All cause mortality CVD incidence Cancer incidence Overall 0 0.5 1 1.5 2 2.5 Hazard Ratio *Adjusted for physical activity Biswas et al Ann Intern Med, 2015
The relationship between body weight, calorie intake, and physical activity. Mayer J. 1956 Am J Clin Nutr Why Do We Need Exercise? Normal activity range Sedentary zone Normal activity range Sedentary zone
Trends for Job based physical activity, 1960 - 2008 • Large decrease in jobs that require physical activity! • Increase in sedentary jobs!! Church et al. PLoS One, 2011 Why do we need Exercise?
Obese women have lower PA and greater sitting time per day compared with lean women. Why do we need PA? Johannsen DL, Obesity , 2008
Some exercise may promote weight loss….. More exercise may not produce additional weight loss….. Exercise and Weight Loss Church et al. PLoS One, 2009 .
Exercise and Weight Loss Church et al. PLoS One, 2009 . Individual weight changes in DREW Predicted Wt. Loss Swift et al. Obesity, 2016 . CLW = 5%
Exercise and Weight Loss Church et al. PLoS One, 2009 . Weight Compensation • Predicted – Actual EE
Exercise and Weight Loss Stewart et al. MSSE, 2011. Chronic inflammation (CRP) is reduced with exercise, but only in those with significant weight loss.
Exercise and Weight Loss Swift et al. Obesity, 2016 . Effect of weight loss with exercise on markers of insulin sensitivity: • HOMA-IR – fasting insulin and glucose values • HOMA-2 – calculator Significant reductions in insulin resistance with exercise and weight loss. NOTE: Subanalysis in exercisers only
Jackson et al. Arch Intern Med, 2009 • Non-linear decline in cardiorespiratory fitness in men and women with age. • Can exercise: 1. Reduce/reverse the decline in fitness? 2.If so, what is the minimal, required, and optimal dose?
051015202530WomenMenCVD Mortality Rates by Fitness: Aerobic Center Longitudinal Study (ACLS)Blair SN et al. JAMA1989;262:2395-2401.Deaths per 10,000 person-yearsLowModerateHigh
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