Does physical activity reduce the risk of cardiovascular disease in overweight and obese individuals?
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Corresponding author Glenn A. Gaesser, PhD Kinesiology Program, University of Virginia, 210 Emmet Street South, PO Box 400407, Charlottesville, VA 22904, USA. E-mail: [email protected] Current Cardiovascular Risk Reports 2007, 1:221–227 Current Medicine Group LLC ISSN 1932-9520 Copyright © 2007 by Current Medicine Group LLC
For individuals considered overweight or obese, physical activity or more structured exercise is recommended to facilitate weight loss and reduce risk of long-term disease. Physical activity and structured exercise programs, however, rarely result in significant loss of body weight or body fat, especially in women. Despite the minimal effect of exercise on weight loss, exercise has multiple health benefits for overweight and obese individuals, including skeletal muscle adaptations that improve fat and glucose metabolism and insulin action; enhanced endothelial function; favorable changes in blood lipids, lipoproteins, and hemostatic factors; and reductions in blood pressures, postprandial lipemia, and proinflammatory markers. These exercise-induced adaptations occur independently of changes in body weight or body fat. Thus, physically inactive individuals considered at increased risk for cardiovascular disease due to both sedentary lifestyle and a high body mass index should be encouraged to engage in regular physical activity, regardless of whether a more active lifestyle leads to weight loss.
Introduction Weight loss is routinely recommended for individuals considered overweight (body mass index [BMI] s 25 and c 30) or obese (BMI > 30) [1]. This is particularly true for individuals with comorbidities that increase risk for cardiovascular disease. Although weight loss can be achieved through exercise and calorie restriction, long-term weight-loss maintenance is poor, particularly if achieved through caloric restriction alone [2]. This is perhaps due to caloric restriction being difficult to sustain for the vast majority of the population. Furthermore,
prospective studies on adults and children indicate that frequent weight loss attempts by means of dieting may increase chances for subsequent and significant weight gain [3]. Efforts to lose weight by caloric restriction may not only fail to achieve the desired outcome, but they may increase risk for the thing dieting is intended to cure—obesity. Increasing physical activity levels may prove to be a more effective and sustainable option for improving the health of the sedentary population, which includes a large percentage of persons considered overweight or obese by BMI criteria. Aside from being routinely recommended as part of a weight loss program, regular physical activity provides numerous health benefits that have been documented in a great many epidemiologic and physical activity intervention studies [4,5••]. However, exercise training by itself rarely results in significant weight loss, especially in women [6••,7,8]. Aerobic exercise training may even result in significant increases in body fat in women [7,8]. An important public health
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