study was to appoint evidence based and clinically applicable advises on weight loss in overweight women with PCOS. A review of the existing literature on weight loss through lifestyle modification and/or metformin treatment in overweight women with PCOS. The primary outcome was weight loss. The clinical manifestations of hyperandrogenism and menstrual cyclicity were secondary outcomes. Metabolic parameters were not included in the present review. Weight loss is most effectively achieved through a 12-1500 kcal/day diet, which results in a clinically relevant weight loss. The type of diet has no implications for degree of weight loss. Physical activity has no significant additive effect on weight loss. Metformin combined with a low calorie diet has subtle additive effect on weight loss and level of androgens when compared to diet alone. Weight loss through life style changes, preferably a low calorie diet, should be the first line treatment in overweight/obese women with PCOS. Metformin can be considered as an additional treatment but has subtle additive effect.

Reactive Oxygen Species Response to Exercise Training and Weight Loss in Sedentary Overweight and Obese Female Adults.

PubMed

Bianchi, Vittorio E; Ribisl, Paul M

2015-01-01

Reactive oxygen species (ROS) are implicated in cardiovascular disease and in the pathogenesis of type 2 diabetes and its complications, and it has been shown to increase insulin resistance. The purpose of this study was to examine the effect of aerobic exercise training and weight loss on ROS in overweight and obese patients as applied in a community clinical setting. Fifty healthy female clinic patients (M ± SEM: age, 41.0 ± 1.8 years; body mass index, 28.2 ± 0.8 kg/m2), free of cardiovascular events and not on drug therapy were evaluated before and after 3 months of dietary restriction (∼150 to 300 kcal/day deficit) and aerobic training (3 days/week for 1 hour at ∼75% VO2max). Measures included ROS, maximal power (kg/min) on cycle ergometry, postexercise heart rate recovery responses at 1 and 2 minutes, and selected anthropometric and hematologic variables. Significant (P < .01) improvements were observed after aerobic training and weight loss in body weight in kilograms (-7.1%); maximal power in kg/min (+32.6%), ROS in U.CARR (Carratelli units) (-25.7%); and heart rate recovery 1 minute in beats per minute (-37.6%) following the program. Significant improvements were also noted in other anthropometric, cardiovascular, and hematologic measures. A 12-week program of nutritional and exercise intervention in overweight/obese sedentary women improves levels of oxidative stress when accompanied by weight loss and improved fitness. More than restricted caloric intake, physical activity at a relatively high intensity was effective in improving cardiovascular risk markers. The reduction in ROS may be an additional mechanism by which physical activity may contribute to preventing metabolic syndrome and subsequent atherosclerotic disease.

Does when you eat and exercise matter? Differences in eating and physical activity patterns in overweight and obese adults.

PubMed

Hoffmann, Debra A; Carels, Robert A

2016-03-01

Despite current recommendations and guidelines on the treatment of overweight and obesity, little is known about what patterns of energy intake or expenditure are ideal for weight loss. The present study examined patterns in energy intake and expenditure and explored whether those differences were associated with weight loss. Self-monitoring data on energy intake and expenditure, along with minutes spent in exercise, were obtained from 90 overweight or obese adults (mean BMI = 38.0) enrolled in two behavioral weight loss programs. Energy intake and minutes of daily exercise were self-reported and energy expenditure was obtained from the Caltrac accelerometers that were provided to participants. On weekends (Friday through Sunday), participants consumed more calories from breakfast (271 vs. 241 kcals/day; p < .01), dinner (605 vs. 547 kcals/day; p < .001), and alcohol (59 vs. 27 kcals/day; p < .01), as well as total daily calories (1669 vs. 1520 kcals/day; p < .001) and expended fewer total calories (2515 vs. 2614 kcals/day; p < .01) than on weekdays. Higher caloric intake on weekdays was associated with less overall weight loss (r = -.29, p < .01) and was marginally associated on weekends (r = -.19, p = .051). This investigation found evidence that while eating patterns clearly contribute to daily energy intake on weekdays and weekends, they may not necessarily contribute to weight change. At the end of the day, what may be most important is regular self-monitoring and total caloric intake on both the weekdays and weekends.

Change in health-related quality of life and social cognitive outcomes in obese, older adults in a randomized controlled weight loss trial: Does physical activity behavior matter?

PubMed

Fanning, Jason; Walkup, Michael P; Ambrosius, Walter T; Brawley, Lawrence R; Ip, Edward H; Marsh, Anthony P; Rejeski, W Jack

2018-06-01

This article compared the effect of dietary weight loss administered alone (WL) or in combination with aerobic training (WL + AT) or resistance training (WL + RT) on health related quality of life, walking self-efficacy, stair climb self-efficacy, and satisfaction with physical function in older adults with cardiovascular disease or the metabolic syndrome. Participants (N = 249; M age  = 66.9) engaged in baseline assessments and were randomly assigned to one of three interventions, each including a 6-month intensive phase and a 12-month follow-up. Those in WL + AT and WL + RT engaged in 4 days of exercise training weekly. All participants engaged in weekly group behavioral weight loss sessions with a goal of 7-10% reduction in body weight. Participants in WL + AT and WL + RT reported better quality of life and satisfaction with physical function at 6- and 18-months relative to WL. At month 6, WL + AT reported greater walking self-efficacy relative to WL + RT and WL, and maintained higher scores compared to WL at month 18. WL + AT and WL + RT reported greater stair climbing efficacy at month 6, and WL + RT remained significantly greater than WL at month 18. The addition of either AT or RT to WL differentially improved HRQOL and key psychosocial outcomes associated with maintenance of physical activity and weight loss. This underscores the important role of exercise in WL for older adults, and suggests health care providers should give careful consideration to exercise mode when designing interventions.

The influence of diet and/or exercise and parental compliance on health-related quality of life in obese children.

PubMed

Yackobovitch-Gavan, Michal; Nagelberg, Nessia; Phillip, Moshe; Ashkenazi-Hoffnung, Liat; Hershkovitz, Eli; Shalitin, Shlomit

2009-06-01

Recent findings of a direct association of obesity and impaired health-related quality of life (HRQOL) in children suggest a need for early weight-management interventions that address psychosocial issues and lifestyle. Our aim was to compare the effects of exercise, diet, or diet + exercise on HRQOL in obese children. We hypothesized that HRQOL will improve as a result of the weight-loss intervention and will be correlated with the amount of weight loss achieved by each of the intervention groups. A total of 162 children aged 6 to 11 years with a body mass index (BMI) exceeding the 95th percentile were randomly allocated to a 12-week regimens of diet, exercise, or diet + exercise. Weight, height, and percent fat mass were measured, and parents completed the Pediatric Quality of Life Inventory (PedsQL) 4.0 at baseline and at the end of the intervention. The reductions in BMI were significantly greater in the diet and diet + exercise groups than in the exercise group. Pediatric Quality of Life Inventory scores improved significantly, with no differences among the groups. A greater reduction in BMI occurred in children whose parents completed the PedsQL at baseline (n = 105) than in children whose parents did not (n = 15) (-1.8 +/- 1.3 vs -1.0 +/- 1.5; P = .048) and in children whose parents completed the PedsQL at the end of the intervention (n = 73) than in children whose parents did not (n = 47) (-2.0 +/- 1.3 vs -1.3 +/- 1.3; P = .013). Weight-management programs that promote a healthy eating and physical activity can serve as an effective tool to improve the low HRQOL of obese children. Parental compliance is an important factor and may be assessed by the parents' cooperativeness in completing questionnaires.

Improved nutrient intake in older obese adults undergoing a structured diet and exercise intentional weight loss program.

PubMed

Miller, G D

2010-06-01

Physicians are often reluctant to advise older obese patients to lose weight for fear of compromised nutrition and excessive loss of muscle mass and strength, all of which may lead to a loss of independence and accelerate disability. Therefore, the purpose of this study was to examine nutrient intake in older obese adults undergoing a weight loss intervention. The study setting was at a university research facility. A total of 71 participants (age, 69.5 (SD = 5.8) yrs; 62% female; BMI, 34.6 (4.4) kg/m2) were recruited. Individuals were randomized into either a weight stable (WS) control group or an intensive weight loss (WL) group. The WL intervention was for 6 months and utilized partial meal replacements (PMR) and a facility-based 3 d/wk, 60 min/session exercise training program encompassing both aerobic and strength exercises. Weight loss goal for WL was 10% from baseline at 6-months. Variables were obtained at baseline and 6-months and included 3 day dietary records along with daily step counts for 7 days. Total energy, macronutrients (g and % of energy), micronutrients (vitamins and minerals), as well as use of PMR were assessed from the diet records. Body mass and body fat (g and % of body mass) were determined at the 2 time points. Estimated marginal means (SEM) for weight loss at 6-months was -8.8 (0.7)% for WL and -0.1 (0.7)% for WS. Daily energy intake at 6-months was lower for WL (1396 (64) kcals) compared to WS (1817 (71) kcals). Additionally, those in the WL group (compared to WS) had lower intakes of total fat (27.5 (1.2)%, WL vs. 36.1 (4.6)%, WS) and saturated fatty acids (8.5 (0.4)% vs. 10.8 (0.5)%), and had higher levels of carbohydrates (57.6 (1.5)% vs. 49.0 (1.7)%), protein (18.4 (0.5% vs. 16.2 (0.6)%), and dietary fiber (21.0 (0.9) g vs. 17.4 (1.0) g) at 6-months. Even with reduced total calorie intake, key micronutrients (calcium, iron, vitamin D, vitamin E, vitamin C) were higher for WL vs. WS at 6-months. Total daily step counts were higher for WL vs. WS at 6-months. A nutrition intervention to promote weight loss in older obese adults was achieved using PMR as a primary strategy. Diet quality was improved for WL vs. WS in using the nutrient fortified product, even with a reduction in total energy intake.

The Penn State Heart Assistant: A pilot study of a web-based intervention to improve self-care of heart failure patients.

PubMed

Lloyd, Tom; Buck, Harleah; Foy, Andrew; Black, Sara; Pinter, Antony; Pogash, Rosanne; Eismann, Bobby; Balaban, Eric; Chan, John; Kunselman, Allen; Smyth, Joshua; Boehmer, John

2017-05-01

The Penn State Heart Assistant, a web-based, tablet computer-accessed, secure application was developed to conduct a proof of concept test, targeting patient self-care activities of heart failure patients including daily medication adherence, weight monitoring, and aerobic activity. Patients (n = 12) used the tablet computer-accessed program for 30 days-recording their information and viewing a short educational video. Linear random coefficient models assessed the relationship between weight and time and exercise and time. Good medication adherence (66% reporting taking 75% of prescribed medications) was reported. Group compliance over 30 days for weight and exercise was 84 percent. No persistent weight gain over 30 days, and some indication of weight loss (slope of weight vs time was negative (-0.17; p value = 0.002)), as well as increased exercise (slope of exercise vs time was positive (0.08; p value = 0.04)) was observed. This study suggests that mobile technology is feasible, acceptable, and has potential for cost-effective opportunities to manage heart failure patients safely at home.

Enhancement of Self-Monitoring in a Web-Based Weight Loss Program by Extra Individualized Feedback and Reminders: Randomized Trial

PubMed Central

Hutchesson, Melinda Jane; Tan, Chor Yin; Morgan, Philip; Callister, Robin

2016-01-01

Background Self-monitoring is an essential behavioral strategy for effective weight loss programs. Traditionally, self-monitoring has been achieved using paper-based records. However, technology is now more frequently used to deliver treatment programs to overweight and obese adults. Information technologies, such as the Internet and mobile phones, allow innovative intervention features to be incorporated into treatment that may facilitate greater adherence to self-monitoring processes, provide motivation for behavior change, and ultimately lead to greater weight loss success. Objective The objective of our study was to determine whether the consistency of self-monitoring differed between participants randomly assigned to a basic or an enhanced 12-week commercial Web-based weight loss program. Methods We randomly assigned a sample of 301 adults (mean age 42.3 years; body mass index 31.3 kg/m2; female 176/301, 58.5%) to the basic or enhanced group. The basic program included tools for self-monitoring (online food and exercise diary, and a weekly weigh-in log) with some feedback and reminders to weigh in (by text or email). The enhanced program included the basic components, as well as extra individualized feedback on self-monitoring entries and reminders (by text, email, or telephone) to engage with self-monitoring tools. We evaluated the level of self-monitoring by examining the consistency of self-monitoring of food, exercise, and weight during the 12 weeks. Consistency was defined as the number of weeks during which participants completed a criterion number of entries (ie, ≥3 days of online food or exercise diary records per week and ≥1 weigh-in per week). Results The enhanced group’s consistency of use of self-monitoring tools was significantly greater than that of the basic group throughout the 12 weeks (median consistency for food 8 vs 3 weeks, respectively, P<.001; for exercise 2.5 vs 1 weeks, respectively, P=.003). Conclusions Enhanced features, including additional individualized feedback and reminders, are effective in enhancing self-monitoring behaviors in a Web-based weight loss program. ClinicalTrial Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12610000197033; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=335159 (Archived by WebCite at http://www.webcitation.org/6gCQdj21G) PMID:27072817

MILEPOST Multicenter Randomized Controlled Trial: 12-Month Weight Loss and Satiety Outcomes After pose SM vs. Medical Therapy.

PubMed

Miller, Karl; Turró, R; Greve, J W; Bakker, C M; Buchwald, J N; Espinós, J C

2017-02-01

Pose SM is an endolumenal weight-loss intervention in which suture anchors are placed endoscopically in the gastric fundus/distal gastric body. Observational studies of pose have shown safe, effective weight loss. Twelve-month results of a randomized controlled trial comparing weight loss and satiety after pose vs. conventional medical therapy are reported. Subjects with classes I-II obesity were randomized in a 3:1 ratio to pose or diet/exercise guidance only (control). Pose subjects received gastric fundus and distal body suture-anchor plications with diet/exercise counseling. Total body (%TBWL) and excess weight loss (%EWL) were assessed at 6 and 12 months. Analysis of covariance (ANCOVA) was used to analyze 12-month %TBWL. Satiety changes were assessed at 6 and 12 months. From November 2013 to July 2014, 44 subjects were randomized (34, 77.3 % female; mean age, 38.3 ± 10.7 years; body mass index, 36.5 ± 3.4 kg/m 2 ) to pose (n = 34) or control (n = 10) groups in three centers. Mean pose procedure time was 51.8 ± 14.5 min; pose subjects received a mean 8.8 ± 1.3 fundal and 4.2 ± 0.7 distal body plications. Twelve-month TBWL: pose, 13.0 % (EWL, 45.0 %), n = 30 vs. control group, 5.3 % (18.1 %), n = 9; significant mean difference, 7.7 % (95 % CI 2.2, 13.2; p < 0.01). Pose subjects showed significant reductions in satiety parameters (p < 0.001); controls experienced reduced caloric intake and satiety volume (p < 0.05). No serious device- or procedure-related adverse events occurred. In a randomized controlled trial at 12 months, pose-treated subjects had significantly greater weight loss than those treated with diet/exercise guidance alone. At 6 and 12 months, pose subjects showed significant reduction in satiety parameters. clinicaltrials.gov identifier # NCT01843231.

Why Do We Get Middle-Age Spread?

MedlinePlus

... mice. “Our society attributes the weight gain and lack of exercise at mid-life (approximately 30–60 years) primarily to poor lifestyle choices and lack of will power, but this study shows that ... loss of exercise capacity at mid-life,” Chung says. These findings ...

Exercise program adherence using a 5-kilometer (5K) event as an achievable goal in people with schizophrenia.

PubMed

Warren, Kimberly R; Ball, M Patricia; Feldman, Stephanie; Liu, Fang; McMahon, Robert P; Kelly, Deanna L

2011-10-01

People with schizophrenia have a higher prevalence of obesity than the general population. Many people with this illness struggle with weight gain, due, in part, to medications and other factors that act as obstacles to exercise and healthy eating. Several studies have shown the benefits of behavioral weight loss programs targeting eating and/or exercise in people with schizophrenia. Fewer studies have used competitive events as a goal for an exercise program. The current study tested the feasibility of preparing, using an exercise program, for a 5-kilometer (5K) event in people with schizophrenia. The exercise program was a 10-week training program consisting of three supervised walking/jogging sessions per week and a weekly educational meeting on healthy behaviors. Almost 65% (11/17) of the subjects participated in all of the training sessions, and 82% (14/17) participated in the 5K event. Participants did not gain a significant amount of weight during the exercise program (median weight change = 0.7 kg; 25th percentile 0.5, 75th percentile 3.9, p = .10). This study suggests that using an achievable goal, such as a 5K event, promotes adherence to an exercise program and is feasible in a population of people with chronic schizophrenia.

Can exercise increase fitness and reduce weight in patients with schizophrenia and depression?

PubMed

Krogh, Jesper; Speyer, Helene; Nørgaard, Hans Christian Brix; Moltke, Ane; Nordentoft, Merete

2014-01-01

Psychiatric patients have a reduced life expectancy of 15-20 years compared with the general population. Most years of lost life are due to the excess mortality from somatic diseases. Sedentary lifestyle and medication is partly responsible for the high frequency of metabolic syndrome in this patient group and low levels of physical activity is associated with increased risk of cardiovascular disease, diabetes, and all-cause mortality. This study aimed to review trials allocating patients with either schizophrenia or depression to exercise interventions for effect on cardiovascular fitness, strength, and weight. We searched PubMed, Embase, and PsycINFO including randomized clinical trial allocating patients with either schizophrenia or depression to isolated exercise interventions. We identified five trials including patients with schizophrenia (n = 94) and found little evidence that exercise could increase cardiovascular fitness or decrease weight. Nine exercise trials for patients with depression (n = 892) were identified increasing cardiovascular fitness by 11-30% and strength by 33-37%. No evidence in favor of exercise for weight reduction was found. Based on the current evidence isolated exercise interventions are unlikely to improve cardiovascular fitness or induce weight loss in patients with schizophrenia. In patients with depression, exercise interventions are likely to induce clinically relevant short term effects, however, due to lack of reporting, little is known about the effect on weight reduction and cardiovascular fitness. Future exercise trials regarding patients with mental illness should preferably measure changes in cardiovascular strength, repetition maximum, and anthropometric outcomes. Ideally, participants should be assessed beyond the intervention to identify long lasting effects.

Exercise load index and changes in body weight during long-duration confinement in an isolated environment

NASA Technical Reports Server (NTRS)

Kraft, Norbert O.; Lyons, Terence J.; Binder, Heidi; Inoue, Natsuhiko; Ohshima, Hiroshi; Sekiguchi, Chiharu

2003-01-01

PURPOSE: The objectives of this project were to investigate exercise load and body weight related to long-duration confinement in a closed environment simulating ISS flight conditions, and to evaluate subjects' motivation to continue the experiment and their adaptation to isolation. METHODS: Four Russian male subjects participated in a 240-d experiment (Group I), and four subjects (three male subjects and one female subject) from Austria, Canada, Japan, and Russia participated in a 110-d experiment (Group II). Exercise load was estimated during confinement using a modified Rating of Perceived Exertion scale. Free reports were used to determine subjects' motivation. Body weight was measured before, during, and after confinement. RESULTS: Group I achieved their lowest exercise loads during their first month of isolation; problems with adaptation to the isolation environment were also reported during this first month. Group II exercise load was significantly lower in the second month due to crewmember problems; loss of motivation could be noted from their free reports. The subject with the lowest exercise load retired from the isolation experiment earlier than scheduled. Exercise load was not correlated with prior exercise habits. Significant differences in body weight was observed between group I and II and between Russian and non-Russian subjects. One subject in Group I experienced a significant increase in his body weight. CONCLUSION: Exercise load may be a good indicator for adaptation problems and motivation changes in closed environments. Immobility, lack of space, and smoking cessation in general did not induce significant body weight changes.

Success of women in a worksite weight loss program: Does being part of a group help?

PubMed

Rigsby, Andrea; Gropper, Daniel M; Gropper, Sareen S

2009-04-01

This study reports the results of a worksite weight loss program which allowed female hospital and nursing home employees to enroll in a worksite weight loss program as individuals or as part of a group. After 8 weeks, employees (irrespective of group versus individual participation) lost an average of 6.2 lb and 1.5% body fat. The initial weight, body fat, and body mass index reductions were all significantly greater, in absolute and percentage terms, among group participants than individual participants. Weight reduction averaged 7.6+1.1 lb for group participants and 4.2+6.4 lb for individual participants; body fat reduction was 1.7+1.3% for group participants and 0.9+1.3% for individual participants. Exercising more frequently was significantly associated with weight loss in those participating as a group, while following a written diet plan was significantly associated with weight loss in those participating as individuals.

Acceleration training for improving physical fitness and weight loss in obese women.

PubMed

So, Rina; Eto, Miki; Tsujimoto, Takehiko; Tanaka, Kiyoji

2014-01-01

Reducing body weight and visceral adipose tissue (VAT) are the primary goals for maintaining health in obese individuals as compared to those of normal weight, but it is also important to maintain physical fitness for a healthy life after weight-loss. Acceleration training (AT) has recently been indicated as an alternative to resistance training for elite athletes and also as a component of preventive medicine. However, it is unclear whether combining AT with a weight-loss diet will improve physical fitness in obese individuals. The present study aimed to determine the synergistic effects of AT on body composition and physical fitness with weight-loss program in overweight and obese women. Twenty-eight obese, middle-aged women were divided into two groups as follows: diet and aerobic exercise group (DA; BMI: 29.3 ± 3.0 kg/m2); and diet, aerobic exercise and acceleration training group (DAA; BMI: 31.2 ± 4.0 kg/m2). Both groups included a 12-week weight-loss program. Body composition, visceral adipose tissue (VAT) area and physical fitness (hand grip, side-to-side steps, single-leg balance with eyes closed, sit-and-reach and maximal oxygen uptake) were measured before and after the program. Body weight, BMI, waist circumference and VAT area decreased significantly in both groups. Hand grip (2.1 ± 3.0 kg), single-leg balance (11.0 ± 15.4 s) and sit-and-reach (6.5 ± 4.8 cm) improved significantly only in the DAA group. Our findings indicate that combining AT with classical lifestyle modifications is effective at reducing VAT, and it may enhance muscle strength and performance in overweight and obese women. © 2014 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.

Potential benefits of weight loss in coronary heart disease.

PubMed

Ades, Philip A; Savage, Patrick D

2014-01-01

The prevalence of overweight, obesity and insulin resistance in patients with coronary heart disease (CHD) exceeds that of the general population. Obesity is associated with a constellation of coronary risk factors that predispose to the development and progression of CHD. Intentional weight loss, accomplished through behavioral weight loss and exercise, improves insulin sensitivity and associated cardio-metabolic risk factors such as lipid measures, blood pressure, measures of inflammation and vascular function both in healthy individuals and patients with CHD. Additionally, physical fitness, physical function and quality of life all improve. There is evidence that intentional weight loss prevents the onset of CHD in high risk overweight individuals. While weight loss associated improvements in insulin resistance, fitness and related risk factors strongly supports favorable prognostic effects in individuals with established CHD, further study is needed to determine if long-term clinical outcomes are improved. © 2014.

Mechanisms of Weight Regain following Weight Loss.

PubMed

Blomain, Erik Scott; Dirhan, Dara Anne; Valentino, Michael Anthony; Kim, Gilbert Won; Waldman, Scott Arthur

2013-01-01

Obesity is a world-wide pandemic and its incidence is on the rise along with associated comorbidities. Currently, there are few effective therapies to combat obesity. The use of lifestyle modification therapy, namely, improvements in diet and exercise, is preferable over bariatric surgery or pharmacotherapy due to surgical risks and issues with drug efficacy and safety. Although they are initially successful in producing weight loss, such lifestyle intervention strategies are generally unsuccessful in achieving long-term weight maintenance, with the vast majority of obese patients regaining their lost weight during followup. Recently, various compensatory mechanisms have been elucidated by which the body may oppose new weight loss, and this compensation may result in weight regain back to the obese baseline. The present review summarizes the available evidence on these compensatory mechanisms, with a focus on weight loss-induced changes in energy expenditure, neuroendocrine pathways, nutrient metabolism, and gut physiology. These findings have added a major focus to the field of antiobesity research. In addition to investigating pathways that induce weight loss, the present work also focuses on pathways that may instead prevent weight regain. Such strategies will be necessary for improving long-term weight loss maintenance and outcomes for patients who struggle with obesity.

Lifestyle Therapy for the Management of Atrial Fibrillation.

PubMed

Abdul-Aziz, Ahmad A; Altawil, Mahmoud; Lyon, Amanda; MacEachern, Mark; Richardson, Caroline R; Rubenfire, Melvyn; Pelosi, Frank; Jackson, Elizabeth A

2018-05-01

Atrial fibrillation (AF) is a common arrhythmia associated with increased risk of morbidity and mortality. There is evidence that lifestyle interventions may serve as complementary treatments to reduce AF burden. The objective of this review was to summarize the efficacy of lifestyle interventions for the management of AF. Studies which included patients with systolic heart failure (ejection fraction ≤40%), and those limited to an examination of vigorous physical activity were excluded from our search. Studies were identified through a search of the following databases: MEDLINE, EMBASE, CINAHIL, and PubMed, run from inception through August 2016. All studies were graded for quality using the Oxford Centre for Evidence-based Medicine recommendations. Meta-analyses of the studies were not performed due to the heterogeneity of the studies. From a total of 1,811 publications, 10 articles were identified and included. Selected publications included 1 study on yoga, 2 studies on acupuncture, 3 studies that examined weight loss programs, and 4 studies that evaluated the impact of moderate physical activity. Yoga was associated with less symptomatic AF episodes and improved quality of life. Acupuncture was associated with reduced AF occurrence in patients with persistent and paroxysmal AF. Weight loss was associated with a significant reduction AF burden and symptoms. Moderate exercise resulted in greater arrhythmia free survival and a mean reduction in AF burden. In conclusion, evidence exists to suggest that yoga, weight loss, and moderate exercise are associated with reductions in AF burden and symptoms. Evidence is greatest for weight loss and moderate exercise. Copyright © 2018 Elsevier Inc. All rights reserved.

Metabolic Benefits of Prior Weight Loss with and without Exercise on Subsequent 6-Month Weight Regain.

PubMed

Ryan, Alice S; Serra, Monica C; Goldberg, Andrew P

2018-01-01

To determine the 6-month follow-up effects after intentional 6-month weight loss alone (WL) and after weight loss with aerobic exercise (AEX + WL) on body composition, glucose metabolism, and cardiovascular disease risk factors in older postmenopausal women and to identify the mechanisms for weight regain. Women (n = 65, BMI > 25 kg/m 2 ) underwent maximal oxygen consumption testing, dual-energy x-ray absorptiometry, computed tomography scans, and oral glucose tolerance tests before and after 6 months of AEX + WL or WL and at 12 months ad libitum follow-up. Insulin sensitivity (M) (hyperinsulinemic-euglycemic clamp) was measured at baseline and 6 months. Thirty WL and thirty-five AEX + WL women completed a follow-up at 12 months. Similar weight loss was observed (-8%) in both groups from 0 to 6 months. Total fat mass, fat-free mass, visceral fat area, subcutaneous abdominal and midthigh fat areas, fasting glucose, insulin levels, homeostatic model assessment of insulin resistance (HOMA-IR), insulin areas under the curve, and triglyceride levels decreased similarly after WL and AEX + WL and remained lower at 12 months than at baseline, despite weight regain at 12 months. Initial M was associated with weight regain (r = -0.40, P < 0.01). Weight regain was related to independent changes in leptin and HOMA-IR from 6 to 12 months in a multiple regression model (r = 0.77, P < 0.0001). Reductions in body fat and improvements in insulin sensitivity after AEX + WL and WL were maintained at 12 months despite modest weight regain. Baseline insulin resistance partially predicted the magnitude of weight regain in postmenopausal women. © 2017 The Obesity Society.

From morbid obesity to a healthy weight using cognitive-behavioral methods: a woman's three-year process with one and one-half years of weight maintenance.

PubMed

Annesi, James J; Tennant, Gisèle A

2012-01-01

Obesity is a national health problem regularly confronting medical professionals. Although reduced-energy (kilocalorie [kcal]) eating and increased exercise will reliably reduce weight, these behaviors have been highly resistant to sustained change. To control eating using theory-based cognitive-behavioral methods that leverage the positive psychosocial effects of newly initiated exercise as an alternate to typical approaches of education about appropriate nutrition. A woman, age 48 years, with morbid obesity initiated exercise through a 6-month exercise support protocol based on social cognitive and self-efficacy theory (The Coach Approach). This program was followed by periodic individual meetings with a wellness professional intended to transfer behavioral skills learned to adapt to regular exercise, to then control eating. There was consistent recording of exercises completed, foods consumed, various psychosocial and lifestyle factors, and weight. Over the 4.4 years reported, weight decreased from 117.6 kg to 59.0 kg, and body mass index (BMI) decreased from 43.1 kg/m(2) to 21.6 kg/m(2). Mean energy intake initially decreased to 1792 kcal/day and further dropped to 1453 kcal/day by the end of the weight-loss phase. Consistent with theory, use of self-regulatory skills, self-efficacy, and overall mood significantly predicted both increased exercise and decreased energy intake. Morbid obesity was reduced to a healthy weight within 3.1 years, and weight was maintained in the healthy range through the present (1.3 years later). This case supports theory-based propositions that exercise-induced changes in self-regulation, self-efficacy, and mood transfer to and reinforce improvements in corresponding psychosocial factors related to controlled eating.

Combination of meal and exercise timing with a high-fat diet influences energy expenditure and obesity in mice.

PubMed

Sasaki, Hiroyuki; Ohtsu, Teiji; Ikeda, Yuko; Tsubosaka, Miku; Shibata, Shigenobu

2014-11-01

In mice, obesity has been observed not only in those freely fed a high-fat diet (HFD) but also in those fed while physically inactive. In contrast, a HFD during physically active periods protects against obesity and the impairments in the circadian rhythm induced by free feeding of a HFD. Although exercise is known to be effective for obesity prevention and management, the optimal timing of exercise has not yet been determined. In the present experiments, we aimed to determine the best combination of daily timing of HFD consumption and exercise for the prevention of HFD-induced weight gain in mice. In this experiment, "morning" refers to the beginning of the active phase (the "morning" for nocturnal animals). Increases in body weight related to free feeding of a HFD was significantly reduced with 4 h of exercise during the late (evening) or middle (noon) active period compared to 4 h of exercise during the early (morning) active period or free access to exercise, which resulted in hours of exercise similar to that of morning exercise. These results suggested that eating in the morning or at noon followed by exercise in the evening could prevent weight gain more effectively than exercise in the morning followed by eating at noon or in the evening. The group fed a HFD for 4 h in the morning had lower body weight than the group fed a HFD for 4 h in the evening without exercise. The last group of experiments tested the hypothesis that there would be an interaction between mealtime and exercise time (i.e. time of day) versus order (i.e. which comes first) effects. We compared groups that exercised for 4 h at noon and were fed either in the morning or evening and groups that were fed for 4 h at noon and either exercised in the morning or evening. We found that the groups that were fed before exercise gained less body and fat weight and more skeletal muscle weight compared to the groups that exercised before eating. Corresponding to the body and fat weight changes, the respiratory exchange ratio (RER) was lower and energy expenditure was higher in the groups fed before exercise than in the groups fed after exercise, and these effects on energy metabolism were also observed in the early stage of HFD feeding before obesity. When obese mice fed a HFD for 12 weeks were exposed to a combination of feeding and exercise timing in an effort to reduce body weight, eating followed by exercise resulted in greater weight loss, similar to the experiments conducted to prevent weight gain. These results demonstrate that a combination of daily timing of eating and exercise may influence weight gain and that eating followed by exercise may be effective for minimizing increases in body and fat weight as well as maximizing increases in skeletal muscle weight.

Long-term effects of an inpatient weight-loss program in obese children and the role of genetic predisposition-rationale and design of the LOGIC-trial.

PubMed

Rank, Melanie; Siegrist, Monika; Wilks, Désirée C; Haller, Bernhard; Wolfarth, Bernd; Langhof, Helmut; Halle, Martin

2012-03-19

The prevalence of childhood obesity has increased worldwide, which is a serious concern as obesity is associated with many negative immediate and long-term health consequences. Therefore, the treatment of overweight and obesity in children and adolescents is strongly recommended. Inpatient weight-loss programs have shown to be effective particularly regarding short-term weight-loss, whilst little is known both on the long-term effects of this treatment and the determinants of successful weight-loss and subsequent weight maintenance.The purpose of this study is to evaluate the short, middle and long-term effects of an inpatient weight-loss program for children and adolescents and to investigate the likely determinants of weight changes, whereby the primary focus lies on the potential role of differences in polymorphisms of adiposity-relevant genes. The study involves overweight and obese children and adolescents aged 6 to 19 years, who participate in an inpatient weight-loss program for 4 to 6 weeks. It started in 2006 and it is planned to include 1,500 participants by 2013. The intervention focuses on diet, physical activity and behavior therapy. Measurements are taken at the start and the end of the intervention and comprise blood analyses (DNA, lipid and glucose metabolism, adipokines and inflammatory markers), anthropometry (body weight, height and waist circumference), blood pressure, pubertal stage, and exercise capacity. Physical activity, dietary habits, quality of life, and family background are assessed by questionnaires. Follow-up assessments are performed 6 months, 1, 2, 5 and 10 years after the intervention: Children will complete the same questionnaires at all time points and visit their general practitioner for examination of anthropometric parameters, blood pressure and assessment of pubertal stage. At the 5 and 10 year follow-ups, blood parameters and exercise capacity will be additionally measured. Apart from illustrating the short, middle and long-term effects of an inpatient weight-loss program, this study will contribute to a better understanding of inter-individual differences in the regulation of body weight, taking into account the role of genetic predisposition and lifestyle factors. NCT01067157.

Effects of Intensive Diet and Exercise on Knee Joint Loads, Inflammation, and Clinical Outcomes Among Overweight and Obese Adults With Knee Osteoarthritis

PubMed Central

Messier, Stephen P.; Mihalko, Shannon L.; Legault, Claudine; Miller, Gary D.; Nicklas, Barbara J.; DeVita, Paul; Beavers, Daniel P.; Hunter, David J.; Lyles, Mary F.; Eckstein, Felix; Williamson, Jeff D.; Carr, J. Jeffery; Guermazi, Ali; Loeser, Richard F.

2015-01-01

IMPORTANCE Knee osteoarthritis (OA), a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity. OBJECTIVE To determine whether a ≥10% reduction in body weight induced by diet, with or without exercise, would improve mechanistic and clinical outcomes more than exercise alone. DESIGN, SETTING, AND PARTICIPANTS Single-blind, 18-month, randomized clinical trial at Wake Forest University between July 2006 and April 2011. The diet and exercise interventions were center-based with options for the exercise groups to transition to a home-based program. Participants were 454 overweight and obese older community-dwelling adults (age ≥55 years with body mass index of 27–41) with pain and radiographic knee OA. INTERVENTIONS Intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise. MAIN OUTCOMES AND MEASURES Mechanistic primary outcomes: knee joint compressive force and plasma IL-6 levels; secondary clinical outcomes: self-reported pain (range, 0–20), function (range, 0–68), mobility, and health-related quality of life (range, 0–100). RESULTS At 18 months, 399 participants (88%) completed the study. Compared with exercise participants, knee compressive forces were lower in diet participants and IL-6 levels were lower in diet and diet + exercise participants. 18-mo Outcomes, Mean (95% CI) Exercise(E) Diet (D) D + E Difference,E vs D Difference, Evs D+E Weight loss, kg −1.8(−5.7to1.8) −8.9(−12.4 to −5.3) −10.6(−14.1 to −7.1) Knee compressiveforces, N 2687(2590 to 2784) 2487(2393 to 2581) 2543(2448 to 2637) 200(55 to 345)a 144(1 to 287) IL-6, pg/mL 3.1(2.9 to 3.4) 2.7(2.4 to 3.0) 2.7(2.5 to 3.0) 0.43(0.01 to 0.85)a 0.39(−0.03 to 0.81)a Pain 4.7(4.2 to 5.1) 4.8(4.3 to 5.2) 3.6(3.2 to 4.1) −0.11(−0.81 to 0.59) 1.02(0.33 to 1.71)a Function 18.4(16.9 to 19.9) 17.4(15.9 to 18.9) 14.1(12.6 to 15.6) 0.98(−1.24 to 3.20) 4.29(2.07 to 6.50)a SF-36 physical 41.9(40.5 to 43.2) 42.4(41.1 to 43.7) 44.7(43.4 to 46.0) −0.55(−2.53 to 1.43) −2.81(−4.76 to −0.86)a a Differences were significant. CONCLUSIONS AND RELEVANCE Among overweight and obese adults with knee OA, after 18 months, participants in the diet + exercise and diet groups had more weight loss and greater reductions in IL-6 levels than those in the exercise group; those in the diet group had greater reductions in knee compressive force than those in the exercise group. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00381290 PMID:24065013

Rapid weight loss in the context of Ramadan observance: recommendations for judokas

PubMed Central

Chtourou, H; Briki, W; Tabben, M; Chaouachi, A; Souissi, N; Shephard, RJ; Chamari, K

2016-01-01

Judo is a weight-classified combat sport, and many athletes seek to compete at the lightest possible weight category to gain an advantage from competing against shorter/smaller, and supposedly weaker opponents. To achieve a desired weight, most judokas opt for rapid weight loss techniques. Short-duration maximal efforts are not greatly affected by “making weight”, but prolonged and/or repeated exercise is significantly impaired. Negative effects on mood, ratings of perceived exertion, and cognitive function are also reported. Moreover, rapid weight loss reduces maximal cardiac output and glycogen stores, and impairs thermo-regulation. Limited empirical data suggest that Ramadan reduces judokas’ performance, and this is likely to be exacerbated by attempts at rapid weight loss. Weight reduction during Ramadan tends to be counterproductive, and judokas who aim for a lower weight category are advised to attempt any desired reduction of body mass during the weeks leading up to Ramadan, rather than during the holy month. PMID:28090146

American College of Sports Medicine position stand. Nutrition and athletic performance.

PubMed

Rodriguez, Nancy R; Di Marco, Nancy M; Langley, Susie

2009-03-01

It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of foods and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This updated position paper couples a rigorous, systematic, evidence-based analysis of nutrition and performance-specific literature with current scientific data related to energy needs, assessment of body composition, strategies for weight change, nutrient and fluid needs, special nutrient needs during training and competition, the use of supplements and ergogenic aids, nutrition recommendations for vegetarian athletes, and the roles and responsibilities of the sports dietitian. Energy and macronutrient needs, especially carbohydrate and protein, must be met during times of high physical activity to maintain body weight, replenish glycogen stores, and provide adequate protein to build and repair tissue. Fat intake should be sufficient to provide the essential fatty acids and fat-soluble vitamins and to contribute energy for weight maintenance. Although exercise performance can be affected by body weight and composition, these physical measures should not be a criterion for sports performance and daily weigh-ins are discouraged. Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses. Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia. Vitamin and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density may require supplements. Because regulations specific to nutritional ergogenic aids are poorly enforced, they should be used with caution and only after careful product evaluation for safety, efficacy, potency, and legality. A qualified sports dietitian and, in particular, the Board Certified Specialist in Sports Dietetics in the United States, should provide individualized nutrition direction and advice after a comprehensive nutrition assessment.

Changing the endpoints for determining effective obesity management.

PubMed

Ross, Robert; Blair, Steve; de Lannoy, Louise; Després, Jean-Pierre; Lavie, Carl J

2015-01-01

Health authorities worldwide recommend weight loss as a primary endpoint for effective obesity management. Despite a growing public awareness of the importance of weight loss and the spending of billions of dollars by Americans in attempts to lose weight, obesity prevalence continues to rise. In this report we argue that effective obesity management in today's environment will require a shift in focus from weight loss as the primary endpoint, to improvements in the causal behaviors; diet and exercise/physical activity (PA). We reason that increases in PA combined with a balanced diet are associated with improvement in many of the intermediate risk factors including cardiorespiratory fitness (CRF) associated with obesity despite minimal or no weight loss. Consistent with this notion, we suggest that a focus on healthy behaviors for the prevention of additional weight gain may be an effective way of managing obesity in the short term. Copyright © 2014 Elsevier Inc. All rights reserved.

The Eating and Exercise Behavior Questionnaire: A Validity Assessment.

ERIC Educational Resources Information Center

Brandon, Jeffrey E.; And Others

1988-01-01

Three studies assessing the Eating and Exercise Behavior Questionnaire indicated that it is reliable and useful in studying the eating patterns of the obese, differences in behavioral cue responses to eating, and multiple and single session weight loss training effectiveness.The research utility of the instrument is discussed. (CB)

Effects of Inactivity and Exercise on Bone.

ERIC Educational Resources Information Center

Smith, Everett L.; Gilligan, Catherine

1987-01-01

Research has shown that bone tissue responds to the forces of gravity and muscle contraction. The benefits of weight-bearing exercise in preventing or reversing bone mass loss related to osteoporosis is reviewed. The effects of weightlessness and immobilization, and the possible effects of athletic amenorrhea, on bone mineral density are…

Exercise training improves obesity-related lymphatic dysfunction.

PubMed

Hespe, Geoffrey E; Kataru, Raghu P; Savetsky, Ira L; García Nores, Gabriela D; Torrisi, Jeremy S; Nitti, Matthew D; Gardenier, Jason C; Zhou, Jie; Yu, Jessie Z; Jones, Lee W; Mehrara, Babak J

2016-08-01

Obesity results in perilymphatic inflammation and lymphatic dysfunction. Lymphatic dysfunction in obesity is characterized by decreased lymphatic vessel density, decreased collecting lymphatic vessel pumping frequency, decreased lymphatic trafficking of immune cells, increased lymphatic vessel leakiness and changes in the gene expression patterns of lymphatic endothelial cells. Aerobic exercise, independent of weight loss, decreases perilymphatic inflammatory cell accumulation, improves lymphatic function and reverses pathological changes in gene expression in lymphatic endothelial cells. Although previous studies have shown that obesity markedly decreases lymphatic function, the cellular mechanisms that regulate this response remain unknown. In addition, it is unclear whether the pathological effects of obesity on the lymphatic system are reversible with behavioural modifications. The purpose of this study, therefore, was to analyse lymphatic vascular changes in obese mice and to determine whether these pathological effects are reversible with aerobic exercise. We randomized obese mice to either aerobic exercise (treadmill running for 30 min per day, 5 days a week, for 6 weeks) or a sedentary group that was not exercised and analysed lymphatic function using a variety of outcomes. We found that sedentary obese mice had markedly decreased collecting lymphatic vessel pumping capacity, decreased lymphatic vessel density, decreased lymphatic migration of immune cells, increased lymphatic vessel leakiness and decreased expression of lymphatic specific markers compared with lean mice (all P < 0.01). Aerobic exercise did not cause weight loss but markedly improved lymphatic function compared with sedentary obese mice. Exercise had a significant anti-inflammatory effect, resulting in decreased perilymphatic accumulation of inflammatory cells and inducible nitric oxide synthase expression. In addition, exercise normalized isolated lymphatic endothelial cell gene expression of lymphatic specific genes, including VEGFR-3 and Prox1. Taken together, our findings suggest that obesity impairs lymphatic function via multiple mechanisms and that these pathological changes can be reversed, in part, with aerobic exercise, independent of weight loss. In addition, our study shows that obesity-induced lymphatic endothelial cell gene expression changes are reversible with behavioural modifications. © 2016 The Authors. The Journal of Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.

The role of social support in weight loss maintenance: results from the MedWeight study.

PubMed

Karfopoulou, Eleni; Anastasiou, Costas A; Avgeraki, Evangelia; Kosmidis, Mary H; Yannakoulia, Mary

2016-06-01

The role of social support in weight management is not fully understood, as more support has been linked to both favorable and unfavorable outcomes. We examined social support in relation to weight loss maintenance, comparing between maintainers and regainers of weight loss. The MedWeight study is a Greek registry of people who have intentionally lost ≥10 % of their weight and are either maintaining this loss for over a year (maintainers), or have regained weight (regainers). Demographics and lifestyle habits questionnaires are completed online. Dietary assessment is carried out by two telephone 24 h recalls. Perceived social support was assessed by validated scales examining support from family and friends regarding healthy eating and exercise. 289 maintainers and 122 regainers participated. Regainers received more support compared to maintainers. However, maintainers reported receiving compliments and active participation, whereas regainers receiving verbal instructions and encouragements. Maintainers who received diet support displayed improved dietary intakes, such as lower energy intake; regainers' diet was unaffected by support. Positive, rather than instructive, support appears beneficial in weight loss maintenance.

Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese post-menopausal women

PubMed Central

Foster-Schubert, KE; Alfano, CM; Duggan, CR; Xiao, L; Campbell, KL; Kong, A; Bain, C; Wang, CY; Blackburn, G; McTiernan, A

2012-01-01

Lifestyle interventions for weight loss are the cornerstone of obesity therapy, yet their optimal design is debated. This is particularly true for postmenopausal women; a population with a high prevalence of obesity yet towards whom fewer studies are targeted. We conducted a year-long, 4-arm randomized trial among 439 overweight-to-obese postmenopausal sedentary women to determine the effects of a calorie-reduced, low-fat diet (D), a moderate-intensity, facility-based aerobic exercise program (E), or the combination of both interventions (D+E), vs. a no-lifestyle-change control (C) on change in body weight and composition. The group-based dietary intervention had a weight-reduction goal of ≥10%, and the exercise intervention consisted of a gradual escalation to 45 min aerobic exercise 5 d/wk. Participants were predominantly non-Hispanic Whites (85%) with a mean age of 58.0±5.0 years, a mean BMI of 30.9±4.0 kg/m2 and an average of 47.8±4.4% body fat. Baseline and 12-month weight and adiposity measures were obtained by staff blinded to participants’ intervention assignment. 399 women completed the trial (91% retention). Using an intention-to-treat analysis, average weight loss at 12 months was −8.5% for the D group (P<0.0001 vs. C), −2.4% for the E group (P=0.03 vs. C), and −10.8% for the D+E group (P<0.0001 vs. C), while the C group experienced a non-significant −0.8% decrease. BMI, waist circumference, and % body fat were also similarly reduced. Among postmenopausal women, lifestyle change involving diet, exercise, or both combined over 1 year improves body weight and adiposity, with the greatest change arising from the combined intervention. PMID:21494229

Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women.

PubMed

Foster-Schubert, Karen E; Alfano, Catherine M; Duggan, Catherine R; Xiao, Liren; Campbell, Kristin L; Kong, Angela; Bain, Carolyn E; Wang, Ching-Yun; Blackburn, George L; McTiernan, Anne

2012-08-01

Lifestyle interventions for weight loss are the cornerstone of obesity therapy, yet their optimal design is debated. This is particularly true for postmenopausal women; a population with a high prevalence of obesity yet toward whom fewer studies are targeted. We conducted a year-long, 4-arm randomized trial among 439 overweight-to-obese postmenopausal sedentary women to determine the effects of a calorie-reduced, low-fat diet (D), a moderate-intensity, facility-based aerobic exercise program (E), or the combination of both interventions (D+E), vs. a no-lifestyle-change control (C) on change in body weight and composition. The group-based dietary intervention had a weight-reduction goal of ≥10%, and the exercise intervention consisted of a gradual escalation to 45-min aerobic exercise 5 day/week. Participants were predominantly non-Hispanic whites (85%) with a mean age of 58.0 ± 5.0 years, a mean BMI of 30.9 ± 4.0 kg/m(2) and an average of 47.8 ± 4.4% body fat. Baseline and 12-month weight and adiposity measures were obtained by staff blinded to participants' intervention assignment. Three hundred and ninety nine women completed the trial (91% retention). Using an intention-to-treat analysis, average weight loss at 12 months was -8.5% for the D group (P < 0.0001 vs. C), -2.4% for the E group (P = 0.03 vs. C), and -10.8% for the D+E group (P < 0.0001 vs. C), whereas the C group experienced a nonsignificant -0.8% decrease. BMI, waist circumference, and % body fat were also similarly reduced. Among postmenopausal women, lifestyle-change involving diet, exercise, or both combined over 1 year improves body weight and adiposity, with the greatest change arising from the combined intervention.

Beneficial impact of aerobic exercises on bone mineral density in obese premenopausal women under caloric restriction.

PubMed

Hosny, Iman Abbas; Elghawabi, Hamed Samir; Younan, Wael Bahat Fahmy; Sabbour, Adly Aly; Gobrial, Mona Abdel Messih

2012-04-01

The aim of this study was to assess the impact of caloric restriction diet versus caloric restriction diet combined with aerobic exercises on bone mineral density (BMD) in obese premenopausal women. Forty premenopausal obese women were classified randomly into two groups equal in number. The first group (group A) received caloric restriction diet, while the second (group B) received caloric restriction diet combined with a program of aerobic exercises, over 3 months. The variables measured in this study included age, weight, height, body mass index, fat weight, lean mass, fat percent, basal metabolic rate, and BMD. The comparison between group A and group B showed significantly higher post-treatment lean mass, basal metabolic rate, and BMD in weight-bearing bones (L2-L4 lumbar spine and total hip) in group B compared to group A. In contrast to the BMD of the weight-bearing bones, the BMD of the radius showed significant decrease between the pre- and post-treatment results in groups A and B with no significant differences between the two groups. A greater improvement in the BMD of weight-bearing bones was observed in obese premenopausal women undergoing caloric restriction combined with exercise than in those not undergoing exercise. Anaerobic exercises incorporated into weight loss programs help offset the adverse effects of dietary restriction on bone.

National Athletic Trainers' Association position statement: safe weight loss and maintenance practices in sport and exercise.

PubMed

Turocy, Paula Sammarone; DePalma, Bernard F; Horswill, Craig A; Laquale, Kathleen M; Martin, Thomas J; Perry, Arlette C; Somova, Marla J; Utter, Alan C

2011-01-01

To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the commonly used term. All weight management and exercise protocols used to achieve these goals should be safe and based on the most current evidence. Athletes, clients, parents, and coaches should be educated on how to determine safe weight and body composition so that athletes and clients more safely achieve competitive weights that will meet sport and activity requirements while also allowing them to meet their energy and nutritional needs for optimal health and performance.

Gene–Physical Activity Interactions: Overview of Human Studies

PubMed Central

Rankinen, Tuomo; Bouchard, Claude

2009-01-01

Physical activity level is an important component of the total daily energy expenditure and as such contributes to body weight regulation. A body of data indicates that the level of physical activity plays a role in the risk of excessive weight gain, in weight loss programs, and particularly in the prevention of weight regain. Most studies dealing with potential gene–physical activity interaction effects use an exercise and fitness or performance paradigm as opposed to an obesity-driven model. From these studies, it is clear that there are considerable individual differences in the response to an exercise regimen and that there is a substantial familial aggregation component to the observed heterogeneity. Few studies have focused on the role of specific genes in accounting for the highly prevalent gene–exercise interaction effects. Results for specific genes have been inconsistent with few exceptions. Progress is likely to come when studies will be designed to truly address gene–exercise or physical activity interaction issues and with sample sizes that will provide adequate statistical power. PMID:19037212

Differential Effects of Bariatric Surgery Versus Exercise on Excessive Visceral Fat Deposits

PubMed Central

Wu, Fu-Zong; Huang, Yi-Luan; Wu, Carol C.; Wang, Yen-Chi; Pan, Hsiang-Ju; Huang, Chin-Kun; Yeh, Lee-Ren; Wu, Ming-Ting

2016-01-01

Abstract The aim of the present study was to compare differential impacts of bariatric surgery and exercise-induced weight loss on excessive abdominal and cardiac fat deposition. Excessive fat accumulation around the heart may play an important role in the pathogenesis of cardiovascular disease. Recent evidences have suggested that bariatric surgery results in relatively less decrease in epicardial fat compared with abdominal visceral fat and paracardial fat. Sixty-four consecutive overweight or obese subjects were enrolled in the study. Clinical characteristics and metabolic profiles were recorded. The volumes of abdominal visceral adipose tissue (AVAT), abdominal subcutaneous adipose tissue (ASAT), epicardial (EAT), and paracardial adipose tissue (PAT) were measured by computed tomography in the bariatric surgery group (N = 25) and the exercise group (N = 39) at baseline and 3 months after intervention. Subjects in both the surgery and exercise groups showed significant reduction in body mass index (15.97%, 7.47%), AVAT (40.52%, 15.24%), ASAT (31.40, 17.34%), PAT (34.40%, 12.05%), and PAT + EAT (22.31%, 17.72%) (all P < 0.001) after intervention compared with baseline. In both the groups, the decrease in EAT was small compared with the other compartments (P < 0.01 in both groups). Compared with the exercise group, the surgery group had greater loss in abdominal and cardiac visceral adipose tissue (AVAT, ASAT, PAT, EAT+PAT) (P < 0.001), but lesser loss in EAT (P = 0.037). Compared with the exercise group, bariatric surgery results in significantly greater percentage loss of excessive fat deposits except for EAT. EAT, but not PAT, was relatively preserved despite weight reduction in both the groups. The physiological impact of persistent EAT deserves further investigation. PMID:26844473

Relationships Between Body Size Satisfaction and Weight Control Practices Among US Adults

PubMed Central

Millstein, Rachel A.; Carlson, Susan A.; Fulton, Janet E.; Galuska, Deborah A.; Zhang, Jian; Blanck, Heidi M.; Ainsworth, Barbara E.

2008-01-01

Context Few studies of US adults have specifically examined body size satisfaction Objectives Describe correlates of body size satisfaction and examine whether satisfaction was associated with trying to lose weight or specific weight control practices among US adults using a national sample of women and men. Design, Setting & Participants The National Physical Activity and Weight Loss Survey (NPAWLS) was a population-based, cross-sectional telephone survey of US adults (n = 9740). Main Outcome Measures Participants reported their weight, height, body size satisfaction, and weight loss practices. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each dependent variable. Results Among women and men, higher body mass index (BMI) was significantly associated with body size dissatisfaction. Dissatisfaction, compared with being very satisfied, was positively associated with trying to lose weight among women and men. This association was modified by BMI for women (OR normal weight = 19.69, overweight = 8.79, obese = 4.05; P < .01 for interaction) but not men (OR normal weight = 8.72, overweight = 10.50, obese = 7.86; P = 0.93 for interaction). Compared with women who were very satisfied, dissatisfied women used diet more (OR = 2.03), but not physical activity/exercise (OR = 0.55) or both strategies (OR = 0.63), to try to lose weight. Men who were somewhat satisfied, compared with those who were very satisfied, were more likely to use physical activity/exercise (OR = 1.64) and both diet and physical activity/exercise (OR = 1.54) to try to lose weight. Conclusion These findings highlight the sex differences in body size satisfaction, actions taken to try to lose weight, and the importance of considering body size satisfaction when designing weight-management programs. PMID:18596944

Improving Weight Loss Outcomes of Community Interventions by Incorporating Behavioral Strategies

PubMed Central

Crane, Melissa M.; Thomas, J. Graham; Kumar, Rajiv; Weinberg, Brad

2010-01-01

Objectives. We examined whether adding behavioral weight loss strategies could improve the outcomes of a community weight loss campaign. Methods. Shape Up RI is a 12-week, online, team-based program for health improvement in Rhode Island. In study 1, we randomly assigned participants to the standard Shape Up RI program or to the program plus video lessons on weight loss. In study 2, we randomly assigned participants to the standard program or to the program plus video lessons; daily self-monitoring of weight, eating, and exercise; and computer-generated feedback. Results. Adding video lessons alone (study 1) did not result in significantly improved weight loss (2.0 ±2.8 kg vs 1.4 ±2.9 kg; P = .15). However, when the video lessons were supplemented with self-monitoring and feedback (study 2), the average weight loss more than doubled (3.5 ±3.8 kg vs 1.4 ±2.7 kg; P < .01), and the proportion of individuals achieving a weight loss of 5% or more tripled (40.5% vs 13.2%; P < .01). Participants in study 2 submitted self-monitoring records on 78% of days, and adherence was significantly related to outcome. Conclusions. Adding behavioral strategies to community campaigns may improve weight loss outcomes with minimal additional cost. PMID:20966375

Intentional weight loss in older adults: useful or wasting disease generating strategy?

PubMed

Darmon, Patrice

2013-05-01

Strategies for weight management in older adults remain controversial as overweight may protect them against mortality whereas weight loss may have harmful effects by promoting sarcopenia and bone loss. It has been suggested that weight management for obese older adults should focus more on maintaining weight and improving physical function than promoting weight loss. This review aims to specify whether intentional weight loss in older adults is a useful or a wasting disease generating strategy. Recent randomized controlled studies have shown that a supervised, moderate caloric restriction coupled with regular exercise (both aerobic and resistance) in obese older adults do not increase mortality risk and may conversely reduce insulin resistance, metabolic complications, and disabilities without exacerbating lean mass and bone mineral density loss. In obese older adults, moderate weight loss may have beneficial effects on comorbidities, functional performances, and quality of life provided that regular physical activity can be associated. An individual approach considering life expectancy, chronic comorbidities, functional status, personal motivation, and social support should be preferred. More research is needed to define the circumstances in which cautious dietary restrictions are reasonably justified in older adults. In any case, in the oldest (≥80 years) as in frail individuals, it seems reasonable to abstain from recommending weight loss.

Young adults, technology, and weight loss: a focus group study.

PubMed

Stephens, Janna; Moscou-Jackson, Gyasi; Allen, Jerilyn K

2015-01-01

Overweight and obesity are a major concern in young adults. Technology has been integrated into many weight loss interventions; however little is known about the use of this technology in young adults. The purpose of this study was to explore through focus group sessions the opinions of young adults on the use of technology for weight loss. A total of 17 young adults, between 18 and 25 years of age, participated in three focus group sessions. Major results indicated that young adults have very little knowledge on the use of Smartphone technology for weight loss but would like to use this type of technology to help them lose weight. Results also indicated that young adults struggle to make healthy food choices and have priorities that outweigh exercise and they need support and guidance to make better decisions. In conclusion, young adults would be open to using Smartphone technology for weight loss but also need feedback and guidance to help make healthy decisions.

Reciprocal effects of exercise and nutrition treatment-induced weight loss with improved body image and physical self-concept.

PubMed

Annesi, James J; Porter, Kandice J

2015-01-01

Improvements in self-image and mood are often reported as outcomes of obesity interventions. However, they may also concurrently influence weight loss, suggesting a reciprocal effect. Although previously reported for overweight women, such relationships were untested in morbidly obese women whose psychosocial responses to treatment may be different, and health-risks greater. Women (N = 161, Meanage = 42 years) with morbid obesity (MeanBMI = 45.1 kg/m(2)) participated in a 6-month, behaviorally based physical activity and nutrition treatment. Significant within-group improvements in weight-loss behaviors (physical activity and eating), weight, body satisfaction, physical self-concept, and depression were found. After controlling for age, mediation analyses indicated that, as a result of the treatment, weight loss was both an outcome and mediator of improvements in body-areas satisfaction and physical self-concept (reciprocal effects), but not depression. Results replicated findings from women with lower degrees of overweight, and suggested that weight-loss treatments emphasize changes in self-perception.

Young Adults, Technology, and Weight Loss: A Focus Group Study

PubMed Central

Moscou-Jackson, Gyasi; Allen, Jerilyn K.

2015-01-01

Overweight and obesity are a major concern in young adults. Technology has been integrated into many weight loss interventions; however little is known about the use of this technology in young adults. The purpose of this study was to explore through focus group sessions the opinions of young adults on the use of technology for weight loss. A total of 17 young adults, between 18 and 25 years of age, participated in three focus group sessions. Major results indicated that young adults have very little knowledge on the use of Smartphone technology for weight loss but would like to use this type of technology to help them lose weight. Results also indicated that young adults struggle to make healthy food choices and have priorities that outweigh exercise and they need support and guidance to make better decisions. In conclusion, young adults would be open to using Smartphone technology for weight loss but also need feedback and guidance to help make healthy decisions. PMID:25789170

Dietary habits and weight maintenance success in high versus low exercisers in the National Weight Control Registry

PubMed Central

Ogden, Lorraine G.; Phelan, Suzanne; Thomas, J. Graham; Hill, James O; Wing, Rena R.; Wyatt, Holly R.

2015-01-01

Background The National Weight Control Registry (NWCR) was established to examine characteristics of successful weight loss maintainers. This study compares the diet and behavioral characteristics and weight regain trajectories of NWCR members with differing physical activity (PA) levels at baseline. Methods Participants (n=3591) were divided into 4 levels of self-reported PA at registry entry (<1000, 1000 to <2250, 2250 to <3500, and ≥3500 kcals/week). We compared self-reported energy intake (EI), macronutrient composition, eating behaviors (dietary restraint, hunger, and disinhibition), weight loss maintenance strategies, and 3 year weight regain between these 4 activity groups. Results Those with the highest PA at registry entry had lost the most weight, and reported lower fat intake, more dietary restraint, and greater reliance on several specific dietary strategies to maintain weight loss. Those in the lowest PA category maintained weight loss despite low levels of PA and without greater reliance on dietary strategies. There were no differences in odds of weight regain at year 3 between PA groups. Conclusions These findings suggest that there is not a “one size fits all strategy” for successful weight loss maintenance and that weight loss maintenance may require the use of more strategies by some individuals than others. PMID:24385447

Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis.

PubMed

Johnston, Bradley C; Kanters, Steve; Bandayrel, Kristofer; Wu, Ping; Naji, Faysal; Siemieniuk, Reed A; Ball, Geoff D C; Busse, Jason W; Thorlund, Kristian; Guyatt, Gordon; Jansen, Jeroen P; Mills, Edward J

2014-09-03

Many claims have been made regarding the superiority of one diet or another for inducing weight loss. Which diet is best remains unclear. To determine weight loss outcomes for popular diets based on diet class (macronutrient composition) and named diet. Search of 6 electronic databases: AMED, CDSR, CENTRAL, CINAHL, EMBASE, and MEDLINE from inception of each database to April 2014. Overweight or obese adults (body mass index ≥25) randomized to a popular self-administered named diet and reporting weight or body mass index data at 3-month follow-up or longer. Two reviewers independently extracted data on populations, interventions, outcomes, risk of bias, and quality of evidence. A Bayesian framework was used to perform a series of random-effects network meta-analyses with meta-regression to estimate the relative effectiveness of diet classes and programs for change in weight and body mass index from baseline. Our analyses adjusted for behavioral support and exercise. Weight loss and body mass index at 6- and 12-month follow-up (±3 months for both periods). Among 59 eligible articles reporting 48 unique randomized trials (including 7286 individuals) and compared with no diet, the largest weight loss was associated with low-carbohydrate diets (8.73 kg [95% credible interval {CI}, 7.27 to 10.20 kg] at 6-month follow-up and 7.25 kg [95% CI, 5.33 to 9.25 kg] at 12-month follow-up) and low-fat diets (7.99 kg [95% CI, 6.01 to 9.92 kg] at 6-month follow-up and 7.27 kg [95% CI, 5.26 to 9.34 kg] at 12-month follow-up). Weight loss differences between individual diets were minimal. For example, the Atkins diet resulted in a 1.71 kg greater weight loss than the Zone diet at 6-month follow-up. Between 6- and 12-month follow-up, the influence of behavioral support (3.23 kg [95% CI, 2.23 to 4.23 kg] at 6-month follow-up vs 1.08 kg [95% CI, -1.82 to 3.96 kg] at 12-month follow-up) and exercise (0.64 kg [95% CI, -0.35 to 1.66 kg] vs 2.13 kg [95% CI, 0.43 to 3.85 kg], respectively) on weight loss differed. Significant weight loss was observed with any low-carbohydrate or low-fat diet. Weight loss differences between individual named diets were small. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.

Effect of onsite dietitian counseling on weight loss and lipid levels in an outpatient physician office.

PubMed

Welty, Francine K; Nasca, Melita M; Lew, Natalie S; Gregoire, Sue; Ruan, Yuheng

2007-07-01

We examined the effect of an outpatient office-based diet and exercise counseling program on weight loss and lipid levels with an onsite dietitian who sees patients at the same visit with the physician and is fully reimbursable. Eighty overweight or obese patients (average age 55 +/- 12 years, baseline body mass index 30.1 +/- 6.4 kg/m(2)) with > or =1 cardiovascular risk factor (86%) or coronary heart disease (14%) were counseled to exercise 30 minutes/day and eat a modified Dietary Approaches to Stop Hypertension (DASH) diet (saturated fat <7%, polyunsaturated fat to 10%, monounsaturated fat to 18%, low in glycemic index and sodium and high in fiber, low-fat dairy products, fruits, and vegetables). Weight, body mass index, lipid levels, and blood pressure were measured at 1 concurrent follow-up visit with the dietitian and physician and > or =1 additional follow-up with the physician. Maximum weight lost was an average of 5.6% (10.8 lb) at a mean follow-up of 1.75 years. Sixty-four (81%) of these patients maintained significant weight loss (average weight loss 5.3%) at a mean follow-up of 2.6 years. Average decrease in low-density lipoprotein cholesterol was 9.3%, average decrease in triglycerides was 34%, and average increase in high-density lipoprotein cholesterol was 9.6%. Systolic blood pressure was lowered from 129 to 126 mm Hg (p = 0.21) and diastolic blood pressure from 79 to 75 mm Hg (p = 0.003). In conclusion, having a dietitian counsel patients concurrently with a physician in the outpatient setting is effective in achieving and maintaining weight loss and is fully reimbursable.

Self-selection accounts for inverse association between weight and cardiorespiratory fitness.

PubMed

Williams, Paul T

2008-01-01

Men and women who exercise regularly and who are physically fit tend to be leaner than those who are sedentary and not fit. Although exercise is known to attenuate weight gain and promote weight loss, there may also be a propensity for leaner men and women to choose to exercise vigorously (self-selection). Pre-exercise body weights have been shown to account for all the weight differences between fast and slow walkers, but seem to account for only a portion of the weight differences associated with walking distances. Whether these results apply to maximum exercise performance (i.e., cardiorespiratory fitness) as well as to doses of vigorous exercise (metabolic equivalents >6) remains to be determined. Assess whether the cross-sectional relationships of BMI to cardiorespiratory fitness and vigorous activity are explained by BMI prior to exercising. Cross-sectional study of the relationships between cardiorespiratory fitness (running speed during 10 km foot race) and vigorous physical activity (weekly running distance) to current BMI (BMI(current)) and BMI at the start of running (BMI(starting)) in 44,370 male and 25,252 female participants of the National Runners' Health Study. BMI(starting) accounted entirely for the association between fitness and BMI(current) in both sexes, but only a quarter of the association between vigorous physical activity levels and BMI(current) in men. In women, BMI(starting) accounted for 58% of the association between BMI(current) and vigorous activity levels. Self-selection based on pre-exercise BMI accounts entirely for the association found between fitness and BMI (and possibly a portion of other health outcomes).

Pre-Training Muscle Characteristics of Subjects Who Are Obese Determine How Well Exercise Training Will Improve Their Insulin Responsiveness.

PubMed

Stuart, Charles A; Lee, Michelle L; South, Mark A; Howell, Mary E A; Cartwright, Brian M; Ramsey, Michael W; Stone, Michael H

2017-03-01

Stuart, CA, Lee, ML, South, MA, Howell, MEA, Cartwright, BM, Ramsey, MW, and Stone, MH. Pre-training muscle characteristics of subjects who are obese determine how well exercise training will improve their insulin responsiveness. J Strength Cond Res 31(3): 798-808, 2017-Only half of prediabetic subjects who are obese who underwent exercise training without weight loss increased their insulin responsiveness. We hypothesized that those who improved their insulin responsiveness might have pretraining characteristics favoring a positive response to exercise training. Thirty nondiabetic subjects who were obese volunteered for 8 weeks of either strength training or endurance training. During training, subjects increased their caloric intake to prevent weight loss. Insulin responsiveness by euglycemic clamps and muscle fiber composition, and expression of muscle key biochemical pathways were quantified. Positive responders initially had 52% higher intermediate muscle fibers (fiber type IIa) with 27% lower slow-twitch fibers (type I) and 23% lower expression of muscle insulin receptors. Whether after weight training or stationary bike training, positive responders' fiber type shifted away from type I and type IIa fibers to an increased proportion of type IIx fibers (fast twitch). Muscle insulin receptor expression and glucose transporter type 4 (GLUT4) expression increased in all trained subjects, but these moderate changes did not consistently translate to improvement in whole-body insulin responsiveness. Exercise training of previously sedentary subjects who are obese can result in muscle remodeling and increased expression of key elements of the insulin pathway, but in the absence of weight loss, insulin sensitivity improvement was modest and limited to about half of the participants. Our data suggest rather than responders being more fit, they may have been less fit, only catching up to the other half of subjects who are obese whose insulin responsiveness did not increase beyond their pretraining baseline.

Self-paced exercise program for office workers: impact on productivity and health outcomes.

PubMed

Low, David; Gramlich, Martha; Engram, Barbara Wright

2007-03-01

The impact of a self-paced exercise program on productivity and health outcomes of 32 adult workers in a large federal office complex was investigated during 3 months. Walking was the sole form of exercise. The first month, during which no walking occurred, was the control period. The second and third months were the experimental period. Participants were divided into three levels based on initial weight and self-determined walking distance goals. Productivity (using the Endicott Work Productivity Scale), walking distance (using a pedometer), and health outcomes (blood pressure, weight, pulse rate, and body fat percentage) were measured weekly. Results from this study, based on a paired t test analysis, suggest that although the self-paced exercise program had no impact on productivity, it lowered blood pressure and promoted weight loss. Further study using a larger sample and a controlled experimental design is recommended to provide conclusive evidence.

Schizophrenia and weight management: a systematic review of interventions to control weight.

PubMed

Faulkner, G; Soundy, A A; Lloyd, K

2003-11-01

Weight gain is a frequent side effect of antipsychotic medication which has serious implications for a patient's health and well being. This study systematically reviews the literature on the effectiveness of interventions designed to control weight gain in schizophrenia. A systematic search strategy was conducted of major databases in addition to citation searches. Study quality was rated. Sixteen studies met the inclusion criteria. Five of eight pharmacological intervention studies reported small reductions in weight (<5% baseline body weight). All behavioural (including diet and/or exercise) interventions reported small reductions in, or maintenance of, weight. Weight loss may be difficult but it is not impossible. Given the inconsistent results, the widespread use of pharmacological interventions cannot be recommended. Both dietary and exercise counselling set within a behavioural modification programme is necessary for sustained weight control.

Comparison of bone density in amenorrheic women due to athletics, weight loss, and premature menopause.

PubMed

Jones, K P; Ravnikar, V A; Tulchinsky, D; Schiff, I

1985-07-01

Studied was the peripheral bone density of 39 women (ages 18 to 43) with the diagnosis of secondary amenorrhea in an effort to define the population of amenorrheic women at risk for osteoporosis. Eight women had exercise-induced amenorrhea (athletes), 20 women had amenorrhea associated with weight loss, and 11 women had premature menopause. These diagnoses were made on the basis of history, physical examination, and luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin levels, and failure to have withdrawal bleeding after the administration of progestin. Twenty-five nonathletic, normally menstruating women served as control subjects. The peripheral bone density of the amenorrheic athletes (0.738 g/cm2 +/- 0.047) was not significantly different from that of the controls (0.726 g/cm2 +/- 0.044). The average bone density of the group with weight loss-associated amenorrhea (0.672 g/cm2 +/- 0.066) was significantly less than controls (P less than .005) as was that of the women with premature menopause (0.616 g/cm2 +/- 0.048, P less than .001). There was a significant correlation between months of amenorrhea and decrease in bone density (r = 0.506, P less than .001). From this study it was concluded that women with exercise-associated amenorrhea are not at significant risk for cortical bone loss as measured by direct photon absorptiometry. Women with weight loss-associated amenorrhea and women with premature menopause are at significant risk for bone loss when compared with normal controls.

Central and peripheral effects of physical exercise without weight reduction in obese and lean mice

PubMed Central

de Carvalho, Francine Pereira; Moretto, Thaís Ludmilla; Benfato, Izabelle Dias; Barthichoto, Marcela; Ferreira, Sandra Mara; Costa-Júnior, José Maria; de Oliveira, Camila Aparecida Machado

2018-01-01

To investigate the central (hypothalamic) and peripheral effects of exercise without body weight change in diet-induced obesity (DIO). Twelve-week-old male C57Bl/6 mice received a control (C) or a high-fat diet (H). Half of them had free access to running wheels for 5 days/week for 10 weeks (CE) and HE, respectively). Hypothalamic expression of genes related to energy homeostasis, and leptin (Stat3 and p-Stat3) and insulin (Akt and p-Akt) signaling were evaluated. Glucose and leptin tolerance, peripheral insulin sensitivity, and plasma insulin, leptin and adiponectin were determined. Perigonadal and retroperitoneal fat depots were increased by diet but reduced by exercise despite lack of effect of exercise on body weight. Blood glucose during intraperitoneal glucose tolerance test (ipGTT) was higher and glucose decay during intraperitoneal insulin tolerance test (ipITT) was lower in H and HE compared with C and CE. Exercise increased liver p-Akt expression and reduced fast glycemia. High-fat diet increased plasma insulin and leptin. Exercise had no effect on insulin but decreased leptin and increased adiponectin. Leptin inhibited food intake in all groups. Hypothalamic total and p-Stat3 and Akt were similar amongst the groups despite higher plasma levels of leptin and insulin in H and HE mice. High-fat diet modulated gene expression favoring a positive energy balance. Exercise only marginally changed the gene expression. Exercise induced positive changes (decreased fast glycemia and fat depots; increased liver insulin signaling and adiponectin concentration) without weight loss. Thus, despite reducing body weight could bring additional benefits, the effects of exercise must not be overlooked when weight reduction is not achieved. PMID:29371411

Health effects resulting from exercise versus those from body fat loss.

PubMed

Williams, P T

2001-06-01

The purpose of this review was to assess whether body weight confounds the relationships between physical activity and its health benefits. The review includes 80 reports from population-based studies (Evidence Category C) of physical activity or fitness and cardiovascular disease (CVD) or coronary heart disease (CHD). Eleven of 64 reports on activity found no relationship between physical activity and disease. Of the remaining 53 reports, 11 did not address the possible confounding effects of body weight, nine cited reasons that weight differences should not explain their observed associations, and 33 statistically adjusted for weight (as required). Only three of these changed their associations from significant to nonsignificant when adjusted. Ten of 16 reports on cardiorespiratory fitness and CHD or CVD used statistical adjustment, and none of these changed their findings to nonsignificant. Population studies show that vigorously active individuals also have higher high-density lipoprotein (HDL)-cholesterol concentration, a major risk factor for CHD and CVD, than sedentary individuals when statistically adjusted for weight. In contrast, intervention studies, which relate dynamic changes in weight and HDL, suggest that adjustment for weight loss largely eliminates the increase in HDL-cholesterol in sedentary men who begin exercising vigorously. Adjusting the cross-sectional HDL-cholesterol differences for the dynamic effects of weight loss eliminates most of the HDL-cholesterol difference between active and sedentary men. Population studies show that the lower incidence of CHD and CVD and higher HDL of fit, active individuals are not because of lean, healthy individuals choosing to be active (i.e., self-selection bias). Nevertheless, metabolic processed associated weight loss may be primarily responsible for the HDL differences between active and sedentary men, and possibly also their differences in CHD and CVD.

Weight loss practices among newly enrolling clients in a commercial weightloss program in Ghana.

PubMed

Ayisi-Addo, Sandra; Ayisi-Addo, Stephen; Ohemeng, Agartha

2016-03-01

In Ghana, obesity is showing a rising trend and there are weight loss initiatives being practised by individuals. However, the levels of commitment to such programs and the reasons for discontinuing have not been assessed. The objectives of this study were to investigate the weight loss practices of participants and reasons for quitting chosen weight loss programs. This was a cross-sectional study involving 50 subjects conveniently selected from people who were enrolling into a commercial weight loss program. A questionnaire was used to collect data on past weight loss practices and reasons for abandoning chosen programs. Data analysis was conducted using simple frequency and descriptive tests of the Excel software. More than half of the subjects (66%) had undertaken a weight loss practice before enrolment in study. Of these, 88.5% abandoned the strategy before the achievement of their desired weight goal. The three common programs that were practised were internet based diets (67.9%), commercial weight loss shakes (42.9%) and exercises (28.6%). Reasons given for abandoning programs included lack of sustainability (50%), lack of determination on the part of the client (15%), boredom with program (10%), not achieving desired results (10%), safety concerns (10%), and getting pregnant (5%). The findings suggest that future weight loss programs can be effective and have reduced attrition rates if they are designed to achieve sustainable dietary and other lifestyle changes, as well as boost motivation for weight loss.

Adolescent Athleticism, Exercise, Body Image, and Dietary Practices.

ERIC Educational Resources Information Center

Rainey, Cheryl J.; McKeown, Robert E.; Sargent, Roger G.; Valois, Robert F.

1998-01-01

Investigated relationships between physical activity and athletic participation and body-size perceptions, diet, and weight-control practice among high school students, noting racial and gender differences. Surveys indicated that diet quality improved and weight-loss attempts increased as physical activity and athletic participation increased.…

Voluntary exercise in pregnant rats improves post-lactation maternal bone parameters but does not affect offspring outcomes in early life.

PubMed

Rosa, B V; Blair, H T; Vickers, M H; Morel, P C; Cockrem, J F; Firth, E C

2012-12-01

The objectives of this study were to examine the effects of voluntary exercise during pregnancy on maternal post-lactation bone parameters and offspring growth. Pregnant Wistar rats were housed in conventional cages (control), or were housed in raised cages requiring them to rise to an erect, bipedal stance to obtain food/water, throughout pregnancy. Dual energy X-ray absorptiometry and peripheral quantitative computed tomography scans were performed pre-mating and post-weaning. Maternal stress was assessed by fecal corticosterone measurement. Offspring weights were assessed at postnatal days 1 and 25 (weaning). Changes in bone mineral over the pregnancy/lactation period were site-specific. Exercise did not affect loss of bone mineral from the lumbar spine, but did attenuate the loss of trabecular bone mineral from the tibial metaphysis and enhance the strength strain index and cross-sectional moment of inertia at the tibial diaphysis (P≤0.05) in dams in the exercised group. Fecal corticosterone did not differ between dam groups. There were no significant differences in offspring weight between the exercised and control group at either time point. Voluntary exercise in the pregnant rat can improve some post-lactation bone parameters and does not adversely affect early postnatal outcomes of the offspring.

Effect of Exercise Type During Intentional Weight Loss on Body Composition in Older Adults with Obesity.

PubMed

Beavers, Kristen M; Ambrosius, Walter T; Rejeski, W Jack; Burdette, Jonathan H; Walkup, Michael P; Sheedy, Jessica L; Nesbit, Beverly A; Gaukstern, Jill E; Nicklas, Barbara J; Marsh, Anthony P

2017-11-01

To examine the long-term effects of exercise modality during weight loss on body composition and associations between body composition and physical function changes. Two hundred forty-nine older adults (66.9 ± 4.7 years, 71% women, 32% African American, BMI: 34.4 ± 3.7 kg/m 2 ) were randomized to weight loss (WL; n = 82), WL plus aerobic training (WL + AT; n = 86), or WL plus resistance training (WL + RT; n = 81) for 18 months. Dual-energy x-ray absorptiometry-acquired body composition, 400-m walk time, and knee extensor strength were measured at baseline and at 6 and 18 months. Total body mass loss was enhanced when WL was combined with exercise (WL: -5.7 ± 0.7 kg, WL + AT: -8.5 ± 0.7 kg, WL + RT: -8.7 ± 0.7 kg; P < 0.01). Total body fat mass loss was significantly greater in WL + AT (-6.8 ± 0.6 kg, -16.4%) and WL + RT (-7.8 ± 0.5 kg, -19.0%) than WL (-4.8 ± 0.6 kg, -10.9%); both P < 0.01. Lean mass loss was greatest in WL + AT (-1.6 ± 0.3 kg, -3.1%) compared with WL + RT (-0.8 ± 0.3 kg, -1.5%) or WL (-1.0 ± 0.3 kg; -2.0%); both P ≤ 0.02. Change in 400-m walk time was associated with change in fat mass (β/SD = +6.1 s; P < 0.01), while change in knee extensor strength was associated with change in lean mass (β/SD = +1.6 Nm; P < 0.01). WL + RT results in less lean mass lost than WL + AT; WL plus exercise yields greater fat mass loss than WL alone. © 2017 The Obesity Society.

Using Avatars to Model Weight Loss Behaviors: Participant Attitudes and Technology Development

PubMed Central

Napolitano, Melissa A.; Hayes, Sharon; Russo, Giuseppe; Muresu, Debora; Giordano, Antonio; Foster, Gary D.

2013-01-01

Background: Virtual reality and other avatar-based technologies are potential methods for demonstrating and modeling weight loss behaviors. This study examined avatar-based technology as a tool for modeling weight loss behaviors. Methods: This study consisted of two phases: (1) an online survey to obtain feedback about using avatars for modeling weight loss behaviors and (2) technology development and usability testing to create an avatar-based technology program for modeling weight loss behaviors. Results: Results of phase 1 (n = 128) revealed that interest was high, with 88.3% stating that they would participate in a program that used an avatar to help practice weight loss skills in a virtual environment. In phase 2, avatars and modules to model weight loss skills were developed. Eight women were recruited to participate in a 4-week usability test, with 100% reporting they would recommend the program and that it influenced their diet/exercise behavior. Most women (87.5%) indicated that the virtual models were helpful. After 4 weeks, average weight loss was 1.6 kg (standard deviation = 1.7). Conclusion: This investigation revealed a high level of interest in an avatar-based program, with formative work indicating promise. Given the high costs associated with in vivo exposure and practice, this study demonstrates the potential use of avatar-based technology as a tool for modeling weight loss behaviors. PMID:23911189

Taking weight-loss supplements may elicit liberation from dietary control. A laboratory experiment.

PubMed

Chang, Yevvon Yi-Chi; Chiou, Wen-Bin

2014-01-01

Given that changes in diet and exercise habits are difficult to initiate and maintain, the use of weight-loss supplements has become an appealing alternative approach to weight management for many individuals. The current research examined whether the use of weight-loss supplements induced overly optimistic assessments of progress toward weight reduction, leading to psychological abdication of dietary regulation. Participants were randomly assigned to take either an identified placebo or a purported weight-loss supplement (actually the same placebo). Each participant reported perceived progress toward weight reduction following the manipulation. Consumption of snacks in a taste test and choice of sugary drinks were recorded. The results showed that participants receiving a purported supplement ate more in a taste task and preferred larger quantities of sugar in their reward drinks than did controls. Mediation analysis supported that the perception of progress toward weight reduction contributed to the liberating effect. Using weight-loss supplements may increase perceived progress toward weight reduction but decrease dietary self-regulation. These thought-provoking findings can serve as a basis for educating the public about the myth that they are free to feel liberated from the need to regulate their eating when using weight-loss supplements. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effects of self-selected dehydration and meaningful rehydration on anaerobic power and heart rate recovery of elite wrestlers.

PubMed

Cengiz, Asim

2015-05-01

[Purpose] This study aimed to verify the effects of self-directed weight loss on lower- and upper-body power, fatigue index, and heart rate recovery immediately before a meaningful competition (12 hours of recovery). In addition, this study tested the hypothesis that weight loss provides advantages in strength and power, as the relative power of the wrestlers is higher than that of opponents in the same weight class who do not reduce weight. [Subjects and Methods] Eleven well-trained wrestlers volunteered for the study. At baseline, their mean ± SD age, body mass, and height were 20.45 ± 2.69 years, 74.36 ± 9.22 kg, and 177 ± 5.71 cm, respectively. Repeated-measures one-way analysis of variance was performed to analyze differences. [Results] Rapid weight loss achieved by restriction of energy and fluid intake resulted in exercise-impaired decreases in peak power and increased fatigue index. Moreover, weight loss by dehydration negatively affected cardiovascular stability. [Conclusion] Most of the negative effects of rapid weight loss disappear after a 12-hour recovery period, and relative peak power increases after weight loss.

Self-determination theory and weight loss in a Diabetes Prevention Program translation trial.

PubMed

Trief, Paula M; Cibula, Donald; Delahanty, Linda M; Weinstock, Ruth S

2017-06-01

We examined self-determination theory (SDT) and weight loss, and hypothesized that the Diabetes Prevention Program's (DPP) intervention would result in an increase in autonomous regulation of motivation (AR) in participants. Further, that those with higher AR, and those who perceived educators as supporting SDT-defined needs, would lose more weight. Support, Health Information, Nutrition and Exercise (SHINE) Study data (N = 257) were analyzed. SHINE was a randomized, controlled DPP translation trial (2-years, telephonic, primary care staff). Autonomous motivation in males increased significantly, while females showed no change. Males with high AR, but not females, lost more weight. However, the significance of these relationships varied over time. Participants who perceived educators as more supportive of psychological needs lost more weight (especially males). However, effect of support on weight loss was not mediated by AR change. Autonomous motivation and educator support are relevant to male weight loss. Future research might develop interventions to enhance autonomous motivation and educator support, and understand change pathways.

Effects of exercise on insulin resistance and body composition in overweight and obese women with and without polycystic ovary syndrome.

PubMed

Hutchison, Samantha K; Stepto, Nigel K; Harrison, Cheryce L; Moran, Lisa J; Strauss, Boyd J; Teede, Helena J

2011-01-01

Polycystic ovary syndrome (PCOS) is an insulin-resistant (IR) state. Visceral fat (VF) is independently associated with IR. The objectives of the study were to explore mechanisms underpinning IR by assessing the effect of exercise training on IR and body composition in overweight PCOS and non-PCOS women. This was a prospective exercise intervention study. The study was conducted at an academic medical center. Participants included 20 overweight PCOS and 14 overweight non-PCOS women. The intervention included 12 wk of intensified aerobic exercise (3 h/wk). IR on euglycemic hyperinsulinemic clamp, body composition including abdominal visceral and sc fat distribution by computer tomography and lipids was measured. PCOS subjects were more IR (P = 0.02) and had more VF (P = 0.04 age adjusted) than non-PCOS women. In PCOS women, IR correlated with VF (r = -0.78, P < 0.01). With exercise training, both groups maintained weight but within PCOS, VF (-12.0 cm(2), P = 0.03) and within non-PCOS abdominal sc fat (-40.2 cm(2), P = 0.02) decreased. Despite exercise-induced improvement in IR within PCOS (+27.9 mg · m(-2) · min(-1), P = 0.03), no relationship with decreased VF (r = -0.08, P = 0.84) and no differential changes in IR and VF between groups were noted. Triglycerides decreased within PCOS (-0.27 mmol/liter, P = 0.02) and decreased differentially between groups (P < 0.01). Higher IR was related to increased VF in PCOS, suggesting an etiological role for VF in intrinsic IR in PCOS; however, changes with exercise intervention did not support a causal relationship. Triglycerides were modulated more by exercise training in PCOS than non-PCOS women. Within-group exercise-induced reductions in cardiometabolic risk factors including IR, triglycerides, and VF in PCOS were observed without significant weight loss and if confirmed in future controlled trials, suggest weight loss should not be the sole focus of exercise programs.

Changes in self-efficacy for exercise and improved nutrition fostered by increased self-regulation among adults with obesity.

PubMed

Annesi, James J; Johnson, Ping H; McEwen, Kristin L

2015-10-01

Behavioral theory suggests that treatments that increase participants' use of self-regulatory skills and/or their feelings of ability (self-efficacy) will improve exercise and nutrition behaviors. In addition, psychosocial factors associated with increased exercise may carry over to improved eating. Self-regulation might enhance self-efficacy through feelings of ability to manage barriers to maintaining weight-loss behaviors. Sedentary adults with severe or morbid obesity (M age = 43 years; M BMI = 40.1 kg/m(2)) participated in a 6-month study within a community-based YMCA center. We randomly assigned participants to one of the two groups that incorporated the same cognitive-behavioral support of exercise paired with methods for controlled, healthy eating emphasizing either (a) self-efficacy (n = 138), or (b) self-regulation (n = 136) methods. Mixed model repeated measures ANOVAs indicated significant improvements in exercise- and eating-related self-regulation over 3 months, and exercise- and eating-related self-efficacy over 6 months. The Self-Regulation Treatment Group demonstrated greater improvements in self-regulation for eating and fruit and vegetable intake than the Self-Efficacy Group. Regression analyses indicated that for both exercise and eating, self-regulation change significantly predicted self-efficacy change. In separate equations, changes in exercise and fruit and vegetable intake mediated those relationships, and change in self-efficacy and the corresponding behavioral changes demonstrated reciprocal, mutually reinforcing, relationships. There was evidence of carry-over, or generalization, of both self-regulation and self-efficacy changes from an exercise context to an eating context. We discussed findings in terms of leveraging self-regulation to improve self-efficacy, and provide a rationale for why exercise is the strongest predictor of success with weight loss. Results may be used to inform future behavioral weight-management treatments through improved knowledge of relationships among theoretically derived psychosocial factors.

Overweight and Obesity, Weight Perception, and Weight Management Practices Among Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Participants in Georgia: A Needs Assessment.

PubMed

Bailey, Claudette; Lee, Jung Sun

2017-05-01

Examine associations among weight status, weight perception, and weight management practices of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) participants in Georgia. Self-reported weight, height, and weight-related practices were assessed and analyzed in 270 SNAP-Ed participants. Almost three quarters of the sample self-reported overweight or obesity. Among overweight and obese subjects, 39% and 69%, respectively, accurately perceived themselves as overweight. More than half of the sample desired weight loss and 44% had attempted weight loss in the past year. Overweight/obese subjects who accurately perceived their weight were more likely to desire and to have attempted weight loss than those who under-perceived their weight. Approximately 58% of all subjects who had attempted to lose weight reported use of both methods suggested for weight loss: exercise and dietary changes. The high prevalence of self-reported overweight/obesity combined with a desire to lose weight among the study sample demonstrated the necessity to develop SNAP-Ed curricula emphasizing weight management. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Evaluation of the Human/Extreme Environment Interaction: Implications for Enhancing Operational Performance and Recovery

DTIC Science & Technology

2011-10-01

healthy conditions such as exercise (6) and weight loss (22,48) while fission (degradation, dysfunction) is associated with obesity and disease (3,4...before each trial. Following an overnight 12 hour fast , participants arrived at the laboratory in the early morning to complete testing. Upon...type 2 diabetes, obesity , weight loss, and the regulatory role of tumor necrosis factor alpha and interleukin-6. Diabetes 54: 2685-2693, 2005. 4

Dose-response effects of aerobic exercise on energy compensation in postmenopausal women: combined results from two randomized controlled trials.

PubMed

McNeil, J; Brenner, D R; Courneya, K S; Friedenreich, C M

2017-08-01

Despite the clear health benefits of exercise, exercised-induced weight loss is often less than expected. The term 'exercise energy compensation' is used to define the amount of weight loss below what is expected for the amount of exercise energy expenditure. We examined the dose-response effects of exercise volume on energy compensation in postmenopausal women. Data from Alberta Physical Activity and Breast Cancer Prevention (ALPHA) and Breast Cancer and Exercise Trial in Alberta (BETA) were combined for the present analysis. The ALPHA and BETA trials were two-centred, two-armed, 12-month randomized controlled trials. The ALPHA trial included 160 participants randomized to 225 min per week of aerobic exercise, and the BETA trial randomized 200 participants to each 150 and 300 min per week of aerobic exercise. All participants were aged 50-74 years, moderately inactive (<90 min per week of exercise), had no previous cancer diagnosis and a body mass index between 22 and 40 kg m -2 . Energy compensation was based on changes in body composition (dual-energy X-ray absorptiometry scan) and estimated exercise energy expenditure from completed exercise volume. Associations between Δenergy intake, ΔVO 2peak and Δphysical activity time with energy compensation were assessed. No differences in energy compensation were noted between interventions. However, there were large inter-individual differences in energy compensation between participants; 9.4% experienced body composition changes that were greater than expected based on exercise energy expenditure, 64% experienced some degree of energy compensation and 26.6% experienced weight gain based on exercise energy expenditure. Increases in VO 2peak were associated with reductions in energy compensation (β=-3.44 ml kg -1  min -1 , 95% confidence interval for β=-4.71 to -2.17 ml kg -1  min -1 ; P=0.0001). Large inter-individual differences in energy compensation were noted, despite no differences between activity doses. In addition, increases in VO 2peak were associated with lower energy compensation. Future studies are needed to identify behavioral and metabolic factors that may contribute to this large inter-individual variability in energy compensation.

Body weight gain induced by a newer antipsychotic agent reversed as negative symptoms improved.

PubMed

Koga, M; Nakayama, K

2005-07-01

We describe a patient in whom improvement in negative symptoms contributed to early weight loss and subsequent long-term improvement in weight management. Case report. A 26-year-old woman with schizophrenia gained 7 kg over the course of 1 year after starting treatment with olanzapine. However, as negative symptoms gradually improved with treatment, she became motivated to diet and exercise regularly. She quickly lost 9 kg and subsequently maintained optimal weight (55 kg; body mass index, 24.1 kg/m(2) ). Important strategies for minimizing weight gain in patients taking antipsychotic agents include improving negative symptoms of avolition and apathy, regular monitoring of body weight and potential medical consequences of overweight and obesity, and educating the patient about the importance of diet and regular exercise.

Commentary on the shifting processes model: a conceptual model for weight management.

PubMed

Pagoto, Sherry; Rodrigues, Stephanie

2013-12-01

Macchi and colleagues propose a theoretical model that merges concepts from the biopsychosocial model and family systems theory to produce a broader framework for understanding weight loss and maintenance (see record 2013-28564-001). The Shifting Processes Model views individual weight loss and maintenance in the context of family dynamics, including family eating and exercise habits, home environment, and family relationships. The authors reason that traditional models put the burden of change on the individual rather than the family system, when the latter is an important context of individual behavior.

Physical activity in obesity and metabolic syndrome

PubMed Central

Strasser, Barbara

2013-01-01

Biological aging is typically associated with a progressive increase in body fat mass and a loss of lean body mass. Owing to the metabolic consequences of reduced muscle mass, it is understood that normal aging and/or decreased physical activity may lead to a higher prevalence of metabolic disorders. Lifestyle modification, specifically changes in diet, physical activity, and exercise, is considered the cornerstone of obesity management. However, for most overweight people it is difficult to lose weight permanently through diet or exercise. Thus, prevention of weight gain is thought to be more effective than weight loss in reducing obesity rates. A key question is whether physical activity can extenuate age-related weight gain and promote metabolic health in adults. Current guidelines suggest that adults should accumulate about 60 minutes of moderate-intensity physical activity daily to prevent unhealthy weight gain. Because evidence suggests that resistance training may promote a negative energy balance and may change body fat distribution, it is possible that an increase in muscle mass after resistance training may be a key mediator leading to better metabolic control. PMID:23167451

Does psychological functioning mediate the relationship between bullying involvement and weight loss preoccupation in adolescents? A two-stage cross-sectional study.

PubMed

Lee, Kirsty; Guy, Alexa; Dale, Jeremy; Wolke, Dieter

2017-03-24

Adolescent bullying is associated with a range of adversities for those who are bullied i.e., victims and bully-victims (e.g., those who bully others and get victimised), including reduced psychological functioning and eating disorder symptoms. Bullies are generally well-adjusted psychologically, but previous research suggests that bullies may also engage in problematic diet behaviours. This study investigates a) whether adolescents involved in bullying (bullies, victims, bully-victims) are at increased risk of weight loss preoccupation, b) whether psychological functioning mediates this relationship and c) whether sex is a key moderator. A two-stage design was used. In stage 1, adolescents (n = 2782) from five UK secondary schools were screened for bullying involvement using self and peer reports. In stage 2, a sample of bullies, victims, bully-victims and uninvolved adolescents (n = 767) completed a battery of assessments. The measures included the eating behaviours component of the Child and Adolescent Psychiatric Assessment, which was reduced to one factor (weight loss preoccupation) and used as the outcome variable. Measures of self-esteem, body-esteem and emotional problems were reduced to a latent (mediator) variable of psychological functioning. Multi-group analysis examined the effects of sex and all models were adjusted for covariates (BMI, pubertal stage, age, parental education and ethnicity). Bullies, victims and bully-victims were at increased risk of weight loss preoccupation compared to adolescents uninvolved in bullying. The mechanism by which bullying involvement related to increased weight loss preoccupation varied by bullying role: in bullies the effect was direct, in victims the effect was indirect (via reduced psychological functioning) and in bully-victims the effect was both direct and indirect. Sex significantly moderated the relationship in bullies: weight loss preoccupation was only statistically significant in bullies who were boys. Bullying involvement during adolescence is associated with weight loss preoccupation. Bullies are likely driven by a desire to increase attractiveness and social status; whereas weight loss preoccupation in bullied adolescents may have maladaptive influences on diet and exercise behaviours due to its association with reduced psychological functioning. Future research should consider peer victimisation as a potential modifiable risk factor for reduced psychological functioning and weight loss preoccupation, which if targeted, may help to prevent maladaptive diet and exercise behaviours.

The effects of weight loss on relative bone mineral density in premenopausal women.

PubMed

Hamilton, Kara C; Fisher, Gordon; Roy, Jane L; Gower, Barbara A; Hunter, Gary R

2013-03-01

This study compared BMD relative to body weight following a ∼6-month weight loss program and a 1-year weight maintenance phase in premenopausal women and determined whether African American (AA) and European-American (EA) women's BMD respond similarly during weight loss. Premenopausal women (n = 115, 34 ± 5 years) were evaluated in an overweight state (BMI between 27 and 30 kg/m(2) ), following an 800 kcal/day diet/exercise program designed to reduce BMI<25 kg/m(2) , and 1-year following weight loss. BMD relative to body weight (Z-scores) increased after weight loss, but decreased during the 1-year weight maintenance phase. All 1-year follow-up BMD Z-scores were increased (except L1) compared to baseline measurements (P < 0.05). These sites included the hip neck (+0.088, P = 0.014), total hip (+0.099, P = 0.001), L2 (+0.127, P = 0.013), L3 (+0.135, P = 0.014), and L4 (+0.199, P = 0.002). AAs had significantly higher absolute BMD at all sites (P < 0.05) compared to EAs, but no time by race interactions were evident during weight loss (except in L3). These results may indicate that weight loss is safe with regard to bone health for overweight premenopausal women. Copyright © 2013 The Obesity Society.

Changes in diet quality in a randomized weight loss trial in breast cancer survivors: the lifestyle, exercise, and nutrition (LEAN) study.

PubMed

Anderson, Chelsea; Harrigan, Maura; George, Stephanie M; Ferrucci, Leah M; Sanft, Tara; Irwin, Melinda L; Cartmel, Brenda

2016-01-01

Obesity is associated with increased breast cancer recurrence and mortality. Though some post-diagnosis weight loss interventions have achieved weight loss outcomes, it is unclear whether they also improve diet quality. In the Lifestyle, Exercise, and Nutrition (LEAN) study, overweight or obese breast cancer survivors were randomized to either usual care group ( n =33) or the 6-month lifestyle intervention ( n =67). Dietary intake was assessed at baseline and 6 months using a validated food frequency questionnaire, and overall diet quality was calculated using the Healthy Eating Index (HEI)-2010 (range 0-100). Intervention effects on diet were evaluated with generalized linear models. Among the 81 participants (51 intervention, 30 usual care) with dietary data, the mean baseline HEI score was 70.5 (s.d.=8.8) and was improved at 6 months (intervention group=6.8 point increase vs usual care=3.1, P =0.09). Intervention group participants achieved greater reductions in percent of energy from total fat (-4.2% vs -1.2%; P =0.013) and saturated fat (-2.2% vs -1.1%; P =0.003), and greater increases in fiber (4.8 g per 1000 kcal vs 1.3 g per 1000 kcal; P =0.007) and fruit (0.5 servings vs 0.0 servings; P =0.006) intake. Intervention group participants who lost ⩾5% body weight ( n =27) demonstrated significantly greater improvements in HEI score (10.4 vs 2.8) than those who lost <5% ( n =23). The intervention increased fruit and fiber intake and decreased percent energy from fat, and those with greater weight loss achieved greater increases in overall diet quality. These findings support the ability of a weight loss intervention to improve diet among breast cancer survivors.

Using self-determination theory to promote physical activity and weight control: a randomized controlled trial in women.

PubMed

Silva, Marlene N; Vieira, Paulo N; Coutinho, Sílvia R; Minderico, Cláudia S; Matos, Margarida G; Sardinha, Luís B; Teixeira, Pedro J

2010-04-01

Behavior change interventions are effective to the extent that they affect appropriately-measured outcomes, especially in experimental controlled trials. The primary goal of this study was to analyze the impact of a 1-year weight management intervention based on self-determination theory (SDT) on theory-based psychosocial mediators, physical activity/exercise, and body weight and composition. Participants were 239 women (37.6 +/- 7.1 years; 31.5 +/- 4.1 kg/m(2)) who received either an intervention focused on promoting autonomous forms of exercise regulation and intrinsic motivation, or a general health education program (controls). At 12 months, the intervention group showed increased weight loss (-7.29%,) and higher levels of physical activity/exercise (+138 +/- 26 min/day of moderate plus vigorous exercise; +2,049 +/- 571 steps/day), compared to controls (P < 0.001). Main intervention targets such as more autonomous self-regulation (for treatment and for exercise) and a more autonomous perceived treatment climate revealed large effect sizes (between 0.80 and .96), favoring intervention (P < 0.001). Results suggest that interventions grounded in SDT can be successfully implemented in the context of weight management, enhancing the internalization of more autonomous forms of behavioral regulation, and facilitating exercise adherence, while producing clinically-significant weight reduction, when compared to a control condition. Findings are fully consistent with previous studies conducted within this theoretical framework in other areas of health behavior change.

Daughters and Mothers Against Breast Cancer (DAMES): Main outcomes of a randomized controlled trial of weight loss in overweight mothers with breast cancer and their overweight daughters

PubMed Central

Demark-Wahnefried, Wendy; Jones, Lee W; Snyder, Denise C; Sloane, Richard J; Kimmick, Gretchen G; Hughes, Daniel C; Badr, Hoda J; Miller, Paige E; Burke, Lora E; Lipkus, Isaac M

2014-01-01

BACKGROUND Few studies to date have used the cancer diagnosis as a teachable moment to promote healthy behavior changes in survivors of cancer and their family members. Given the role of obesity in the primary and tertiary prevention of breast cancer, the authors explored the feasibility of a mother-daughter weight loss intervention. METHODS A randomized controlled trial of a mailed weight loss intervention was undertaken among 68 mother-daughter dyads (n = 136), each comprised of a survivor of breast cancer (AJCC stage 0-III) and her adult biological daughter. All women had body mass indices ≥ 25 kg/m2 and underwent in-person assessments at baseline, 6 months, and 12 months, with accelerometry and exercise capacity performed on a subset of individuals. All women received a personalized workbook and 6 newsletters over a 1-year period that promoted weight loss; exercise; and a nutrient-rich, low-energy density diet. A total of 25 dyads received individually tailored instruction (INDIVIDUAL), 25 dyads received team-tailored instruction (TEAM), and 18 dyads received standardized brochures (CONTROL). RESULTS The trial met its accrual target, experienced 90% retention, and caused no serious adverse events. Significant differences in baseline to 12-month changes were observed between INDIVIDUAL versus CONTROL mothers for body mass index, weight, and waist circumference (WC); significant differences also were observed in the WC of corresponding daughters (P < .05). Significant differences were found between INDIVIDUAL versus CONTROL and TEAM versus CONTROL dyads for WC (P = .0002 and .018, respectively), minutes per week of physical activity (P = .031 and .036, respectively), and exercise capacity (P = .047 for both). CONCLUSIONS Significant improvements in lifestyle behaviors and health outcomes are possible with tailored print interventions directed toward survivors of cancer and their family members. For greater impact, more research is needed to expand this work beyond the mother-daughter dyad. Cancer 2014;120:2522–2534. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. Obesity is a major risk factor for the incidence and mortality of several cancers. The results of this randomized controlled trial of weight loss among 136 women diagnosed with breast cancer and their biological daughters suggests that the diagnosis of cancer can be used to motivate healthy diet and exercise behaviors among survivors of cancer and their family members using mailed print interventions. PMID:24804802

Behaviors and motivations for weight loss in children and adolescents.

PubMed

Brown, Callie Lambert; Skelton, Joseph A; Perrin, Eliana M; Skinner, Asheley Cockrell

2016-02-01

To examine the association between weight loss behaviors and motivations for weight loss in children and adolescents and the association of weight status with these behaviors and motivations in a nationally representative sample. Data from the National Health and Nutrition Examination Survey (NHANES) was examined, focusing on children in the United States aged 8-15 years, in repeated cross-sections from 2005 to 2011. Half of participants (N = 6,117) reported attempting to lose weight, and children with obesity attempted to lose weight more frequently (76%) than children who were a healthy weight (15%). Children reported attempting to lose weight by both healthy and unhealthy means: "exercising" (92%), "eating less sweets or fatty foods" (84%), "skipping meals" (35%), and "starving" (18%). The motivation to be better at sports was more likely to be associated with attempting weight loss through healthy behaviors, whereas children motivated by teasing were more likely to engage in unhealthy behaviors. Motivations for losing weight differed by weight status. Many children and adolescents attempt to lose weight, using either or both healthy and unhealthy behaviors, and behaviors differed based on motivations for weight loss. Future research should examine how physicians, parents, and teachers can inspire healthy behavior changes. © 2015 The Obesity Society.

Lifestyle interventions targeting body weight changes during the menopause transition: a systematic review.

PubMed

Jull, Janet; Stacey, Dawn; Beach, Sarah; Dumas, Alex; Strychar, Irene; Ufholz, Lee-Anne; Prince, Stephanie; Abdulnour, Joseph; Prud'homme, Denis

2014-01-01

To determine the effectiveness of exercise and/or nutrition interventions and to address body weight changes during the menopause transition. A systematic review of the literature was conducted using electronic databases, grey literature, and hand searching. Two independent researchers screened for studies using experimental designs to evaluate the impact of exercise and/or nutrition interventions on body weight and/or central weight gain performed during the menopausal transition. Studies were quality appraised using Cochrane risk of bias. Included studies were analyzed descriptively. Of 3,564 unique citations screened, 3 studies were eligible (2 randomized controlled trials, and 1 pre/post study). Study quality ranged from low to high risk of bias. One randomized controlled trial with lower risk of bias concluded that participation in an exercise program combined with dietary interventions might mitigate body adiposity increases, which is normally observed during the menopause transition. The other two studies with higher risk of bias suggested that exercise might attenuate weight loss or weight gain and change abdominal adiposity patterns. High quality studies evaluating the effectiveness of interventions targeting body weight changes in women during their menopause transition are needed. Evidence from one higher quality study indicates an effective multifaceted intervention for women to minimize changes in body adiposity.

Lifestyle Interventions Targeting Body Weight Changes during the Menopause Transition: A Systematic Review

PubMed Central

Jull, Janet; Stacey, Dawn; Beach, Sarah; Dumas, Alex; Strychar, Irene; Ufholz, Lee-Anne; Prince, Stephanie; Abdulnour, Joseph; Prud'homme, Denis

2014-01-01

Objective. To determine the effectiveness of exercise and/or nutrition interventions and to address body weight changes during the menopause transition. Methods. A systematic review of the literature was conducted using electronic databases, grey literature, and hand searching. Two independent researchers screened for studies using experimental designs to evaluate the impact of exercise and/or nutrition interventions on body weight and/or central weight gain performed during the menopausal transition. Studies were quality appraised using Cochrane risk of bias. Included studies were analyzed descriptively. Results. Of 3,564 unique citations screened, 3 studies were eligible (2 randomized controlled trials, and 1 pre/post study). Study quality ranged from low to high risk of bias. One randomized controlled trial with lower risk of bias concluded that participation in an exercise program combined with dietary interventions might mitigate body adiposity increases, which is normally observed during the menopause transition. The other two studies with higher risk of bias suggested that exercise might attenuate weight loss or weight gain and change abdominal adiposity patterns. Conclusions. High quality studies evaluating the effectiveness of interventions targeting body weight changes in women during their menopause transition are needed. Evidence from one higher quality study indicates an effective multifaceted intervention for women to minimize changes in body adiposity. PMID:24971172

Determinants of high and low attendance to diet and exercise interventions among overweight and obese older adults. Results from the arthritis, diet, and activity promotion trial.

PubMed

van Gool, Coen H; Penninx, Brenda W J H; Kempen, Gertrudis I J M; Miller, Gary D; van Eijk, Jacques Th M; Pahor, Marco; Messier, Stephen P

2006-06-01

Determinants of adherence to lifestyle regimens are ill understood. Attendance to intervention sessions is crucial for patients to acquire knowledge and skills regarding the core elements of an intervention. Therefore, we explored demographic, health-related, and social determinants of high and low attendance to diet and exercise sessions among overweight and obese patients with knee osteoarthritis (> or = 60 years; N = 206). The Arthritis, Diet, and Activity Promotion Trial was an 18-month randomized controlled trial on the effectiveness of dietary weight loss and exercise interventions. We conducted chi-square and t-tests, and logistic regression analyses on categories of short- and long-term attendance to intervention sessions. Over the 18-month duration of the study, 60.7% (+/- 28.5) of diet sessions, and 53.2% (+/- 29.0) of exercise sessions were attended. Not being married, low social participation, and single intervention randomization predicted high attendance to diet sessions during months 1-4. Exercising at home, and single intervention randomization predicted high attendance to exercise sessions during months 5-18. High attendance to sessions early in the intervention was a significant determinant of high session attendance thereafter. Offering people a choice where to exercise, and stimulating early intervention session attendance can be effective in improving long-term attendance to both interventions. Several determinants we found may be amenable to change to enhance intervention adherence of future randomized controlled trials involving dietary weight loss and/or physical exercise.

High intensity interval training improves liver and adipose tissue insulin sensitivity.

PubMed

Marcinko, Katarina; Sikkema, Sarah R; Samaan, M Constantine; Kemp, Bruce E; Fullerton, Morgan D; Steinberg, Gregory R

2015-12-01

Endurance exercise training reduces insulin resistance, adipose tissue inflammation and non-alcoholic fatty liver disease (NAFLD), an effect often associated with modest weight loss. Recent studies have indicated that high-intensity interval training (HIIT) lowers blood glucose in individuals with type 2 diabetes independently of weight loss; however, the organs affected and mechanisms mediating the glucose lowering effects are not known. Intense exercise increases phosphorylation and inhibition of acetyl-CoA carboxylase (ACC) by AMP-activated protein kinase (AMPK) in muscle, adipose tissue and liver. AMPK and ACC are key enzymes regulating fatty acid metabolism, liver fat content, adipose tissue inflammation and insulin sensitivity but the importance of this pathway in regulating insulin sensitivity with HIIT is unknown. In the current study, the effects of 6 weeks of HIIT were examined using obese mice with serine-alanine knock-in mutations on the AMPK phosphorylation sites of ACC1 and ACC2 (AccDKI) or wild-type (WT) controls. HIIT lowered blood glucose and increased exercise capacity, food intake, basal activity levels, carbohydrate oxidation and liver and adipose tissue insulin sensitivity in HFD-fed WT and AccDKI mice. These changes occurred independently of weight loss or reductions in adiposity, inflammation and liver lipid content. These data indicate that HIIT lowers blood glucose levels by improving adipose and liver insulin sensitivity independently of changes in adiposity, adipose tissue inflammation, liver lipid content or AMPK phosphorylation of ACC.

Gender Differences in Exercise Habits and Quality of Life Reports: Assessing the Moderating Effects of Reasons for Exercise

PubMed Central

Craft, Baine B.; Carroll, Haley A.; Lustyk, M. Kathleen B.

2016-01-01

Men and women report different exercise habits and reasons for exercise. Given that quality of life is affected by exercise habits and reasons for exercise, the present study explored gender differences among these variables. Participants reported quality of life, exercise habits, and motives. Results revealed that women (n = 108) reported significantly higher exercise and quality of life levels than men (n = 72). Women reported exercising for weight loss and toning more than men, whereas men reported exercising for enjoyment more than women. Reasons for exercise predicted quality of life for women over exercise. For men, exercise was the best predictor of quality of life. Ultimately, exercise is not beneficial for a woman's quality of life under all conditions. PMID:27668243

African american women, hair care, and health barriers.

PubMed

Gathers, Raechele Cochran; Mahan, Meredith Grace

2014-09-01

The objective of this study was to elucidate the prevalence of hair loss among African American women; explore the psychosocial impact of hair grooming difficulties; and examine both perceptions related to physician encounters in this group and the relationship between hair grooming, physical activity, and weight maintenance. An anonymous retrospective and qualitative survey, the Hair Care Assessment Survey, is an 18-question novel survey instrument designed at the Henry Ford Hospital Department of Dermatology Multicultural Dermatology Center. The Hair Care Assessment Survey was distributed at church-related functions at predominantly African American metropolitan Detroit churches. Two hundred African American women from metropolitan Detroit, Michigan, aged 21 to 83. The Hair Care Assessment Survey collected data relating to hair loss and hair care, psychosocial experiences relating to hair loss, and hair care as it relates to exercise and body weight management. Data was collected on doctor-patient hair-related medical visits and experiences with commercially available ethnic hair care products. More than 50 percent reported excessive hair loss. Twenty-eight percent had visited a physician to discuss hair issues, but only 32 percent felt their physician understood African American hair. Forty-five percent reported avoiding exercise because of hair concerns, and 22 percent felt that their hair impeded maintaining healthy body weight. Hair loss affects a compelling number of African American women, and a significant number express dissatisfaction in hair-related physician encounters. Additionally, hair styling problems present a serious impediment to physical activity and weight management among this already high-risk population.

Atorvastatin

MedlinePlus

Atorvastatin is used together with diet, weight loss, and exercise to reduce the risk of heart attack ... who are at risk of developing heart disease. Atorvastatin is also used to decrease the amount of ...

Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance.

PubMed

Rodriguez, Nancy R; DiMarco, Nancy M; Langley, Susie

2009-03-01

It is the position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine that physical activity, athletic performance, and recovery from exercise are enhanced by optimal nutrition. These organizations recommend appropriate selection of foods and fluids, timing of intake, and supplement choices for optimal health and exercise performance. This updated position paper couples a rigorous, systematic, evidence-based analysis of nutrition and performance-specific literature with current scientific data related to energy needs, assessment of body composition, strategies for weight change, nutrient and fluid needs, special nutrient needs during training and competition, the use of supplements and ergogenic aids, nutrition recommendations for vegetarian athletes, and the roles and responsibilities of sports dietitians. Energy and macronutrient needs, especially carbohydrate and protein, must be met during times of high physical activity to maintain body weight, replenish glycogen stores, and provide adequate protein to build and repair tissue. Fat intake should be sufficient to provide the essential fatty acids and fat-soluble vitamins, as well as contribute energy for weight maintenance. Although exercise performance can be affected by body weight and composition, these physical measures should not be a criterion for sports performance and daily weigh-ins are discouraged. Adequate food and fluid should be consumed before, during, and after exercise to help maintain blood glucose concentration during exercise, maximize exercise performance, and improve recovery time. Athletes should be well hydrated before exercise and drink enough fluid during and after exercise to balance fluid losses. Sports beverages containing carbohydrates and electrolytes may be consumed before, during, and after exercise to help maintain blood glucose concentration, provide fuel for muscles, and decrease risk of dehydration and hyponatremia. Vitamin and mineral supplements are not needed if adequate energy to maintain body weight is consumed from a variety of foods. However, athletes who restrict energy intake, use severe weight-loss practices, eliminate one or more food groups from their diet, or consume unbalanced diets with low micronutrient density, may require supplements. Because regulations specific to nutritional ergogenic aids are poorly enforced, they should be used with caution, and only after careful product evaluation for safety, efficacy, potency, and legality. A qualified sports dietitian and in particular in the United States, a Board Certified Specialist in Sports Dietetics, should provide individualized nutrition direction and advice subsequent to a comprehensive nutrition assessment.

Piloting a multidisciplinary clinic for the management of non-alcoholic fatty liver disease: initial 5-year experience

PubMed Central

Cobbold, Jeremy F L; Raveendran, Sarrah; Peake, Christopher M; Anstee, Quentin M; Yee, Michael S; Thursz, Mark R

2013-01-01

Objective A multidisciplinary approach is advocated for the management of Non-Alcoholic Fatty Liver Disease (NAFLD), but few clinical data exist to support this. The objective of this study was to investigate the effectiveness of a multidisciplinary NAFLD clinic using surrogate markers of liver injury and cardiovascular risk. Design Retrospective survey of clinical practice. Setting The multidisciplinary NAFLD clinic in a secondary/tertiary care setting with hepatology, diabetology, dietetic and exercise therapy input: initial 5-years’ experience (2007–2012). Patients 180 patients with NAFLD but without hepatic comorbidities were followed up for a median of 19.5 (range 3–57) months. 52% had type 2 diabetes mellitus, 48% were Europoid Caucasian, 17% were South Asian. Interventions Multiple clinical interventions were employed including lifestyle (diet and exercise) advice, pharmacological intervention for cardiovascular risk factors, weight loss and exercise therapy. Main outcome measures Change in alanine aminotransferase (ALT), weight, HbA1c, lipid profile and blood pressure. Results Median ALT fell from 61 (12–270) U/l to 50 (11–221) U/l, −18%, p<0.001, and weight fell from 90.5 (42.7–175.0) kg to 87.3 (45.9–175.3) kg, −3.5%, p<0.001. There were significant improvements in total cholesterol overall, triglycerides (among dyslipidaemic patients), HbA1c (among diabetic patients) and systolic blood pressure (among hypertensive patients). 24% of patients achieved ≥7% weight loss during follow-up and 17% maintained this weight loss throughout. Conclusions Improvement in liver biochemistry and cardiovascular risk factors was seen in patients attending the multidisciplinary NAFLD clinic. Refinement of this approach is warranted in light of these data, novel therapies and a growing evidence base. PMID:28839736

Expression of ghrelin gene in peripheral blood mononuclear cells and plasma ghrelin concentrations in patients with metabolic syndrome.

PubMed

Mager, Ursula; Kolehmainen, Marjukka; de Mello, Vanessa D F; Schwab, Ursula; Laaksonen, David E; Rauramaa, Rainer; Gylling, Helena; Atalay, Mustafa; Pulkkinen, Leena; Uusitupa, Matti

2008-04-01

We examined the expression of ghrelin and ghrelin receptors in peripheral blood mononuclear cells (PBMCs) and evaluated the effect of weight loss or exercise on plasma ghrelin concentrations in subjects with the metabolic syndrome. Data from 75 overweight/obese subjects randomized to a weight loss, aerobic exercise, resistance exercise or control group for a 33-week intervention period were analysed. The plasma ghrelin concentrations and indices of insulin and glucose metabolism were assessed, and mRNA expression of ghrelin, its receptors and various cytokines in PBMCs was studied using real-time PCR. Ghrelin and GH secretagogue receptor 1b were expressed in PBMCs of subjects with metabolic syndrome. Ghrelin gene expression correlated positively with the expressions of tumour necrosis factor-alpha (P<0.001), interleukin-1beta (P<0.001) and interleukin-6 (P=0.026) during the study, but was not associated with the plasma ghrelin concentration. Genotype-specific ghrelin gene expression in PBMCs was found for the -604G/A and the -501A/C polymorphisms in the ghrelin gene. At baseline, the plasma ghrelin levels were associated with fasting serum insulin concentrations, insulin sensitivity index and high-density lipoprotein cholesterol. However, longitudinally weight, BMI or waist circumference and acute insulin response in i.v. glucose tolerance test were stronger predictors of the ghrelin concentration. Plasma ghrelin did not change over the study period in the weight reduction group, but it tended to decrease in the control group (P=0.050). Ghrelin mRNA expression in PBMCs suggests an autocrine role for ghrelin within an immune microenvironment. Moderate long-term weight loss may prevent a decline in ghrelin concentration over time in individuals with metabolic syndrome.

Design of the SHAPE-2 study: the effect of physical activity, in addition to weight loss, on biomarkers of postmenopausal breast cancer risk.

PubMed

van Gemert, Willemijn A M; Iestra, Jolein I; Schuit, Albertine J; May, Anne M; Takken, Tim; Veldhuis, Wouter B; van der Palen, Job; Wittink, Harriët; Peeters, Petra H M; Monninkhof, Evelyn M

2013-08-23

Physical inactivity and overweight are two known risk factors for postmenopausal breast cancer. Former exercise intervention studies showed that physical activity influences sex hormone levels, known to be related to postmenopausal breast cancer, mainly when concordant loss of body weight was achieved. The question remains whether there is an additional beneficial effect of physical activity when weight loss is reached. The SHAPE-2 study is a three-armed, multicentre trial. 243 sedentary, postmenopausal women who are overweight or obese (BMI 25-35 kg/m2) are enrolled. After a 4-6 week run-in period, wherein a baseline diet is prescribed, women are randomly allocated to (1) a diet group, (2) an exercise group or (3) a control group. The aim of both intervention groups is to lose an amount of 5-6 kg body weight in 10-14 weeks. The diet group follows an energy restricted diet and maintains the habitual physical activity level. The exercise group participates in a 16-week endurance and strength training programme of 4 hours per week. Furthermore, they are prescribed a moderate caloric restriction. The control group is asked to maintain body weight and continue the run-in baseline diet. This study will give insight in the potential attributable effect of physical activity on breast cancer risk biomarkers and whether this effect is mediated by changes in body composition, in postmenopausal women. Eventually this may lead to the design of specific lifestyle guidelines for prevention of breast cancer. The SHAPE-2 study is registered in the register of clinicaltrials.gov, Identifier: NCT01511276.

Physical exercise in overweight to obese individuals induces metabolic- and neurotrophic-related structural brain plasticity

PubMed Central

Mueller, Karsten; Möller, Harald E.; Horstmann, Annette; Busse, Franziska; Lepsien, Jöran; Blüher, Matthias; Stumvoll, Michael; Villringer, Arno; Pleger, Burkhard

2015-01-01

Previous cross-sectional studies on body-weight-related alterations in brain structure revealed profound changes in the gray matter (GM) and white matter (WM) that resemble findings obtained from individuals with advancing age. This suggests that obesity may lead to structural brain changes that are comparable with brain aging. Here, we asked whether weight-loss-dependent improved metabolic and neurotrophic functioning parallels the reversal of obesity-related alterations in brain structure. To this end we applied magnetic resonance imaging (MRI) together with voxel-based morphometry and diffusion-tensor imaging in overweight to obese individuals who participated in a fitness course with intensive physical training twice a week over a period of 3 months. After the fitness course, participants presented, with inter-individual heterogeneity, a reduced body mass index (BMI), reduced serum leptin concentrations, elevated high-density lipoprotein-cholesterol (HDL-C), and alterations of serum brain-derived neurotrophic factor (BDNF) concentrations suggesting changes of metabolic and neurotrophic function. Exercise-dependent changes in BMI and serum concentration of BDNF, leptin, and HDL-C were related to an increase in GM density in the left hippocampus, the insular cortex, and the left cerebellar lobule. We also observed exercise-dependent changes of diffusivity parameters in surrounding WM structures as well as in the corpus callosum. These findings suggest that weight-loss due to physical exercise in overweight to obese participants induces profound structural brain plasticity, not primarily of sensorimotor brain regions involved in physical exercise, but of regions previously reported to be structurally affected by an increased body weight and functionally implemented in gustation and cognitive processing. PMID:26190989

Zinc-α2-glycoprotein expression in adipose tissue of obese postmenopausal women before and after weight loss and exercise + weight loss.

PubMed

Ge, Shealinna; Ryan, Alice S

2014-08-01

Zinc-Alpha 2-Glycoprotein (ZAG) has recently been implicated in the regulation of adipose tissue metabolism due to its negative association with obesity and insulin resistance. The purpose of this study is to investigate the relationships between adipose tissue ZAG expression and central obesity, and the effects of six-months of weight loss (WL) or aerobic exercise + weight loss (AEX + WL) on ZAG expression. A six-month, longitudinal study of 33 healthy, overweight or obese postmenopausal women (BMI: 25-46 kg/m(2)) was conducted. Abdominal and gluteal adipose tissue samples were obtained before and after AEX + WL (n = 17) and WL (n = 16). ZAG expression was determined by RT-PCR. Prior to interventions, abdominal ZAG expression was negatively correlated with visceral fat (r = -0.50, P < 0.005), sagittal diameter (r = -0.42, P < 0.05), and positively related to VO(2)max (r = 0.37, P < 0.05). Gluteal ZAG expression was negatively correlated with weight, fat-free mass, visceral fat, resting metabolic rate, and fasting insulin (r = -0.39 to -0.50, all P < 0.05). Abdominal ZAG mRNA levels increased, though not significantly, 5% after AEX + WL and 11% after WL. Gluteal ZAG mRNA levels also did not change significantly with AEX + WL and WL. Abdominal ZAG expression may be important in central fat accumulation and fitness but only modestly increase (nonsignificantly) with weight reduction alone or with aerobic training in obese postmenopausal women. Published by Elsevier Inc.

Barriers to Recruitment and Adherence in a Randomized Controlled Diet and Exercise Weight Loss Intervention Among Minority Breast Cancer Survivors.

PubMed

Aycinena, A Corina; Valdovinos, Cristina; Crew, Katherine D; Tsai, Wei Yann; Mata, Jennie M; Sandoval, Rossy; Hershman, Dawn; Greenlee, Heather

2017-02-01

Minority recruitment to cancer trials is low and there are limited data on minority adherence to lifestyle modification interventions. We examined factors related to recruitment and adherence to a pilot weight loss intervention among Hispanic and black breast cancer survivors. Participants completed a detailed screening interview to assess barriers to enrollment. An index was created to assess adherence at 6 months. 112 potentially eligible women were identified; 66 consented and completed a screening interview. After screening, 9 were ineligible; 15 opted to not enroll; and 42 were randomized. Among eligible women, earlier stage at diagnosis, treatment type, and negative beliefs related to exercise and diet after diagnosis were negatively associated with study enrollment (P < 0.05). Self-reported barriers to adherence included fatigue, family responsibilities, illness, work, transportation, and negative perceptions of exercise and diet. Results from this study emphasize the need to adapt recruitment and adherence strategies to address these factors.

Impact of high- and low-intensity targeted exercise training on the type of substrate utilization in obese boys submitted to a hypocaloric diet.

PubMed

Brandou, F; Savy-Pacaux, A M; Marie, J; Bauloz, M; Maret-Fleuret, I; Borrocoso, S; Mercier, J; Brun, J F

2005-09-01

We assessed the effect of two programs combining a hypocaloric diet with low-intensity (LI) or high-intensity (HI) exercise training, during two months, on substrate utilization at exercise in obese children. Fifteen obese boys participated in a combined program of exercise and caloric restriction-induced weight loss (diet starting two weeks before the training program). The maximal fat oxidation point (Lipox max) was determined to individualize exercise training. Training consisted of cycling at either LI (Lipox max) for seven children or HI (Lipoxmax+40% Lipox max) for eight children. All children exhibited a decrease in weight (LI: -5.2 kg +/- 0.7 (P<0.01), HI: -7 kg +/- 0.7 (P<0.01)). While in the LI group, both fat and CHO oxidation were unchanged after training, HI group oxidize less fat and more CHO after training when exercising at 20% and 30% Wmax th (P = 0.02). While a LI exercise training program maintains (but does not improve) the ability to oxidize fat at exercise, HI training actually shifts towards CHO the balance of substrate oxidation during exercise. Thus, a low intensity training protocol seems to counteract to some extent the decline in lipid oxidation at exercise that occurs after a hypocaloric diet, and is thus likely to be synergistic to diet in the weight lowering strategy.

The Role of Nutrition in the Changes in Bone and Calcium Metabolism During Space Flight

NASA Technical Reports Server (NTRS)

Morey-Holton, Emily R.; Arnaud, Sara B.

1995-01-01

On Earth, the primary purpose of the skeleton is provide structural support for the body. In space, the support function of the skeleton is reduced since, without gravity, structures have only mass and no weight. The adaptation to space flight is manifested by shifts in mineral distribution, altered bone turnover, and regional mineral deficits in weight-bearing bones. The shifts in mineral distribution appear to be related to the cephalic fluid shift. The redistribution of mineral from one bone to another or to and from areas in the same bone in response to alterations in gravitational loads is more likely to affect skeletal function than quantitative whole body losses and gains. The changes in bone turnover appear dependent upon changes in body weight with weight loss tending to increase bone resorption as well as decrease bone formation. During bedrest, the bone response to unloading varies depending upon the routine activity level of the subjects with more active subjects showing a greater suppression of bone formation in the iliac crest with inactivity. Changes in body composition during space flight are predicted by bedrest studies on Earth which show loss of lean body mass and increase tn body fat in adult males after one month. In ambulatory studies on Earth, exercising adult males of the same age, height, g weight, body mass index, and shoe size show significantly higher whole body mineral and lean body mass. than non-exercising subjects. Nutritional preference appears to change with activity level. Diet histories in exercisers and nonexercisers who maintain identical body weights show no differences in nutrients except for slightly higher carbohydrate intake in the exercisers. The absence of differences in dietary calcium in men with higher total body calcium is noteworthy. In this situation, the increased bone mineral content was facilitated by the calcium endocrine system. This regulatory system can be by-passed by raising dietary calcium. Increased calcium intake can increase the calcium content in normally loaded bone. However, bone with a higher calcium content still decreases proportionally to normal bone during unloading. Nutritional requirements in space should be reevaluated with respect to these adaptive changes to loading and physical activity.

Perceived adherence to prescribed or recommended standards of care among adults with diabetes.

PubMed

Jorgensen, Wendy A; Polivka, Barbara J; Lennie, Terry A

2002-01-01

Adults with diabetes were surveyed to determine the extent to which respondents perceived specific preventive regimens (diet, exercise, weight control, and education) had been prescribed or recommended, adhered to their prescribed regimens, and identified barriers to nonadherence. Surveys were mailed to 2 samples of adults diagnosed with diabetes. The clinic sample was from health department clinics (n = 264); the agency sample was from a nonprofit agency serving people with diabetes (n = 111). Of the 4 preventive measures under investigation, diet plans and weight reduction were perceived as most commonly recommended by health professionals; exercise schedules were the least commonly recommended. Diabetes self-management education was reportedly recommended more often among the agency sample. In terms of adherence, approximately half of both samples were able to lose weight. A smaller portion of the clinic sample was able to get needed foods and exercise, and maintain weight loss. The most frequently cited reasons for nonadherence were cost, transportation, and other health conditions. Improvement in the implementation of preventive behaviors is needed, particularly exercise schedules. Barriers to care, such as costs and transportation, may need special consideration.

An 8-week web-based weight loss challenge with celebrity endorsement and enhanced social support: observational study.

PubMed

Hutchesson, Melinda J; Collins, Clare E; Morgan, Philip J; Callister, Robin

2013-07-04

Initial engagement and weight loss within Web-based weight loss programs may predict long-term success. The integration of persuasive Web-based features may boost engagement and therefore weight loss. To determine whether an 8-week challenge within a commercial Web-based weight loss program influenced weight loss, website use, and attrition in the short term, when compared to the standard program. De-identified data for participants (mean age 36.7±10.3 years; 86% female) who enrolled in the Biggest Loser Club (BLC) (n=952) and the BLC's Shannan Ponton Fast Track Challenge (SC) for 8 weeks (n=381) were compared. The BLC program used standard evidence-based website features, with individualized calorie and exercise targets to facilitate a weight loss of 0.5-1 kg per week (-500kcal/day less than estimated energy expenditure). SC used the same website features but in addition promoted greater initial weight loss using a 1200 kcal/day energy intake target and physical activity energy expenditure of 600 kcal/day. SC used persuasive features to facilitate greater user engagement, including offering additional opportunities for social support (eg, webinar meetings with a celebrity personal trainer and social networking) endorsed by a celebrity personal trainer. Self-reported weekly weight records were used to determine weight change after 8 weeks. A primary analysis was undertaken using a generalized linear mixed model (GLMM) with all available weight records for all participants included. Dropout (participants who cancelled their subscription) and nonusage (participants who stopped using the Web-based features) attrition rates at 8 weeks were calculated. The number of participants who accessed each website feature and the total number of days each feature was used were calculated. The difference between attrition rates and website use for the two programs were tested using chi-square and Wilcoxon Rank Sum tests, respectively. Using GLMM, including weight data for all participants, there was significantly greater (P=.03) 8-week weight loss in SC (-5.1 kg [-5.5 to -4.6 kg] or -6.0%) compared to BLC participants (-4.5 kg [-4.8, -4.2] or -5.0%). Dropout rates were low and consistent across groups (BLC: 17 (1.8%) vs SC: 2 (0.5%), P=.08) and 48.7% (456/936) of BLC and 51.2% (184/379) of SC participants accessed the website at 8 weeks, with no difference between programs (P=.48). SC participants accessed the discussion forums, menu plans, exercise plans, and educational materials significantly more than BLC participants (P<.05). Using a short-term challenge with persuasive features, including online social support with endorsement by a celebrity personal trainer, as well as a greater energy balance deficit, within a commercial Web-based weight loss program may facilitate greater initial weight loss and engagement with some program components. The results support the need for a more rigorous and prospective evaluation of Web-based weight loss programs that incorporate additional strategies to enhance initial weight loss and engagement, such as a short-term challenge.

An 8-Week Web-Based Weight Loss Challenge With Celebrity Endorsement and Enhanced Social Support: Observational Study

PubMed Central

Collins, Clare E; Morgan, Philip J; Callister, Robin

2013-01-01

Background Initial engagement and weight loss within Web-based weight loss programs may predict long-term success. The integration of persuasive Web-based features may boost engagement and therefore weight loss. Objective To determine whether an 8-week challenge within a commercial Web-based weight loss program influenced weight loss, website use, and attrition in the short term, when compared to the standard program. Methods De-identified data for participants (mean age 36.7±10.3 years; 86% female) who enrolled in the Biggest Loser Club (BLC) (n=952) and the BLC’s Shannan Ponton Fast Track Challenge (SC) for 8 weeks (n=381) were compared. The BLC program used standard evidence-based website features, with individualized calorie and exercise targets to facilitate a weight loss of 0.5-1 kg per week (–500kcal/day less than estimated energy expenditure). SC used the same website features but in addition promoted greater initial weight loss using a 1200 kcal/day energy intake target and physical activity energy expenditure of 600 kcal/day. SC used persuasive features to facilitate greater user engagement, including offering additional opportunities for social support (eg, webinar meetings with a celebrity personal trainer and social networking) endorsed by a celebrity personal trainer. Self-reported weekly weight records were used to determine weight change after 8 weeks. A primary analysis was undertaken using a generalized linear mixed model (GLMM) with all available weight records for all participants included. Dropout (participants who cancelled their subscription) and nonusage (participants who stopped using the Web-based features) attrition rates at 8 weeks were calculated. The number of participants who accessed each website feature and the total number of days each feature was used were calculated. The difference between attrition rates and website use for the two programs were tested using chi-square and Wilcoxon Rank Sum tests, respectively. Results Using GLMM, including weight data for all participants, there was significantly greater (P=.03) 8-week weight loss in SC (–5.1 kg [–5.5 to –4.6 kg] or –6.0%) compared to BLC participants (–4.5 kg [–4.8, –4.2] or –5.0%). Dropout rates were low and consistent across groups (BLC: 17 (1.8%) vs SC: 2 (0.5%), P=.08) and 48.7% (456/936) of BLC and 51.2% (184/379) of SC participants accessed the website at 8 weeks, with no difference between programs (P=.48). SC participants accessed the discussion forums, menu plans, exercise plans, and educational materials significantly more than BLC participants (P<.05). Conclusions Using a short-term challenge with persuasive features, including online social support with endorsement by a celebrity personal trainer, as well as a greater energy balance deficit, within a commercial Web-based weight loss program may facilitate greater initial weight loss and engagement with some program components. The results support the need for a more rigorous and prospective evaluation of Web-based weight loss programs that incorporate additional strategies to enhance initial weight loss and engagement, such as a short-term challenge. PMID:23827796

A systematic review of the interrelation between diet- and surgery-induced weight loss and vitamin D status.

PubMed

Himbert, Caroline; Ose, Jennifer; Delphan, Mahmoud; Ulrich, Cornelia M

2017-02-01

Obesity is a major global health problem and has been associated with vitamin D deficiency. Intentional weight loss may alter vitamin D status and, conversely, vitamin D supplementation has been hypothesized to aid in weight loss. A systematic literature search in PubMed/Medline identified 3173 articles of which 37 studies (randomized controlled trials (RCT) [n=17], non-RCTs [n=20]) are summarized as effect of: (I) diet-induced weight loss on vitamin D status (n=7), (II) vitamin D supplementation on diet-induced weight loss (n=11), (III) surgery-induced weight loss on vitamin D status (n=15), and (IV) vitamin D supplementation after surgery-induced weight loss on vitamin D status (n=5). While all studies on the effect of diet-induced weight loss on vitamin D status have consistently reported increased vitamin D levels, the targeted percentage of weight loss that is necessary for an increase has varied between 5% and >10%. N=11 RCTs testing the effect of vitamin D supplementation observe that vitamin D supplementation does not result in increased weight loss, but may affect body fat loss. Vitamin D deficiency and subsequent hyperparathyroidism have been detected in post-surgery patients, and there is evidence that vitamin D supplementation improves these post-surgery complications. We review the current evidence addressing the role of vitamin D status and supplementation in diet- and surgery-induced weight loss. Subsequently, we highlight gaps in current research and suggest directions for future research including differences in vitamin D supplementation dosages, indoor vs. outdoor exercise, and the assessment of vitamin D status in different body pools. Published by Elsevier Inc.

What is the relationship between exercise and metabolic abnormalities? A review of the metabolic syndrome.

PubMed

Carroll, Sean; Dudfield, Mike

2004-01-01

Prevention of the metabolic syndrome and treatment of its main characteristics are now considered of utmost importance in order to combat the epidemic of type 2 diabetes mellitus and to reduce the increased risk of cardiovascular disease and all-cause mortality. Insulin resistance/hyperinsulinaemia are consistently linked with a clustering of multiple clinical and subclinical metabolic risk factors. It is now widely recognised that obesity (especially abdominal fat accumulation), hyperglycaemia, dyslipidaemia and hypertension are common metabolic traits that, concurrently, constitute the distinctive insulin resistance or metabolic syndrome. Cross-sectional and prospective data provide an emerging picture of associations of both physical activity habits and cardiorespiratory fitness with the metabolic syndrome. The metabolic syndrome, is a disorder that requires aggressive multi-factorial intervention. Recent treatment guidelines have emphasised the clinical utility of diagnosis and an important treatment role for 'therapeutic lifestyle change', incorporating moderate physical activity. Several previous narrative reviews have considered exercise training as an effective treatment for insulin resistance and other components of the syndrome. However, the evidence cited has been less consistent for exercise training effects on several metabolic syndrome variables, unless combined with appropriate dietary modifications to achieve weight loss. Recently published randomised controlled trial data concerning the effects of exercise training on separate metabolic syndrome traits are evaluated within this review. Novel systematic review and meta-analysis evidence is presented indicating that supervised, long-term, moderate to moderately vigorous intensity exercise training, in the absence of therapeutic weight loss, improves the dyslipidaemic profile by raising high density lipoprotein-cholesterol and lowering triglycerides in overweight and obese adults with characteristics of the metabolic syndrome. Lifestyle interventions, including exercise and dietary-induced weight loss may improve insulin resistance and glucose tolerance in obesity states and are highly effective in preventing or delaying the onset of type 2 diabetes in individuals with impaired glucose regulation. Randomised controlled trial evidence also indicates that exercise training decreases blood pressure in overweight/obese individuals with high normal blood pressure and hypertension. These evidence-based findings continue to support recommendations that supervised or partially supervised exercise training is an important initial adjunctive step in the treatment of individuals with the metabolic syndrome. Exercise training should be considered an essential part of 'therapeutic lifestyle change' and may concurrently improve insulin resistance and the entire cluster of metabolic risk factors. Copyright 2004 Adis Data Information BV

National survey on management of weight reduction in PCOS women in the United Kingdom.

PubMed

Sharma, Aarti; Walker, Dawn-Marie; Atiomo, William

2010-10-01

To identify the most commonly used methods for weight reduction in women with polycystic ovarian syndrome (PCOS) utilized by obstetricians and gynaecologists in the United Kingdom (UK). Permission was sought from the Royal College of Obstetricians and Gynaecologists (RCOG) to conduct an electronic survey of all consultants practising in the UK. The questionnaire was anonymous and an electronic link was sent via email to the 1140 consultants whose details were provided by the RCOG. A 27-item questionnaire was developed. The variables evaluated were first-line methods of weight reduction used, proportion of women with PCOS seen that were obese, whether the patients had tried other weight reduction methods before seeking help, the optimal dietary advice and optimal composition, the optimal duration and frequency of exercise suggested, BMI used for suggesting weight loss, percentage of women in whom weight loss worked, length of time allowed prior to suggesting another method, methods considered most effective by patients, use of metformin for weight loss, criteria used for prescribing metformin, first-line anti-obesity drugs preferred if any, second- and third-line methods used, referral to other specialists and criteria for referral for bariatric surgery. Responses were categorical and are reported as proportions. One hundred and seven (9.4%) consultants responded to the questionnaire. One hundred and four (97%) provided advice on diet and 101 (94%) advice on exercise as their first-line strategy for weight management. Fifty-one (47.7%) stated that they provided specific information on an optimal dietary intake, 53 (49.9%) on the optimal dietary composition and 61 (57%) on the optimal duration and frequency of exercise per week. The commonest second-line methods used were anti-obesity drugs and metformin and the most popular third-line management options were anti-obesity drugs and bariatric surgery. The results suggest that the information provided to women with PCOS on weight management is variable, and highlight the need for specific guidelines and further research on weight management in women with this condition. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Bone loss in Crohn's disease: exercise as a potential countermeasure.

PubMed

Lee, Naomi; Radford-Smith, Graham; Taaffe, Dennis R

2005-12-01

Crohn's disease (CD) is associated with a number of secondary conditions including osteoporosis, which increases the risk of bone fracture. The cause of metabolic bone disease in this population is believed to be multifactorial and may include the disease itself and associated inflammation, high-dose corticosteroid use, weight loss and malabsorption, a lack of exercise and physical activity, and an underlying genetic predisposition to bone loss. Reduced bone mineral density has been reported in between 5% to 80% of CD sufferers, although it is generally believed that approximately 40% of patients suffer from osteopenia and 15% from osteoporosis. Recent studies suggest a small but significantly increased risk of fracture compared with healthy controls and, perhaps, sufferers of other gastrointestinal disorders such as ulcerative colitis. The role of physical activity and exercise in the prevention and treatment of CD-related bone loss has received little attention, despite the benefits of specific exercises being well documented in healthy populations. This article reviews the prevalence of and risk factors for low bone mass in CD patients and examines various treatments for osteoporosis in these patients, with a particular focus on physical activity.

Effects of various forms of calcium on body weight and bone turnover markers in women participating in a weight loss program.

PubMed

Wagner, Ginger; Kindrick, Shirley; Hertzler, Steven; DiSilvestro, Robert A

2007-10-01

This study examined the effects of calcium intake on body weight, body fat, and markers of bone turnover in pre-menopausal adult women undergoing a 12 week weight loss program of diet and exercise. Subjects were prescribed a 12 week diet with a 500 Kcal restriction containing about 750 mg calcium/day, exercised 3 times/week, and were given either placebo capsules, capsules of calcium lactate or calcium phosphate (daily dose about 800 mg calcium), or low fat milk (daily dose about 800 mg calcium). Subjects completed and returned daily diet diaries weekly. Daily calcium intake in mg from diet records + supplement assignment was: 788 +/- 175 (placebo), 1698 +/- 210 (Ca lactate), 1566 +/- 250 (Ca phosphate), 1514 +/- 225 (milk)(no significant differences among the calcium and milk groups). Each group had statistically significant changes in body weight (p < 0.01), but there were no significant differences among groups for the weight loss: 5.8 +/- 0.8 kg (placebo), 4.1 +/- 0.7 kg (Ca lactate), 5.4 +/- 1.3 kg (Ca phosphate), 4.2 +/- 0.8 kg (milk). Body fat was changed significantly in each group (p < 0.01), with milk group showing a little less change than the other groups. Serum bone specific alkaline phophatase activity, a bone synthesis marker, increased similarly in all groups (p < 0.001 within groups, no significance for changes among groups). In contrast, the Ca lactate group, but not other groups, had a drop in urine values for alpha helical peptide, a bone resorption marker (p < 0.05). For the conditions of this study, increased calcium intake, by supplement or milk, did not enhance loss of body weight or fat, though calcium lactate supplementation lowered values for a marker of bone degradation.

A randomised trial comparing low-fat diets differing in carbohydrate and protein ratio, combined with regular moderate intensity exercise, on glycaemic control, cardiometabolic risk factors, food cravings, cognitive function and psychological wellbeing in adults with type 2 diabetes: Study protocol.

PubMed

Watson, Nerylee Ann; Dyer, Kathryn Ann; Buckley, Jonathan David; Brinkworth, Grant David; Coates, Alison Mary; Parfitt, Gaynor; Howe, Peter Ranald Charles; Noakes, Manny; Dye, Louise; Chadwick, Helen; Murphy, Karen Joy

2015-11-01

Hypocaloric low-fat diets, high in protein with moderate carbohydrate (HP) can enhance weight loss, improve glycaemic control and improve cardiometabolic health risk factors in type 2 diabetes mellitus (T2DM). However, it is unclear whether the metabolic benefits observed during weight loss are sustained during energy-balance and weight maintenance. Furthermore, there is a lack of evidence regarding the effect of HP diets on food cravings, cognitive function and psychological wellbeing in T2DM, despite carbohydrate food cravings, cognitive impairment and depression being associated with hyperglycaemia. Overweight/obese adults with T2DM were randomised to consume either a HP diet (n=32, ~32% protein, 33% carbohydrate, 30% fat) or a higher-carbohydrate diet (HC, n=29, ~22% protein, 51% carbohydrate, 22% fat) for 24 weeks with 30 min of moderate intensity exercise five days/week for the study duration. There were 2 phases: a 12 week weight loss phase followed by a 12 week weight maintenance phase. Primary outcome was glycaemic control (glycosylated haemoglobin; HbA1c). Secondary outcomes were cardiometabolic risk factors (body composition, fasting blood pressure, blood lipids, glucose, insulin and C-reactive protein), food cravings, cognitive function (memory; psychomotor and executive function and psychological well-being. Outcomes were measured at baseline and the end of each 12-week intervention phase. Data will be analysed as intention-to-treat using linear mixed effects models. This study will examine the effects of two dietary interventions on health outcomes in T2DM during weight loss and notably following weight maintenance where there is a paucity of evidence. Copyright © 2015. Published by Elsevier Inc.

National Athletic Trainers' Association Position Statement: Safe Weight Loss and Maintenance Practices in Sport and Exercise

PubMed Central

Turocy, Paula Sammarone; DePalma, Bernard F.; Horswill, Craig A.; Laquale, Kathleen M.; Martin, Thomas J.; Perry, Arlette C.; Somova, Marla J.; Utter, Alan C.

2011-01-01

Objective: To present athletic trainers with recommendations for safe weight loss and weight maintenance practices for athletes and active clients and to provide athletes, clients, coaches, and parents with safe guidelines that will allow athletes and clients to achieve and maintain weight and body composition goals. Background: Unsafe weight management practices can compromise athletic performance and negatively affect health. Athletes and clients often attempt to lose weight by not eating, limiting caloric or specific nutrients from the diet, engaging in pathogenic weight control behaviors, and restricting fluids. These people often respond to pressures of the sport or activity, coaches, peers, or parents by adopting negative body images and unsafe practices to maintain an ideal body composition for the activity. We provide athletic trainers with recommendations for safe weight loss and weight maintenance in sport and exercise. Although safe weight gain is also a concern for athletic trainers and their athletes and clients, that topic is outside the scope of this position statement. Recommendations: Athletic trainers are often the source of nutrition information for athletes and clients; therefore, they must have knowledge of proper nutrition, weight management practices, and methods to change body composition. Body composition assessments should be done in the most scientifically appropriate manner possible. Reasonable and individualized weight and body composition goals should be identified by appropriately trained health care personnel (eg, athletic trainers, registered dietitians, physicians). In keeping with the American Dietetics Association (ADA) preferred nomenclature, this document uses the terms registered dietitian or dietician when referring to a food and nutrition expert who has met the academic and professional requirements specified by the ADA's Commission on Accreditation for Dietetics Education. In some cases, a registered nutritionist may have equivalent credentials and be the commonly used term. All weight management and exercise protocols used to achieve these goals should be safe and based on the most current evidence. Athletes, clients, parents, and coaches should be educated on how to determine safe weight and body composition so that athletes and clients more safely achieve competitive weights that will meet sport and activity requirements while also allowing them to meet their energy and nutritional needs for optimal health and performance. PMID:21669104

Preferences and motivation for weight loss among knee replacement patients: implications for a patient-centered weight loss intervention.

PubMed

Pellegrini, Christine A; Ledford, Gwendolyn; Hoffman, Sara A; Chang, Rowland W; Cameron, Kenzie A

2017-08-01

Most knee replacement patients are overweight/obese, yet are commonly excluded from evidence-based weight loss programs due to mobility limitations and barriers faced around the time of surgery. The purpose of this study was to identify knee replacement patient preferences for weight loss programs and qualitatively understand previous motives for weight loss attempts as well as strategies used to facilitate behavior changes. Patients who were either scheduled to have knee replacement or had one recently completed within the last 3 months were recruited to participate. Patients completed a brief weight loss program preference questionnaire assessing preferred components of a weight loss program (i.e. self-monitoring, educational topics, program duration). Qualitative interviews were completed to identify motives for and strategies used during past weight loss attempts. All interviews were transcribed, de-identified, and analyzed using constant comparative analysis. Twenty patients (11 pre-operative and 9 post-operative) between 47 and 79 years completed the study (55% male, 90% White, and 85% with a BMI ≥25 kg/m 2 ). Patients reported a preference for a weight loss program that starts before surgery, is at least 6 months in duration, and focuses both on diet and exercise. The majority of patients preferred to have a telephone-based program and wanted to track diet and physical activity on a smartphone application. The most common motive for weight loss mentioned by patients related to physical appearance (including how clothing fit), followed by wanting to lose weight to improve knee symptoms or to prevent or delay knee replacement. Strategies that patients identified as helpful during weight loss attempts included joining a formal weight loss program, watching portion sizes, and self-monitoring their dietary intake, physical activity, or weight. This study provides a preliminary examination into the motives for weight loss, strategies utilized during past weight loss attempts, and preferences for future weight loss programs as described by knee replacement patients. These results will help guide the development and adaptation of future patient-centered weight loss programs as well as help clinicians recommend targeted weight programs based on the specific preferences of the knee replacement population.

Outrunning major weight gain: a prospective study of 8,340consistent runners during 7 years of follow-up

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, Paul T.

2006-01-06

Background: Body weight increases with aging. Short-term,longitudinal exercise training studies suggest that increasing exerciseproduces acute weight loss, but it is not clear if the maintenance oflong-term, vigorous exercise attenuates age-related weight gain inproportion to the exercise dose. Methods: Prospective study of 6,119 maleand 2,221 female runners whose running distance changed less than 5 km/wkbetween their baseline and follow-up survey 7 years later. Results: Onaverage, men who ran modest (0-24 km/wk), intermediate (24-48 km/wk) orprolonged distances (>_48 km/wk) all gained weight throughage 64,however, those who ran ?48 km/wk had one-half the average annual weightgain of those who ran<24 km/wk. Age-related weightmore » gain, and itsreduction by running, were both greater in younger than older men. Incontrast, men s gain in waist circumference with age, and its reductionby running, were the same in older and younger men. Women increased theirbody weight and waist and hip circumferences over time, regardless ofage, which was also reduced in proportion to running distance. In bothsexes, running did not attenuate weight gain uniformly, but ratherdisproportionately prevented more extreme increases. Conclusion: Men andwomen who remain vigorously active gain less weight as they age and thereduction is in proportion to the exercise dose.« less

Weight loss - unintentional

MedlinePlus

... thyroid medicines Drug abuse such as amphetamines and cocaine Stress or anxiety Chronic digestive system problems that ... health care provider may suggest changes in your diet and an exercise program depending on the cause ...

Rosuvastatin

MedlinePlus

Crestor® ... Rosuvastatin is used together with diet, weight-loss, and exercise to reduce the risk of heart attack ... who are at risk of developing heart disease. Rosuvastatin is also used to decrease the amount of ...

Aerobic exercise training without weight loss reduces dyspnea on exertion in obese women

PubMed Central

Bernhardt, Vipa; Stickford, Jonathon L.; Bhammar, Dharini M.; Babb, Tony G.

2015-01-01

Dyspnea on exertion (DOE) is a common symptom in obesity. We investigated whether aerobic exercise training without weight loss could reduce DOE. Twenty-two otherwise healthy obese women participated in a 12-week supervised aerobic exercise training program, exercising 30 min/day at 70–80% heart rate reserve, 4 days/week. Subjects were grouped based on their Ratings of Perceived Breathlessness (RPB) during constant load 60W cycling: +DOE (n = 12, RPB ≥ 4, 37 ± 7 years, 34 ± 4kg/m2) and −DOE (n = 10, RPB ≤ 2, 32 ± 6 years, 33 ± 3kg/m2). No significant differences between the groups in body composition, pulmonary function, or cardiorespiratory fitness were observed pre-training. Post-training, peak was improved significantly in both groups (+DOE: 12 ± 7, −DOE: 14 ± 8%). RPB was significantly decreased in the + DOE (4.7 ± 1.0–2.5 ± 1.0) and remained low in the −DOE group (1.2 ± 0.6–1.3 ± 1.0) (interaction p < 0.001). The reduction in RPB was not significantly correlated with the improvement in cardiorespiratory fitness. Aerobic exercise training improved cardiorespiratory fitness and DOE and thus appears to be an effective treatment for DOE in obese women. PMID:26593640

Change in Bone Mineral Density During Weight Loss with Resistance Versus Aerobic Exercise Training in Older Adults.

PubMed

Beavers, Kristen M; Beavers, Daniel P; Martin, Sarah B; Marsh, Anthony P; Lyles, Mary F; Lenchik, Leon; Shapses, Sue A; Nicklas, Barbara J

2017-10-12

To examine the effect of exercise modality during weight loss on hip and spine bone mineral density (BMD) in overweight and obese, older adults. This analysis compared data from two 5-month, randomized controlled trials of caloric restriction (CR; inducing 5-10% weight loss) with either resistance training (RT) or aerobic training (AT) in overweight and obese, older adults. Participants in the RT + CR study underwent 3 days/week of 8 upper/lower body exercises (3 sets, 10 repetitions at 70% 1 RM) and participants in the AT+CR study underwent 4 days/week of treadmill walking (30 min at 65-70% heart rate reserve). BMD at the total hip, femoral neck, and lumbar spine was assessed via dual-energy X-ray absorptiometry at baseline and 5 months. A total of 123 adults (69.4 ± 3.5 years, 67% female, 81% Caucasian) participated in the RT+CR (n = 60) and AT+CR (n = 63) interventions. Average weight loss was 5.7% (95% CI: 4.6-6.7%) and 8.2% (95% CI: 7.2-9.3%) in RT+CR and AT+CR groups, respectively. After adjustment for age, gender, race, baseline BMI and BMD, and weight change, differential treatment effects were observed for total hip and femoral neck (both p < .05), but not lumbar spine. Total hip (1.83 [-3.90, 7.55] mg/cm2) and femoral neck (9.14 [-0.70, 18.98] mg/cm2) BMD was unchanged in RT+CR participants, and modestly decreased in AT+CR participants (total hip: -7.01 [-12.73, -1.29] mg/cm2; femoral neck: -5.36 [-14.92, 4.20] mg/cm2). Results suggest performing resistance, rather than aerobic, training during CR may attenuate loss of hip and femoral neck BMD in overweight and obese older adults. Findings warrant replication from a long-term, adequately powered, RCT. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Ghrelin and PYY levels in adolescents with severe obesity: effects of weight loss induced by long-term exercise training and modified food habits.

PubMed

Gueugnon, Carine; Mougin, Fabienne; Nguyen, Nhu Uyen; Bouhaddi, Malika; Nicolet-Guénat, Marie; Dumoulin, Gilles

2012-05-01

This study investigated (a) changes in ghrelin and peptide YY (PYY) concentrations during a weight reduction programme and (b) baseline ghrelin and PYY levels as predictors of weight loss in 32 severely obese adolescents (BMI z score = 4.1). Subjects spent an academic year in an institution for childhood obesity. Fasting ghrelin and PYY, leptin, insulin levels and insulin resistance were measured at baseline (month 0) and during the programme (months 3, 6, 9). In addition, 15 normal-weight teenagers served as reference for the baseline assessments. At baseline, obese teenagers had lower ghrelin and PYY concentrations than normal-weight adolescents (P < 0.05). Moreover, they showed significantly higher leptin, insulin levels and homeostasis model assessment (HOMA) (P < 0.0001). During the lifestyle modification, there was a significant decrease in body weight among obese teenagers, associated with an increase in ghrelin (apparent from month 6; P < 0.05), a decrease in leptin (from month 3; P < 0.05) and a decrease in insulin and HOMA (from month 3; P < 0.0001), without any significant change in PYY. Anthropometrical changes were correlated neither with baseline ghrelin levels nor with changes in ghrelin and PYY after the lifestyle modification. However, higher baseline PYY tended to correlate with greater anthropometrical changes (P < 0.1). In adolescents with severe obesity, a long-term combination of supervised aerobic exercises and a balanced diet led to weight reduction and increased ghrelin concentrations, without any change in PYY concentrations. Moreover, baseline PYY concentrations might be considered as predictors of weight loss.

Physiological adaptations to weight loss and factors favouring weight regain

PubMed Central

Greenway, F L

2015-01-01

Obesity is a major global health problem and predisposes individuals to several comorbidities that can affect life expectancy. Interventions based on lifestyle modification (for example, improved diet and exercise) are integral components in the management of obesity. However, although weight loss can be achieved through dietary restriction and/or increased physical activity, over the long term many individuals regain weight. The aim of this article is to review the research into the processes and mechanisms that underpin weight regain after weight loss and comment on future strategies to address them. Maintenance of body weight is regulated by the interaction of a number of processes, encompassing homoeostatic, environmental and behavioural factors. In homoeostatic regulation, the hypothalamus has a central role in integrating signals regarding food intake, energy balance and body weight, while an ‘obesogenic' environment and behavioural patterns exert effects on the amount and type of food intake and physical activity. The roles of other environmental factors are also now being considered, including sleep debt and iatrogenic effects of medications, many of which warrant further investigation. Unfortunately, physiological adaptations to weight loss favour weight regain. These changes include perturbations in the levels of circulating appetite-related hormones and energy homoeostasis, in addition to alterations in nutrient metabolism and subjective appetite. To maintain weight loss, individuals must adhere to behaviours that counteract physiological adaptations and other factors favouring weight regain. It is difficult to overcome physiology with behaviour. Weight loss medications and surgery change the physiology of body weight regulation and are the best chance for long-term success. An increased understanding of the physiology of weight loss and regain will underpin the development of future strategies to support overweight and obese individuals in their efforts to achieve and maintain weight loss. PMID:25896063

Long-term effects of a very low-carbohydrate weight loss diet on exercise capacity and tolerance in overweight and obese adults.

PubMed

Wycherley, Thomas P; Buckley, Jonathan D; Noakes, Manny; Clifton, Peter M; Brinkworth, Grant D

2014-01-01

Compare the long-term effects of an energy-restricted very low-carbohydrate, high-fat (LC) diet with an isocaloric high-carbohydrate, low-fat (HC) diet on exercise tolerance and capacity in overweight and obese adults. Seventy-six adults (25 males; age 49.2 ± 1.1 years; BMI 33.6 ± 0.5 kg/m(2)) were randomized to either a hypocaloric (6-7 MJ/day) LC diet (35% protein, 4% carbohydrate, 61% fat) or isocaloric HC diet (24% protein, 46% carbohydrate, 30% fat) for 52 weeks. Pre- and postintervention, participants' body weight and composition, handgrip, and isometric knee extensor strength were assessed and participants performed an incremental exercise test to exhaustion. Forty-three participants completed the study (LC = 23; HC = 20). Overall, peak relative oxygen uptake increased (+11.3%) and reductions occurred in body weight (-14.6%), body fat percentage (-6.9% [absolute]), isometric knee extensor strength (-12.4%), handgrip strength (-4.5%), and absolute peak oxygen uptake (-5.2%; p ≤ 0.02 time for all) with no diet effect (p ≥ 0.18). During submaximal exercise, rating of perceived exertion did not change in either group (p = 0.16 time, p = 0.59 Time × Group). Compared to the HC diet, the LC diet had greater reductions in respiratory exchange ratio (LC -0.04 ± 0.01, HC -0.00 ± 0.01; p = 0.03), and increased fat oxidation (LC 15.0 ± 5.3% [of energy expenditure], HC 0.5 ± 3.9%; p = 0.04). In overweight and obese patients, an LC diet promoted greater fat utilization during submaximal exercise. Both an LC diet and an HC diet had similar effects on aerobic capacity and muscle strength, suggesting that long-term consumption of an LC weight loss diet does not adversely affect physical function or the ability to perform exercise.

A 12-week weight reduction intervention for overweight individuals taking antipsychotic medications.

PubMed

Green, Carla A; Janoff, Shannon L; Yarborough, Bobbi Jo H; Yarborough, Micah T

2014-11-01

People taking antipsychotic medications are at increased risk for obesity, diabetes, and early mortality. Few weight loss interventions have targeted this population. Thirty-six individuals were randomized to an evidence-based 12-week weight loss intervention (PREMIER with DASH diet, n = 18) or to usual care (n = 18) in this feasibility trial. Average attendance was 8.6 of 12 sessions. Intent-to-treat analyses of covariance, adjusted for baseline weight, showed significant changes in weight: Mean weight in intervention participants declined from 213.3 to 206.6 pounds, while control participants' weight was unchanged. It is possible to recruit, assess, intervene with, and retain participants taking antipsychotic medications in a dietary and exercise lifestyle change trial. Participants reported high levels of satisfaction with the intervention.

Gender Differences in the Associations among Body Mass Index, Weight Loss, Exercise, and Drinking among College Students

ERIC Educational Resources Information Center

Barry, Adam E.; Whiteman, Shawn; Piazza-Gardner, Anna K.; Jensen, Alexander C.

2013-01-01

Objective: To explore gender differences regarding weight management behaviors of college drinkers. Participants: Nationally representative sample of college students from the fall 2008 American College Health Association's National College Health Assessment II ("N" = 26,062 students). Methods: Structural equation modeling was used…

Common and specific process factors in cardiac rehabilitation: independent and interactive effects of the working alliance and self-efficacy.

PubMed

Burns, John W; Evon, Donna

2007-11-01

Therapeutic processes in cardiac rehabilitation programs are virtually unexamined. Models were tested by which changes in the working alliance between patient and staff (agreement on goals/tasks; emotional bond) may affect outcomes in conjunction with changes in patient self-efficacy to change their diets and increase exercise. Cardiac patients (n = 79) participated in a 12-week program, and completed assessments at early, mid, and late treatment. Changes in cardiac depression, physical health, perceived exertion during exercise, rate/pressure product at submaximal exercise tolerance, weight loss, return to work, total fat intake. Early-treatment changes in agreement on goals/tasks were related to changes in psychosocial factors and perceived exertion during exercise independent of effects of changes in self-efficacy. Early-treatment changes in goals/tasks and self-efficacy interacted to predict changes in cardiorespiratory fitness, weight loss, and return to work such that patients high on both goals/tasks and self-efficacy showed the most gains. Sound therapeutic relationships between patients and staff may play an important role in facilitating the achievement of a wide-range of salutary outcomes during cardiac rehabilitation. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons – a narrative review

PubMed Central

Goisser, Sabine; Kemmler, Wolfgang; Porzel, Simone; Volkert, Dorothee; Sieber, Cornel Christian; Bollheimer, Leo Cornelius; Freiberger, Ellen

2015-01-01

One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity. PMID:26346071

Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons--a narrative review.

PubMed

Goisser, Sabine; Kemmler, Wolfgang; Porzel, Simone; Volkert, Dorothee; Sieber, Cornel Christian; Bollheimer, Leo Cornelius; Freiberger, Ellen

2015-01-01

One of the many threats to independent life is the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia. Another important health risk in old age leading to functional decline is obesity. Obesity prevalence in older persons is increasing, and like sarcopenia, severe obesity has been consistently associated with several negative health outcomes, disabilities, falls, and mobility limitations. Both sarcopenia and obesity pose a health risk for older persons per se, but in combination, they synergistically increase the risk for negative health outcomes and an earlier onset of disability. This combination of sarcopenia and obesity is commonly referred to as sarcopenic obesity. The present narrative review reports the current knowledge on the effects of complex interventions containing nutrition and exercise interventions in community-dwelling older persons with sarcopenic obesity. To date, several complex interventions with different outcomes have been conducted and have shown promise in counteracting either sarcopenia or obesity, but only a few studies have addressed the complex syndrome of sarcopenic obesity. Strong evidence exists on exercise interventions in sarcopenia, especially on strength training, and for obese older persons, strength exercise in combination with a dietary weight loss intervention demonstrated positive effects on muscle function and body fat. The differences in study protocols and target populations make it impossible at the moment to extract data for a meta-analysis or give state-of-the-art recommendations based on reliable evidence. A conclusion that can be drawn from this narrative review is that more exercise programs containing strength and aerobic exercise in combination with dietary interventions including a supervised weight loss program and/or protein supplements should be conducted in order to investigate possible positive effects on sarcopenic obesity.

CLINICAL AND NUTRITIONAL ASPECTS IN OBESE WOMEN DURING THE FIRST YEAR AFTER ROUX-EN-Y GASTRIC BYPASS

PubMed Central

dos SANTOS, Tiago Dália; BURGOS, Maria Goretti Pessoa de Araújo; de LEMOS, Maria da Conceição Chaves; CABRAL, Poliana Coelho

2015-01-01

Background: Clinic care for morbid obesity is not very effective. Bariatric surgery is being considered the best way of intervention for this kind of obesity. Aim : Evaluate the clinical and nutritional evolution during the first year of obese women submitted to Roux-en-Y gastric bypass. Method : Retrospective series non-concurrent with 61 women. The variables were weight, BMI, weight loss percentage, loss of excessive weight percentage, waist circumference, hip circumference, lipid profile, daily use of supplements, practice of physical exercise, occurrence of sickness, nausea, constipation, diarrhea, asthenia, alopecia, dry skin, cramps and brittle nails. Results : They presented significant weight and IMC reduction as well as improvement in their lipid profile, in all consultations. After one year they presented 36,6% loss of the initial weight and 75% loss of excessive weight. The waist circumference also presented a considerable reduction on all the moments, decreasing from 122,1±13,4 cm to 94,1±10,6 cm. Regarding the intercurrences, the most frequent were alopecia, asthenia, dry skin and cramps. Conclusion : The Roux-en-Y gastric bypass was effective in promoting and maintenance weight loss during the period of the first postoperative year. PMID:26537276

Immediate and long-term effects of addition of exercise to a 16-week very low calorie diet on low-grade inflammation in obese, insulin-dependent type 2 diabetic patients.

PubMed

Snel, Marieke; van Diepen, Janna A; Stijnen, Theo; Pijl, Hanno; Romijn, Johannes A; Meinders, A E; Voshol, Peter; Jazet, Ingrid M

2011-12-01

To assess the short- and long-term effects of addition of exercise to a very low calorie diet (VLCD) on low-grade inflammation in obese patients with type 2 diabetes mellitus (T2DM). Twenty seven obese, insulin-dependent T2DM patients followed a 4-month VLCD with (n=13) or without (n=14) exercise and were followed up to 18 months. Anthropometric measurements, metabolic and inflammatory parameters were assessed before, directly after the intervention and at 6 and 18 months follow-up. The same measurements were performed only once in 56 healthy lean and 56 healthy obese controls. At baseline hsCRP, IL10 and IL8 were significantly elevated in obese T2DM compared to lean healthy controls. After 4 months, despite substantial weight loss (-25.4 ± 1.3 kg), neither the VLCD nor VLCD+exercise had an effect on plasma cytokines. At 6 months, in the weight-stabilizing period, measures of low-grade inflammation had decreased substantially and equally in both intervention groups. Despite subsequent weight regain, beneficial effect was sustained up to 18 months in both groups, except for IL1 and hsCRP which had returned to baseline in the VLCD-only group. Our findings suggest that severe caloric restriction increases cytokine production by adipose tissue macrophages and that the beneficial effects of weight loss become apparent only in the eucaloric state. Copyright © 2011 Elsevier Ltd. All rights reserved.

Effects of Exercise Induced Dehydration and Glycerol Rehydration on Anaerobic Power in Male Collegiate Wrestlers.

PubMed

McKenna, Zachary J; Gillum, Trevor L

2017-11-01

McKenna, ZJ and Gillum, TL. Effects of exercise induced dehydration and glycerol rehydration on anaerobic power in male collegiate wrestlers. J Strength Cond Res 31(11): 2965-2968, 2017-Wrestlers attempting to reach a specific weight class often use rapid weight loss (RWL). Rapid weight loss is associated with high levels of dehydration, which may hinder athletic performance. Thus, there is a need for wrestlers to optimize rehydration after achieving a specific weight. We sought to observe the effects of RWL on anaerobic power and the impact of glycerol on rehydration and power in male collegiate wrestlers (n = 7, 19.75 ± 1.67 years, 76.8 ± 4.32 kg, 11.6 ± 4.32% body fat, 59.9 ± 6.42 ml·kg·min). Subjects were assessed for body mass (BM), hydration, and mean power output (Wmean) before exercise (pre), immediately after exercise (3% dehydrated), and 60 minutes after exercise (rehydrated). Participants ran at 70% of V[Combining Dot Above]O2max in a heated room (30° C) until 3% BM loss (BML). Subjects rehydrated drinking either 26 ml·kg of water (control) or a 3% glycerol (treatment) solution containing 26 ml·kg of water and 1 g·kg of glycerol. Participants lost 3.00 ± 0.31% (control) and 2.89 ± 0.26% (treatment) of their BM from the pre- to dehydrated conditions. Wmean (control: 659.29 ± 79.12, 651.43 ± 70.71, 659.71 ± 82.78; treatment: 647.71 ± 110.64, 644.57 ± 118.15, 638.14 ± 100.71) did not differ across time (p = 0.87) nor condition (p = 0.80). In addition, glycerol had no significant impact on acute hydration (control: urine-specific gravity [SG] = 1.019 ± 0.010; treatment: SG = 1.017 ± 0.017). These data show that 3% BML did not impair anaerobic performance, and furthermore that glycerol proved ineffective for rehydration in a match like scenario for the competing wrestler.

Diet and exercise in management of obesity and overweight.

PubMed

Fock, Kwong Ming; Khoo, Joan

2013-12-01

According to World Health Organization, in 2010 there were over 1 billion overweight adults worldwide with 400 million adults who were obese. Obesity is a major risk factor for diabetes, cardiovascular disease, musculoskeletal disorders, obstructive sleep apnea, and cancers (prostate, colorectal, endometrial, and breast). Obese people may present to the gastroenterologists with gastroesophageal reflux, non-alcoholic fatty liver, and gallstones. It is important, therefore, to recognize and treat obesity. The main cause of obesity is an imbalance between calories consumed and calories expended, although in a small number of cases, genetics and diseases such as hypothyroidism, Cushing's disease, depression, and use of medications such as antidepressants and anticonvulsants are responsible for fat accumulation in the body. The main treatment for obesity is dieting, augmented by physical exercise and supported by cognitive behavioral therapy. Calorie-restriction strategies are one of the most common dietary plans. Low-calorie diet refers to a diet with a total dietary calorie intake of 800-1500, while very low-calorie diet has less than 800 calories daily. These dietary regimes need to be balanced in macronutrients, vitamins, and minerals. Fifty-five percent of the dietary calories should come from carbohydrates, 10% from proteins, and 30% from fats, of which 10% of total fat consist of saturated fats. After reaching the desired body weight, the amount of dietary calories consumed can be increased gradually to maintain a balance between calories consumed and calories expended. Regular physical exercise enhances the efficiency of diet through increase in the satiating efficiency of a fixed meal, and is useful for maintaining diet-induced weight loss. A meta-analysis by Franz found that by calorie restriction and exercise, weight loss of 5-8.5 kg was observed 6 months after intervention. After 48 months, a mean of 3-6 kg was maintained. In conclusion, there is evidence that obesity is preventable and treatable. Dieting and physical exercise can produce weight loss that can be maintained. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

An exploratory analysis of the effects of a weight loss plus exercise program on cellular quality control mechanisms in older overweight women.

PubMed

Wohlgemuth, Stephanie E; Lees, Hazel A; Marzetti, Emanuele; Manini, Todd M; Aranda, Juan M; Daniels, Michael J; Pahor, Marco; Perri, Michael G; Leeuwenburgh, Christian; Anton, Stephen D

2011-06-01

Obese older adults are particularly susceptible to sarcopenia and have a higher prevalence of disability than their peers of normal weight. Interventions to improve body composition in late life are crucial to maintaining independence. The main mechanisms underlying sarcopenia have not been determined conclusively, but chronic inflammation, apoptosis, and impaired mitochondrial function are believed to play important roles. It has yet to be determined whether impaired cellular quality control mechanisms contribute to this process. The objective of this study was to assess the effects of a 6-month weight loss program combined with moderate-intensity exercise on the cellular quality control mechanisms autophagy and ubiquitin-proteasome, as well as on inflammation, apoptosis, and mitochondrial function, in the skeletal muscle of older obese women. The intervention resulted in significant weight loss (8.0 ± 3.9 % vs. 0.4 ± 3.1% of baseline weight, p = 0.002) and improvements in walking speed (reduced time to walk 400 meters, - 20.4 ± 16% vs. - 2.5 ± 12%, p = 0.03). In the intervention group, we observed a three-fold increase in messenger RNA (mRNA) levels of the autophagy regulators LC3B, Atg7, and lysosome-associated membrane protein-2 (LAMP-2) compared to controls. Changes in mRNA levels of FoxO3A and its targets MuRF1, MAFBx, and BNIP3 were on average seven-fold higher in the intervention group compared to controls, but these differences were not statistically significant. Tumor necrosis factor-α (TNF-α) mRNA levels were elevated after the intervention, but we did not detect significant changes in the downstream apoptosis markers caspase 8 and 3. Mitochondrial biogenesis markers (PGC1α and TFAm) were increased by the intervention, but this was not accompanied by significant changes in mitochondrial complex content and activity. In conclusion, although exploratory in nature, this study is among the first to report the stimulation of cellular quality control mechanisms elicited by a weight loss and exercise program in older obese women.

Improvements in Functional Exercise Capacity after a Residential Behavioural Change, Diet and Fitness Program for Obese Adults.

PubMed

Errickson, Sadye Paez; Kolotkin, Ronette L; Skidmore, Megan Simmons; Endress, Gerald; Østbye, Truls; Crosby, Ross; Eisenson, Howard

2016-06-01

Obese adults are at an increased risk for mobility-related problems. National guidelines recommend calorie restrictions and exercise for obese adults as a means to improve functional fitness capacity and to increase mobility. Yet, lifestyle weight loss interventions often fail to measure fitness changes. The aim of this study was to assess whether a 1-month, intensive behavioural change, diet and fitness intervention for overweight and obese adults would result in statistically significant and clinically meaningful changes in functional exercise. A pre-post test design was used in this study. Seventy-two participants (40 women, 32 men; mean baseline body mass index (BMI) = 42.6 + 9.0; mean age = 45.8 + 16.8) completed a modified 6-minute walk test (6MWT), performed on a treadmill, at baseline and at end of treatment. Significant improvements included decreased BMI (2.7 + 1.7 kg m(-2) , p < 0.001) and increased 6MWT distance (66.4 + 73.0 m, p < 0.001). The 6MWT improved by 66 m on average, a reported clinically meaningful difference. Greater improvements in the 6MWT were significantly correlated with greater weight loss and BMI reduction. Our findings suggest that rehabilitation beyond weight loss may be derived from participation in a brief, intensive behavioural change, diet and fitness programme. Physiotherapists are in a prime position to address the physical and motivational challenges participants face while living with severe obesity: targeting functional exercise capacity is one key strategy for addressing immobility associated with obesity. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Effect of rapid weight loss on performance in combat sport male athletes: does adaptation to chronic weight cycling play a role?

PubMed

Mendes, Sandro H; Tritto, Aline C; Guilherme, João Paulo L F; Solis, Marina Y; Vieira, Douglas E; Franchini, Emerson; Lancha, Antonio H; Artioli, Guilherme G

2013-12-01

Studies failing to show a negative effect of rapid weight loss (RWL) on performance have been conducted in athletes who have been cycling weight for years. It has been suggested that chronic weight cycling could lead combat athletes to become resistant to the stresses associated with weight loss. To investigate the effects of RWL up to 5% of body mass on high-intensity intermittent performance in weight cyclers (WC) and non-weight cyclers (non-WC). Eighteen male combat athletes (WC: n=10; non-WC: n=8) reduced up to 5% of their body mass in 5 days. Body composition, high-intensity performance and plasma lactate were assessed preweight loss and postweight loss. Athletes had 4 h to re-feed and rehydrate following the weigh-in. Food intake was recorded during the weight loss and the recovery periods. Athletes significantly decreased body mass, lean body mass (most likely due to fluid loss) and fat mass following weight loss. No significant changes in performance were found from preweight loss to postweight loss in both groups. Plasma lactate was significantly elevated after exercise in both groups, but no differences were found between groups and in response to RWL. For all these variables no differences were observed between groups. Athletes from both groups ingested high amounts of energy and carbohydrates during the recovery period after the weigh-in. Chronic weight cycling does not protect athletes from the negative impact of RWL on performance. The time to recover after weigh-in and the patterns of food and fluid ingestion during this period is likely to play the major role in restoring performance to baseline levels.

Aerobic exercise and weight loss reduce vascular markers of inflammation and improve insulin sensitivity in obese women.

PubMed

Ryan, Alice S; Ge, Shealinna; Blumenthal, Jacob B; Serra, Monica C; Prior, Steven J; Goldberg, Andrew P

2014-04-01

To examine the relationships between plasma and tissue markers of systemic and vascular inflammation and obesity and insulin resistance and determine the effects of aerobic exercise training plus weight loss (AEX+WL) and weight loss (WL) alone on these biomarkers. Prospective controlled study. Veterans Affairs Medical Center and University research setting. Overweight and obese sedentary postmenopausal women (N = 77). Six months, 3 d/wk AEX+WL (n = 37) or WL (n = 40). Total-body dual-energy X-ray absorptiometry, abdominal computed tomography, hyperinsulinemic-euglycemic clamps (a criterion standard method of assessing insulin sensitivity), adipose tissue biopsies (n = 28), and blood for homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA). Body weight (P < .001), percentage of fat (P < .001), visceral fat (P < .005), triglyceride levels (P < .001), and systolic blood pressure decreased comparably after WL and AEX+WL (P = .04). Maximal oxygen consumption increased 16% after AEX+WL (P < .001). Insulin resistance decreased in both groups (P = .005). Glucose utilization according to the clamp increased 10% (P = .04) with AEX+WL and 8% with WL (P = .07). AEX+WL decreased CRP by 29% (P < .001) and WL by 21% (P = .02). SAA levels decreased twice as much after AEX+WL (-19%, P = .02) as after WL (-9%, P = .08). Plasma sICAM-1 and sVCAM-1 levels did not change, but women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose (P = .02), insulin (P = .02), and insulin resistance (P = .004). Gluteal ICAM messenger ribonucleic acid levels decreased 27% after AEX+WL (P = .02) and did not change after WL. Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP, SAA, and tissue ICAM decrease with exercise and weight loss, suggesting that exercise training is a necessary component of lifestyle modification in obese postmenopausal women. © Published 2014. This article is a U.S. Government work and is in the public domain in the U.S.A.

Maintaining vigorous activity attenuates 7-yr weight gain in 8340 runners.

PubMed

Williams, Paul T

2007-05-01

Body weight generally increases with aging in Western societies. Although training studies show that exercise produces acute weight loss, it is unclear whether the long-term maintenance of vigorous exercise attenuates the trajectory of age-related weight gain. Specifically, prior studies have not tested whether the maintenance of physical activity, in the absence of any change in activity, prevents weight gain. Prospective study of 6119 male and 2221 female runners whose running distances changed < 5 km x wk(-1) between baseline and follow-up surveys 7 yr later. On average, men who maintained modest (0-23 km x wk(-1)), intermediate (24-47 km x wk(-1)), or prolonged running distances (> or = 48 km x wk(-1)) all gained weight through age 64; however, those who maintained > or = 48 km x wk(-1) had one half the average annual weight gain of those who maintained < 24 km x wk(-1). For example, between the ages of 35 and 44 in men and 30 and 39 yr in women, those who maintained < 24 km x wk(-1) gained, on average, 2.1 and 2.9 kg more per decade than those averaging > 48 km x wk(-1). Age-related weight gain, and its attenuation by maintained exercise, were both greater in younger than in older men. Men's gains in waist circumference with age, and its attenuation by maintaining running, were the same in older and younger men. Regardless of age, women increased their body weight, waist circumference, and hip circumference over time, and these measurements were attenuated in proportion to their maintained running distance. In both sexes, running disproportionately prevented more extreme increases in weight. As they aged, men and women gained less weight in proportion to their levels of sustained vigorous activity. This long-term beneficial effect is in addition to the acute weight loss that occurs with increased activity.

The emperor's tailors: the failure of the medical weight loss paradigm and its causal role in the obesity of America.

PubMed

Puterbaugh, J S

2009-06-01

During the past century, the medical profession has developed a paradigm for the treatment of obesity, which prescribes specific exercise and dietary goals under the umbrella of 'lifestyle change'. It has three components, all of which evolved from origins that had nothing to do with weight control. First, it is individually prescriptive, that is weight loss is considered the responsibility of the individual as contrasted to a societal or group responsibility. Second, it recommends exercise aimed towards structured, or non-functional, activities with a variety of physiological endpoints. Last, dietary goals are defined by calories, exchanges, food groups and various nutritional components. Diets are usually grouped by these goals. This model is unique to America, it is not working and it has also played a causal role in the obesity it is attempting to eliminate. A new model must be developed, which contains an observationally based societal prescription and links activity with functional outcomes and diets, which are food rather than nutritionally based.

Weight Loss Strategies in Combat Sports and Concerning Habits in Mixed Martial Arts.

PubMed

Barley, Oliver R; Chapman, Dale W; Abbiss, Chris R

2017-12-28

Combat sports are typically divided into weight classes and body mass manipulation to reach a weight class is commonplace. Previous research suggests that mixed martial arts (MMA) weight loss practices may be more extreme than other combat sports. We sought to investigate the magnitude of weight lost and prevalence of weight loss strategies in different combat sports. Competitors (n=637) from Brazilian jiu jitsu (BJJ), boxing, judo, MMA, muay Thai/kickboxing (MT/K), taekwondo (TKD) and wrestling completed an online questionnaire seeking information regarding their weight loss practices. Body mass manipulation was commonly undertaken by all combat sports athletes, with a particularly high incidence of gradual dieting, increased exercise and fluid restriction. Skipping meals was higher in TKD and wrestling (84%) compared with the other combat sports (~58%), whilst training in heated rooms and forced oral fluid loss (spitting) was higher in wrestling (83% and 47%, respectively) compared with other combat sports (~45% and ~19%, respectively). MMA athletes reported the highest usage of sauna (76%) and water loading (67%) whilst also reporting the second highest use of training in rubber/plastic suits (63%). Body mass manipulation was present in all combat sports with the prevalence and magnitude of acute weight loss greater in MMA. The incidence of and practices reported will assist support staff to be fully aware of the variety of methods these athletes and coaches may use to achieve weight loss. Additionally, the results could aid regulatory bodies in the further development of policies on weight cutting.

Health-related behaviours of people with diabetes and those with cardiometabolic risk factors: results from SHIELD.

PubMed

Green, A J; Bazata, D D; Fox, K M; Grandy, S

2007-11-01

The study assessed knowledge, attitudes and behaviours towards health, diabetes, diet and exercise among respondents with type 2 diabetes mellitus and those with cardiometabolic risk factors. Respondents in the SHIELD study reported their health conditions, exercise, diet and weight loss. Three groups were assessed: (i) type 2 diabetes, (ii) high risk (HR) defined as 3-5 of the following factors: abdominal obesity, BMI > or = 28 kg/m(2), reported diagnosis of dyslipidaemia, hypertension, coronary heart disease or stroke and (iii) low risk (LR) defined as < or = 2 factors. Comparisons across groups were made using analysis of variance. More type 2 diabetes and HR respondents (> 46%) received recommendations to change their lifestyle habits (increase exercise and change eating habits), compared with < 29% of LR respondents, p < 0.0001. Less than 25% of respondents agreed that type 2 diabetes is not as serious as type 1 diabetes and > 85% agreed that obesity can aggravate or contribute to onset of chronic conditions. Mean number of healthcare visits was highest in type 2 diabetes (11.0) than HR (9.4) and LR (6.1) groups, p < 0.05. Type 2 diabetes and HR respondents were least likely to report exercising regularly (26%), compared with LR (37%), p < 0.05. More type 2 diabetes (70%) and HR (72%) respondents reported trying to lose weight vs. LR respondents (55%), p < 0.05. Type 2 diabetes and HR respondents reported attitudes and knowledge conducive to good health, but the majority of respondents did not translate these positive traits into healthy behaviour with respect to diet, exercise and weight loss.

No effect of caloric restriction on salivary cortisol levels in overweight men and women.

PubMed

Tam, Charmaine S; Frost, Elizabeth A; Xie, Wenting; Rood, Jennifer; Ravussin, Eric; Redman, Leanne M

2014-02-01

The effect of weight loss by diet or diet and exercise on salivary cortisol levels, a measure of hypothalamic pituitary adrenal activity, in overweight individuals is not known. The objective was to test the hypothesis that 24 weeks of moderate caloric restriction (CR) (25%) by diet or diet and aerobic exercise would alter morning and diurnal salivary cortisol levels. Randomized control trial in an institutional research center. Thirty-five overweight (BMI: 27.8±0.7 kg/m(2)) but otherwise healthy participants (16 M/19 F). Participants were randomized to either calorie restriction (CR: 25% reduction in energy intake, n=12), calorie restriction+exercise (CR+EX: 12.5% reduction in energy intake+12.5% increase in exercise energy expenditure, n=12) or control (healthy weight-maintenance diet, n=11) for 6 months. Salivary cortisol measured at 8:00, 8:30, 11:00, 11:30, 12:30, 13:00, 16:00 and 16:30. Morning cortisol was defined as the mean cortisol concentration at 08:00 and 08:30. Diurnal cortisol was calculated as the mean of the 8 cortisol measures across the day. In the whole cohort, higher morning and diurnal cortisol levels were associated with impaired insulin sensitivity (morning: P=0.004, r(2)=0.24; diurnal: P=0.02, r(2)=0.15). Using mixed model analysis, there was no significant effect of group, time or sex on morning or diurnal cortisol levels. A 10% weight loss with a 25% CR diet alone or with exercise did not impact morning or diurnal salivary cortisol levels. © 2013.

Canine obesity: an overview.

PubMed

Gossellin, J; Wren, J A; Sunderland, S J

2007-08-01

Canine patients are generally regarded as being clinically obese when their body weight is at least 15% above ideal. The incidence of obesity in dogs is thought to be in the range of 20-40% of the general population and, since obesity is known to predispose or exacerbate a range of serious medical conditions, its importance cannot be overstated. Management of obesity through dietary restriction and increased exercise is often difficult to achieve and dependent upon owner compliance. Until recently there has been no authorized therapeutic medication available for weight reduction in dogs, and drugs used in people have proved unsuitable. However, with the development of microsomal triglyceride transfer protein inhibitors for canine use, such as dirlotapide, the veterinarian has a novel method with which to augment traditional weight control programmes. This approach has the additional advantage that weight loss is achieved without dietary restriction or change in exercise regimen, providing encouragement for the owner to comply with subsequent dietary and exercise recommendations, thereby increasing the likelihood for long-term success.

Preventing weight gain: a population cohort study of the nature and effectiveness of mid-age women's weight control practices.

PubMed

Williams, L; Germov, J; Young, A

2007-06-01

To examine women's weight control practices and their effectiveness in preventing weight gain. Retrospective cohort study of weight control practices and 2-year weight change among mid-age women participating in the Australian Longitudinal Study on Women's Health (ALSWH). 11,589 Australian women (aged 47-52 years). The prevalence and types of self-reported weight control practices used were assessed by a nine-item instrument. Two-year weight change was self-reported and adjusted for baseline body mass index (BMI) and other potential confounders. Seventy-four per cent of the cohort (N=8556) reported actively trying to control their weight. Dietary modification was used more frequently than exercise. Two-thirds of the weight-controlling women used a combination of practices, the two most common being 'decreased food quantity, cut down on fats/sugars and exercise' (32%, baseline BMI 25.87(0.10)), and 'decreased food quantity and cut down on fats/sugars without exercise' (15.6%, baseline BMI 27.04(0.14)). Potentially health-damaging practices (smoking, laxatives, fasting) were relatively uncommon, at 7.9%. Only one combination of practices (decreased food quantity, cut down on fats/sugars, use of a commercial weight loss programme and exercise) prevented mean weight gain (-0.03 kg), whereas the mean (s.d.) weight of the cohort increased (+1.19(4.78)) over the 2-year period. The majority of mid-age women attempting weight control used practices consistent with public health messages. Despite their efforts, the group was mostly unsuccessful in preventing weight gain. Public health authorities and health practitioners may need to make more quantitative recommendations and emphasize the importance of balancing physical activity with dietary intake to achieve successful weight control for women at this life stage.

Dose–response effects of aerobic exercise on energy compensation in postmenopausal women: combined results from two randomized controlled trials

PubMed Central

McNeil, J; Brenner, D R; Courneya, K S; Friedenreich, C M

2017-01-01

Background/objectives: Despite the clear health benefits of exercise, exercised-induced weight loss is often less than expected. The term ‘exercise energy compensation’ is used to define the amount of weight loss below what is expected for the amount of exercise energy expenditure. We examined the dose–response effects of exercise volume on energy compensation in postmenopausal women. Participants/methods: Data from Alberta Physical Activity and Breast Cancer Prevention (ALPHA) and Breast Cancer and Exercise Trial in Alberta (BETA) were combined for the present analysis. The ALPHA and BETA trials were two-centred, two-armed, 12-month randomized controlled trials. The ALPHA trial included 160 participants randomized to 225 min per week of aerobic exercise, and the BETA trial randomized 200 participants to each 150 and 300 min per week of aerobic exercise. All participants were aged 50–74 years, moderately inactive (<90 min per week of exercise), had no previous cancer diagnosis and a body mass index between 22 and 40 kg m−2. Energy compensation was based on changes in body composition (dual-energy X-ray absorptiometry scan) and estimated exercise energy expenditure from completed exercise volume. Associations between Δenergy intake, ΔVO2peak and Δphysical activity time with energy compensation were assessed. Results: No differences in energy compensation were noted between interventions. However, there were large inter-individual differences in energy compensation between participants; 9.4% experienced body composition changes that were greater than expected based on exercise energy expenditure, 64% experienced some degree of energy compensation and 26.6% experienced weight gain based on exercise energy expenditure. Increases in VO2peak were associated with reductions in energy compensation (β=−3.44 ml kg−1 min−1, 95% confidence interval for β=−4.71 to −2.17 ml kg−1 min−1; P=0.0001). Conclusions: Large inter-individual differences in energy compensation were noted, despite no differences between activity doses. In addition, increases in VO2peak were associated with lower energy compensation. Future studies are needed to identify behavioral and metabolic factors that may contribute to this large inter-individual variability in energy compensation. PMID:28360432

Influence of ADRB2 Gln27Glu and ADRB3 Trp64Arg polymorphisms on body weight and body composition changes after a controlled weight-loss intervention.

PubMed

Szendrei, Barbara; González-Lamuño, Domingo; Amigo, Teresa; Wang, Guan; Pitsiladis, Yannis; Benito, Pedro J; Gomez-Candela, Carmen; Calderón, Francisco J; Cupeiro, Rocío

2016-03-01

The β-2 and β-3 adrenergic receptors (ADRB2 and ADRB3) are thought to play a role in energy expenditure and lipolysis. However, the effects of the ADRB2 glutamine (Gln) 27 glutamic acid (glutamate) (Glu) and ADRB3 tryptophan (Trp) 64 arginine (Arg) polymorphisms on weight loss remain controversial. The aim of this study was to investigate the effect of these polymorphisms on changes in weight and body composition during a controlled weight-loss program. One hundred seventy-three healthy overweight and obese participants (91 women, 82 men) aged 18-50 years participated in a 22-week-long intervention based on a hypocaloric diet and exercise. They were randomly assigned to 1 of 4 groups: strength, endurance, strength and endurance combined, and physical activity recommendations only. Body weight, body mass index (BMI), and body composition variables were assessed before and after the intervention. Genetic analysis was carried out according to standard protocols. No effect of the ADRB2 gene was shown on final weight, BMI, or body composition, although in the supervised male group, Glu27 carriers tended to have greater weight (p = 0.019, 2.5 kg) and BMI (p = 0.019, 0.88 kg/m(2)) reductions than did noncarriers. There seems to be an individual effect of the ADRB3 polymorphism on fat mass (p = 0.004) and fat percentage (p = 0.036), in addition to an interaction with exercise for fat mass (p = 0.038). After the intervention, carriers of the Arg64 allele had a greater fat mass and fat percentage than did noncarriers (p = 0.004, 2.8 kg). In conclusion, the ADRB2 Gln27Glu and ADRB3 Trp64Arg polymorphisms may influence weight loss and body composition, although the current evidence is weak; however, further studies are necessary to clarify their roles.

Maintenance of weight loss: a needs assessment.

PubMed

DePue, J D; Clark, M M; Ruggiero, L; Medeiros, M L; Pera, V

1995-05-01

This study identified facilitators and obstacles to maintenance of weight loss following a very-low-calorie-diet and behavior modification program. A survey was mailed to a random sample of 178 program completers and received a 61% response rate; the most frequent follow-up period was more than 2 years. Twenty-nine percent reported weighing the same (within 10 lbs) or less than the end of their participation in the treatment program (maintainers), while 71% reported their present weight was a mean of 65% higher than their initial weight loss (regainers). Maintainers were significantly more likely to report engaging in regular aerobic exercise, attending a maintenance support group, and confidence in their ability to manage their weight in the future, while regainers were more likely to report stress and motivation as frequent weight management obstacles. Respondents consistently identified the need for low/no cost ongoing support. Maintainers and relapsers reported similar challenges in managing their weight, yet with different results, suggesting the need to identify subgroups for which different post-treatment support options could be applied.

African American Women, Hair Care, and Health Barriers

PubMed Central

Mahan, Meredith Grace

2014-01-01

Objectives: The objective of this study was to elucidate the prevalence of hair loss among African American women; explore the psychosocial impact of hair grooming difficulties; and examine both perceptions related to physician encounters in this group and the relationship between hair grooming, physical activity, and weight maintenance. Design: An anonymous retrospective and qualitative survey, the Hair Care Assessment Survey, is an 18-question novel survey instrument designed at the Henry Ford Hospital Department of Dermatology Multicultural Dermatology Center. Setting: The Hair Care Assessment Survey was distributed at church-related functions at predominantly African American metropolitan Detroit churches. Participants: Two hundred African American women from metropolitan Detroit, Michigan, aged 21 to 83. Measurements: The Hair Care Assessment Survey collected data relating to hair loss and hair care, psychosocial experiences relating to hair loss, and hair care as it relates to exercise and body weight management. Data was collected on doctor-patient hair-related medical visits and experiences with commercially available ethnic hair care products. Results: More than 50 percent reported excessive hair loss. Twenty-eight percent had visited a physician to discuss hair issues, but only 32 percent felt their physician understood African American hair. Forty-five percent reported avoiding exercise because of hair concerns, and 22 percent felt that their hair impeded maintaining healthy body weight. Conclusion: Hair loss affects a compelling number of African American women, and a significant number express dissatisfaction in hair-related physician encounters. Additionally, hair styling problems present a serious impediment to physical activity and weight management among this already high-risk population. PMID:25276273

Treatment of NAFLD with diet, physical activity and exercise.

PubMed

Romero-Gómez, Manuel; Zelber-Sagi, Shira; Trenell, Michael

2017-10-01

Lifestyle intervention can be effective when treating non-alcoholic fatty liver diseases (NAFLD) patients. Weight loss decreases cardiovascular and diabetes risk and can also regress liver disease. Weight reductions of ⩾10% can induce a near universal non-alcoholic steatohepatitis resolution and fibrosis improvement by at least one stage. However, modest weight loss (>5%) can also produce important benefits on the components of the NAFLD activity score (NAS). Additionally, we need to explore the role of total calories and type of weight loss diet, micro- and macronutrients, evidence-based benefits of physical activity and exercise and finally support these modifications through established behavioural change models and techniques for long-term maintenance of lifestyle modifications. Following a Mediterranean diet can reduce liver fat even without weight loss and is the most recommended dietary pattern for NAFLD. The Mediterranean diet is characterised by reduced carbohydrate intake, especially sugars and refined carbohydrates (40% of the calories vs. 50-60% in a typical low fat diet), and increased monounsaturated and omega-3 fatty acid intake (40% of the calories as fat vs. up-to 30% in a typical low fat diet). Both TV sitting (a reliable marker of overall sedentary behaviour) and physical activity are associated with cardio-metabolic health, NAFLD and overall mortality. A 'triple hit behavioural phenotype' of: i) sedentary behaviour, ii) low physical activity, and iii) poor diet have been defined. Clinical evidence strongly supports the role of lifestyle modification as a primary therapy for the management of NAFLD and NASH. This should be accompanied by the implementation of strategies to avoid relapse and weight regain. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Exercise and activity for weight loss

MedlinePlus

... light activity such as cleaning house or playing baseball or golf. 370 to 460 calories doing activity ... or karate class. You could also join a baseball or bowling team, or even a mall-walking ...

Omega-3 Fatty Acids

MedlinePlus

Omega-3 fatty acids are used together with lifestyle changes (diet, weight-loss, exercise) to reduce the amount ... the blood in people with very high triglycerides. Omega-3 fatty acids are in a class of medications ...

High intensity interval training improves liver and adipose tissue insulin sensitivity

PubMed Central

Marcinko, Katarina; Sikkema, Sarah R.; Samaan, M. Constantine; Kemp, Bruce E.; Fullerton, Morgan D.; Steinberg, Gregory R.

2015-01-01

Objective Endurance exercise training reduces insulin resistance, adipose tissue inflammation and non-alcoholic fatty liver disease (NAFLD), an effect often associated with modest weight loss. Recent studies have indicated that high-intensity interval training (HIIT) lowers blood glucose in individuals with type 2 diabetes independently of weight loss; however, the organs affected and mechanisms mediating the glucose lowering effects are not known. Intense exercise increases phosphorylation and inhibition of acetyl-CoA carboxylase (ACC) by AMP-activated protein kinase (AMPK) in muscle, adipose tissue and liver. AMPK and ACC are key enzymes regulating fatty acid metabolism, liver fat content, adipose tissue inflammation and insulin sensitivity but the importance of this pathway in regulating insulin sensitivity with HIIT is unknown. Methods In the current study, the effects of 6 weeks of HIIT were examined using obese mice with serine–alanine knock-in mutations on the AMPK phosphorylation sites of ACC1 and ACC2 (AccDKI) or wild-type (WT) controls. Results HIIT lowered blood glucose and increased exercise capacity, food intake, basal activity levels, carbohydrate oxidation and liver and adipose tissue insulin sensitivity in HFD-fed WT and AccDKI mice. These changes occurred independently of weight loss or reductions in adiposity, inflammation and liver lipid content. Conclusions These data indicate that HIIT lowers blood glucose levels by improving adipose and liver insulin sensitivity independently of changes in adiposity, adipose tissue inflammation, liver lipid content or AMPK phosphorylation of ACC. PMID:26909307

Calorie restriction in overweight older adults: Do benefits exceed potential risks?

PubMed

Locher, Julie L; Goldsby, TaShauna U; Goss, Amy M; Kilgore, Meredith L; Gower, Barbara; Ard, Jamy D

2016-12-15

The evidence regarding recommendations of calorie restriction as part of a comprehensive lifestyle intervention to promote weight loss in obese older adults has remained equivocal for more than a decade. The older adult population is the fastest growing segment of the US population and a greater proportion of them are entering old age obese. These older adults require treatments based on solid evidence. Therefore the purpose of this review is three-fold: 1) to provide a more current status of the knowledge regarding recommendations of calorie restriction as part of a comprehensive lifestyle intervention to promote weight loss in obese older adults, 2) to determine what benefits and/or risks calorie restriction adds to exercise interventions in obese older adults, and 3) to consider not only outcomes related to changes in body composition, bone health, cardiometabolic disease risk, markers of inflammation, and physical function, but, also patient-centered outcomes that evaluate changes in cognitive status, quality of life, out-of-pocket costs, and mortality. Seven randomized controlled trials were identified that examined calorie restriction while controlling for exercise intervention effects. Overall, the studies found that calorie restriction combined with exercise is effective for weight loss. Evidence was mixed regarding other outcomes. The risk-benefit ratio regarding calorie restriction in older adults remains uncertain. Greater long-term follow-up is necessary, and complementary effectiveness studies are needed to identify strategies currently used by obese older adults in community settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Longitudinal changes in reproductive hormones and menstrual cyclicity in cynomolgus monkeys during strenuous exercise training: abrupt transition to exercise-induced amenorrhea.

PubMed

Williams, N I; Caston-Balderrama, A L; Helmreich, D L; Parfitt, D B; Nosbisch, C; Cameron, J L

2001-06-01

Cross-sectional studies of exercise-induced reproductive dysfunction have documented a high proportion of menstrual cycle disturbances in women involved in strenuous exercise training. However, longitudinal studies have been needed to examine individual susceptibility to exercise-induced reproductive dysfunction and to elucidate the progression of changes in reproductive function that occur with strenuous exercise training. Using the female cynomolgus monkey (Macaca fascicularis), we documented changes in menstrual cyclicity and patterns of LH, FSH, estradiol, and progesterone secretion as the animals developed exercise-induced amenorrhea. As monkeys gradually increased running to 12.3 +/- 0.9 km/day, body weight did not change significantly although food intake remained constant. The time spent training until amenorrhea developed varied widely among animals (7-24 months; mean = 14.3 +/- 2.2 months) and was not correlated with initial body weight, training distance, or food intake. Consistent changes in function of the reproductive axis occurred abruptly, one to two menstrual cycles before the development of amenorrhea. These included significant declines in plasma reproductive hormone concentrations, an increase in follicular phase length, and a decrease in luteal phase progesterone secretion. These data document a high level of interindividual variability in the development of exercise-induced reproductive dysfunction, delineate the progression of changes in reproductive hormone secretion that occur with exercise training, and illustrate an abrupt transition from normal cyclicity to an amenorrheic state in exercising individuals, that is not necessarily associated with weight loss.

Effects of Moderate and Vigorous Exercise on Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial.

PubMed

Zhang, Hui-Jie; He, Jiang; Pan, Ling-Ling; Ma, Zhi-Min; Han, Cheng-Kun; Chen, Chung-Shiuan; Chen, Zheng; Han, Hai-Wei; Chen, Shi; Sun, Qian; Zhang, Jun-Feng; Li, Zhi-Bin; Yang, Shu-Yu; Li, Xue-Jun; Li, Xiao-Ying

2016-08-01

Nonalcoholic fatty liver disease (NAFLD) is a prevalent risk factor for chronic liver disease and cardiovascular disease. To compare the effects of moderate and vigorous exercise on intrahepatic triglyceride content and metabolic risk factors among patients with NAFLD. In this randomized clinical trial, participants with central obesity and NAFLD were recruited from community-based screening in Xiamen, China, from December 1, 2011, through December 25, 2013. Data analysis was performed from August 28, 2015, through December 15, 2015. Participants were randomly assigned to vigorous-moderate exercise (jogging 150 minutes per week at 65%-80% of maximum heart rate for 6 months and brisk walking 150 minutes per week at 45%-55% of maximum heart rate for another 6 months), moderate exercise (brisk walking 150 minutes per week for 12 months), or no exercise. Primary outcome, change in intrahepatic triglyceride content measured by proton magnetic resonance spectroscopy at 6 and 12 months; secondary outcomes, changes in body weight, waist circumference, body fat, and metabolic risk factors. A total of 220 individuals (mean [SD] age, 53.9 [7.1] years; 149 woman [67.7%]) were randomly assigned to control (n = 74), moderate exercise (n = 73), and vigorous-moderate exercise (n = 73) groups. Of them, 211 (95.9%) completed the 6-month follow-up visit; 208 (94.5%) completed the 12-month follow-up visit. Intrahepatic triglyceride content was reduced by 5.0% (95% CI, -7.2% to 2.8%; P < .001) in the vigorous-moderate exercise group and 4.2% (95% CI, -6.3% to -2.0%; P < .001) in the moderate exercise group compared with the control group at the 6-month assessment. It was reduced by 3.9% (95% CI, -6.0% to -1.7%; P < .001) in the vigorous-moderate exercise group and 3.5% (95% CI, -5.6% to -1.3%; P = .002) in the moderate exercise group compared with the control group at the 12-month assessment. Changes in intrahepatic triglyceride content were not significantly different between vigorous-moderate and moderate exercise at the 6- or 12-month assessment. Body weight, waist circumference, and blood pressure were significantly reduced in the vigorous-moderate exercise group compared with the moderate exercise and control groups at the 6-month assessment and in the vigorous-moderate and moderate exercise groups compared with the control group at the 12-month assessment. In addition, body fat was significantly reduced in the vigorous-moderate exercise group compared with the moderate exercise and control groups at the 12-month assessment. After adjusting for weight loss, the net changes in intrahepatic triglyceride content were diminished and became nonsignificant between the exercise and control groups (except for the moderate exercise group at the 6-month assessment). Vigorous and moderate exercise were equally effective in reducing intrahepatic triglyceride content; the effect appeared to be largely mediated by weight loss. clinicaltrials.gov Identifier: NCT01418027.

Stereotypical images and implicit weight bias in overweight/obese people

PubMed Central

Hinman, Nova G.; Burmeister, Jacob M.; Hoffmann, Debra A.; Ashrafioun, Lisham; Koball, Afton M.

2013-01-01

Purpose In this brief report, an unanswered question in implicit weight bias research is addressed: Is weight bias stronger when obese and thin people are pictured engaging in stereotype consistent behaviors (e.g., obese—watching TV/eating junk food; thin—exercising/eating healthy) as opposed to the converse? Methods Implicit Associations Test (IAT) data were collected from two samples of overweight/obese adults participating in weight loss treatment. Both samples completed two IATs. In one IAT, obese and thin people were pictured engaging in stereotype consistent behaviors (e.g., obese—watching TV/eating junk food; thin—exercising/eating healthy). In the second IAT, obese and thin people were pictured engaging in stereotype inconsistent behaviors (e.g., obese—exercising/eating healthy; thin—watching TV/eating junk food). Results Implicit weight bias was evident regardless of whether participants viewed stereotype consistent or inconsistent pictures. However, implicit bias was significantly stronger for stereotype consistent compared to stereotype inconsistent images. Conclusion Implicit anti-fat attitudes may be connected to the way in which people with obesity are portrayed. PMID:24057679

Behavioral Lifestyle Intervention in the Treatment of Obesity

PubMed Central

Looney, Shannon M.; Raynor, Hollie A.

2013-01-01

This article provides an overview of research regarding adult behavioral lifestyle intervention for obesity treatment. We first describe two trials using a behavioral lifestyle intervention to induce weight loss in adults, the Diabetes Prevention Program (DPP) and the Look AHEAD (Action for Health in Diabetes) trial. We then review the three main components of a behavioral lifestyle intervention program: behavior therapy, an energy- and fat-restricted diet, and a moderate- to vigorous-intensity physical activity prescription. Research regarding the influence of dietary prescriptions focusing on macronutrient composition, meal replacements, and more novel dietary approaches (such as reducing dietary variety and energy density) on weight loss is examined. Methods to assist with meeting physical activity goals, such as shortening exercise bouts, using a pedometer, and having access to exercise equipment within the home, are reviewed. To assist with improving weight loss outcomes, broadening activity goals to include resistance training and a reduction in sedentary behavior are considered. To increase the accessibility of behavioral lifestyle interventions to treat obesity in the broader population, translation of efficacious interventions such as the DPP, must be undertaken. Translational studies have successfully altered the DPP to reduce treatment intensity and/or used alternative modalities to implement the DPP in primary care, worksite, and church settings; several examples are provided. The use of new methodologies or technologies that provide individualized treatment and real-time feedback, and which may further enhance weight loss in behavioral lifestyle interventions, is also discussed. PMID:25114557

Effect of Weight Loss, Exercise, or Both on Undercarboxylated Osteocalcin and Insulin Secretion in Frail, Obese Older Adults

PubMed Central

Napoli, Nicola; Phadnis, Uma; Armamento-Villareal, Reina

2017-01-01

Background Obesity exacerbates age-related decline in glucometabolic control. Undercarboxylated osteocalcin (UcOC) regulates pancreatic insulin secretion. The long-term effect of lifestyle interventions on UcOC and insulin secretion has not been investigated. Methods One hundred seven frail, obese older adults were randomized into the control (N = 27), diet (N = 26), exercise (N = 26), and diet-exercise (N = 28) groups for 1 year. Main outcomes included changes in UcOC and disposition index (DI). Results UcOC increased in the diet group (36 ± 11.6%) but not in the other groups (P < 0.05 between groups). Although similar increases in DI occurred in the diet-exercise and diet groups at 6 months, DI increased more in the diet-exercise group (92.4 ± 11.4%) than in the diet group (61.9 ± 15.3%) at 12 months (P < 0.05). UcOC and body composition changes predicted DI variation in the diet group only (R2 = 0.712), while adipocytokines and physical function changes contributed to DI variation in both the diet (∆R2 = 0.140 and 0.107) and diet-exercise (∆R2 = 0.427 and 0.243) groups (P < 0.05 for all). Conclusions Diet, but not exercise or both, increases UcOC, whereas both diet and diet-exercise increase DI. UcOC accounts for DI variation only during active weight loss, while adipocytokines and physical function contribute to diet-exercise-induced DI variation, highlighting different mechanisms for lifestyle-induced improvements in insulin secretion. This trial was registered with ClinicalTrials.gov number NCT00146107. PMID:28951766

Effect of Weight Loss, Exercise, or Both on Undercarboxylated Osteocalcin and Insulin Secretion in Frail, Obese Older Adults.

PubMed

Colleluori, Georgia; Napoli, Nicola; Phadnis, Uma; Armamento-Villareal, Reina; Villareal, Dennis T

2017-01-01

Obesity exacerbates age-related decline in glucometabolic control. Undercarboxylated osteocalcin (UcOC) regulates pancreatic insulin secretion. The long-term effect of lifestyle interventions on UcOC and insulin secretion has not been investigated. One hundred seven frail, obese older adults were randomized into the control ( N = 27), diet ( N = 26), exercise ( N = 26), and diet-exercise ( N = 28) groups for 1 year. Main outcomes included changes in UcOC and disposition index (DI). UcOC increased in the diet group (36 ± 11.6%) but not in the other groups ( P < 0.05 between groups). Although similar increases in DI occurred in the diet-exercise and diet groups at 6 months, DI increased more in the diet-exercise group (92.4 ± 11.4%) than in the diet group (61.9 ± 15.3%) at 12 months ( P < 0.05). UcOC and body composition changes predicted DI variation in the diet group only ( R 2 = 0.712), while adipocytokines and physical function changes contributed to DI variation in both the diet (∆ R 2 = 0.140 and 0.107) and diet-exercise (∆ R 2 = 0.427 and 0.243) groups ( P < 0.05 for all). Diet, but not exercise or both, increases UcOC, whereas both diet and diet-exercise increase DI. UcOC accounts for DI variation only during active weight loss, while adipocytokines and physical function contribute to diet-exercise-induced DI variation, highlighting different mechanisms for lifestyle-induced improvements in insulin secretion. This trial was registered with ClinicalTrials.gov number NCT00146107.

Impact of weight-related advice from healthcare professionals on body mass index of patients in the USA.

PubMed

Yang, H-Y; Chen, H-J; Hsu, Y-J; Cheskin, L J; Wang, Y

2018-06-01

Healthcare professionals (HCPs) can help promote healthy eating and active living in patients. This study assessed the effects of weight-related advice from HCPs on change in body mass index (BMI) of patients in the USA. A 1-year follow-up study of 20,002 adults who participated in a nationally representative survey between 2004 and 2008. Using the 2004-2008 Medical Expenditure Panel Survey data, 1-year BMI and weight status changes were compared between patients who did and did not report receiving advice on exercise or on restricted intake of fat and cholesterol from their HCPs. Patients who received weight-related advice had a greater increase in BMI compared with those who did not receive weight-related advice. Stratified by the baseline weight status of patients (i.e. normal weight, overweight or obese), adverse direction of BMI change was only significantly associated with advice on exercise. Patients who received advice to exercise more were more likely to move to a higher weight status than remaining at the same weight status, compared with patients who did not receive advice to exercise more. This study did not find that weight-related advice from HCPs had a positive impact on BMI loss in patients. On the contrary, patients who reported receiving weight-related advice from HCPs had worse weight outcomes 1 year later than patients who did not report receiving weight-related advice. Further research is warranted to elucidate the role of weight-related advice from HCPs on lifestyle change and obesity prevention and control. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

No effect of weight loss on LINE-1 methylation levels in peripheral blood leukocytes from postmenopausal overweight women.

PubMed

Duggan, Catherine; Xiao, Liren; Terry, Mary Beth; McTiernan, Anne

2014-09-01

Obesity and weight-loss are associated with methylation patterns in specific genes, but their effect on Long Interspersed Nuclear Elements (LINE-1) methylation, a measure of global methylation is largely unknown. Three hundred overweight/obese post-menopausal women (50-75 years) were part of a completed, 1-year randomized controlled trial, comparing independent and combined effects of a reduced-calorie weight-loss diet, and exercise program, versus control. DNA was extracted from peripheral blood leukocytes collected at baseline and 12-months, and LINE-1 methylation analyzed by pyrosequencing. Mean changes between groups using generalized estimating equations and examined effects of weight-loss on LINE-1 methylation using stratified analyses (gained weight/no weight-loss [N = 84]; <5% [N = 45]; 5%-10% [N = 45]; >10% of baseline weight-loss [N = 126]) within each arm, adjusted by blood cell counts were compared. Associations between LINE-1 methylation and previously measured biomarkers, and anthropometrics were also examined. No significant difference in LINE-1 methylation levels was detected in any intervention group versus controls. The magnitude of weight-loss was not associated with LINE-1 methylation at 12-months. There were no associations between baseline characteristics of participants, or previously measured biomarkers, and LINE-1 methylation. Our results suggest that lifestyle changes sufficient to significantly reduce weight over 12-months may not change LINE-1 DNA methylation levels. © 2014 The Obesity Society.

The impact of weight loss on the 24-h profile of circulating peptide YY and its association with 24-h ghrelin in normal weight premenopausal women.

PubMed

Hill, Brenna R; De Souza, Mary Jane; Wagstaff, David A; Williams, Nancy I

2013-11-01

Peptide YY (PYY) and ghrelin exhibit a reciprocal association and antagonistic physiological effects in the peripheral circulation. Research has yet to clarify the effect of weight loss on the 24h profile of PYY or its association to 24h ghrelin. We sought to determine if diet- and exercise-induced weight loss affects the 24h profile of PYY and its association with 24h ghrelin in normal weight, premenopausal women. Participants (n = 13) were assessed at baseline (BL) and after a 3-month diet and exercise intervention (post). Blood samples obtained q10 min for 24h were assayed for total PYY and total ghrelin q60 min from 0800 to 1000 h and 2000 to 0800 h and q20 min from 1000 to 2000 h. The ghrelin/PYY ratio was used as an index of hormonal exposure. Statistical analyses included paired t-tests and linear mixed effects modeling. Body weight (-1.85 ± 0.67 kg; p = 0.02), and body fat (-2.53 ± 0.83%; p = 0.01) decreased from BL to post. Ghrelin AUC (5252 ± 2177 pg/ml/24h; p=0.03), 24h mean (216 ± 90 pg/ml; p = 0.03) and peak (300 ± 134 pg/ml; p = 0.047) increased from BL to post. No change occurred in PYY AUC (88.2 ± 163.7 pg/ml; p = 0.60), 24h mean (4.8 ± 6.9 pg/ml; p = 0.50) or peak (3.6 ± 6.4 pg/ml; p = 0.58). The 24h association between PYY and ghrelin at baseline (p = 0.04) was weakened at post (p = 0.14); however, the ghrelin/PYY lunch ratio increased (p = 0.01) indicating the potential for ghrelin predominance over PYY in the circulation. PYY and ghrelin are reciprocally associated during a period of weight stability, but not following weight loss. An "uncoupling" may have occurred, particularly at lunch, due to factors that modulate ghrelin in response to weight loss. Copyright © 2013 Elsevier Inc. All rights reserved.

Fresh Start, a postpartum weight loss intervention for diverse low-income women: design and methods for a randomized clinical trial.

PubMed

Rosal, Milagros C; Haughton, Christina F; Estabrook, Barbara B; Wang, Monica L; Chiriboga, Germán; Nguyen, Oahn H T; Person, Sharina D; Lemon, Stephenie C

2016-09-09

Overweight and obesity are prevalent among young women and are greater among minority and low-income women. The postpartum period is critical in women's weight trajectories as many women do not lose their pregnancy weight, and others lose some and then plateau or experience weight gain. Excess weight puts women at greater risk of chronic disease and thus weight loss in the postpartum period may be key to the long-term health of young women. This paper describes the design and methods of a randomized clinical trial of Fresh Start, an innovative narrative-based group intervention aimed at promoting postpartum weight loss among low-income, diverse women. Study participants were recruited from the five sites of the Women, Infants and Children (WIC) program in central Massachusetts. Participants were English-speaking, age ≥ 18 years, 6 weeks to 6 months postpartum, with a body mass index (BMI) ≥ 27 kg/m(2). The Fresh Start postpartum weight loss intervention, adapted from the Diabetes Prevention Program (DPP) in collaboration with WIC staff and clients, consisted of an 8-week group-based curriculum followed by nine monthly telephone calls. It included a narrative component (i.e., storytelling), group discussions, print materials and access to exercise facilities. The study is a two-arm randomized controlled trial. The control condition included print materials and access to exercise facilities. In-person assessments were conducted at baseline and at 6 and 12 months following the eight-week intervention phase. The Fresh Start intervention translated key elements of an evidence-based weight loss protocol into a format that is hypothesized to be relevant, acceptable and effective for the target audience of low-SES postpartum women. This novel intervention was developed in collaboration with WIC to be sustainable within the context of its clinics, which reach approximately 9 million individuals per year across the U.S. via 10,000 clinics. clinicaltrials.gov NCT02176915 . Registered 25 June 2014.

Reduced Mitogenicity of Sera Following Weight Loss in Premenopausal Women

PubMed Central

Azrad, Maria; Chang, Pi-Ling; Gower, Barbara A.; Hunter, Gary R.; Nagy, Tim R.

2011-01-01

We investigated whether serum from normal weight women is less mitogenic and more apoptotic than sera from the same women in the overweight state. Sera from premenopausal women, age (mean ±SEE) 34.6±0.53 years, who were randomized to caloric restriction (CR) (n=13), CR + aerobic exercise (AE) (n=14) or CR + resistance training (RT) (n=20) were used to culture endometrial cancer cells. Phases of the cell cycle were determined, proliferating cell nuclear antigen (PCNA) positivity was used to assess proliferation and apoptosis was assessed by determining cleaved caspase-3 and poly-ADP-ribose polymerase (PARP). Analyses showed that overall, cells grown in sera from the weight-reduced state had significantly more cells in G0/G1 and significantly fewer cells in the S and G2/M phases of the cell cycle than cells grown in sera from the overweight state. PCNA staining confirmed that cells grown in sera from the weight-reduced state had fewer proliferating cells. Cleaved caspase-3 and PARP were not different in cells grown in sera from the weight-reduced state compared to the overweight state. We conclude that weight loss with or without exercise could lower the risk for cancer through changes in serum that result in reduced cellular mitogenicity. PMID:21774593

Effects of Weight Loss with and without Exercise on Regional Body Fat Distribution in Postmenopausal Women.

PubMed

Serra, Monica C; Blumenthal, Jacob B; Addison, Odessa R; Miller, Ann J; Goldberg, Andrew P; Ryan, Alice S

2017-01-01

The purpose was to determine whether lifestyle interventions have different effects on regional fat in women with normal glucose tolerance vs. impaired glucose tolerance (NGT vs. IGT). Changes in glucose metabolism (2-h oral glucose-tolerance tests), android to gynoid fat mass ratio (dual energy X-ray absorptiometry [DXA]), visceral to subcutaneous abdominal fat area ratio (CT), and abdominal to gluteal subcutaneous fat cell weight (FCW; adipose tissue biopsies) were determined in 60 overweight postmenopausal women (45-80 years) following 6 months of weight loss alone (WL; n = 28) or with aerobic exercise (AEX + WL; n = 32). The interventions led to ∼8% decrease in weight, but only the AEX + WL group improved fitness (↑11% in VO2max) and reduced the android-to-gynoid fat mass ratio (↓5%; p < 0.05). Both NGT and IGT groups reduced visceral and subcutaneous abdominal fat areas and abdominal and gluteal FCWs, which related to improvements in homeostatic model assessment (r = 0.34-0.42) and 2-h glucose (r = 0.34-0.35), respectively (p < 0.05). The decline in FCW was 2× greater in women with IGT following WL (p < 0.05). The ratios of abdominal-to-gluteal FCW did not change following either intervention. The mechanisms by which WL with and without exercise impact regional fat loss should be explored as reductions in abdominal fat area and subcutaneous FCW appear to influence glucose metabolism. This is a work of the U.S. Government and is not subject to copyright protection in the United States. Foreign copyrights may apply. Published by S. Karger AG, Basel.

Aerobic exercise + weight loss decreases skeletal muscle myostatin expression and improves insulin sensitivity in older adults.

PubMed

Ryan, A S; Li, G; Blumenthal, J B; Ortmeyer, H K

2013-07-01

To determine whether aerobic exercise training + weight loss (AEX + WL) would affect the expression of myostatin and its relationship with insulin sensitivity in a longitudinal, clinical intervention study. Thirty-three obese sedentary postmenopausal women and men (n = 17 and 16, age: 61 ± 1 years, body mass index: 31 ± 1 kg/m(2) , VO2 max: 21.9 ± 1.0 mL/kg/min, X ± Standard error of the mean (SEM)) completed 6 months of 3 days/week AEX + WL. During an 80 mU m(-2) min(-1) hyperinsulinemic-euglycemic clamp, we measured glucose utilization (M), myostatin, myogenin, and MyoD gene expression by real-time RT-PCR in vastus lateralis muscle at baseline and 2 h. Body weight (-8%) and fat mass (-17%) decreased after AEX + WL (P < 0.001). Fat-free mass (FFM) and mid-thigh muscle area by computed tomography did not change but muscle attenuation increased (P < 0.05). VO2 max increased 14% (P < 0.001). AEX + WL increased M by 18% (P < 0.01). Myostatin gene expression decreased 19% after AEX + WL (P < 0.05). Basal mRNA myostatin levels were negatively associated with M before the intervention (r = -0.43, P < 0.05). Insulin infusion increased myoD and myogenin expression before and after AEX + WL (both P < 0.001) but basal levels did not change. The insulin effect on myostatin expression was associated with the change in M after AEX + WL (r = 0.56, P < 0.005). Exercise and weight loss results in a downregulation of myostatin mRNA and an improvement in insulin sensitivity in obese older men and women. Copyright © 2012 The Obesity Society.

Survivor Fitness: An Exercise Program for Young Survivors and Patients With Cancer.

PubMed

Acevedo, Jose A

2017-04-01

Young survivors of cancer often face challenges reintegrating into their schools and communities after treatment. Maintaining a physically active lifestyle is recommended, but finding appropriate exercises that cater to their needs can be difficult. As a result, the pilot fitness program Move4Fun/Move4Fitness was developed. This 12-week basic fitness program teaches young survivors of cancer appropriate exercises and how they can exercise on their own with limited space and equipment. Participants experienced physical and mental transformations demonstrated through weight loss, building of muscle, and increased self-confidence.

A losing battle: weight regain does not restore weight loss-induced bone loss in postmenopausal women.

PubMed

Villalon, Karen L; Gozansky, Wendolyn S; Van Pelt, Rachael E; Wolfe, Pam; Jankowski, Catherine M; Schwartz, Robert S; Kohrt, Wendy M

2011-12-01

Previously, we reported significant bone mineral density (BMD) loss in postmenopausal women after modest weight loss. It remains unclear whether the magnitude of BMD change in response to weight loss is appropriate (i.e., proportional to weight loss) and whether BMD is recovered with weight regain. We now report changes in BMD after a 1-year follow-up. Subjects (n = 23) in this secondary analysis were postmenopausal women randomized to placebo as part of a larger trial. They completed a 6-month exercise-based weight loss program and returned for follow-up at 18 months. Dual-energy X-ray absorptiometry (DXA) was performed at baseline, 6, and 18 months. At baseline, subjects were aged 56.8 ± 5.4 years (mean ± s.d.), 10.0 ± 9.2 years postmenopausal, and BMI was 29.6 ± 4.0 kg/m(2). They lost 3.9 ± 3.5 kg during the weight loss intervention. During follow-up, they regained 2.9 ± 3.9 kg. Six months of weight loss resulted in a significant decrease in lumbar spine (LS) (-1.7 ± 3.5%; P = 0.002) and hip (-0.04 ± 3.5%; P = 0.03) BMD that was accompanied by an increase in a biomarker of bone resorption (serum C-terminal telopeptide of type I collagen, CTX: 34 ± 54%; P = 0.08). However, weight regain was not associated with LS (0.05 ± 3.8%; P = 0.15) or hip (-0.6 ± 3.0%; P = 0.81) bone regain or decreased bone resorption (CTX: -3 ± 37%; P = 0.73). The findings suggest that BMD lost during weight reduction may not be fully recovered with weight regain in hormone-deficient, postmenopausal women. Future studies are needed to identify effective strategies to prevent bone loss during periods of weight loss.

Weight-Loss Study in African-American Women: Lessons Learned from Project Take HEED and Future, Technologically Enhanced Directions

PubMed Central

Murphy, Pamala J; Williams, Roger L

2013-01-01

Introduction African-American women are more overweight and have greater difficulty maintaining weight loss than do Caucasian women. Evidence suggests that African-American women are more successful with culturally tailored weight-loss programs. Methods: Begun in 2005, an 18-month randomized clinical trial, Project Take HEED (Healthy Eating and Exercise Decisions), culturally adapted an evidence-based dietary approach and exercise program to fit the female African-American population in an attempt to improve program attrition rates. The study was conducted with 223 African-American women (120 women in the experimental group; 103 controls), age 35 to 65 years, with a body mass index of 30 kg/m2 or higher. The experimental group received education and instruction at 24 group sessions and were asked to record their daily food intake and physical activity. Cultural adaptation included social and spiritual components. Controls received usual care (referral to a dietitian). Results: After 18 months, Project Take HEED demonstrated the following outcomes: Attrition: the treatment group consisted of 12 African-American women at the end of month 18—(an attrition rate of 87%). (It had been 70% at the end of month 15.)Factors contributing to attrition included: caregiver responsibilities, transportation difficulties, work schedules, and others. Those clients that did remain, however, provided the impetus for our next study. The remaining participants had, by and large, begun the study as being low in self-efficacy regarding weight loss and weight loss maintenance Conclusion: Initial Findings: The high self-efficacy that some women had at the beginning of the intervention did not translate into the desired behavior change. The inverse relationship seen in this study suggests that treatments that improve participants’ self-efficacy may result in greater weight loss. New Directions: A new study, commencing in 2013, will use at-home Web-based and virtual reality technology (avatars) in an attempt to enhance client motivation to persist in long-term weight management programs. Bandura’s pioneering work on self-efficacy will be the theoretical foundation of the pilot study, also enrolling African-American women. PMID:23704845

Weight-loss study in African-American Women: lessons learned from project take HEED and future, technologically enhanced directions.

PubMed

Murphy, Pamala J; Williams, Roger L

2013-01-01

African-American women are more overweight and have greater difficulty maintaining weight loss than do Caucasian women. Evidence suggests that African-American women are more successful with culturally tailored weight-loss programs. Begun in 2005, an 18-month randomized clinical trial, Project Take HEED (Healthy Eating and Exercise Decisions), culturally adapted an evidence-based dietary approach and exercise program to fit the female African-American population in an attempt to improve program attrition rates. The study was conducted with 223 African-American women (120 women in the experimental group; 103 controls), age 35 to 65 years, with a body mass index of 30 kg/m(2) or higher. The experimental group received education and instruction at 24 group sessions and were asked to record their daily food intake and physical activity. Cultural adaptation included social and spiritual components. Controls received usual care (referral to a dietitian). After 18 months, Project Take HEED demonstrated the following outcomes: ATTRITION: the treatment group consisted of 12 African-American women at the end of month 18-(an attrition rate of 87%). (It had been 70% at the end of month 15.)FACTORS CONTRIBUTING TO ATTRITION INCLUDED: caregiver responsibilities, transportation difficulties, work schedules, and others. Those clients that did remain, however, provided the impetus for our next study. The remaining participants had, by and large, begun the study as being low in self-efficacy regarding weight loss and weight loss maintenance. Initial Findings: The high self-efficacy that some women had at the beginning of the intervention did not translate into the desired behavior change. The inverse relationship seen in this study suggests that treatments that improve participants' self-efficacy may result in greater weight loss. New Directions: A new study, commencing in 2013, will use at-home Web-based and virtual reality technology (avatars) in an attempt to enhance client motivation to persist in long-term weight management programs. Bandura's pioneering work on self-efficacy will be the theoretical foundation of the pilot study, also enrolling African-American women.

Association of Weight Loss and Medication Adherence Among Adults With Type 2 Diabetes Mellitus: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes)☆

PubMed Central

Grandy, Susan; Fox, Kathleen M.; Hardy, Elise

2013-01-01

Background Adherence to prescribed diabetes medications is suboptimal, which can lead to poor glycemic control and diabetic complications. Treatment-related weight gain is a side effect of some oral antidiabetic agents and insulin, which may negatively affect adherence to therapy. Objective This study investigated whether adults with type 2 diabetes mellitus (T2DM) who lost weight had better medication adherence than those who gained weight. Methods Weight change over 1 year (2007 to 2008) was assessed among respondents in the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). Weight loss of >1.0%, ≥3%, and ≥5% of weight was compared with weight gain of ≥1.0%. Medication adherence was assessed using the Morisky 4-item questionnaire for medication-taking behavior, with lower scores representing better adherence. Results There were 746 T2DM respondents who lost >1.0%, 483 who lost ≥3%, 310 who lost ≥5%, and 670 who gained ≥1.0% of weight. Each weight-loss group had significantly lower Morisky scores than the weight-gain group; mean scores of 0.389 versus 0.473 (P = 0.050) for the >1.0% weight-loss group, 0.365 versus 0.473 (P = 0.026) for the ≥3% weight-loss group, and 0.334 versus 0.473 (P = 0.014) for the ≥5% weight-loss group. Significantly fewer respondents who lost weight had received insulin, sulfonylurea, or thiazolidinedione therapy (57%) compared with respondents who gained weight (64%) (P = 0.002). Demographics, exercise habits, and dieting were similar between weight-loss and weight-gain groups. Conclusions T2DM respondents with weight loss had significantly better medication adherence and were less likely to be on treatment regimens that increase weight than T2DM respondents with weight gain. These findings suggest that strategies that lead to weight loss, including use of diabetes medications associated with weight loss, may improve medication adherence. PMID:24465048

Effect of Weight Loss, Diet, Exercise, and Bariatric Surgery on Nonalcoholic Fatty Liver Disease.

PubMed

Hannah, William N; Harrison, Stephen A

2016-05-01

Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. NAFLD is the most common liver disease in developed countries. Weight reduction of 3% to 5% is associated with improved steatosis; reductions of 5% to 7% are necessary for decreased inflammation; with 7% to 10%, individuals may experience NAFLD/NASH remission and regression of fibrosis. No specific dietary intervention has proven beneficial beyond calorie restriction. Physical activity without weight loss seems to decrease hepatic steatosis. Bariatric surgery is associated with decreased cardiovascular risk and improved overall mortality in addition to reduction in hepatic steatosis, inflammation, and fibrosis. Published by Elsevier Inc.

Exercise, Appetite and Weight Control: Are There Differences between Men and Women?

PubMed Central

Thackray, Alice E.; Deighton, Kevin; King, James A.; Stensel, David J.

2016-01-01

Recent years have witnessed significant research interest surrounding the interaction among exercise, appetite and energy balance, which has important implications for health. The majority of exercise and appetite regulation studies have been conducted in males. Consequently, opportunities to examine sex-based differences have been limited, but represent an interesting avenue of inquiry considering postulations that men experience greater weight loss after exercise interventions than women. This article reviews the scientific literature relating to the acute and chronic effects of exercise on appetite control in men and women. The consensus of evidence demonstrates that appetite, appetite-regulatory hormone and energy intake responses to acute exercise do not differ between the sexes, and there is little evidence indicating compensatory changes occur after acute exercise in either sex. Limited evidence suggests women respond to the initiation of exercise training with more robust compensatory alterations in appetite-regulatory hormones than men, but whether this translates to long-term differences is unknown. Current exercise training investigations do not support sex-based differences in appetite or objectively assessed energy intake, and increasing exercise energy expenditure elicits at most a partial energy intake compensation in both sexes. Future well-controlled acute and chronic exercise studies directly comparing men and women are required to expand this evidence base. PMID:27657127

Strength Exercise Improves Muscle Mass and Hepatic Insulin Sensitivity in Obese Youth

PubMed Central

van der Heijden, Gert-Jan; Wang, Zhiyue J.; Chu, Zili; Toffolo, Gianna; Manesso, Erica; Sauer, Pieter J.J.; Sunehag, Agneta L.

2010-01-01

Introduction Data are limited on the metabolic effects of resistance exercise (strength training) in adolescents. Purpose The objective of this study was to determine whether a controlled resistance exercise program without dietary intervention or weight loss, reduces body fat accumulation, increases lean body mass, and improves insulin sensitivity and glucose metabolism in sedentary obese Hispanic adolescents. Methods Twelve obese adolescents (15.5±0.5y; 35.3 ±0.8kg/m2;40.8±1.5% body fat), completed a 12 wk resistance exercise program (2×1h/wk, exercising all major muscle groups). At baseline and completion of the program, body composition was measured by DXA, abdominal fat distribution by Magnetic Resonance Imaging, hepatic and intramyocellular fat by Magnetic Resonance Spectroscopy, peripheral insulin sensitivity by the Stable Labeled IV Glucose Tolerance Test and hepatic insulin sensitivity by the Hepatic Insulin Sensitivity Index =1000/(GPR*fasting insulin). Glucose production rate (GPR), gluconeogenesis and glycogenolysis were quantified using Stable Isotope-Gas Chromatography/Mass Spectrometry techniques. Results All participants were normoglycemic. The exercise program resulted in significant strength gain in both upper and lower body muscle groups. Body weight increased from 97.0±3.8 to 99.6±4.2 kg (p<0.01). The major part (~80%) was accounted for by increased lean body mass (55.7±2.8 to 57.9±3.0 kg; p≤0.01).Total, visceral, hepatic and intramyocellular fat content remained unchanged. Hepatic insulin sensitivity increased by 24±9% (p<0.05), while peripheral insulin sensitivity did not change significantly. GPR decreased by 8±1% (p<0.01) due to a 12±5% decrease in glycogenolysis (p<0.05). Conclusion We conclude that a controlled resistance exercise program without weight loss increases strength and lean body mass, improves hepatic insulin sensitivity and decreases GPR without affecting total fat mass or visceral, hepatic and intramyocellular fat content. PMID:20351587

Yerba Maté (Ilex paraguariensis) Metabolic, Satiety, and Mood State Effects at Rest and during Prolonged Exercise

PubMed Central

Alkhatib, Ahmad; Atcheson, Roisin

2017-01-01

Yerba Maté (YM), has become a popular herb ingested for enhancing metabolic health and weight-loss outcomes. No studies have tested the combined metabolic, satiety, and psychomotor effects of YM during exercise. We tested whether YM ingestion affects fatty acid oxidation (FAO), profile of mood state score (POMS), and subjective appetite scale (VAS), during prolonged moderate exercise. Twelve healthy active females were randomized to ingest either 2 g of YM or placebo (PLC) in a repeated-measures design. Participants rested for 120 min before performing a 30-min cycling exercise corresponding to individuals’ crossover point intensity (COP). FAO, determined using indirect calorimetry, was significantly higher during the 30-min exercise in YM vs. PLC (0.21 ± 0.07 vs. 0.17 ± 0.06 g/min, p < 0.05). VAS scores for hunger, prospective eating, and desire to eat were all reduced (p < 0.05). Whereas, POMS measures of focus, energy, and concentration were all increased (p < 0.05). There was no significant time-effect for any of the measured variables, nor was there any interaction effects between YM treatment and time. Combining YM intake with prolonged exercise at targeted ”fat-loss”’ intensities augments FAO and improves measures of satiety and mood state. Such positive combined metabolic, satiety, and psychomotor effects may provide an important role for designing future fat and weight-loss lifestyle interventions. PMID:28809814

Targeting Lifestyle Behavior Change in Adults with NAFLD During a 20-min Consultation: Summary of the Dietary and Exercise Literature.

PubMed

Hallsworth, Kate; Avery, Leah; Trenell, Michael I

2016-03-01

Non-alcoholic fatty liver disease (NAFLD) is largely linked to poor diet, lack of physical activity/exercise, and being overweight. In the absence of approved pharmaceutical agents, lifestyle modification, encompassing dietary change and increased physical activity/exercise to initiate weight loss, is the recommended therapy for NAFLD. Despite this, the use of lifestyle therapy within clinical settings is lacking with limited guidance available about what it should involve, how it should be delivered, and whether it can be feasibly delivered as part of standard care. This paper highlights the evidence for the use of lifestyle modification in NAFLD. While there is evidence to support use of behavioral strategies to support lifestyle behavior change in other clinical populations, these are yet to be assessed in people with NAFLD. However, there is sufficient evidence to suggest that behavioral intervention targeting diet and physical activity to promote weight loss in general is effective and a number of practical strategies are presented on how this could be achieved.

Associations between weight perceptions, weight control and body fatness in a multiethnic sample of adolescent girls.

PubMed

Duncan, J Scott; Duncan, Elizabeth K; Schofield, Grant

2011-01-01

The purpose of the present study was to examine the interactions between weight perceptions, weight control behaviours and body fatness in a multiethnic sample of adolescent girls. A cross-sectional study. Girls from European (37.7 %), Pacific Island (21.6 %), East Asian (15.8 %), Maori (10.2 %) and South Asian (9.6 %) populations and from other ethnicities (5.0 %). A sample of 954 girls aged 11-15 years participated in the study. BMI was derived from height and weight, whereas body fat (BF) was determined from hand-to-foot bioimpedance measurements. Weight perceptions, weight control behaviours and pubertal stage were assessed by questionnaire. Body size and fatness varied significantly across ethnic groups. Although few differences in weight perceptions were observed between BMI and %BF percentile groups, a relatively high degree of weight misclassification was evident across all BF categories. The number of girls trying to lose weight exceeded those who perceived themselves as being overweight, with the magnitude of the difference dependent on ethnicity. Of the girls trying to lose weight, the combination of dieting and exercise was the most common weight loss practice; however, a substantial proportion reported neither exercise nor dieting. Weight status perception was a stronger predictor of weight loss intent than actual BF when controlling for all other factors. Interventions and educational campaigns that assist girls in recognising a state of excess BF are a priority for all ethnic groups to increase the likelihood that behavioural changes necessary to combat widespread overweight and obesity are adopted.

Tackling overweight and obesity: does the public health message match the science?

PubMed

Hafekost, Katherine; Lawrence, David; Mitrou, Francis; O'Sullivan, Therese A; Zubrick, Stephen R

2013-02-18

Despite the increasing understanding of the mechanisms relating to weight loss and maintenance, there are currently no validated public health interventions that are able to achieve sustained long-term weight loss or to stem the increasing prevalence of obesity in the population. We aimed to examine the models of energy balance underpinning current research about weight-loss intervention from the field of public health, and to determine whether they are consistent with the model provided by basic science. EMBASE was searched for papers published in 2011 on weight-loss interventions. We extracted details of the population, nature of the intervention, and key findings for 27 articles. Most public health interventions identified were based on a simple model of energy balance, and thus attempted to reduce caloric consumption and/or increase physical activity in order to create a negative energy balance. There appeared to be little consideration of homeostatic feedback mechanisms and their effect on weight-loss success. It seems that there has been a lack of translation between recent advances in understanding of the basic science behind weight loss, and the concepts underpinning the increasingly urgent efforts to reduce excess weight in the population. Public health weight-loss interventions seem to be based on an outdated understanding of the science. Their continued failure to achieve any meaningful, long-term results reflects the need to develop intervention science that is integrated with knowledge from basic science. Instead of asking why people persist in eating too much and exercising too little, the key questions of obesity research should address those factors (environmental, behavioral or otherwise) that lead to dysregulation of the homeostatic mechanism of energy regulation. There is a need for a multidisciplinary approach in the design of future weight-loss interventions in order to improve long-term weight-loss success.

Method‐of‐use study of naltrexone sustained release (SR)/bupropion SR on body weight in individuals with obesity

PubMed Central

Shan, Kevin; Walsh, Brandon; Gilder, Kye; Fujioka, Ken

2016-01-01

Objective This study assessed the effects of 32 mg naltrexone sustained release (SR)/360 mg bupropion SR (NB) on body weight in adults with obesity, with comprehensive lifestyle intervention (CLI), for 78 weeks. Methods In this phase 3b, randomized, open‐label, controlled study, subjects received NB + CLI or usual care (standard diet/exercise advice) for 26 weeks. NB subjects not achieving 5% weight loss at week 16 were discontinued, as indicated by product labeling. After week 26, usual care subjects began NB + CLI. Assessments continued through week 78. The primary end point was percent change in weight from baseline to week 26 in the per protocol population. Other end points included percentage of subjects achieving ≥5%, ≥10%, and ≥15% weight loss, percent change in weight at week 78, and adverse events (AEs) necessitating study medication discontinuation. Results NB + CLI subjects lost significantly more weight than usual care subjects at week 26 (8.52% difference; P < 0.0001). Weight loss persisted through 78 weeks. In total, 20.7% of subjects discontinued medication for AEs, including 7.0% for nausea. Conclusions Treatment with NB, used as indicated by prescribing information and with CLI, significantly improved weight loss over usual care alone. NB‐facilitated weight loss was sustained for 78 weeks and was deemed safe and well tolerated. PMID:28026920

Perceived barriers to exercise and healthy eating among women from disadvantaged neighborhoods: Results from a focus groups assessment

PubMed Central

Sharpe, Patricia A.; Parra-Medina, Deborah; Wilcox, Sara

2014-01-01

This study explored perceptions and experiences with barriers to exercise and healthy eating among women from predominately African American, disadvantaged neighborhoods. Four focus groups (n=28) were conducted between April and May 2008 with overweight or obese women (93% African American; 34.3±8.9 years; BMI 40.4±8.5). Individual, social, and environmental factors were frequently mentioned as barriers to exercise and healthy eating. Insults from strangers about their body size (e.g. from children, people at the gym), and feelings of intimidation and embarrassment about not being able to complete exercises due to their body size were described as barriers to exercise. Lack of support and pressure from family, friends, and co-workers were barriers to healthy eating; participants experienced pressure from family and friends to eat more and were told they did not need to lose weight. Participants discussed the importance of not losing their curves; this concern needs to be considered when developing weight control programs for African American women. The findings of this qualitative study guided the development of a weight loss intervention for women from disadvantaged neighborhoods. PMID:24617795

Perceived barriers to exercise and healthy eating among women from disadvantaged neighborhoods: results from a focus groups assessment.

PubMed

Baruth, Meghan; Sharpe, Patricia A; Parra-Medina, Deborah; Wilcox, Sara

2014-01-01

This study explored perceptions and experiences with barriers to exercise and healthy eating among women from predominately African American, disadvantaged neighborhoods. Four focus groups (n = 28) were conducted between April and May 2008 with overweight or obese women (93% African American; 34.3 ± 8.9 years; body mass index [BMI] 40.4 ± 8.5). Individual, social, and environmental factors were frequently mentioned as barriers to exercise and healthy eating. Insults from strangers about their body size (e.g., from children or people at the gym), and feelings of intimidation and embarrassment about not being able to complete exercises due to their body size were described as barriers to exercise. Lack of support and pressure from family, friends, and co-workers were barriers to healthy eating; participants experienced pressure from family and friends to eat more and were told they did not need to lose weight. Participants discussed the importance of not losing their curves; this concern needs to be considered when developing weight control programs for African American women. The findings of this qualitative study guided the development of a weight loss intervention for women from disadvantaged neighborhoods.

Effect of an exercise and weight control curriculum: views of obesity among exercise science students.

PubMed

Richardson, Laura A; Fister, Carrie L; Ramlo, Susan E

2015-06-01

Awareness of effective weight management strategies is necessary to prepare exercise science students for future work with obesity. Exercise science faculty members developed a course related to exercise as a therapeutic tool and options available for weight loss. The purpose of the present study was to investigate student views of weight management and obesity, which can be a difficult task using traditional methods such as Likert scale surveys. To investigate student views relative to the course content, Q methodology, which is a mixed-method research approach, was used at the beginning and end of the course. Students completed a Q sort, ranking 44 statements related to obesity in accordance to their own points of view. The pretest/posttest design enabled an opportunity to determine if course goals were accomplished and if student perceptions related to obesity were transformed. Factor analysis of precourse sorts revealed that students possessed a naïve singular view of weight-related concepts. Analysis of sorts at course completion resulted in a two-factor solution revealing changes in perspective; some students took on a health professional type of view, whereas others demonstrated antifat views. In conclusion, the findings revealed key variables that should be addressed in curricula involving therapeutic obesity interventions. An improved curriculum based on these results should better encourage students to develop a broad comprehension of multifactorial causes and treatment for weight management and obesity. Implementing the use of Q methodology may serve as a valuable asset to measure and evaluate subjectivity of obesity discrimination. Antifat attitudes among exercise science students may influence future clients' potential achievements. Copyright © 2015 The American Physiological Society.

Temporality in British young women's magazines: food, cooking and weight loss.

PubMed

Spencer, Rosemary J; Russell, Jean M; Barker, Margo E

2014-10-01

The present study examines seasonal and temporal patterns in food-related content of two UK magazines for young women focusing on food types, cooking and weight loss. Content analysis of magazines from three time blocks between 1999 and 2011. Desk-based study. Ninety-seven magazines yielding 590 advertisements and 148 articles. Cluster analysis of type of food advertising produced three clusters of magazines, which reflected recognised food behaviours of young women: vegetarianism, convenience eating and weight control. The first cluster of magazines was associated with Christmas and Millennium time periods, with advertising of alcohol, coffee, cheese, vegetarian meat substitutes and weight-loss pills. Recipes were prominent in article content and tended to be for cakes/desserts, luxury meals and party food. The second cluster was associated with summer months and 2010 issues. There was little advertising for conventional foods in cluster 2, but strong representation of diet plans and foods for weight loss. Weight-loss messages in articles focused on short-term aesthetic goals, emphasising speedy weight loss without giving up nice foods or exercising. Cluster 3 magazines were associated with post-New Year and 2005 periods. Food advertising was for everyday foods and convenience products, with fewer weight-loss products than other clusters; conversely, article content had a greater prevalence of weight-loss messages. The cyclical nature of magazine content - indulgence and excess encouraged at Christmas, restraint recommended post-New Year and severe dieting advocated in the summer months - endorses yo-yo dieting behaviour and may not be conducive to public health.

Exercise training with weight loss and either a high or low glycemic diet reduces metabolic syndrome severity in older adults

PubMed Central

Malin, Steven K.; Niemi, Nicole; Solomon, Thomas P.J.; Haus, Jacob M.; Kelly, Karen R.; Filion, Julianne; Rocco, Michael; Kashyap, Sangeeta R.; Barkoukis, Hope; Kirwan, John P.

2012-01-01

Background The efficacy of combining carbohydrate quality with exercise on metabolic syndrome risk is unclear. Thus, we determined the effects of exercise training with a low or high glycemic diet on metabolic syndrome severity (Z-score). Methods Twenty-one adults (66.2 ± 1.1 yr; BMI = 35.3 ± 0.9 kg/m2) with metabolic syndrome were randomized to 12 weeks of exercise (60 minutes/d for 5 d/week at ~85% HRmax) and provided a low-glycemic (n=11; LoGIx) or high glycemic (n=10; HiGIx) diet. Z-scores were determined from: blood pressure, triglycerides (TG), high-density lipoproteins (HDL), fasting plasma glucose (FPG), and waist circumference (WC) before and after the intervention. Body composition, aerobic fitness, insulin resistance, and non-esterfied fatty acid (NEFA) suppression were also assessed. Results LoGIx and HiGIx decreased body mass and insulin resistance and increased aerobic fitness comparably (p < 0.05). LoGIx and HiGIx decreased the Z-score similarly, as each intervention decreased blood pressure, TG, FPG, and WC (p < 0.05). HiGIx tended to suppress NEFA during insulin stimulation compared to LoGIx (p = 0.06). Conclusions Our findings highlight that exercise with weight loss reduces metabolic syndrome severity whether individuals were randomized to a high or low glycemic index diet. PMID:23036993

Bone structure and quality preserved by active versus passive muscle exercise in 21 days tail-suspended rats

NASA Astrophysics Data System (ADS)

Luan, Huiqin; Sun, Lian-wen; Fan, Yu-bo

2012-07-01

Humans in Space suffer from microgravity-induced attenuated bone strength that needs to be addressed by on-orbit exercise countermeasures. However, exercise prescriptions so far did not adequately counteract the bone loss of astronauts in spaceflight because even active muscle contractions were converted to passive mode during voluntary bouts. We tested our hypothesis in unloaded rat hind limb following twenty-one days of tail-suspension (TS) combined with exercise using a hind limb stepper device designed by our group. Female Sprague Dawley rats (250g b.wt.) were divided into four groups (n=5, each): TS-only (hind limb unloading), TS plus passive mode exercise (TSP) induced by mechanically-forced passive hind limb lifting, TS plus active mode exercise (TSA) entrained by plantar electrostimulation, and control (CON) group. Standard measures of bone (e.g., mineral density, trabecular microstructure, biomechanics and ash weight) were monitored. Results provided that the attenuated properties of unloaded hind limb bone in TS-rats were more effectively supported by active mode than by passive mode motions. We here propose a modified exercise regimen combined with spontaneous muscle contractions thereby considering the biodynamic demands of both muscle and bone during resistive-load exercise in microgravity. Keywords: rat, BMD, DXA, passive exercise, active exercise, bone loss, tail suspension, spaceflight analogue, exercise countermeasure.

Nutritional interventions for optimizing healthy body composition in older adults in the community: an umbrella review of systematic reviews.

PubMed

Schultz, Timothy J; Roupas, Peter; Wiechula, Richard; Krause, Debra; Gravier, Susan; Tuckett, Anthony; Hines, Sonia; Kitson, Alison

2016-08-01

Optimizing body composition for healthy aging in the community is a significant challenge. There are a number of potential interventions available for older people to support both weight gain (for those who are underweight) and weight loss (for overweight or obese people). While the benefits of weight gain for underweight people are generally clearly defined, the value of weight loss in overweight or obese people is less clear, particularly for older people. This umbrella review aimed to measure the effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community and to explore theirqualitative perceptions. The participants were older adults, 60 years of age or older, living in the community. The review examinedsix types of nutritional interventions: (i) dietary programs, (ii) nutritional supplements, (iii) meal replacements, (iv) food groups, (v) food delivery support and eating behavior, and (vi) nutritional counselling or education. This umbrella review considered any quantitative systematic reviews and meta-analyses of effectiveness, or qualitative systematic reviews, or a combination (i.e. comprehensive reviews). The quantitative outcome measures of body composition were: (i) nutritional status (e.g. proportion of overweight or underweight patients); (ii) fat mass (kg), (iii) lean mass or muscle mass (kg), (iv) weight (kg) or BMI (kg/m), (v) bone mass (kg) or bone measures such as bone mineral density, and (vi) hydration status. The phenomena of interestwere the qualitative perceptions and experiences of participants. We developed an iterative search strategy for nine bibliometric databases and gray literature. Critical appraisal of 13 studies was conducted independently in pairs using standard Joanna Briggs Institute tools. Six medium quality and seven high quality studies were identified. Data was extracted independently in pairs from all 13 included studies using the standard Joanna Briggs Institute data extraction tool. Only quantitative studies of effectiveness were included. The strength of evidence assessing the effectiveness of interventionswas graded using a traffic light system (green, amber, red). An overall assessment of the quality of the evidence for each comparison was undertaken. More systematic reviews investigating weight gain than those investigating weight loss were included. Studies onweight gain showed improved body composition for oral nutritional supplements on its own, for oral nutritional supplements in combination with resistance exercise training, and for oral nutritional supplements in combination with nutrition counselling. Studies on weight loss showed that diet in combination with exercise, diet in combination with exercise and nutrition counselling, and nutrition counselling on its own all can lead to reduced weight in older people. The outcomes of lean mass and weight/BMI were responsive to nutritional interventions, but fat mass did not vary. There were no qualitative reviews identified. Although effective interventions for weight gain and weight loss to optimize body composition of older people in the community were identified,making long term, clinically relevant changes in body composition is difficult. Multiple interventions are more effective than single interventions.

The Biomechanics of Exercise Countermeasures

NASA Technical Reports Server (NTRS)

Cavanagh, Peter R.; Arnold, Steven; Derr, Janice; Sharkey, Neil; Wu, Ge

1999-01-01

The Penn State Zero-gravity Simulator (PSZS) is a device developed by the Center for Locomotion Studies (CELOS) to enable ground studies of exercise countermeasures for the bone loss that has been shown to occur during long-term exposure to zero gravity (0G). The PSZS simulates 0G exercise by providing a suspension system that holds an individual in a horizontal (supine) position above the floor in order to enable exercise on a wall-mounted treadmill. Due to this orientation, exercise performed in the PSZS is free of the force of -ravity in the direction that would normally contribute to ground reaction forces. In order for movements to be more similar to those in 0G, a constant force suspension of each segment (equal to the segment weight) is provided regardless of limb position. During the preliminary development of the PSZS, CELOS researchers also designed an optional gravity-replacement simulation feature for the PSZS. This feature was a prototype tethering system that consisted of a spring tension system to pull an exercising individual toward the treadmill. The immediate application of the tethering system was to be the provision of gravity-replacement loading so that exercise in 0G- and 1G-loading conditions could be compared, and the PSZS could then be used to evaluate exercise countermeasures for bone loss during space flight. This tethering system would also be a model for the further refinement of gravity-replacement systems provided for astronaut usage while performing prescribed exercise countermeasures for bone loss during long-term space flights.

Bone loss during partial weight bearing (1/6th gravity) is mitigated by resistance and aerobic exercise in mice

NASA Astrophysics Data System (ADS)

Boudreaux, R. D.; Metzger, C. E.; Macias, B. R.; Shirazi-Fard, Y.; Hogan, H. A.; Bloomfield, S. A.

2014-06-01

Astronauts on long duration missions continue to experience bone loss, as much as 1-2% each month, for up to 4.5 years after a mission. Mechanical loading of bone with exercise has been shown to increase bone formation, mass, and geometry. The aim of this study was to compare the efficacy of two exercise protocols during a period of reduced gravitational loading (1/6th body weight) in mice. Since muscle contractions via resistance exercise impart the largest physiological loads on the skeleton, we hypothesized that resistance training (via vertical tower climbing) would better protect against the deleterious musculoskeletal effects of reduced gravitational weight bearing when compared to endurance exercise (treadmill running). Young adult female BALB/cBYJ mice were randomly assigned to three groups: 1/6 g (G/6; n=6), 1/6 g with treadmill running (G/6+RUN; n=8), or 1/6 g with vertical tower climbing (G/6+CLB; n=9). Exercise was performed five times per week. Reduced weight bearing for 21 days was achieved through a novel harness suspension system. Treadmill velocity (12-20 m/min) and daily run time duration (32-51 min) increased incrementally throughout the study. Bone geometry and volumetric bone mineral density (vBMD) at proximal metaphysis and mid-diaphysis tibia were assessed by in vivo peripheral quantitative computed tomography (pQCT) on days 0 and 21 and standard dynamic histomorphometry was performed on undemineralized sections of the mid-diaphysis after tissue harvest. G/6 caused a significant decrease (P<0.001) in proximal tibia metaphysis total vBMD (-9.6%). These reductions of tibia metaphyseal vBMD in G/6 mice were mitigated in both G/6+RUN and G/6+CLB groups (P<0.05). After 21 days of G/6, we saw an absolute increase in tibia mid-diaphysis vBMD and in distal metaphysis femur vBMD in both G/6+RUN and G/6+CLB mice (P<0.05). Substantial increases in endocortical and periosteal mineralizing surface (MS/BS) at mid-diaphysis tibia in G/6+CLB demonstrate that bone formation can be increased even in the presence of reduced weight bearing. These data suggest that moderately vigorous endurance exercise and resistance training, through treadmill running or climb training mitigates decrements in vBMD during 21 days of reduced weight bearing. Consistent with our hypothesis, tower climb training, most pronounced in the tibia mid-diaphysis, provides a more potent osteogenic response compared to treadmill running.

Weight loss treatment influences untreated spouses and the home environment: Evidence of a ripple effect

PubMed Central

Gorin, Amy A.; Wing, Rena R.; Fava, Joseph L.; Jakicic, John M.; Jeffery, Robert; West, Delia Smith; Brelje, Kerrin; DiLillo, Vicki G.

2009-01-01

Objectives To examine whether a weight loss program delivered to one spouse has beneficial effects on the untreated spouse and the home environment. Methods We assessed untreated spouses of participants in 3 sites of Look AHEAD, a multi-center randomized controlled trial evaluating the impact of intentional weight loss on cardiovascular outcomes in overweight individuals with type 2 diabetes. Participants and spouses (n=357 pairs) were weighed and completed measures of diet and physical activity at 0 and 12 months. Spouses completed household food and exercise environment inventories. We examined differences between spouses of participants assigned to the Intensive Lifestyle Intervention (ILI) or to enhanced usual care (DSE). Results Spouses of ILI participants lost -2.2±4.5 kg vs. -0.2±3.3 kg in spouses of DSE participants (p<.001). In addition, more ILI spouses lost ≥ 5% of their body weight than DSE spouses (26% vs. 9%, p<.001). Spouses of ILI participants also had greater reductions in reported energy intake (p=.007) and percentage of energy from fat (p=.012) than DSE spouses. Spouse weight loss was associated with participant weight loss (p<.001) and decreases in high-fat foods in the home (p=.05). Conclusion The reach of behavioral weight loss treatment can extend to a spouse, suggesting that social networks can be utilized to promote the spread of weight loss thus creating a ripple effect. PMID:18762804

Self-reported body weight perception and dieting practices in community-dwelling patients with schizophrenia.

PubMed

Strassnig, Martin; Brar, Jaspreet S; Ganguli, Rohan

2005-06-15

Many patients with schizophrenia are exposed to serious health risks associated with their excess body weight. Evidence exists that even a moderate amount of weight loss may have significant health benefits. Thus, weight control in schizophrenia patients has become an important treatment goal. Although studies in the general population show that satisfaction with body weight is an important predictor for engagement in various weight loss measures, the perspective of schizophrenia patients has not been assessed. Information on self-reported weight perception, desire to lose weight as well as weight loss attempts was obtained according to methods employed in the National Health and Nutrition Examination Survey, Cycle III (NHANES III). Body weight and height were measured and body mass index (BMI) was calculated. Perception of body weight and desire to lose weight were correlated to BMI. Both obese female and male subjects (BMI30) were aware of their weight status. However, whereas overweight females (BMI>25< or =29.9) accurately perceived themselves so, males in this category had difficulties perceiving themselves overweight, and consequently neither wanted to lose weight, nor tried to lose weight. As means of weight loss, caloric restriction (diet) was most frequently employed (by more than 80% of study subjects); yet only a third of study subjects (34.4%) engaged in the recommended combination of diet and exercise to lose weight. Questionable weight loss practices were also frequently employed, especially among women. Obese patients (BMI> or =30) were generally aware of their excess body weight and wanted to lose weight. Only non-obese, yet overweight males (BMI>25< or =29.9) did not perceive themselves as overweight and consequently did not try to lose weight. Weight loss practices did not always follow established recommendations. Especially women were likely to approach weight loss with questionably appropriate and unsafe methods.

Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters.

PubMed

Senekal, Marjanne; Lasker, Gabrielle L; van Velden, Lindsay; Laubscher, Ria; Temple, Norman J

2016-09-01

Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Two hundred and fifty female students from South Africa universities, aged 18-25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters) and 88 were non-dieters. Weight and height were measured and BMI (kg/m(2)) computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data). Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m(2)) were identified using regression models. Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students), dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased risk for BMI ≥25 included weight-loss attempt during the past year, race, dissatisfaction with waist, perception of currently being "chubby," and higher frequencies of intake of a snack and fatty foods. Attempting weight-loss is common among female students and predicts BMI. Healthy (mainly), unhealthy and extreme weight loss methods are used. Dieters are characterized by a less realistic body image, lower body satisfaction, higher pressure to lose weight, use of informal weight-management information and a healthier life-style.

Citrus aurantium as a thermogenic, weight-reduction replacement for ephedra: an overview.

PubMed

Preuss, Harry G; DiFerdinando, Donna; Bagchi, Manashi; Bagchi, Debasis

2002-01-01

Obesity is a serious health problem throughout the world. More than half of U.S. adults are overweight (61%) and more than a quarter (26%) of U.S. adults are obese. The inability of many individuals to keep their weight in check by diet and exercise has created a need for additional therapeutic means to combat obesity. Despite great effort, the pharmaceutical industry has not come up with the solution; because most weight-loss drugs to date have serious adverse effects to health and well-being. The theory that beta agonists, especially beta 3 agonists, can affect body weight and fat mass is well accepted. Ephedrine has proven time and time again that it is an effective weight loss agent through its ability to increase thermogenesis and quench appetite. However, the publicity concerning adverse reactions has led to its gradual withdrawal from use by many despite the perceived consequences of obesity. Many companies are now substituting Citrus aurantium for ephedra in their formulations. Citrus aurantium, an agent containing beta agonists, has been reported to aid in weight loss in two studies and increase thermogenesis, at least to some extent, in three studies. Colker et al. (1999) reported that in a double-blind, placebo-controlled, randomized study the subjects receiving a combination of Citrus aurantium, caffeine and St John's Wort, lost significant amounts of total body weight while on a strict diet and exercise. Those in the placebo and control groups who also were on the same restricted diet did not. However, intergroup analysis showed no statistical significance among the weight changes in the three groups. In contrast, the loss of fat mass in the test group was significantly greater compared to the placebo and control groups. Jones describes an open labeled study performed on 9 women. The subjects showed a mean of 0.94 kg lost during the first week when no product was given and 2.40 kg during the second week when a Citrus aurantium product was taken. Body weight losses were statistically greater during the second week compared to the first week. Since most clinicians would agree that the most weight loss should occur initially coinciding with a greater fluid loss during the first week, these differences are even more remarkable. Three studies reported increased metabolic rates when ingesting Citrus aurantium products, however, at least two of these studies were acute. At present, Citrus aurantium may be the best thermogenic substitute for ephedra. However, more studies are needed to establish this definitively.

The Role of Episodic Postprandial Peptides in Exercise-Induced Compensatory Eating.

PubMed

Gibbons, Catherine; Blundell, John E; Caudwell, Phillipa; Webb, Dominic-Luc; Hellström, Per M; Näslund, Erik; Finlayson, Graham

2017-11-01

Prolonged physical activity gives rise to variable degrees of body weight and fat loss, and is associated with variability in appetite control. Whether these effects are modulated by postprandial, peptides is unclear. We examined the role of postprandial peptide response in compensatory eating during 12 weeks of aerobic exercise and in response to high-fat, low-carbohydrate (HFLC) and low-fat, high-carbohydrate (LFHC) meals. Of the 32 overweight/obese individuals, 16 completed 12 weeks of aerobic exercise and 16 nonexercising control subjects were matched for age and body mass index. Exercisers were classified as responders or nonresponders depending on net energy balance from observed compared with expected body composition changes from measured energy expenditure. Plasma samples were collected before and after meals to compare profiles of total and acylated ghrelin, insulin, cholecystokinin, glucagon-like peptide 1 (GLP-1), and total peptide YY (PYY) between HFLC and LFHC meals, pre- and postexercise, and between groups. No differences between pre- and postintervention peptide release. Responders had greater suppression of acylated ghrelin (P < 0.05) than nonresponders, as well as higher postprandial levels of GLP-1 (P < 0.001) and total PYY (P < 0.001) compared with nonresponders and control subjects. No impact on postprandial peptide release was found after 12 weeks of aerobic exercise. Responders to exercise-induced weight loss showed greater suppression of acylated ghrelin and greater release of GLP-1 and total PYY at baseline. Therefore, episodic postprandial peptide profiles appear to form part of the pre-existing physiology of exercise responders and suggest differences in satiety potential may underlie exercise-induced compensatory eating. Copyright © 2017 Endocrine Society

Effects of diet and exercise on weight-related outcomes for breast cancer survivors and their adult daughters: an analysis of the DAMES trial.

PubMed

Tometich, Danielle B; Mosher, Catherine E; Winger, Joseph G; Badr, Hoda J; Snyder, Denise C; Sloane, Richard J; Demark-Wahnefried, Wendy

2017-08-01

Few trials have aimed to promote diet and exercise behaviors in both cancer survivors and their family members and examine their associations with weight-related outcomes. We conducted a secondary analysis to examine associations between change in diet and exercise behaviors and weight-related outcomes for overweight breast cancer survivors and their overweight adult daughters in the Daughters And MothErS Against Breast Cancer (DAMES) randomized trial. The DAMES trial assessed the impact of two iteratively tailored, mailed print diet and exercise interventions against standard brochures over a 12-month period. This analysis examined change in diet and exercise behaviors and weight-related variables from baseline to post-intervention for the 50 breast cancer survivors and their adult daughters randomized to the intervention arms. To reduce the potential for type II error in this pilot, p values <0.10 were considered statistically significant. For mothers, change in diet quality was uniquely related to change in BMI (β = -0.12, p = 0.082), weight (β = -0.12, p = 0.060), and waist circumference (β = -0.38, p = 0.001), whereas change in caloric intake was related to waist circumference (β = 0.21, p = 0.002). For daughters, change in caloric intake was related to change in waist circumference (β = 0.12, p = 0.055). However, change in diet quality was not associated with weight-related outcomes in daughters. Additionally, change in exercise was not associated with weight-related outcomes in mothers or daughters. Findings support mail-based and other tailored interventions for weight loss in this population, with an emphasis on diet quality for breast cancer survivors and caloric intake for their adult daughters.

Role of fermented beverages in the maintenance of weight loss

PubMed

Monereo Megías, Susana; Arnoriaga Rodríguez, María; Olmedilla Ishishi, Yoko Lucía; Martínez de Icaya, Purificación

2016-07-12

Obesity is a very prevalent disease with multiple chronic complications that decrease or disappear after a small (5-10%) but maintained weight loss. Nevertheless, maintaining weight loss after the treatment is very difficult and it involves one of the biggest challenges to control this epidemic. Although the reasons that contribute to regain the lost weight are diverse and related to the biological response to caloric restriction and the lack of adherence to treatment, up to 20% of the patients are able to keep it off. The keys to success, involve the maintenance of healthy habits, exercise and a reasonable daily calorie intake to allow a normal way of life, without sacrificing the social life. At this point, learning to distinguish food and drink options in a society where social life often revolves around the table is very important. We review the keys to keep the weight off after a diet as well as the role of fermented beverages such as beer, in this process. In conclusion, maintenance the weight loss is harder than losing it. The mild-to-moderate consumption of fermented beverages such as beer is not associated with weight increase.

Low-Carbohydrate-High-Fat Diet: Can it Help Exercise Performance?

PubMed Central

Borer, Katarina; Lin, Po-Ju

2017-01-01

Abstract Low-carbohydrate-high-fat (LCHF) diets have been used as a means of weight loss and control of symptoms in several clinical conditions. There is emerging evidence that the metabolic changes induced by LCHF diets enhance endurance performance. The aims of this review are to examine the evidence of LCHF diets in improving various aspects of athletic performance. Long-term LCHF dietary intake may help control body weight and fat mass while maintaining lean body mass in athletes in weight-sensitive sports. LCHF-adapted endurance athletes can reach the maximal fat oxidation rate of approximately 1.5 g/min, with a lower carbohydrate oxidation rate and similar muscle glycogen content and a resynthesis rate compared to their counterparts consuming high-carbohydrate-low-fat (HCLF) diets. The elevated fat oxidation rate and glycogen sparing effect may improve performance in ultra-endurance events. These metabolic changes may also prevent the decline in performance in later stages of repeated high-intensity movements, in which the aerobic metabolism becomes more important. However, elevated blood concentrations of non-esterified fatty acids and ammonia during exercise after LCHF diets may lead to early development of central fatigue. It appears that at least several months of adaptation to a LCHF diet are required for the metabolic changes and restoration of muscle glycogen to occur. Further investigations on LCHF diets are needed regarding (1) performance after weight loss in weight-categorized sports; (2) repeated high-intensity exercise performance; (3) development of central fatigue during endurance events; (4) perceptual-motor performance during prolonged intermittent sports; and (5) ideal dietary fatty acid compositions. PMID:28469746

Low-Carbohydrate-High-Fat Diet: Can it Help Exercise Performance?

PubMed

Chang, Chen-Kang; Borer, Katarina; Lin, Po-Ju

2017-02-01

Low-carbohydrate-high-fat (LCHF) diets have been used as a means of weight loss and control of symptoms in several clinical conditions. There is emerging evidence that the metabolic changes induced by LCHF diets enhance endurance performance. The aims of this review are to examine the evidence of LCHF diets in improving various aspects of athletic performance. Long-term LCHF dietary intake may help control body weight and fat mass while maintaining lean body mass in athletes in weight-sensitive sports. LCHF-adapted endurance athletes can reach the maximal fat oxidation rate of approximately 1.5 g/min, with a lower carbohydrate oxidation rate and similar muscle glycogen content and a resynthesis rate compared to their counterparts consuming high-carbohydrate-low-fat (HCLF) diets. The elevated fat oxidation rate and glycogen sparing effect may improve performance in ultra-endurance events. These metabolic changes may also prevent the decline in performance in later stages of repeated high-intensity movements, in which the aerobic metabolism becomes more important. However, elevated blood concentrations of non-esterified fatty acids and ammonia during exercise after LCHF diets may lead to early development of central fatigue. It appears that at least several months of adaptation to a LCHF diet are required for the metabolic changes and restoration of muscle glycogen to occur. Further investigations on LCHF diets are needed regarding (1) performance after weight loss in weight-categorized sports; (2) repeated high-intensity exercise performance; (3) development of central fatigue during endurance events; (4) perceptual-motor performance during prolonged intermittent sports; and (5) ideal dietary fatty acid compositions.

Body Weight Perception and Weight Control Practices among Teenagers

PubMed Central

Jeewon, Rajesh

2013-01-01

Background. Weight-loss behaviours are highly prevalent among adolescents, and body weight perception motivates weight control practices. However, little is known about the association of body weight perception, and weight control practices among teenagers in Mauritius. The aim of this study is to investigate the relationships between actual body weight, body weight perception, and weight control practices among teenagers. Methods. A questionnaire-based survey was used to collect data on anthropometric measurements, weight perception and weight control practices from a sample of 180 male and female students (90 boys and 90 girls) aged between 13 and 18 years old. Results. Based on BMI, 11.7% of students were overweight. Overall, 43.3% of respondents reported trying to lose weight (61.1% girls and 25.6% boys). Weight-loss behaviours were more prevalent among girls. Among the weight-loss teens, 88.5% students perceived themselves as overweight even though only 19.2% were overweight. Reducing fat intake (84.6%), exercising (80.8%), and increasing intake of fruits and vegetables (73.1%) and decreasing intake of sugar (66.7%) were the most commonly reported methods to lose weight. Conclusion. Body weight perception was poorly associated with actual weight status. Gender difference was observed in body weight perception. PMID:24967256

Obesity and Atrial Fibrillation Prevalence, Pathogenesis, and Prognosis: Effects of Weight Loss and Exercise.

PubMed

Lavie, Carl J; Pandey, Ambarish; Lau, Dennis H; Alpert, Martin A; Sanders, Prashanthan

2017-10-17

Both obesity and atrial fibrillation (AF) are increasing in epidemic proportions, and both increase the prevalence of cardiovascular disease events. Obesity has adverse effects on cardiovascular hemodynamics and cardiac structure and function, and increases the prevalence of AF, partly related to electroanatomic remodeling in obese patients. However, numerous studies, including in AF, have demonstrated an obesity paradox, where overweight and obese patients with these disorders have a better prognosis than do leaner patients with the same degree of severity of cardiovascular disease/AF. In this paper, the authors discuss special issues regarding AF in obesity, as well as the evidence that despite the presence of an obesity paradox, there are benefits of weight loss, physical activity/exercise training, and increases in cardiorespiratory fitness on the prognosis of obese patients with AF. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Cultural expectations of thinness in women: a partial replication and update of magazine content.

PubMed

Saraceni, R; Russell-Mayhew, S

2007-09-01

To determine if magazine articles in mainstream women's magazines, continue to emphasize weight reduction. Articles devoted to diet, exercise, and cosmetic surgery were tabulated from January 1989 to April 2007 in eight popular women's magazines. The number of cosmetic surgery articles has substantially increased since 1989, while exercise articles continue to decline. Diet for weight loss articles have progressively decreased since 1989, with a marginal increase between 2003-2007. The upward trend in cosmetic surgery articles indicates that cosmetic surgery is now viewed as an alternate means to diet and exercise that women may choose to alter their physical appearance. One of the implications of moving to cosmetic surgery as a means to conform is that when it comes to female beautification, there are few extremes.

Individual Differences and Short-Term Military Factors Associated With Unhealthy Weight Control Behaviors Among Active Duty and Reserve Army Soldiers

DTIC Science & Technology

2009-03-01

syndrome eating disorders (Eisenberg & Neumark-Sztainer, 2008; Neumark-Sztainer et al., 2002; Rukavina & Pokrajac-Bulian, 2006). Although the...risk for developing full- syndrome eating disorders. Repeated periods of extreme weight loss behavior may reinforce that purging, fasting, or excessive...exercise are “good” ways to lose weight. In fact, many individuals with full syndrome eating disorders start by engaging in repeated periods of

Aerobic exercise is necessary to improve glucose utilization with moderate weight loss in women.

PubMed

Ryan, Alice S; Nicklas, Barbara J; Berman, Dora M

2006-06-01

To determine the effects of weight loss (WL) alone and combined with aerobic exercise on visceral adipose tissue (VAT), intramuscular fat, insulin-stimulated glucose uptake, and the rate of decline in free fatty acid (FFA) concentrations during hyperinsulinemia. We studied 33 sedentary, obese (BMI = 32 +/- 1 kg/m(2)) postmenopausal women who completed a 6-month (three times per week) program of either WL alone (n = 16) or WL + aerobic exercise (AEX) (n = 17). Glucose utilization (M) was measured during a 3-hour hyperinsulinemic-euglycemic clamp (40 mU/m(2) per minute). M/I, the amount of glucose metabolized per unit of plasma insulin (I), was used as an index of insulin sensitivity. Body weight, total fat mass, and percentage fat decreased similarly in both groups (p < 0.01). VAT, subcutaneous abdominal adipose tissue, mid-thigh subcutaneous fat, and intramuscular fat decreased to a similar extent in both groups and between 14% and 27% after WL and WL+AEX (p < 0.05). WL alone did not change M or M/I; however, M and M/I increased 15% and 21% after WL+AEX (p < 0.05). Fasting concentrations and rate of decline of FFA did not change in either group. In stepwise regression models to determine the independent predictors of changes in M and M/I, the change in VAT was the single independent predictor of M (r(2) = 0.30) and M/I (r(2) = 0.33). Intramuscular fat decreases similarly with 6 months of moderate WL alone or with aerobic exercise in postmenopausal women. In contrast, only WL combined with exercise results in increased glucose utilization and insulin sensitivity. These findings should be validated in a larger population.

Dose response of exercise training following roux-en-Y gastric bypass surgery: A randomized trial.

PubMed

Woodlief, Tracey L; Carnero, Elvis A; Standley, Robert A; Distefano, Giovanna; Anthony, Steve J; Dubis, Gabe S; Jakicic, John M; Houmard, Joseph A; Coen, Paul M; Goodpaster, Bret H

2015-12-01

Roux-en-Y gastric bypass (RYGB) surgery can cause profound weight loss and improve overall cardiometabolic risk factors. Exercise (EX) training following RYGB can provide additional improvements in insulin sensitivity (SI ) and cardiorespiratory fitness. However, it remains unknown whether a specific amount of EX post-RYGB is required to achieve additional benefits. We performed a post hoc analysis of participants who were randomized into either a 6-month structured EX program or a health education control (CON). The EX group (n = 56) was divided into tertiles according to the amount of weekly exercise performed, compared with CON (n = 42): low-EX = 54 ± 8; middle-EX = 129 ± 4; and high-EX = 286 ± 40 min per week. The high-EX lost a significantly greater amount of body weight, total fat mass, and abdominal deep subcutaneous abdominal fat compared with CON (P < 0.005). SI improved to a greater extent in both the middle-EX and high-EX compared with CON (P < 0.04). Physical fitness (VO2 max) significantly improved in the high-EX (9.3% ± 4.2%) compared with CON (-6.0 ± 2.4%) (P < 0.001). Skeletal muscle mitochondrial State 4 (P < 0.002) and 3 (P < 0.04) respiration was significantly higher in the high-EX compared with CON. A modest volume of structured exercise provides additional improvements in insulin sensitivity following RYGB, but higher volumes of exercise are required to induce additional weight loss, changes in body composition, and improvements in cardiorespiratory fitness and skeletal muscle mitochondrial capacity. © 2015 The Obesity Society.

Diet and Physical Activity Behaviors in Primary Care Patients with Recent Intentional Weight Loss.

PubMed

Gibbs, Bethany Barone; Tudorascu, Dana; Bryce, Cindy L; Comer, Diane; Fischer, Gary S; Hess, Rachel; Huber, Kimberly A; McTigue, Kathleen M; Simkin-Silverman, Laurey R; Conroy, Molly B

2017-01-01

Lifestyle habits of primary care patients with recent, intentional weight loss are unclear and need to be better understood to aid in translational health promotion efforts. We aimed to characterize diet and exercise habits in primary care patients with recent, intentional weight loss, comparing those with greater (≥10%) vs. lesser (5 to <10%) weight loss. This was a cross-sectional analysis of baseline data from a randomized trial comparing weight loss maintenance interventions. The study included primary care patients, 18-75 years old, with ≥5% intentional weight loss via lifestyle change in the past 2 years. Participants (74% female, 87% white) had mean age 53 (12) years, body mass index 30.4 (5.9) kg/m 2 , and recent weight loss of 11 (8)%. Dietary habits were measured by the Diet Habits Survey. Physical activity and sedentary behavior were measured by self-report and objectively by pedometer. On average, participants reported high fruits and vegetables intake (5 servings/day), and low intake of fried foods (1 serving/week), desserts (1 serving/week) and sugar-sweetened beverages (0 servings/week). Those with greater vs. lesser weight loss had higher intake of fruits and vegetables (p=0.037) and low fat foods or recipes (p=0.019). Average self-reported moderate-vigorous physical activity was 319 (281) minutes/week, with significant differences between greater (374 (328) minutes/week) vs. lesser (276 (230) minutes/week) weight loss groups (p=0.017). By pedometer, 30% had ≥7,500 steps/day; the proportion was higher in greater (43%) vs. lesser (19%) weight loss groups (p=0.005). For weight loss, clinical patients typically employ simple strategies such as 5+ fruits and vegetables per day, fried foods and desserts ≤1 per week, elimination of sugary drinks, choosing low fat foods/recipes, and physical activity 45-60 min/day.

Reduced Nonexercise Activity Attenuates Negative Energy Balance in Mice Engaged in Voluntary Exercise.

PubMed

Lark, Daniel S; Kwan, Jamie R; McClatchey, P Mason; James, Merrygay N; James, Freyja D; Lighton, John R B; Lantier, Louise; Wasserman, David H

2018-05-01

Exercise alone is often ineffective for treating obesity despite the associated increase in metabolic requirements. Decreased nonexercise physical activity has been implicated in this resistance to weight loss, but the mechanisms responsible are unclear. We quantified the metabolic cost of nonexercise activity, or "off-wheel" activity (OWA), and voluntary wheel running (VWR) and examined whether changes in OWA during VWR altered energy balance in chow-fed C57BL/6J mice ( n = 12). Energy expenditure (EE), energy intake, and behavior (VWR and OWA) were continuously monitored for 4 days with locked running wheels followed by 9 days with unlocked running wheels. Unlocking the running wheels increased EE as a function of VWR distance. The metabolic cost of exercise (kcal/m traveled) decreased with increasing VWR speed. Unlocking the wheel led to a negative energy balance but also decreased OWA, which was predicted to mitigate the expected change in energy balance by ∼45%. A novel behavioral circuit involved repeated bouts of VWR, and roaming was discovered and represented novel predictors of VWR behavior. The integrated analysis described here reveals that the weight loss effects of voluntary exercise can be countered by a reduction in nonexercise activity. © 2018 by the American Diabetes Association.

Psychosocial and behavioral profile and predictors of self-reported energy underreporting in obese middle-aged women.

PubMed

Abbot, Jaclyn Maurer; Thomson, Cynthia A; Ranger-Moore, James; Teixeira, Pedro J; Lohman, Timothy G; Taren, Douglas L; Cussler, Ellen; Going, Scott B; Houtkooper, Linda B

2008-01-01

Energy underreporting is a concern with dietary intake data; therefore, subject characteristics associated with underreporting energy intake should be elucidated. Baseline self-reported dietary intake and measures of diet and weight history, life status, weight-loss readiness, psychology, eating behavior, physical activity, and self-image of obese middle-aged women (mean body mass index [calculated as kg/m(2)]=31.0) enrolled in a lifestyle weight-loss program were evaluated. Of the 155 participating, 71 women were identified as underreporting energy intake using the Goldberg cutoff values. Comparison of means between psychosocial and behavioral measures from energy underreporters and energy accurate reporters were used to help develop logistic regression models that could predict likelihood to underreport energy intake based on baseline measures. Characteristics most predictive of energy underreporting included fewer years of education (P=0.01), less-realistic weight-loss goals (P=0.02), higher perceived exercise competence (P=0.07), more social support to exercise (P=0.04), more body-shape concern (P=0.01), and higher perception of physical condition (P=0.03). These results highlight distinct psychosocial and behavioral characteristics that, at baseline, can help identify the likelihood an overweight middle-aged woman entering a weight-loss intervention will underreport energy intake. These results can help provide a framework for screening study participants for probability of energy underreporting, based on baseline psychosocial and behavioral measures. This knowledge can help researchers target at-risk subjects and, through education and training, improve the accuracy of self-reported energy intake and, ultimately, the accuracy of energy and nutrient intake relationships with health and disease.

Early weight loss while on lorcaserin, diet and exercise as a predictor of week 52 weight-loss outcomes.

PubMed

Smith, Steven R; O'Neil, Patrick M; Astrup, Arne; Finer, Nicholas; Sanchez-Kam, Matilde; Fraher, Kyle; Fain, Randi; Shanahan, William R

2014-10-01

To identify an early treatment milestone that optimizes sensitivity and specificity for predicting ≥5% weight loss at Week (W) 52 in patients with and without type 2 diabetes on lorcaserin or placebo. Post hoc area under the curve for receiver operating characteristic analyses of data from three phase 3 trials comparing lifestyle modification+placebo with lifestyle modification+lorcaserin. A total of 6897 patients (18-65 years; BMI, 30-45 or 27-29.9 kg/m(2) with ≥1 comorbidity) were randomized to placebo or lorcaserin 10 mg bid. Changes (baseline to W52) in cardiometabolic parameters were assessed. Response (≥5% weight loss from baseline) at W12 was a strong predictor of W52 response. Lorcaserin patients with a W12 response achieved mean W52 weight losses of 10.6 kg (without diabetes) and 9.3 kg (with diabetes). Proportions achieving ≥5% and ≥10% weight loss at W52 were 85.5% and 49.8% (without diabetes), and 70.5% and 35.9% (with diabetes). Lorcaserin patients who did not achieve a W12 response lost 3.2 kg (without diabetes) and 2.8 kg (with diabetes) at W52. Responders had greater improvements in cardiometabolic risk factors than the modified intent-to-treat (MITT) population, consistent with greater weight loss. ≥5% weight loss by W12 predicts robust response to lorcaserin at 1 year. Copyright © 2014 The Authors Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

Weight loss and dropout during a commercial weight-loss program including a very-low-calorie diet, a low-calorie diet, or restricted normal food: observational cohort study.

PubMed

Hemmingsson, Erik; Johansson, Kari; Eriksson, Jonas; Sundström, Johan; Neovius, Martin; Marcus, Claude

2012-11-01

The effectiveness of commercial weight-loss programs consisting of very-low-calorie diets (VLCDs) and low-calorie diets (LCDs) is unclear. The aim of the study was to quantify weight loss and dropout during a commercial weight-loss program in Sweden (Itrim; cost: $1300/€1000; all participants paid their own fee). This observational cohort study linked commercial weight-loss data with National Health Care Registers. Weight loss was induced with a 500-kcal liquid-formula VLCD [n = 3773; BMI (in kg/m(2)): 34 ± 5 (mean ± SD); 80% women; 45 ± 12 y of age (mean ± SD)], a 1200-1500-kcal formula and food-combination LCD (n = 4588; BMI: 30 ± 4; 86% women; 50 ± 11 y of age), and a 1500-1800-kcal/d restricted normal-food diet (n = 676; BMI: 29 ± 5; 81% women; 51 ± 12 y of age). Maintenance strategies included exercise and a calorie-restricted diet. Weight loss was analyzed by using an intention-to-treat analysis (baseline substitution). After 1 y, mean (±SD) weight changes were -11.4 ± 9.1 kg with the VLCD (18% dropout), -6.8 ± 6.4 kg with the LCD (23% dropout), and -5.1 ± 5.9 kg with the restricted normal-food diet (26% dropout). In an adjusted analysis, the VLCD group lost 2.8 kg (95% CI: 2.5, 3.2) and 3.8 kg (95% CI: 3.2, 4.5) more than did the LCD and restricted normal-food groups, respectively. A high baseline BMI and rapid initial weight loss were both independently associated with greater 1-y weight loss (P < 0.001). Younger age and low initial weight loss predicted an increased dropout rate (P < 0.001). Treatment of depression (OR: 1.4; 95% CI: 1.1, 1.9) and psychosis (OR: 2.6; 95% CI: 1.1, 6.3) were associated with an increased dropout rate in the VLCD group. A commercial weight-loss program, particularly one using a VLCD, was effective at reducing body weight in self-selected, self-paying adults.

The association of gastrointestinal symptoms with weight, diet, and exercise in weight-loss program participants.

PubMed

Levy, Rona L; Linde, Jennifer A; Feld, Kayla A; Crowell, Michael D; Jeffery, Robert W

2005-10-01

Studies on the relationship between gastrointestinal (GI) symptoms and obesity are limited. Research on the relationship between GI symptoms (including irritable bowel syndrome [IBS]), weight, and weight-related behaviors are rare. This study assessed rates of GI symptoms in a sample of obese patients in a weight-loss program and explored relationships among GI symptoms and obesity, binge eating, dieting (fat and fruit/fiber consumption), and physical activity. A total of 983 participants (70% women) had a mean body mass index (BMI) of 33.2+/-5.7 kg/m2 (range, 25.1-60.8 kg/m2) and a mean age of 52.7+/-12.4 years (range, 20.4-89.8 y). Participants completed a questionnaire about diet and physical activity and a standardized self-report Rome II questionnaire assessing IBS status and GI symptoms. In bivariate analyses BMI was associated positively with abdominal pain and diarrhea whereas healthier diet (lower fat and higher fruit/fiber intake) and higher physical activity were associated with fewer GI symptoms. In multivariate models BMI was not associated with GI symptoms; physical activity remained a protective factor. Although physiologic mechanisms still need to be explored, associations between GI symptoms and diet and exercise behaviors may have implications for the treatment of both obesity and GI symptoms.

[Strategies for successful weight reduction - focus on energy balance].

PubMed

Weck, M; Bornstein, S R; Barthel, A; Blüher, M

2012-10-01

The prevalence of obesity and related health problems is increasing worldwide and also in Germany. It is well known that substantial and sustained weight loss is difficult to accomplish. Therefore, a variety of studies has been performed in order to specify causes for weight gain and create hypotheses for better treatment options. Key factors of this problem are an adaptation of energy metabolism, especially resting metabolic rate (RMR), non-exercise thermogenesis and diet induced thermogenesis. The extremely high failure rate (> 80%) to keep the reduced weight after successful weight loss is due to adaptation processes of the body to maintain body energy stores. This so called "adaptive thermogenesis" is defined as a smaller than predicted change of energy expenditure in response to changes in energy balance. Adaptive thermogenesis appears to be a major reason for weight regain. The foremost objective of weight-loss programs is the reduction in body fat. However, a concomitant decline in lean tissue can frequently be observed. Since lean body mass (LBM) represents a key determinant of RMR it follows that a decrease in lean tissue could counteract the progress of weight loss. Therefore, with respect to long-term effectiveness of weight reduction programs, the loss of fat mass while maintaining LBM and RMR seems desirable. In this paper we will discuss the mechanisms of adaptive thermogenesis and develop therapeutic strategies with respect to avoiding weight regain successful weight reduction. © Georg Thieme Verlag KG Stuttgart · New York.