Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults

Abstract

Overweight and obesity affects more than 66% of the adult population and is associated with a variety of chronic diseases. Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies. Guidelines of the National Heart, Lung, and Blood Institute (NHLBI) encourage a 10% reduction in weight, although considerable literature indicates reduction in health risk with 3% to 5% reduction in weight. Physical activity (PA) is recommended as a component of weight management for prevention of weight gain, for weight loss, and for prevention of weight regain after weight loss. In 2001, the American College of Sports Medicine (ACSM) published a Position Stand that recommended a minimum of 150 min wk(-1) of moderate-intensity PA for overweight and obese adults to improve health; however, 200-300 min wk(-1) was recommended for long-term weight loss. More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss. To this end, we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain, for weight loss, and prevention of weight regain. Evidence supports moderate-intensity PA between 150 and 250 min wk(-1) to be effective to prevent weight gain. Moderate-intensity PA between 150 and 250 min wk(-1) will provide only modest weight loss. Greater amounts of PA (>250 min wk(-1)) have been associated with clinically significant weight loss. Moderate-intensity PA between 150 and 250 min wk(-1) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction. Cross-sectional and prospective studies indicate that after weight loss, weight maintenance is improved with PA >250 min wk(-1). However, no evidence from well-designed randomized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss. Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk. Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk. There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain.

Moderate to vigorous physical activity volume is an important factor for managing nonalcoholic fatty liver disease: A retrospective study

“…Several studies have reported indications for obtaining the direct effect of exercise on hepatic steatosis [6][7][8] ; exercise with less frequency and dose was found to be effective in both light and moderate volume exercise programs, 34 the PA volume of which was below the current guidelines for health promotion 35 and for managing body weight. 36 At present, scientific evidence for the benefits of PA and the optimal dose and modality for PA in NAFLD management is limited. 11 In summary, the results of this study show the beneficial effects of increasing the volume of MVPA combined with dietary restriction on managing NAFLD in obese, middle-aged men.…”

Improvement in HOMA-IR is an independent predictor of reduced carotid intima-media thickness in obese adolescents participating in an interdisciplinary weight-loss program

“…The exercise program was based on guidelines from the American College of Sports Medicine. 23 Resistance training was also designed based on American College of Sports Medicine recommendations. 24 Exercises targeted each of the main muscle groups.…”

Is the Environment Near Home and School Associated with Physical Activity and Adiposity of Urban Preschool Children?

“…7,8 Childhood activity patterns may be particularly important if they persist into adulthood. One proposed strategy involves making structural changes in the environments within which children live, 9 especially in areas where children have the greatest risk of sedentary behavior patterns, obesity, and related chronic diseases.…”