Physical activity

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Physical Activity

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.
Resistance
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
Myths
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

References

Rich Weil, M.Ed, CDE "Body Composition & Changes with Weight."

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