PHYSICAL ACTIVITY AND OBESITY
MARCIN MRUKOWSKI , 18-03-2019
A systematic increase in energy expenditure through physical exercise supports weight reduction and causes positive changes in the human body such as increase in muscle mass, improvement of glucose tolerance, lipid profile, reduction of risk of cardiovascular disease.
Physical activity recommendations should primarily include an increase of exercise related to the so-called dedicated activity, but above all take into account NEAT parameter (non-exercise activity thermogenesis)
In simple terms, NEAT is a term that is associated with thermogenesis and metabolic changes unrelated to training and activities we perform during the day like speaking, walking, etc. This is a parameter which is characterized by high intersonic variability and high heterogeneity. Differences in used energy can vary between 15%-50%. In simple terms, some people move more than others.
The role of physical activity in obesity and overweight
Between 1970 and 1990, the curve reflecting increase in number of obese people was the same as the curve showing cars sales. In many cases, the restriction on movement can be secondary, the effect of a so-called closed circle is created, and further weight gain arises. Wimore presented a meta-analysis of hundreds of cases on weight changes effected by training, without any changes in nutrition.
During the 6-month training, there was an average weight loss of 1.6 kg, a fat loss of 2.6 kg and a 1.0 kg increase in lean weight. Subsequent studies show that in the long term, people who exercise regularly after being on a diet, achieve better results than those who do not engage in any physical activity.
The effect of physical activity on the body
The process of planning the activity of an obese person should be individual, considering many aspects. Main components to be considered are:
Activity should be performed daily and should be planned. Daily activity is any form of non-workout movement like simple pottering around, cleaning etc. The increase of this type of activity can have a significant impact on reducing obesity. What’s important here is a great educational element of an obese person; explaining why any additional movement will significantly reduce their body weight.
As far as a planned activity is concerned, FITTE Principle can be applied (Frequency, Intensity, Time, Type, Enjoyment) when creating recommendations.
WHO Recommendations
150 minutes per week of moderately intense aerobic physical activity in the range of 40- 60% Vo2max or 2.8 – 4.3 on the MET scale. What does that mean? There are several grading scales that can easily target obese or overweight people. One of them is the so-called RPE scale ( Borg’s scale) describing the degree of fatigue in the performance of a given activity . RPE is another scale. In general, a simple rule of intensity is adopted – Walk and Talk. It is a physical activity where you simply talk to another person. It is also beneficial to use heart monitor. It gives you additional motivation, as you can check the amount of calories burned or distance travelled. However, these are not essential tools.
General recommendations of an exercise session for an obese person.
15-20 minute warm-up adapting all basic body systems. You can use modified warm-up ,-so called. RAMP ( Raise, Activate, Mobilise, Potentiate). Exercises should be tailored to the needs of an individual. Treat the phases of exercise in a calm, gentle way paying attention to breathing techniques, diaphragm activation, learning to flex abdominal muscle, restoring basic patterns in daily movements such as sitting down, getting up, safe changes in body direction, stabilization exercises. Any resistance exercises should be performed with extreme caution. An interesting concept in the approach seems to be so called Regressions – Standard – Possible progression of the exercise.
Training can also be static i.e.8-10 exercises that strengthen individual muscle groups. The resistance exercises are aimed at increasing the so-called slender body and as a result an increase in basal metabolism. Resistance exercises for obese people often require instruction from a physiotherapist or an experienced trainer. The most appropriate form of exercise for obese people are those in the so-called Offload – aquatic environment. Problems that may occur in this type of activity are e.g. the mental barrier to undress, and (in the case of people with so-called huge obesity) entrance and exit from the pool.
Training of obese people is difficult, due to many aspects and barriers:
According to Brownell there are:
Obesity is an interdisciplinary problem. Diseases relating to excess body weight have a pandemic nature. We know tools that effectively reduce body weight such as – negative caloric balance, balanced diet controlled by a specialized nutritionist, additional dedicated movement. The problem, on the other hand, is largely of a mental nature. Maintaining the desired due weight for a long period is difficult, and often results in weight fluctuation (Yo-yo) .
Obesity treatment standards should cover areas of medicine such as:
Following topics are covered during the course :
