Physical Activity Moving Toward Obesity Solutions: Workshop Summary (2015) / Chapter Skim
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4 Physical Activity-Related and -Induced Outcomes with Overweight and Obesity
4 Physical Activity-Related and -Induced Outcomes with Overweight and Obesity
Pages 57-74
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From page 57... ...
Kriska remarked that researchers are still analyzing data from an expanded community-wide lifestyle intervention program translated from the successful DPP to suit the community setting. Thus far they have observed increased physical activity, reduced weight, and significant improvements in diabetes and cardiovascular risk factors.
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From page 58... ...
"I think that's where the action really should be," he said. PHYSICAL ACTIVITY AS PART OF COMMUNITY LIFESTYLE INTERVENTION EFFORTS BASED ON THE DIABETES PREVENTION PROGRAM1 The Diabetes Prevention Program The strength of the DPP, Andrea Kriska began, was in the diversity of its participants, in terms of age (25 years and up)
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From page 59... ...
. Lifestyle intervention participants also had significantly greater weight loss than participants in the other two groups by the end of the study (Diabetes Prevention Program Research Group, 2002)
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From page 60... ...
In summary, results from the DPP and its follow-up DPPOS indicate that diabetes can be prevented with lifestyle intervention and that physical activity is a critical component of such intervention. Community Translation of the DPP Lifestyle Intervention DPP investigators in Pittsburgh modified the DPP lifestyle intervention to develop a more community-friendly program called Group Lifestyle Bal ance, a 1-year program that entailed 16 sessions during the first half and
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From page 61... ...
In addition to its impact on weight loss and physical activity, the lifestyle intervention positively improved several diabetes and cardiovascular risk factors -- fasting glucose, hemoglobin A1c (%) (not measured at the military site)
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From page 62... ...
Second, when evaluating the effects of community translation efforts, Kriska suggested considering use of a high-risk approach to understand the full extent of the impact of lifestyle intervention on participants' health. Additionally, she suggested paying attention to the potential influence of seasonal variation on physical activity levels.
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From page 63... ...
Defining successful long-term weight loss as intentionally losing at least 10 percent of initial body weight and keeping it off for at least 1 year, Wing and Hill (2001) suggest that at least 20 percent of overweight or obese individuals who attempt to lose weight can achieve long-term success.
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From page 64... ...
"This is a compelling argument for us to think about not necessarily weight loss in this population," Shaibi said, "but targeted health promotion and disease prevention programs." Data from recent meta-analyses on the effects of exercise in children who are already overweight or obese indicate only small effects on blood pressure (Garcia-Hermoso et al., 2013) , lipid profile (Escalante et al., 2012)
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From page 65... ...
After the 13 weeks of interval training, stroke volume in the obese adolescents had increased significantly, so much so that there was no statistical difference in stroke volume between them and the lean controls by the end of the study. The researchers observed similar changes in global strain, but no change in weight, lipid profile, or blood pressure.
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From page 66... ...
Overall, Shaibi and his team observed statistically significant improvements in insulin sensitivity and glucose tolerance. But on an individual basis, not all the adolescents showed improvement: nine exhibited increases in insulin sensitivity in response to the intervention (the "responders")
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From page 67... ...
PHYSICAL ACTIVITY: IMPLICATIONS FOR WEIGHT LOSS MAINTENANCE AND RELATED HEALTH OUTCOMES4 Asking whether the focus should be physical activity (and its relationship to health) or obesity is the wrong approach, John Jakicic began.
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From page 68... ...
revealed a similar larger effect when weight loss was added to a diet and exercise program for older adults with knee osteoarthritis. Again, Jakicic said, exercise provides benefits, but weight loss induced by dietary change adds to the benefits observed.
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From page 69... ...
The Important Role of Physical Activity in Maintaining Weight Loss Not only is physical activity important for weight loss, but it is also important for the maintenance of weight loss, Jakicic continued. In a study of about 150 individuals who participated in an 18-month weight loss program, he and his research team classified participants into three categories based on their physical activity levels and examined their weight loss trajectories (Jakicic et al., 1999)
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From page 70... ...
The group that had lost weight at the 6-month mark and maintained that weight loss over the course of the entire 18 months lost and sustained, on average, an impressive 18 percent of body weight, Jakicic said. That is the same magnitude of weight loss typically observed following gastric band surgery, he noted, and it may even be greater.
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From page 71... ...
He and his team have done a small amount of work on the psychological response to weight regain and the vicious cycle it starts, beginning with people becoming less adherent. In an 18-month study, they proactively targeted some participants in places where they would tend to slip and observed a 10 percent sustained weight loss among those participants (Jakicic et al., 2015)
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From page 72... ...
Physical Activity Versus Obesity An audience member asked Jakicic what would be lost by dissociating physical activity from weight loss. If someone engages in physical activity, in the questioner's opinion, eventually their obesity will be managed.
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From page 73... ...
"There are a lot of people out there," he said, "who need to lose weight just to be functional." In his opinion, dissociating physical activity from weight loss would be doing those people an injustice.
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