Does physical activity prevent weight gain – a systematic review

Fogelholm, Mikael; Kukkonen-Harjula, Katriina

doi:10.1046/j.1467-789x.2000.00016.x

Cited by 487 publications

(393 citation statements)

References 73 publications

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“…Results from observational studies (but not those from the clinical trials also analysed) suggested that exercise leads to successful weight loss maintenance. 21 Also, in contrast to some studies, [22][23][24][25][26][27] we observed that an initial greater weight loss was very hard to sustain. Our results suggest that individuals changed their lifestyle, but just for a short period, since they partially returned to their previous patterns.…”

Section: Discussioncontrasting

confidence: 87%

“…In general, their results support our own findings. In the review from Fogelholm and KukkonenHarjula, 21 most clinical trials did not find that exercise training improve weight maintenance. Glennny et al 31 in another review evaluating many aspects of obesity treatment and prevention, reported that most trials included demonstrate weight regain either during or after the intervention period.…”

Section: Discussionmentioning

confidence: 99%

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Long-term weight loss after diet and exercise: a systematic review

2005

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OBJECTIVE:To assess the effectiveness of dietary interventions and exercise in long-term weight loss in overweight and obese people. DESIGN: A systematic review with meta-analysis. SUBJECTS: Overweight and obese adultsF18 years old or older with body mass index (calculated as weight divided by the square of height in meters)425. DATA SOURCE: Medline, Cochrane Library and Lilacs databases up to March 2003. Also, published reviews and all relevant studies and their reference lists were reviewed in search for other pertinent publications. No language restrictions were imposed. STUDY SELECTION: Randomised clinical trials comparing diet and exercise interventions vs diet alone. All trials included a follow-up of 1 y after intervention. DATA EXTRACTION: Two reviewers independently abstracted data and evaluated the studies' quality with criteria adapted from the Jadad Scale and the Delphi list. DATA SYNTHESIS: The estimate of the intervention's effect size was based on the differences between the comparison groups, and then the overall effect was calculated. A chi-squared test was used to assess statistical heterogeneity. RESULTS: A total of 33 trials evaluating diet, exercise or diet and exercise were found. Only 6 studies directly comparing diet and exercise vs diet alone were included (3 additional studies reporting repeated observations were excluded). The active intervention period ranged between 10 and 52 weeks across studies. Diet associated with exercise produced a 20% greater initial weight loss. (13 kg vs 9.9 kg; z ¼ 1.86Fp ¼ 0.063, 95%CI). The combined intervention also resulted in a 20% greater sustained weight loss after 1 y (6.7 kg vs 4.5 kg; z ¼ 1.89Fp ¼ 0.058, 95%CI) than diet alone. In both groups, almost half of the initial weight loss was regained after 1 y. CONCLUSION: Diet associated with exercise results in significant and clinically meaningful initial weight loss. This is partially sustained after 1 y.

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Section: Discussioncontrasting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Long-term weight loss after diet and exercise: a systematic review

2005

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“…Existing cross-sectional and longitudinal studies report inconsistent findings, both in children and adults; some report a protective effect of physical activity against obesity, others find no association and a few have suggested that higher activity is related to increased fatness. [1][2][3][4] This lack of consistency is likely to be partly due to the variety of methods used to measure body fat and energy expenditure or physical activity, but may also be due to gender, age and sociocultural differences in type or range of physical activity. In the UK, girls are only slightly less active than boys up to the age of about 7 y, but from then on through into adulthood, female subjects are noticeably less active than males, 5 a gender difference that is common across the Western world.…”

Section: Introductionmentioning

confidence: 99%

Physical activity, television viewing and body mass index: a cross-sectional analysis from childhood to adulthood in the 1958 British cohort

2005

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OBJECTIVE:To investigate relationships between frequency of physical activity or television viewing and body mass index (BMI) cross-sectionally at six ages from childhood to adulthood, to better understand longitudinal relationships. To investigate how the relationships vary with age and gender and whether any relationships are due to confounding factors. METHODS: The 1958 British birth cohort includes all births (approximately 17 000) in one week in March 1958. BMI and physical activity frequency were recorded at 11, 16, 23, 33 and 42 y and television viewing frequency at 11, 16 and 23 y. A total of 11 109 subjects provided BMI and activity data at 42 y. Relationships between BMI and (in)activity were investigated using linear regression. RESULTS: At ages 11, 33 and 42 y in both sexes and at 23 y in female subjects, those who were more active had lower BMIs, and the relationships strengthened with age. At 42 y, the most active had a lower mean BMI than the least active, by 0.83 kg/m 2 in men, and 1.03 kg/m 2 in women. BMI and activity were unrelated at 16 y in female subjects, and 23 y in male subjects. At 16 y in males, the most active males had a mean BMI 0.25 kg/m 2 higher than the least active. At 11 y in female subjects and 23 y in both sexes, those who watched television most frequently had higher BMIs. BMI and television viewing were unrelated at 11 y in males and at 16 y in both sexes. Relationships between BMI and activity or television viewing were largely unexplained by potential confounding factors. CONCLUSIONS: The relationship between BMI and physical activity changes with age. In early adolescence and in adulthood, a higher activity level, or lower frequency of television viewing was associated with a lower BMI. In later adolescence (16 y), television viewing and activity were unrelated to BMI, except for an unexpected BMI-activity relationship in males. We suspect this relationship in males is primarily due to selection effects, whereby physically bigger boys, with a larger BMI, are more likely to take part in exercise activity, and possibly also to BMI being a less accurate predictor of fatness in adolescent boys.

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“…Many studies (including the author's studies) have sought evidence for the role of food intake and physical activity in weight gain and obesity development by investigating the correlations between these exposures taken separately through a broad range of levels at one point in time and the subsequent change in body weight (9)(10)(11)(12)(13)(14)(15)(16) . For such studies to be valid as tests of the role of these exposures in weight gain, a number of assumptions must be made that are not likely to be fulfilled.…”

Section: Extreme Distributions Of Energy Balance Componentsmentioning

confidence: 99%

Challenges in the study of causation of obesity

Sørensen

2008

Proc. Nutr. Soc.

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Use of the energy balance equation for understanding the causation of obesity is discussed. Its basis on the thermodynamic laws is expressed in mathematical models for body-weight changes. Only a very small net energy surplus per time unit constitutes the energy deposition during weight gain, making measurements of its components difficult. The physical laws provide exact quantitative relationships between energy intake, energy expenditure and deposition of energy, but cannot disentangle the initiating and driving forces of the energy imbalance, which may also be an active storage of fat in adipose tissue. These and various other limitations of the energy balance model warrant cautiousness in using the model in studies of obesity causation. Weight gain may be self-promoting and mathematical feedback models allowing estimation of such effects show that they are realistic. Predisposition and susceptibility should be distinguished, and susceptibility as a modifiable predisposition, the genetic and environmental contribution to predisposition and its usefulness as targets for prevention and treatment are discussed. Current progress in unravelling genetic predisposition, the complex geneticallydetermined mechanisms, the slower progress in unravelling the environmental influences, the different nature of genetic and environmental influences, the possible pathways of environmental influences and the environmental influences as mediators of genetic effects are addressed. The evidence behind the prevailing concept of the 'obesogenic' environment is critically analysed. Finally, particular opportunities for the identification of the causes of the obesity epidemic by detailed analysis of an observed irregular development of the epidemic over long time periods are presented, and evidence for predisposition as a result of postnatal environmental influences is inferred from these studies. Causation of obesity: Energy balance: Obesogenic environment: Obesity epidemicThe study of the causation of obesity presents numerous challenges, several of which do not have clear solutions within the framework of currently-existing knowledge and available materials and methods. However, before considering the scientific challenges, there is a more cultural one. Generally, the prevailing opinion seems to be that the causes are well known and that the solution is simple; obesity is a problem emerging from gluttony and sloth, and if these factors are avoided, obesity will disappear (1) . Discussion and debate from time to time raise some doubt and interest, but soon the prevailing opinion establishes itself again. It seems likely that this situation will not change until there is a much better understanding of the causation of obesity and the value of such knowledge in both the prevention and treatment of obesity has been demonstrated.In the present paper some of the more prominent principal challenges, in the author's view, will be presented and discussed. The discussion will be based primarily on theoretical considerations about the causati...

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Does physical activity prevent weight gain – a systematic review

Cited by 487 publications

References 73 publications

Long-term weight loss after diet and exercise: a systematic review

Long-term weight loss after diet and exercise: a systematic review

Physical activity, television viewing and body mass index: a cross-sectional analysis from childhood to adulthood in the 1958 British cohort

Challenges in the study of causation of obesity

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