Physical activity crucial for lowering CV risk, maintaining weight loss

October 16, 2021

3 min read

Source:

Hill JO, et al. Session I: Obesity & Lifestyle. Presented at: Cardiometabolic Health Congress; Oct. 14-17, 2021; National Harbor, Md. (hybrid meeting).


Disclosures:
Hill reports co-founding Shakabuku LLC. Piercy reports no relevant financial disclosures. Wyatt reports receiving consultant fees from Gelesis, holding intellectual property rights for Energy Gap, performing contracted research for National Cattleman’s Beef Association and Novo Nordisk, owning an interest in DRHOLLY LLC, Roman Health and Shakabuku LLC and authoring the book State of Slim.


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Regular physical activity is a critical part of maintaining weight loss, and providers should explore different methods to motivate their patients to be more active, according to three speakers at the Cardiometabolic Health Congress.

James O. Hill

“In our current environment, it is impossible for a population to have low rates of physical activity and low rates of obesity,” James O. Hill, PhD, professor and chair of the department of nutritional sciences and director of the Nutrition Obesity Research Center at the University of Alabama at Birmingham, said during the presentation. “If we’re going to be sedentary, we’re going to be obese. High levels of physical activity are necessary for most people to be successful in maintaining weight loss.:


Exercise cycle 2019

Source: Adobe Stock

CV benefits with physical activity

Katrina Piercy

Physical activity can provide health benefits for all people, according to Katrina Piercy, PhD, RD, ACSM-CEP, FACSM, acting director of the division of prevention services in the office of disease prevention and health promotion at the U.S. Department of Health and Human Services.

“Physical activity can both independently reduce the risk of cardiovascular disease and can impact other factors which can affect CVD, including body weight, blood pressure, cholesterol and type 2 diabetes,” Piercy told Healio.

The HHS 2018 Physical Activity Guidelines Advisory Committee’s scientific report stated that higher amounts of physical activity were associated with decrease in incidence of CVD, stroke and heart failure, and the risk continues to decrease with increased physical activity up to five times higher than recommended levels. Additionally, researchers found a strong inverse dose-response relation between the amount of moderate or vigorous physical activity and CVD mortality, with the greatest benefit seen early on in the dose-response relationship. The report also found strong evidence for reduced risk for CVD mortality in people with hypertension and type 2 diabetes.

Piercy said the Physical Activity Guidelines for Americans provides recommendations for Americans of all ages to get a proper amount of physical activity to stay healthy. In general, adults should have at least 150 minutes of moderate-intensity aerobic activity and 2 days of muscle-strengthening activity each week.

Weight loss maintenance

While it is essential for people with obesity to lose weight, losing weight over the short term only is not enough. Hill said it is essential for people to maintain weight loss over the long term and cited physical activity as the key for weight loss maintenance.

One reason physical activity is essential for weight loss maintenance is it fills the energy gap. Energy expenditure decreases after weight loss, but people experience increased hunger due to changes in hormones and substrates. Instead of eating less to compensate, Hill said, people can participate in more physical activity.

“The more of that gap you fill with physical activity, the more likely you are to keep the weight off,” Hill said during the presentation.

Physical activity also corrects metabolic dysfunction in obesity and improves metabolic flexibility. Finally, exercise also matches up energy expenditure with appetite. Hill said people who participate in higher amounts of physical activity require greater energy intake, allowing a person to maintain body weight even if they’re eating more.

“Lots of data suggest that if we can increase physical activity, we increase people’s ability to regulate their appetite to meet their energy expenditure,” Hill said during the presentation.

Motivating patients

Holly Wyatt

Informing a patient how much physical activity they need to do is only the first step on their weight loss journey, according to Holly Wyatt, MD, professor and vice chair of clinical programs in the department of nutritional sciences at the University of Alabama at Birmingham. She said discussions should not only focus on what physical activity to do, but why it should be done.

“A lot of times, we use the reasons why we think they should (exercise), but we’re not very good at motivating them for why they will tend to do it,” Wyatt said during the presentation. “That’s equally as important as what to do and how they will do it.”

Providers can use extrinsic motivators, such as rewards, motivation from other people, and accountability; or intrinsic motivators, such as asking about a patient’s core values and identifying opportunities for growth. Wyatt said it is crucial to recognize that extrinsic motivators are helpful for short-term changes and intrinsic motivators are more effective for long-term changes.

There are several strategies providers can use to motivate patients, according to Wyatt. First, providers should “peel the onion,” and have a deep conversation with their patients to understand the reason why they want to lose weight. People who want to lose weight should set an emotional goal in addition to a logical and strategic goal, and then tie the two together. Finally, providers should encourage patients to steer away from a fear-based mindset and instead focus on the positive possibilities of weight loss.

“It’s one of the most powerful things people can do,” Wyatt said during the presentation. “Realizing what they actually want is what’s going to motivate them.”

Study: Fitness, Physical Activity Appear Superior to Weight Loss for Reducing Risks of Obesity

Obesity fees throughout the world have tripled around the past 4 a long time, resulting in a rise of a large range of well being difficulties, which include cardiovascular sickness, diabetic issues, and most cancers. In an try to handle these health and fitness ailments, weight loss plans and pounds loss initiatives have also rapidly enhanced, a lot of of these endeavours bringing their very own dangers.

Having said that, new analysis displays that when it comes to obese men and women getting healthful and cutting down mortality chance, escalating physical action and increasing health and fitness show up to be exceptional to concentrating only on dropping bodyweight. The review by Siddhartha Angadi, assistant professor of kinesiology in the UVA University of Education and Human Development, and Glenn Gaesser, professor of work out physiology in the University of Well being Options at Arizona Point out College, was published this month in the journal iScience.

“We would like men and women to know that unwanted fat can be in shape, and that healthy and wholesome bodies arrive in all shapes and sizes,” Gaesser explained. “We notice that in a bodyweight-obsessed lifestyle, it may perhaps be difficult for courses that are not centered on body weight reduction to achieve traction. We’re not automatically towards weight decline we just imagine that it should not be the most important criterion for judging the success of a way of living intervention software.”

Angadi reported the position is “especially critical when you consider the physiological realities of obesity.”

“Body body weight is a really heritable trait, and pounds decline is associated with significant metabolic alterations that eventually thwart excess weight loss servicing,” Angadi explained.

In addition to risks affiliated with weight problems, men and women also incur hazards when fat cycling, usually identified as “yo-yo” dieting, which is a repetitive sample of weight decline and fat regain. Angadi and Gaesser explained that employing a fat-neutral strategy not only serves in the remedy of weight problems-associated health disorders, but it also lowers the health hazards associated with that form of dieting.

“Risks to bodyweight biking involve muscle mass decline, fatty liver disorder and diabetes,” Angadi said. “By concentrating on fitness instead than weight loss, people today can gain the rewards of physical exercise though preventing the dangers linked with body weight biking.”

Recent public health tips endorse that grown ups accumulate 150-300 minutes per week of average-intensity physical action or 75-150 minutes for every 7 days of vigorous-depth actual physical action.

“But it’s important to notice that the added benefits of exercising are dose-dependent, with the most important added benefits coming from just shifting out of the couch-potato zone to executing at the very least some average-intensity exercise,” Gaesser reported. “It’s also essential to emphasize that bodily activity can be gathered during the day. For case in point, various shorter walks all through the working day (even as shorter as two to 10 minutes each) are just as valuable as a single very long wander for wellbeing rewards.”

In the examine, Angadi and Gaesser cite new investigate focused on the magnitude of mortality chance reduction involved with fat reduction in contrast to that connected with an improve in physical exercise or cardiorespiratory health. The hazard reduction involved with raising physical fitness and physical exercise was regularly higher than that affiliated with intentional fat reduction. They also appeared at the magnitude of reduction in the chance markers of cardiovascular disorder that are involved with possibly excess weight loss or enhanced actual physical action. They arrived at these conclusions by analyzing investigate that analyzed pooled data across a multitude of experiments (meta-analyses) that were being carried out in excess of a array of time intervals and across broad geographical areas.

The researchers admit restrictions in the current overall body of exploration, which includes the point that this area is seriously reliant on epidemiological scientific studies that do not definitively establish induce and effect, and be aware that only massive, randomized, managed clinical trials can totally take a look at the outcomes of working with a health-concentrated technique to improve cardiometabolic mortality chance in men and women who are obese.

Increasing physical activity, fitness may be superior to weight loss for reducing health risks

The prevalence of obesity all over the earth has tripled about the past 40 several years, and, together with that increase, dieting and tries to reduce body weight also have soared. But according to a review post publishing September 20 in the journal iScience, when it will come to having healthier and lessening mortality hazard, increasing bodily exercise and enhancing fitness show up to be remarkable to weight decline. The authors say that utilizing a body weight-neutral strategy to the therapy of weight problems-connected wellness conditions also lowers the overall health hazards related with yo-yo dieting.

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We would like people to know that fats can be suit, and that in shape and balanced bodies appear in all designs and measurements. We understand that in a weight-obsessed culture, it may perhaps be challenging for plans that are not centered on fat decline to attain traction. We are not automatically from weight reduction we just feel that it should not be the key criterion for judging the good results of a lifestyle intervention system.”

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Glenn Gaesser, Examine Co-Author, University of Well being Alternatives, Arizona Condition University

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“This is specifically important when you take into account the physiological realities of weight problems,” states co-author Siddhartha Angadi of the College of Schooling and Human Improvement at the College of Virginia. “Body body weight is a very heritable trait, and bodyweight reduction is connected with significant metabolic alterations that finally thwart pounds loss servicing.”

Obesity is linked with a variety of health circumstances, like cardiovascular disorder, diabetic issues, most cancers, and troubles with the bones and joints. But pounds cycling, usually called yo-yo dieting, is also affiliated with health troubles, including muscle decline, fatty liver disease, and diabetes. The authors say that by focusing on fitness somewhat than bodyweight decline, folks can acquire the gains of exercise whilst steering clear of the challenges affiliated with weight biking.

Present public well being guidelines advise that adults accumulate 150–300 minutes for each 7 days of reasonable-depth bodily exercise (the intensity equal to walking at casual-to-brisk pace) or 75–150 minutes per 7 days of vigorous-intensity physical exercise (the depth equal to jogging or operating). “But it is critical to take note that the advantages of exercising are dose dependent, with the greatest benefits coming from just transferring out of the sofa-potato zone to carrying out at the very least some average-intensity action,” Gaesser suggests. “It truly is also significant to emphasize that bodily activity can be gathered all over the day. For illustration, many short walks throughout the working day (even as quick as two to 10 minutes just about every) are just as helpful as one extensive wander for wellness positive aspects.”

In the assessment, the authors cite the latest investigate centered on the magnitude of mortality threat reduction affiliated with excess weight reduction when compared to that affiliated with an raise in physical action or cardiorespiratory exercise. The danger reduction involved with raising fitness and bodily activity was continuously larger than that affiliated with intentional fat reduction. They also seemed at the magnitude of reduction in the danger markers of cardiovascular disorder that are linked with possibly bodyweight reduction or increased actual physical activity. They utilised meta-analyses from quite a few reports carried out over a selection of time durations and throughout a wide geographical space. “Science has frequently supported the main factors proposed in Major Extra fat Lies, a ebook on this matter that I very first released in 1996,” Gaesser notes.

The scientists accept restrictions in the present physique of research, together with the actuality that this industry is intensely reliant on epidemiological scientific tests that do not definitively build bring about and impact, and notice that only substantial, randomized, managed medical trials can completely study the outcomes of employing a conditioning-focused solution to improve cardiometabolic mortality hazard in individuals who are obese. “Collectively, on the other hand, these epidemiological experiments display powerful and consistent associations, and this is why meta-analyses can be practical,” Angadi suggests. “In the situation of bodily exercise and exercise, the epidemiological proof is supported by a significant overall body of experimental experiments and randomized controlled trials that have recognized plausible mechanisms for the dependable findings in epidemiological scientific studies.”

Source:

Journal reference:

Gaesser, G. A., & Angadi, S. S. (2021) Obesity treatment method: Weight loss compared to escalating physical fitness and physical exercise for lessening well being challenges. iScience. doi.org/10.1016/j.isci.2021.102995.

‘Fat can be fit’: Physical fitness rather than weight loss should be focus, says study

When it arrives to health and fitness, a great deal of target falls on shedding pounds and physique mass index (BMI). Research focused on body weight reduction may obtain correlations to reduced mortality threat, but a new paper implies that a lot more aim should really be positioned on bodily activity somewhat than excess weight decline.

Shifting the goal absent from pounds loss could make extra sense for people who are obese and want to be healthier.

“We would like people to know that unwanted fat can be in shape, and that suit and wholesome bodies occur in all styles and sizes,” said paper co-creator Glenn Gaesser of the University of Wellbeing Methods at Arizona Point out College in a push release. “We realize that in a weight-obsessed lifestyle, it may well be challenging for programs that are not centered on weight reduction to achieve traction. We’re not automatically against body weight reduction we just feel that it shouldn’t be the primary criterion for judging the accomplishment of a life-style intervention plan.”

In a paper revealed in iScience, researchers examine data from quite a few reports that look at weight loss or physical activity, or a combination of the two. They suggest a excess weight-neutral technique for the reason that a cardiorespiratory health or actual physical action targeted regimen cuts down or eradicates mortality danger from currently being obese. They define excess weight-neutral as not targeted on weight decline.

The authors write, “40-calendar year tendencies in prevalence of obesity and fat loss makes an attempt suggest that a body weight-centric emphasis on obesity treatment has been largely ineffective.”

Common exercising also improves cardiometabolic well being, and that takes place independently from bodyweight loss.

By separating wellness from fat decline, the experts believe this would be a much more productive way to increase health and fitness and cut down danger for people who are obese.

“This is specially crucial when you think about the physiological realities of obesity,” says co-creator Siddhartha Angadi of the Faculty of Schooling and Human Enhancement at the University of Virginia in the push launch. “Body body weight is a very heritable trait, and excess weight decline is linked with sizeable metabolic alterations that finally thwart excess weight reduction servicing.”


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One particular issue when it comes to finding out this place of health and fitness is that some prior research depend on epidemiological studies that can’t establish results in for weight problems. These kinds of studies collecy various varieties of knowledge that may perhaps be correlated with human body pounds, genetic variables or obesity. To thoroughly take a look at a exercise-based technique to obtaining bodies to a balanced area would involve randomized scientific trials with regulate teams and treatment groups, significantly like what is finished for tests new prescription drugs.

This team of researchers analyzed quite a few of these research to combine the info in a way that they could attempt to make more substantial conclusions.

“Collectively, having said that, these epidemiological experiments display potent and steady associations, and this is why meta-analyses can be helpful,” Angadi said in the push release. “In the circumstance of physical exercise and conditioning, the epidemiological proof is supported by a big human body of experimental studies and randomized managed trials that have founded plausible mechanisms for the constant conclusions in epidemiological research.”

The authors of the paper point out that the latest health investigate suggests that concentrating on bodily activity and cardiorespiratory health reliably final results in better reduction of risk for mortality and heart ailment. One particular examine they cited found that in a study that followed up with folks with coronary heart disease for extra than 15 decades, men and women who managed at the very least very low physical activity experienced 19 {e4f787673fbda589a16c4acddca5ba6fa1cbf0bc0eb53f36e5f8309f6ee846cf} lessen all-result in mortality risk than related folks who were being sedentary. Men and women with large bodily action had even better success with 36 percent reduce mortality threat. The authors also propose that preserving a bodily lively life style might be additional feasible than protecting body weight reduction.


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