Kines 426 Quiz 4

• Over vs under nourished 

• Over 1 billion people worldwide obese

• 800 million people experiencing under eating/food insecurity

• Obesity in pets

• Cats slightly more obese than dogs 

Adiposity

• Number and size of adipose cells

• Body composition measures

• % body fat

• % fat free mass

• % lean body mass

• Measuring obesity

• Body mass index, Waist circumference 

• Body mass index

• Normal = 19-24.9

• Overweight = >25.0

• Obese = >30

• Morbid obesity = >40

• Waist circumference obesity

• Greater than 100 cm 

• As BMI increases…

• body fat increases 

• Body roundness index

• Waist circumference and height

• Obesity prevalence 

• Asians = least obese

• Obese more prevalent in middle age

• Obesity in trends

Obesity in children has increased, NH black females, hispanic males, South obesity rates highest

• Obesity pathology causes

• Excess energy intake that is not expended is stored in the body

• More time sitting than standing/moving

Obesity pathology physical mechanisms

• Possible genetic link

• Hypertrophy or hyperplasia of adipose cells

obesity pathology cognitive/behavioral mechanisms

• Social, cultural, emotional

obesity pathology Energy intake

External and internal influences

• Obesity pathology genes

• strong determinant of body fatness 

  • Especially visceral fat

Danish Study

• biological/adoptive parents 

• 90% of adoptees placed first year of life

• Results = clear relationship btw biological parents and child BMI but no relationship with adoptive parents and child BMI

Twins Study

• Male twins, overfed 84K kcal over 100 days, gained around 8.1kg

• Results = significant relationship btw twins weight gain and visceral fat gain

• How much PA is needed for weight stability

a dose of PA in the range of 13-26 MET-hr/week led to 1-3% weight loss

• How much PA is needed for weight loss

need to add in diet

• How much PA is needed to prevent weight regain?

• More is better

• 31kcal/kg/week

• Effect of PA on body composition parameters

• decreases in total and abdominal adiposity

• Controlling for diet, aerobic PA results in decreases 

• Larger volumes of PA result in decreases in intraabdominal adipose tissue

• Effect of sex or age on energy balance

• Some evidence but not sufficient enough 

• Benefits of regular PA in obese persons

• Decreases loss of/preserves fat free mass associated with weight loss

• Improves maintenance of weight loss

• Improves cardiovascular and metabolic health, independent of weight loss

• ACSM recommendations

• Supports inclusion of PA in medical treatments of excess weight and adiposity 

• At least 150 min/wk of mod intensity PA

• Metabolic Syndrome

• Abdominal obesity

• Hyperinsulinemia 

• High fasting plasma glucose

• Impaired glucose tolerance

• Hypertriglyceridemia 

• Low HDL-cholesterol

• Hypertension

• Metabolic Syndrome trends

• Mexican Americans

• Midwest

• Males

• Effect of PA for preventing MetS

• Inverse does response association 

• 120 to 180 min/week of activity to prevent it

• Obesity and MS conclusions

• Obesity = risk factor for many other chronic conditions

• Balancing intake with expenditure

• PA can help in the prevention, treatment and management of obesity

• PA and Chronic disease: diabetes pathology

• Type 1 = insulin dependent 

  • Insulin producing cells of the pancreas are destroyed 

• Type 2 = insulin resistant 

  • Body does not produce enough or the cells ignore the insulin

• PA and Chronic disease: pre-diabetes

• Blood glucose levels are higher than normal but not high enough to be called diabetes 

• Onset of type 2 can be delayed/prevented by

• Prevalence US diabetes

• % of US with diabetes has increased over the years 

• 45-64 = most diagnosed w/ diabetes

• Risk factors for type 2 diabetes modifiable

• Hypertension

• High cholesterol (low HDL)

• History of CVD

• Obesity 

• Impaired glucose tolerance

• Risk factors for type 2 diabetes nonmodifiable

• Age

• family/history 

• race/ethnicity

• Gestational diabetes/high birth weight

• Polycystic ovary syndrome

• Diabetes co-morbidities and complications

• CVD 

• Obesity

• Complications 

  • Blindness

  • Nerve damage

  • Kidney damage

Kriska

• High risk group of prima indians

• Conclusions: lower rates of lifetime PA associated w/ higher DM and relationship present among men and women

• Does PA have a role in preventing and treating type 2 diabetes?

Increased levels of PA associated with significantly decreased risks of developing T2DM

• Does PA have a role in preventing and treating type 2 diabetes: Dose issues

• Intensity: ]vigorous activity, some moderate walking

• Volume: 30 mins per day 5 days per week

• Fitness and DM risk

• Aerobics center study

  • Fitness inversely related to diabetes risk

• Does PA have a role in reducing macrovascular risks in type 2 diabetes

• High co-morbid incidence in T2DM and CVD

• Does PA have a role in reducing macrovascular risks in type 2 diabetes: dose response

• Volume: mod exercise for >2hrs/week for significant benefit and 3-7hrs/week for max benefit

• Type: combined aerobic and resistance

• US diabetes prevention program patients

• obese and prediabetic

  • Exclusion = meds known to alter glucose tolerance and debilitating illness

• US diabetes prevention program Weight loss and PA

• Lifestyle saw significant changes when there was a significant change in PA, rest saw limited/stayed steady

• Reduction in diabetes incidence for lifestyle

• US diabetes prevention program Response issues 

• Treatment effects didn’t differ for sex or race

• Risk reduction compared to placebo was greater for lifestyle in whites and hispanics 

• African and native americans lifestyle and metformin groups showed similar efficacy

• Asian Americans, metformin showed a nonsignificantly greater reduction than lifestyle

• PA and DM: possible mechanisms 

• Changes in number of insulin receptors (muscle)

• Changes in chemical signaling for insulin (brain)

• Changes in transport of glucose transporters to cell membrane (muscle)

• Changes in glucose transporter mechanisms (blood)

• Enzyme action changes (muscle)

• PA and DM summary and conclusions

• Moderate and growing evidence for PA as treatment for DM 

• PA can impact risk factors