SummaryCreating a negative energy balance by decreasing caloric consumption and increasing physical activity is a common strategy used to treat obesity. A large number of review and original research papers have considered the role of physical activity in weight loss and maintenance. However, their conclusions are at times conflicting. In this review, we have critically evaluated the findings of systematic reviews and meta-analyses and supplemented their conclusions with recently published, high-quality clinical trials. We have eliminated studies that were methodologically flawed in an attempt to reduce the ambiguity in the literature. We further sought, through selective review of these publications, to isolate the effects of various types of exercise, independent of dietary interventions, to further clarify their independent contributions. Thus, our review describes (i) combined calorie restriction with physical activity interventions, (ii) physical activity interventions without calorie restriction and (iii) the role of physical activity on maintenance of weight loss. Through this critical examination of the literature, we have provided conclusions to address certain ambiguities regarding the role of physical activity in obesity treatment that will inform clinical practice. We have also identified several longstanding gaps in knowledge that will inform future research.

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Greater weight loss and reduced cravings, coupled with stronger activations and potential negative modulation of the food reward related regions by the dlPFC during exposure to visual food cues is consistent with increased executive control in TMR vs. TD.

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Background: Estimating the prevalence of severe or critical illness and case fatality of COVID-24 19 outbreak in December, 2019 remains a challenge due to biases associated with surveillance, 25 data synthesis and reporting. We aimed to address this limitation in a systematic review and 26 meta-analysis and to examine the clinical, biochemical and radiological risk factors in a meta-27 regression. 28Methods: PRISMA guidelines were followed. PubMed, Scopus and Web of Science were 29 searched using pre-specified keywords on March 07, 2020. Peer-reviewed empirical studies 30 examining rates of severe illness, critical illness and case fatality among COVID-19 patients 31 were examined. Numerators and denominators to compute the prevalence rates and risk factors 32 were extracted. Random-effects meta-analyses were performed. Results were corrected for 33 publication bias. Meta-regression analyses examined the moderator effects of potential risk 34 factors. 35Results: The meta-analysis included 29 studies representing 2,090 individuals. Pooled rates of 36 severe illness, critical illness and case fatality among COVID-19 patients were 15%, 5% and 37 0.8% respectively. Adjusting for potential underreporting and publication bias, increased these 38 estimates to 26%, 16% and 7.4% respectively. Increasing age and elevated LDH consistently 39 predicted severe / critical disease and case fatality. Hypertension; fever and dyspnea at 40 presentation; and elevated CRP predicted increased severity. 41 Conclusions: Risk factors that emerged in our analyses predicting severity and case fatality 42 should inform clinicians to define endophenotypes possessing a greater risk. Estimated case 43 All rights reserved. No reuse allowed without permission.was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. : medRxiv preprint 3 fatality rate of 7.4% after correcting for publication bias underscores the importance of strict 44 adherence to preventive measures, case detection, surveillance and reporting. 45 46 A novel corona virus, first identified in Wuhan, China in late 2019, resulted in a 64 pandemic by the first quarter of 2020, contributed by the prolonged survival of the virus in the 65 environment and extended length of pre-or post-symptomatic and potential asymptomatic 66shedding. 1-4 While the virus is known to cause only a mild illness in a majority, severe illness 67 characterized by respiratory distress requiring hospital admission is not uncommon. 5 68 Furthermore, the virus has the potential to precipitate a life-threatening critical illness, 69 characterized by respiratory failure, circulatory shock, sepsis or other organ failure, requiring 70 intensive care. 6, 7

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Taken as a whole the literature is suggestive that there may be value in reducing sedentary behavior to have modest impact on health. However, the magnitude of the benefit appears minor and must be considered before making largescale and potentially costly clinical and public health recommendations.