Physical Activity and Training Prescription




© Springer International Publishing Switzerland 2015
Andrea Lenzi, Silvia Migliaccio and Lorenzo Maria Donini (eds.)Multidisciplinary Approach to Obesity10.1007/978-3-319-09045-0_22


22. Physical Activity and Training Prescription



Cosme F. Buzzachera , Marco Meucci  and Carlo Baldari 


(1)
Department of Physical Education, North University of Parana, Avenida Marselha, 591, Londrina, Parana, 86041-120, Brazil

(2)
Department of Health and Exercise Science, Appalachian State University, 111 Rivers Street, Boone, NC 28608-2071, USA

(3)
Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Piazza L. De Bosis, 6, Rome, 00135, Italy

 



 

Cosme F. Buzzachera



 

Marco Meucci



 

Carlo Baldari (Corresponding author)



Overweight and obesity are defined by a body mass index (BMI) of 25–29.9 kg.m−2 and 30 kg.m−2 or greater, respectively. It is known that the prevalence rates of overweight and obesity are rising alarmingly among adults in both developed and developing countries [1]. The increasing rates of overweight and obesity are of concern because of the demonstrated association of excessive body weight with numerous chronic conditions like cardiovascular disease, type 2 diabetes, osteoarthritis, asthma, and certain cancers. The development and implementation of effective interventions for the treatment of excessive body weight and the limitation of obesity-related long-term comorbidities are considered an important public health initiative [2]. Of those who are overweight and/or obese in the USA, nearly 74 % of women and 60 % of men report using one or more weight management strategy [3]. However, it should be noted that even if they achieve weight loss by using management strategies, most of them will experience weight regain over time [4]. This low success rate of lifestyle interventions for overweight and obese adults presents a significant public health challenge.

This chapter describes the interplay among daily physical activity, exercise, and dietary regimens and illustrates how an understanding of exercise prescription can be helpful for the development of effective interventions for the treatment of excessive body weight in adults. First, we will discuss about the key role of physical activity in the prevention of weight gain. Second, we will examine how we can maximize weight control by using an adequate dose of exercise and/or dietary regimen. Third, we will describe how physical activity can promote health benefits for overweight adults independent of body weight. Throughout the chapter, physical activity is defined as any bodily movement produced by skeletal muscles requiring a considerable increase of energy expenditure as compared to a resting phase. Physical activity in daily life may include occupational, conditioning, sports, household, or other activities. Otherwise, exercise is defined as a subset of physical activity that is planned, structured, and repetitive with final or intermediate objectives of the improvement or maintenance of physical fitness.


22.1 Energy Balance and the Role of Physical Activity


As previously noted by Hill and colleagues, obesity is often considered to be a result of assuming too many calories and not getting enough physical activity [5]. This debate about the role of physical activity and/or dietary regimens is often emphasized in the literature [6, 7]; however, it seems clear that this discussion has not yet produced effective or innovative solutions. From a theoretical perspective, the key to managing body weight is related to energy balance. Specifically, a body weight is maintained, over a specified time, if energy intake and energy expenditure are equal. This energy balance is the goal for the prevention of initial weight gain or weight regain after weight loss. Otherwise, body weight can change only when energy intake is not equal to energy expenditure over a given period of time. This energy imbalance is necessary to elicit an energy deficit and promote weight loss in overweight and obese adults [5]. Physical activity, defined as any bodily movement produced by skeletal muscles that requires energy expenditure, is considered a key strategy to the creation of energy deficit in weight loss programs. It should be noted that daily physical activity is the most variable component of energy expenditure and consists of the amount of physical activity performed multiplied by the energy cost of that activity, aside from the energy expended through the resting metabolic rate and the thermic effect of food. However, although physical activity in terms of structured exercise is an essential component of weight loss programs, health professionals are strongly encouraged to understand the magnitude of the contribution of physical activity to weight loss in adults in excess of body weight [8].

Previous research has emphasized the importance of physical activity in terms of structured exercise in the prevention and management of obesity [5, 8], and generic guidelines originally developed for the wider population have been adapted for these specific populations. In fact, physical activity is recommended as an important part of weight management by all public health agencies and scientific organizations, including Centers for Disease Control [9], American Heart Association [10], and American College of Sports Medicine [11]. However, previous studies have found that greater changes in body weight are caused by reductions in energy intake (e.g., diet) [7, 12]. For example, Hagan and colleagues [7] observed that after 3 months, of a dietary restriction of 945 kcal for obese women and 1,705 kcal a day for obese men, body weight decreased by 5.5 and 8.4 kg, respectively. Conversely, performing an exercise training program that included 30 min of walk or jog activities for 5 days a week, obese women and men spent 190 and 255 kcal per session, resulted in a marginal weight loss of 0.6 and 0.3 kg, respectively. Conflicting evidences have been reported also by other authors who used structured, weight loss programs to increase energy expenditure via exercise. Using short-term intervention protocols lasting up to 6 months, they demonstrated that exercise training could be as effective as weight loss programs using energy restriction [6, 13, 14]. Another study conducted by Ross and colleagues [13] on 52 obese men reported a 7.5 kg (3 %) weight loss after 3 months of intervention aiming to reduce obesity and related comorbidities through a dietary restriction of 700 kcal a day or increasing energy expenditure through exercise. These results may confirm that when the energy deficits imposed by diet only and diet plus exercise interventions are similar, weight loss and percent change in body weight are similar. However, most overweight and obese adults are not able to engage in sufficient levels of exercise to produce the magnitude of weight loss typically found with energy restrictions [8]. For example, a 90 kg person would need to perform about 115 min a day of brisk walking to expend 700 kcal a day in exercise to produce this magnitude of weight loss, which is clearly an unrealistic situation for an individual who is engaging in a physical activity program.


22.2 Physical Activity to Improve Body Control



22.2.1 Mode of Exercise


Physical activity in terms of exercise in the prevention and management of obesity should focus on endurance (or cardiovascular/aerobic) modes of exercise. Specifically, this mode of exercise may lead individuals to expend a considerable amount of energy in a given period of time, which in turn may be useful for achieving the target of 2,000 kcal per week. In general, endurance training has been categorized as either weight bearing or non-weight bearing. For example, walking is classified as a weight-bearing activity and is currently considered one of the best modes of exercise for several reasons, including experience of all individuals with the activity and safety. Walking is also available to most individuals and does not require special facilities [15]. However, it should be noted that some people have preexisting musculoskeletal conditions that could prevent certain modes of weight-bearing activities. These conditions are often related to pain in the lower back, hip, knee, and ankle joints that may be chronic. In this case, non-weight-bearing activities, such as stationary cycling, recumbent cycling, upper-body ergometry, water activities, and others, should be selected. These activities are useful at any time but are particularly useful for those with joint injury or pain. In summary, health professionals are encouraged to include endurance training as an important part of their physical activity programs for overweight and obese adults.

Recent guidelines on exercise for weight loss and weight maintenance include resistance training as part of the exercise prescription. However, researchers have noted that resistance training alone is ineffective in promoting weight loss and maintenance in overweight and obese adults but it leads to significant reductions in body weight and fat mass when combined to endurance training [1618]. Furthermore, interventions that combined dietary energy restrictions with resistance exercise have shown no weight loss advantages in comparison with energy restrictions plus other forms of exercise [17]. However, resistance training as well as endurance plus resistance training can increase lean body mass more than endurance training alone. These results suggest that although the energy expenditure associated with resistance training is not large, resistance training may increase muscle mass which may in turn increase 24 h energy expenditure. These benefits of resistance training on muscle structure and function may be advantageous for improving the ability to perform activities of daily living in overweight and obese adults, which in turn results in improvements in quality of life. Thus the addition of resistance training may promote benefits for adults in excess of body weight for reasons other than the impact of this form of exercise and weight loss.

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Jul 5, 2017 | Posted by in UROLOGY | Comments Off on Physical Activity and Training Prescription

Full access? Get Clinical Tree

Get Clinical Tree app for offline access