Emperical Evidence to Support Methodologies
Exercise programs consisting of high caloric expenditures (3,000 calories per week) were more successful at lowering risk factors and metabolic syndrome than exercise programs with low caloric expenditures (800 calories per week). The high calorie group was more successful at: Reducing insulin resistance, losing weight, losing fat mass, reducing waist circumference, and improving total-to-HDL cholesterol levels. The high calorie group also lost two times as much weight as the low calorie group. Overall, metabolic syndrome was reduced by 28%.
The researchers compared high caloric expenditure (3,000 calories per week) versus low caloric expenditure (800 calories per week) in cardiac rehab. The study was performed to see which measure caused more weight loss, insulin sensitivity, and other improvements in the risk factor profile. After five months the high calorie expenditure group had nearly double the weight loss (19 pounds versus 9 pounds), along with larger decreases in fat mass, greater improvements in insulin sensitivity, increased waist reductions, and further improved cholesterol profiles than the low-calorie group. The study concluded that either amount of exercise improved the risk profile, but high calorie expenditure was more beneficial.
Ades, P. A., Savage, P. D., Toth, M. J., Berino, J. H., Schneider, D. J., Bunn, J. Y., Audelin, M. C., & Ludlow, M. (2009). High-calorie-expenditure exercise: A new approach to cardiac rehabilitation for overweight coronary patients. Circulation: Journal of the American Heart Association, 119, 2671-2678. Retrieved from http://circ.ahajournals.org/content/119/20/2671.short
Cardiovascular disease is the cause of over 1 out of every 3 deaths in the United States each year. This is equivalent to nearly 1 million cardiovascular events each year. The primary goal to prevent cardiovascular disease is weight loss and weight control. Weight loss in overweight and obese individuals reduces the likelihood of health problems over time. A goal is to reduce body weight by 10% within the first year.
Benjamin, E. J., Bittner, V., Braun, L. T., Goff, D. C., Havas, S., Labarthe, D. R., Limacher, M. C., & Lloyd-Jones, D. M. (2008). Acc/aha 2008 clinical performance measures for primary prevention of cardiovascular disease in adults. Journal of the American College of Cardiology, 54, 1364-1405. Retrieved from http://content.onlinejacc.org/cgi/content/short/54/14/1364
Nearly 85 million people in the United States have either prediabetes or type-2 diabetes. It is estimated that one in three people born after the year 2000 will have type-2 diabetes. Both cardiovascular and resistance training improve the body’s insulin sensitivity, which helps to prevent or delay type-2 diabetes. The most effective controls of blood glucose have involved supervision of the exercise sessions by qualified exercise trainers. When the supervision is removed, compliance and blood glucose control both deteriorate. An increased level of physical activity and physical fitness also reduced symptoms of depression.
Colberg, S. R., Albright, A. L., Blissmer, B. J., Braun, B., Chasan-Taber, L., Fernhall, B. K., Regensteiner, J. G., & Rubin, R. R. (2010). Exercise and type 2 diabetes. Medicine & Science in Sports and Exercise and American Diabetes Association, 32(7), 345-360. Retrieved from http://journals.lww.com/acsm-msse/Citation/2000/07000/Exercise_and_Type_2_Diabetes.24.aspx
Higher body fat percentages are directly corelated with an increased risk of type-2 diabetes, hypertension, cardiovascular disease, and many others. Moreover, abdominal fat is a better predictor of disease and death than overweight or body fat percentage alone. Weight loss may be the best method to reduce these risks. In fact, for every 2.2 pounds a person lost, there was a subsequent 16% reduction in the risk of developing type-2 diabetes.
In the United States 68% of adults are either overweight or obese. These conditions are associated with metabolic syndrome, type-2 diabetes, stroke, cardiovascular disease, and death. Higher body mass indexes and body fat percentages are associated with higher risks of disease. Reducing body weight and body fat percentages have been shown to reduce the risks.
Cornier, M. A., Despres, J. P., Davis, N., Grossniklaus, D. A., Klein, S., Lamarche, B., Lopez-Jimenez, F., & Rao, G. (2011). Assessing adiposity: A scientific statement from the american heart association. Circulation, 124, Retrieved from http://circ.ahajournals.org/content/124/18/1996.short
Over 66% of the population is now either overweight or obese, which is highly correlated with a variety of chronic diseases. A weight reduction of as little as 3-10% can have a considerable effect on health risk. To reduce weight, a combination of both cardiovascular and resistance exercise has been shown to be more beneficial than either alone. A follow up study performed by Curioni and Lourenco found a 20% greater weight loss in nutrition and exercise interventions compared to nutrition only programs. To a point, a dose-response relationship exists between the amount of physical activity and the associated weight loss.
Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., & Smith, B. K. (2009). Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Medicine & Science in Sports and Exercise, 41(2), 459-471. Retrieved from http://journals.lww.com/acsm-msse/Fulltext/2009/02000/Appropriate_Physical_Activity_Intervention.26.aspx
Subject’s who participate in exercise programs alone reduce their weight by four to six pounds on average. Subjects participating in diet plans alone improve their weight by 10 pounds on average. When diet is combined with exercise, average weight losses exceeded 17 pounds. The weight loss from these programs mainly consisted of decreases in fat mass. Subjects who were not on a diet or exercise plan actually gained four pounds on average. Reductions in LDL cholesterol were also enhanced when exercise was combined with diet. In addition to weight loss, exercise improved insulin sensitivity and provided more muscle cells to uptake glucose.
In a meta-analysis of over 100 studies, they concluded that an inverse relationship exists between exercise and cardiovascular disease. Sedentary individuals generally had about twice the incidence of death from cardiovascular disease compared to more active individuals. The main mechanisms behind the decreased risk of death due to exercise were: Reduced body fat, reduction of blood pressure, improved cholesterol levels, and improved insulin sensitivity. A caloric expenditure from exercise of over 2,000 calories per week was also associated with a 24% reduction in cardiovascular mortality.
Fletcher, G. F., Balady, G. J., Amsterdam, E. A., Chaitman, B., Eckel, R., Fleg, J., Froelicher, V. F., & Leon, A. S. (2001). Exercise standards for testing and training: A statement for healthcare professionals from the american heart association. Circulation: Journal of the American Heart Association, 104, 1694-1740. Retrieved from http://circ.ahajournals.org/content/104/14/1694.full.pdf html
Over 3,000 prediabetics were placed in either a placebo group, a medication group or a lifestyle intervention group (exercise, nutrition, and behavior modification) and were followed up after almost three years to look for effectiveness in treating type-2 diabetes. Results demonstrated that both medication and exercise were more effective at preventing type-2 diabetes than placebo. However, the behavior modification group was 27% more effective at preventing type-2 diabetes after three years than the medication group. In fact, the behavior modification group was 58% less likely than placebo to have type-2 diabetes and the medication group was 31% less likely to develop type-2 diabetes. To prevent one case of diabetes during a period of three years, 6.9 persons would need to participate in a lifestyle intervention program compared to the 13.9 who would have to receive medication.
Weight loss was compared in three separate groups over a twelve-week period. The groups consisted of a nutrition only group, a nutrition plus cardiovascular exercise group, and a nutrition plus cardiovascular and resistance exercise group. The group that included resistance exercise lost 44% more weight than the nutrition only group and 35% more than the nutrition and cardiovascular exercise group. The addition of weight training greatly accelerated fat loss.
Kramer, W. J., Volek, J. S., Gordon, S. E., Puhl, S. M., Koziris, L. P., McBride, J. M., Triplett-McBride, N. T., & Putukian, M. (1999). Influence of exercise training on physiological and performance changes with weight loss in men. Medicine & Science in Sports and Exercise and American Diabetes Association, 31(9), 1320-1329.
In 6,200 men referred to a hospital for exercise testing, higher exercise capacities were the best predictor of risk of death among normal subjects and those with cardiovascular disease. A low exercise capacity was a more influential predictor of death than smoking, congestive heart failure, and heart attack. Each modest increase in exercise capacity of 1 MET conferred with a 12% improvement in survival.
Myers, J., Prakesh, M., Froelicher, V., Do, D., Partington, S., & Atwood, J. E. (2002). Exercise capacity and mortalit among men referred for exercise testing. The New England Journal of Medicine, 346(11), 793-801
Incorporating resistance exercise training into a fitness program has a variety of benefits. These benefits include: Weight loss promotion, reduced risk of coronary heart disease, and type-2 diabetes, reduced risk of colon cancer and osteoporosis, and the promotion of psychological well being.
Ratamess, N. A., Alvar, B. A., Evetoch, T. K., Housh, T. J., Kibler, W. B., Kraemer, W. J., & Triplett, T. (2009). Progression models in resistance training for healthy adults. Medicine & Science in Sports and Exercise, 34(2), 364-380. Retrieved from http://journals.lww.com/acsm-msse/Abstract/2002/02000/Progression_Models_in_Resistance_Training_for.27.aspx
Exercise training and nutrition programs are both successful for weight loss on an individual level. However, the most successful weight loss programs include a combination of exercise training, low calorie nutrition plans, and behavioral therapy. Randomized controlled trials using all three modalities, have been shown to produce weight loss in the range of 10% in less than one year.
Pi-Sunyer, F. X., Becker, D. M., Bouchard, C., Carleton, R. A., Colditz, G. A., Dietz, W. H., Foreyt, J. P., & Garrison, R. J. (1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. National Institute of Health, Retrieved from http://www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm
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