- Four to five 30 minute walks / wk to see significant effects
- Unfit @ any weight category are worse off
- Estimating Energy Expenditure [www.exrx.net/calculators Estimate Energy] [www.caloriesspentperhour.com Cal Calc]
- 52 week program, dont start exercise for 10wks
- If hungry w/ exercise (Last meal? Macronutrient of last meal? Hydration Status?)
- 20 issues lead to gait disturbance in obese patients (knee is worst)
- 4-5x risk of knee OA
- Visceral Fat loss without weight loss --very sensitive to exercise 3x a week @ 45min for 8 weeks dropped HGBA1c by 2 pts
- RMR rises with FFM, strength is NOT higher
- With weight loss, 37% can be from FFM.
- Waist Circ changes before weight
How Much Exercise
- 5 minutes out, 5 minutes back
- HR>150 - 85% max heart rate is vigourous
- Weight Loss
- Prevention of Weight Regain after Weight Loss: ACSM rec (250min/wk of vigourous & weight training)
- Subjects under-report food by ~50% & over-report exercise by ~50%
- For every pound of weight loss there was a 4-fold reduction in reduction of stress on the knee.
- Increase endurance & days / wk first, then intensity
- Increasing duration? Its relative
- Interval training, 1 min up, 3 min active recovery, repeat.
- 1-6 Reps to emphasize strength only
- 8-12 reps for strength and tone
- 12-15 reps for tone, endurance and strength
- 1 set for beginners for 3-4 mos
- then 3 sets after that
- NEAT (Non-exercise Activity Thermogenesis)
- A little movement goes a long way (~100kcal / day)
- Who sits more? 300kcal difference / day
- FITTE (Freq, Intensity, Time, Type, NOT Enjoyment)
- What patients want to hear
- You dont burn fat for 20 min.
- It doesnt count if you dont sweat a lot
- You get fewer calories and get less fit with fat burning workout
- You have to change your workout and "shock" your body
- You shouldnt lift weights until you lose weights
- A Little bit of activity doesn't count
Rich Weil, M.Ed, CDE "Body Composition & Changes with Weight."