For Women With Very Low Body Weight, High Amounts of Exercise Can Result in:

Abstruse

There is evidence to support that low fitness and physical activity, backlog body weight, and excess abdominal fatness are associated with increased health risk. Moreover, prove exists to support that sufficient levels of physical activity can significantly improve trunk weight, fatness, and health risk. Concrete activity has been shown to have a minor upshot on trunk weight that is typically <iii% of initial body weight, but has an additive issue when combined with dietary restriction. Moreover, physical activity has been shown to be an important behavioral gene for enhancing long-term weight loss and minimizing weight regain; nevertheless, this may require relatively high doses of physical activeness that approach 300min/week. Physical activeness may meantime reduce abdominal adiposity, and which may serve as a pathway by which there is as well an improvement in health-related take a chance factors for various chronic diseases. There are important areas of research that require further investigation, with particular need to further examine the dose of physical activity that significantly affects these wellness outcomes. Moreover, there is a demand for improved interventions to promote the adoption and long-term maintenance of concrete action, which can lead to improved weight control, abdominal adiposity, and chronic disease risk factors. Future research is as well needed to understand the physiological/metabolic pathways and mechanisms that explicate the influence of concrete activity on long-term regulation of body weight.

Excess body weight has been associated with an increase in health-related diseases such as center disease, diabetes, certain forms of cancer, musculoskeletal disorders, and other related problems ((i)). The morbidity and mortality of obesity-related conditions accept resulted in an increase in the associated wellness-care cost of these conditions. For example, in the U.s., the estimated cost associated with obesity exceeds $117 billion annually ((ii)). Thus, it is important to consider intervention opportunities to lower the wellness risk associated with obesity, which in turn may reduce the wellness-care costs associated with these conditions. I of the lifestyle-intervention opportunities that has been shown to be effective is concrete activity due to its importance in body-weight regulation and its contained effect on related health outcomes.

There have been numerous studies that have reported on the importance of physical activity for weight control. These studies have focused on prevention of weight gain, successful weight loss, and the prevention of weight regain. The involvement in physical activeness as a lifestyle strategy to combat the increasing prevalence of overweight and obesity stems from the fact that it is the ane method that can exist consistently used to increase free energy expenditure. Every bit highlighted by Ravussin and Bogardus ((3)) physical activity is the almost variable component of total daily free energy expenditure. Therefore, it is important to sympathise the contribution of an increase in free energy expenditure resulting from concrete activity on weight loss, long-term weight-loss maintenance, and the prevention of weight gain. Optimal weight control through physical action may as well contribute to reductions in abdominal adiposity and reductions in metabolic take chances.

Does Physical Activity Affect Health Adventure Independent of Body Weight?

There is a growing body of scientific literature to support the effect of physical activeness on health-related outcomes independent of body weight. For case, data from the Aerobics Center Longitudinal Study has consistently shown an inverse relationship between fitness and mortality in adults regardless of level of weight condition (normal weight, overweight, obese) ((4),(5),(6),(7)). The pattern of an inverse association between health risk and physical activity, independent of weight status, is also supported by a number of other investigations ((8),(ix),(10)). Lee et al. ((eleven)) have as well reported an association between improved risk factor profiles and fitness at varying levels of abdominal adiposity measured past either computed tomography or magnetic resonance imaging.

Despite these findings, there is evidence to support the position that physical action does not completely convalesce the negative health outcomes associated with obesity ((8),(ix),(ten)). This determination is consistent with the findings of Wing et al. ((12)) in a report of over 5,000 individuals with blazon 2 diabetes, which demonstrated that selected chance factors were significantly influenced by weight status (e.m., systolic blood pressure) whereas others were significantly influenced past fitness (due east.g., HbA1_c, ankle brachial index, Framingham Risk Score). Moreover, both physical activeness and a smaller waist circumference accept recently been shown to exist associated with classification of enhanced metabolic health (presence of 0 or 1 cardiometabolic abnormality) in obese individuals ((13)). These results may suggest that information technology is important to intervene on both concrete inactivity and excess body weight to have the greatest comeback in health outcomes.

A potential surface area for additional enquiry related to the independent effect of physical activity on health risks in obese individuals may lie in the study of individuals with Class II (BMI: 35.0–39.9 kg/m²) or III obesity (BMI ≥twoscore kg/m^two). Church et al. ((5)) acknowledged that there are limited data on the relationship betwixt fitness and weight condition among individuals with Class II or III obesity when examining information from the Aerobic Eye Longitudinal Study due to few individuals with this weight status being classified as fit. This observation is confirmed by Wing et al. ((12)) in analysis of data from the Look AHEAD Written report in which only 10% of individuals with Form III obesity were in the highest 40% for fettle classification, with only one.8% of individuals in the highest tertile for waist circumference beingness in the highest fitness category. These findings may advise that it may be hard and uncommon for individuals in the highest categories of obesity and/or waist circumference to be able to accomplish sufficiently high levels of fitness to better health outcomes independent of concomitant reductions in body weight. Again, this may advise that for some individuals, it is important to arbitrate on both physical inactivity and excess torso weight to take the greatest improvement in wellness outcomes.

Effect of Physical Activity on Weight Loss

To finer reduce torso weight it is widely accepted that a negative free energy balance needs to be present; whereas, to maintain weight loss and prevent weight proceeds, free energy balance needs to be present. Thus, physical action can be an important intervention to achieve desired body-weight regulation. Still, the outcome of concrete activity alone on reductions in body weight may be somewhat modest. For example, in a study of overweight and obese adults at risk for the onset of type 2 diabetes, Wing et al. ((14)) compared interventions consisting of diet lone, physical activity lone, and the combination of diet plus physical activity. Results following the initial 6-month intervention period revealed weight losses of 9.ane, 2.1, and 10.four% in these intervention conditions, respectively, with weight loss in the physical activity solitary conditioning beingness significantly less than the weight loss in the diet alone and diet plus physical activeness weather condition. In a report of men, Wood et al. ((xv)) reported that weight loss in response to concrete action was iii.0 and 4.0 kg at 7 and 12 months, which was significantly less than the 7.6 and 7.ii kg weight loss observed in response to a dietary intervention. In response to a 12-week intervention, Hagan et al. ((16)) report significantly less weight loss for men and women (0.six%) in response to physical activity solitary compared to 8.4 and 5.5% in response to dietary brake alone, and compared to 11.4 and 7.5% in response to the combined effects of diet plus concrete action. These data appear to betoken that physical activity has a modest bear on on short-term weight loss in overweight and obese adults.

Donnelly et al. ((17)) examined supervised physical activeness of 45min/day on five days/week over a xvi-calendar month flow in overweight and Class I obese adults. The results of this study demonstrated that when dietary intake is unchanged, for men concrete activeness resulted in weight decrease of 5.two kg vs. a 0.5 decrease observed in non-physical-activity control men. In dissimilarity, physical activity for women blunted weight gain with weight increasing by 0.vi kg in exercising women vs. a two.9 kg increase in non-physical-activity control women. The concrete activity also resulted in significant reductions in abdominal adiposity as measured by computed tomography. For males, nonsignificant differences at 16-month that favored the concrete action vs. the control conditions were observed for visceral fat (difference of 9.nine cm²), subcutaneous fat (divergence of 23.two cm²), and total fat (difference of 33.two cm²). For females, differences favoring the physical activity vs. the control group at 16-months were observed for visceral fat (difference of 8.6 cm²; P = 0.88), subcutaneous fat (difference of 53.iii cmⁱⁱ; P = 0.02), and total fat (difference of 61.9 cm²; P = 0.04) with the pattern of modify in abdominal adiposity mirroring the observed changes in body weight between genders. These gender differences may exist a result of the supervised physical activeness resulting in different energy expenditures, with the average energy expenditure for each physical activity session 667 kcal (6.7 kcal/kg of fat-costless mass) in men vs. 438 kcal (5.four kcal/kg fat-gratis mass) in women ((xviii)). Thus, the observed gender differences may be a event of differences in energy expenditure resulting from physical activeness. Thus, it will exist of import for future studies to examine whether clamping energy expenditure will result in similar changes in body weight in men and women.

The scientific evidence presented in the Concrete Action Guidelines Committee Report in the Us (http:www.health.govPAguidelines) confirms that concrete alone typically results in weight change of <3% of initial trunk weight, with accented weight loss ranging from ∼0.5 to 3.0 kg. This is consequent with the magnitude of 2.4 kg reported by the National Heart, Lung and Blood Establish's Adept Panel ((1)), and the 1–2 kg reduction in body weight reported in a review conducted past Wing ((19)).

This small magnitude of weight loss resulting from physical activity alone is consistent with the definition of "weight stability" as defined by Stevens et al. ((xx)), suggesting that a greater dose of physical activity or physical activeness combined with reductions in energy intake may be required to elicit greater reductions in body weight. Notwithstanding, it is important to note that even pocket-sized reductions in torso weight may be beneficial for reducing cardiometabolic risk. For case, Wing et al. ((14)) reported that a 2.3 kg reduction in body weight over a menstruation of 24 months from physical activeness or the combination of diet plus physical action decreased the relative risk of developing diabetes by ∼30% in individuals initially identified with normal or dumb glucose tolerance.

Effect of Concrete Activity on Long-Term Weight Loss and Weight-Loss Maintenance

Although physical activity may have pocket-sized effects on initial weight loss, physical activity may exist a critically important strategy for the maintenance of weight loss. Jakicic et al. ((21)) have recently reported that relatively high doses of concrete activity may be important for the long-term maintenance of weight loss. In a secondary assay of data from a report of adult women, it was reported that individuals who achieved a weight loss of 10% of initial body weight that was maintained at 24 months were engaging in ∼275min/week of physical activity to a higher place baseline levels. Achievement of a ten% weight loss is consequent with the weight-loss target recommended by the National Heart, Lung and Blood Establish for overweight and obese adults ((1)). The importance of improved long-term weight loss in this report appears to also bear on sustained reduction in abdominal adiposity as measured past waist circumference, sagittal diameter, waist-to-hip ratio (Figure 1).

Changes in (a) waist circumference, sagittal diameter, and hip circumference and (b) waist-to-hip ratio by 24-month weight loss (data adapted from Jakicic et al. ((21))).

These results confirm the importance of relatively high doses of physical activity to maintain weight loss as reported past others ((22),(23),(24),(25),(26)), and may confirm recommendations for weight-loss maintenance that have been reported ((27),(28),(29),(30)). This is of importance considering the maintenance of initial weight loss has been challenging. For case, it has been reported that following weight loss, ∼33–fifty% of initial weight loss is regained in the ensuing 12–eighteen months ((31)). Notwithstanding, physical activity appears to play a fundamental role in the long-term maintenance of weight loss, which may ultimately upshot in sustained improvements in metabolic hazard.

The National Weight Control Registry (NWCR) is a registry of individuals who have self-reported to accept lost at least 30 pounds and have maintained this weight loss for at least 1 yr (ref. (25)). This provides interesting data related to the behaviors of individuals who have successfully lost and maintained pregnant weight loss. Of interest is the blueprint of physical activity in this cohort. Klem et al. ((25)) report that individuals in the NWCR cocky-report participating in ∼2,800 kcal/week of leisure-time physical activity to maintain their body weight. McGuire et al. ((32)) further highlight the importance of concrete action for weight-loss maintenance by reporting that individuals in the National Weight Control Registry who regained weight after one year in this registry reported greater decreases in energy expenditure when compare to those individuals who continued to maintain their significant weight loss.

Evidence of the importance of physical activity for maintenance of weight loss is not limited to the National Weight Control Registry. For example, Kayman et al. ((33)) reported that 76% of individuals who had maintained significant weight loss reported using concrete activity as a weight-loss strategy vs. 36% of individuals who relapsed from initial weight loss. When comparing individuals who had maintained a weight loss of xv pounds vs. those who had relapsed, Gormally and Rardin ((34)) found that 54% of maintainers reported regular physical activity vs. 36% of those who had relapsed. Moreover, Leser et al. ((35)) reported that cocky-reported physical action was inversely correlated (r = −0.53) with weight regain at a 3-year follow-upward to a very-depression-calorie diet intervention for weight loss. Concrete activeness was also shown to be predictive of maintenance of weight loss following an intervention involving pharmacotherapy ((36)). Despite these findings, it is important to note that concrete activity is just 1 component of successful weight-loss maintenance, with Jakicic et al. ((37)) reporting that long-term weight-loss success is achieved through a constellation of behaviors, i of which is physical activeness.

Effect of Physical Action on Prevention of Weight Gain

As reported by Jakicic et al. ((21)), ∼27% of individuals engaged in a behavioral weight-loss intervention achieved a ten% weight loss at 24 months, with 49% of individuals achieving at least 5% weight loss. This confirms the difficulty of achieving long-term weight loss as reported by others ((31)). Thus, it may exist of import to focus intervention efforts on prevention of weight gain and obesity, and physical activity may exist an important component of intervention efforts to prevent weight gain.

Results from cross-exclusive and prospective observational studies appear to support the need for adequate levels of physical activity to prevention weight proceeds. Lee et al. ((8)) demonstrated from cross-exclusive information that individuals who report levels of physical activity that are consistent with the consensus public health guidelines have a lower torso weight than those not reporting this level of concrete activity ((eight)). A potential limitation of this study is the self-reported cess of concrete activity. Brawl et al. ((38)) followed a accomplice of 8,726 young women (age = xviii–23 years) for a period of 4 years to examine predictors of weight maintenance. Results from this study demonstrated that 41% of these young women gained weight over this period of fourth dimension, which was divers equally gaining ≥5% of their initial body weight. Individuals who reported spending ≥33h/week sitting were 17–twenty% more likely to gain weight compare to those reporting sitting <33h/week. These results are consistent with other studies that take demonstrated sedentary behavior such as goggle box viewing to exist associated with increasing levels of torso weight and obesity ((39)). A potential mechanism for this relationship is that a higher level of television viewing is associated with a lower resting metabolic rate in children ((twoscore)). Still, an alternative hypothesis would be that sedentary activities reduce the opportunities for physical activity, which results in an overall reduction in energy expenditure. Therefore, additional studies are required to conclusively determine how sedentary behaviors such as sitting and television viewing contribute to weight proceeds and obesity.

In a study that used an objective measurement of cardiorespiratory fitness, it was reported that weight gain was attenuated over a 4-twelvemonth period as cardiorespiratory fitness increased over this same ascertainment period ((41)). Cardiorespiratory fitness has been shown to ameliorate with increased levels of physical activity. Therefore, these findings may reflect an increase in physical action, with this contributing to the prevention of weight proceeds. In a study to examine predictors of weight gain in the Good for you Worker Project, French et al. ((42)) reported that over a 2-yr period the average weight gain was 0.six kg for women and 0.4 kg for men. Results of this study demonstrated that an increment of 1 walking session per week was predictive of a decrease in body weight over the ii-year period of 0.eight kg and 0.4 kg in women and men, respectively. Yet, these levels of concrete activity combined with dietary behaviors and weight-loss history accounted for ∼9–10% of the weight loss observed.

In that location is likewise evidence from intervention studies supporting the importance of physical activity in the prevention of weight gain. Sherwood et al. ((43)) report that concrete action was predictive of weight change in the Pound of Prevention Study. Results of multivariate cross-sectional analysis revealed that moderate-intensity physical action was predictive of less weight proceeds in this study; whereas multivariate prospective assay revealed that high-intensity physical action was predictive of weight change over the 3-year menstruum. When examining data from intervention studies, the effect of concrete activity on weight gain may result from the not-concrete-activeness control group gaining a minor amount of weight with those individuals participating in concrete activity losing a modest amount of weight. For example, Slentz et al. ((44)) reported that physical activity resulted in a modest decrease in body weight and measures of torso fatness, whereas control subjects not participating in physical activity had a modest increase in torso weight in the STRIDDE Report.

Summary

In summary, based on the scientific evidence, it appears that physical activity tin can exist an important component of intervention efforts for body-weight regulation. These findings are important equally it appears that there is a concurrent reduction in abdominal adiposity with weight loss resulting from concrete activity. All the same, the weight loss achieved with concrete activity lone appears to exist small and is typically <3% of initial body weight. However, the improver of physical action to a dietary intervention can consequence in improved weight loss compared to what is achieved through dietary modification lonely. Moreover, it appears that physical action is a key lifestyle behavior in longer term weight loss and the maintenance of weight loss. Still, as summarized in the Physical Activity Guidelines Advisory Commission Report, boosted research is needed to fully empathize the contribution of physical action to body-weight regulation ((45)). In general, these areas of research include the following:

i. Appropriately designed and powered studies are needed to understand the upshot of unlike modes, intensities, duration, and frequencies of concrete activity on weight loss, weight stability, and weight regain.

2. In that location may be a demand for farther research to understand how demographic characteristics such as historic period, gender, race/ethnicity influence the effect of physical activity on weight loss, weight stability, and weight regain.

3. At that place is a need for further enquiry to be conducted that focus specifically on behavioral strategies that improve the adoption and long-term maintenance of physical activity in overweight and obese adults.

iv. There is a need to examine whether the dose of physical activity that promotes improved long-term outcomes of weight control is different from the dose of physical activeness that results in improvements in chronic disease hazard factors and the onset of chronic illness beyond the entire range of torso weight including those with severe obesity (e.yard., Class 2 and Class 3 obesity).

Disclosure

J.Yard.J. has received consulting fees and grant support from BodyMedia, Proctor & Gamble, Free & Clear, UPMC Health Program.

REFERENCES

• 1 National Institutes of Wellness National Heart Lung and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Handling of Overweight and Obesity in Adults—The Evidence Report. Obes Res 1998; vi (Suppl 2): 51S– 209S.
• 2 Stein CJ, Colditz GA. The epidemic of obesity. J Clin Endocrinol Metab 2004; 89: 2522– 2525.
• iii Ravussin E, Bogardus C. Human relationship of genetics, historic period, and physical fitness to daily free energy expenditure and fuel utilization. Am J Clin Nutr 1989; 49: 968– 975.
• 4 Barlow CE, Kohl HW 3rd, Gibbons LW, Blair SN. Physical fitness, bloodshed and obesity. Int J Obes Relat Metab Disord 1995; nineteen Suppl four: S41– S44.
• v Church building TS, LaMonte MJ, Barlow CE, Blair SN. Cardiorespiratory fitness and body mass index every bit predictors of cardiovascular illness bloodshed among men with diabetes. Arch Intern Med 2005; 165: 2114– 2120.
• 6 Farrell SW, Braun L, Barlow CE, Cheng YJ, Blair SN. The relation of body mass index, cardiorespiratory fitness, and all-cause bloodshed in women. Obes Res 2002; x: 417– 423.
• 7 Lee CD, Blair SN, Jackson AS. Cardiorespiratory fitness, trunk limerick, and all-cause and cardiovascular affliction mortality in men. Am J Clin Nutr 1999; 69: 373– 380.
• 8 Lee IM, Paffenbarger RS Jr. Associations of light, moderate, and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study. Am J Epidemiol 2000; 151: 293– 299.
• ix Lee IM, Rexrode KM, Melt NR, Manson JE, Buring JE. Physical activity and coronary heart disease in women: is "no pain, no gain" passé? JAMA 2001; 285: 1447– 1454.
• ten Manson JE, Greenland P, LaCroix AZ et al. Walking compared with vigorous exercise for the prevention of cardiovascular events in women. Northward Engl J Med 2002; 347: 716– 725.
• 11 Lee S, Kuk JL, Katzmarzyk PT et al. Cardiorespiratory fitness attenuates metabolic risk contained of abdominal subcutaneous and visceral fat in men. Diabetes Care 2005; 28: 895– 901.
• 12 Wing RR, Jakicic J, Neiberg R et al.; Await Ahead RESEARCH Group. Fitness, fatness, and cardiovascular risk factors in type two diabetes: wait ahead study. Med Sci Sports Exerc 2007; 39: 2107– 2116.
• thirteen Wildman RP, Muntner P, Reynolds K et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic hazard factor clustering: prevalence and correlates of 2 phenotypes amidst the Usa population (NHANES 1999–2004). Arch Intern Med 2008; 168: 1617– 1624.
• 14 Fly RR, Venditti E, Jakicic JM, Polley BA, Lang Due west. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care 1998; 21: 350– 359.
• 15 Wood PD, Stefanick ML, Dreon DM et al. Changes in plasma lipids and lipoproteins in overweight men during weight loss through dieting as compared with do. Northward Engl J Med 1988; 319: 1173– 1179.
• 16 Hagan RD, Upton SJ, Wong L, Whittam J. The effects of aerobic conditioning and/or caloric restriction in overweight men and women. Med Sci Sports Exerc 1986; 18: 87– 94.
• 17 Donnelly JE, Hill JO, Jacobsen DJ et al. Effects of a 16-month randomized controlled exercise trial on body weight and composition in immature, overweight men and women: the Midwest Exercise Trial. Arch Intern Med 2003; 163: 1343– 1350.
• 18 Donnelly JE, Smith BK. Is exercise constructive for weight loss with advertizement libitum diet? Energy residuum, bounty, and gender differences. Exerc Sport Sci Rev 2005; 33: 169– 174.
• 19 Fly RR. Physical activity in the treatment of the adulthood overweight and obesity: current bear witness and research problems. Med Sci Sports Exerc 1999; 31: S547– S552.
• xx Stevens J, Truesdale KP, McClain JE, Cai J. The definition of weight maintenance. Int J Obes (Lond) 2006; 30: 391– 399.
• 21 Jakicic JM, Marcus BH, Lang Due west, Janney C. Result of exercise on 24-month weight loss maintenance in overweight women. Arch Intern Med 2008; 168: 1550– 1559; discussion 1559.
• 22 Jakicic JM, Marcus BH, Gallagher KI, Napolitano M, Lang W. Effect of practise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. JAMA 2003; 290: 1323– 1330.
• 23 Jakicic JM, Winters C, Lang W, Fly RR. Effects of intermittent exercise and utilize of home practise equipment on adherence, weight loss, and fettle in overweight women: a randomized trial. JAMA 1999; 282: 1554– 1560.
• 24 Jeffery RW, Wing RR, Sherwood NE, Tate DF. Physical activity and weight loss: does prescribing college physical activity goals improve outcome? Am J Clin Nutr 2003; 78: 684– 689.
• 25 Klem ML, Wing RR, McGuire MT, Seagle HM, Hill JO. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr 1997; 66: 239– 246.
• 26 Schoeller DA, Shay Thousand, Kushner RF. How much physical activity is needed to minimize weight proceeds in previously obese women? Am J Clin Nutr 1997; 66: 551– 556.
• 27 Section of Wellness and Human Services and US Department of Agronomics. Dietary Guidelines for Americans <www.healthierus.govdietaryguidelines> (2005).
• 28 Institute of Medicine of the National Academies. Dietary Reference Intakes for Energy, Carbohydrates, Fiber, Fatty, Protein and Amino Acids (Macronutrients). The National Academies Press: Washington, DC, 2002.
• 29 Jakicic JM, Clark K, Coleman Eastward et al.; American College of Sports Medicine. American College of Sports Medicine position stand. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2001; 33: 2145– 2156.
• 30 Saris WH, Blair SN, van Baak MA et al. How much concrete activity is enough to prevent unhealthy weight proceeds? Outcome of the IASO 1st Stock Conference and consensus statement. Obes Rev 2003; 4: 101– 114.
• 31 Wing RR. Behavioral weight control. In: TA Wadden, AJ Stunkard (eds). Handbook of Obesity Treatment. The Guilford Press: New York, 2002, pp 301– 316.
• 32 McGuire MT, Wing RR, Klem ML, Lang Due west, Loma JO. What predicts weight regain in a group of successful weight losers?. J Consult Clin Psychol 1999; 67: 177– 185.
• 33 Kayman Due south, Bruvold W, Stern JS. Maintenance and relapse after weight loss in women: behavioral aspects. Am J Clin Nutr 1990; 52: 800– 807.
• 34 Gormally J, Rardin D. Weight loss and maintenance changes in diet and do for behavioral counseling and diet education. J Consult Clin Psychol 1981; 28: 295– 304.
• 35 Leser MS, Yanovski SZ, Yanovski JA. A depression-fat intake and greater activity level are associated with lower weight regain 3 years after completing a very-low-calorie diet. J Am Nutrition Assoc 2002; 102: 1252– 1256.
• 36 van Baak MA, van Mil E, Astrup AV et al.; STORM Study Group. Leisure-fourth dimension action is an important determinant of long-term weight maintenance afterwards weight loss in the Sibutramine Trial on Obesity Reduction and Maintenance (Storm trial). Am J Clin Nutr 2003; 78: 209– 214.
• 37 Jakicic JM, Fly RR, Winters-Hart C. Relationship of physical activity to eating behaviors and weight loss in women. Med Sci Sports Exerc 2002; 34: 1653– 1659.
• 38 Brawl M, Brown W, Crawford D. Who does not gain weight? Prevalence and predictors of weight maintenance in young women. Int J Obes Relat Metab Disord 2002; 26: 1570– 1578.
• 39 Foster JA, Gore SA, West DS. Altering TV viewing habits: an unexplored strategy for adult obesity intervention? Am J Wellness Behav 2006; xxx: 3– xiv.
• twoscore Cooper Television set, Klesges LM, Debon K, Klesges RC, Shelton ML. An cess of obese and non obese girls' metabolic rate during tv viewing, reading, and resting. Eat Behav 2006; 7: 105– 114.
• 41 DiPietro 50, Kohl HW 3rd, Barlow CE, Blair SN. Improvements in cardiorespiratory fettle attenuate age-related weight gain in good for you men and women: the Aerobics Middle Longitudinal Written report. Int J Obes Relat Metab Disord 1998; 22: 55– 62.
• 42 French SA, Jeffery RW, Forster JL et al. Predictors of weight alter over two years among a population of working adults: the Good for you Worker Projection. Int J Obes Relat Metab Disord 1994; 18: 145– 154.
• 43 Sherwood NE, Jeffery RW, French SA, Hannan PJ, Murray DM. Predictors of weight gain in the Pound of Prevention study. Int J Obes Relat Metab Disord 2000; 24: 395– 403.
• 44 Slentz CA, Duscha BD, Johnson JL et al. Effects of the amount of exercise on body weight, trunk composition, and measures of cardinal obesity: STRRIDE—a randomized controlled study. Arch Intern Med 2004; 164: 31– 39.
• 45 US Department of Health and Human Services. Physical Action Guidelines Informational Committee Report 2008. US Department of Health and Human Services: Washington, DC, 2008.

Citing Literature

sharpther1940.blogspot.com

Source: https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2009.386

Share this post