(0.25, 2.23)
Note that a negative ES favors the control intervention while a positive ES favors the therapeutic intervention and that for measures of changes to fat-free mass, the indication for retention of mass is considered to be positive. Cells left empty did not have enough responses to indicate either a pooled therapeutic ES relative to control or a CI for ES. Note that D indicates intervention of diet only, ET indicates endurance training, RT indicates resistance training, D(E) indicates intervention of diet with ET, D(R) indicates intervention of diet with resistance training, D(E + R) indicates intervention of diet with combination of training methods.
*Indicates significantly greater response than diet-only intervention, $ Indicates difference between modes of endurance exercise intervention, # indicates difference between intensity used for resistance exercise intervention, ¢ indicates difference in gender response (male > female), ¢* indicates difference in gender response (female > male), for χ 2 -value > χ 2 CV, p < 0.05.
In comparison of blood lipid profiles, e.g., total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL), and triglycerides (TG), all treatment options once again provided an effective means for change relative to either the pre-intervention status or in comparison to the control conditon. The responses invoked by RT, whether alone or in combination with diet, showed a greater effectiveness for eliciting changes in TC and LDL relative to the diet only options (χ 2 = 7.18, 4.95, respectively) and trends toward significance for HDL (χ 2 = 3.38, p = 0.068). But showed no difference to the responses invoked by ET, either with or without the combination of diet. While the use of ET either alone, or in combination with diet, show no difference for effectiveness at eliciting changes blood lipids (TC, LDL and TG) versus the changes elicited by a diet only intervention. Yet trended toward favoring ET for effectiveness in changes seen in HDL (χ 2 = 2.842, p = 0.089). Additionally, there were no differences noted on the pooled effect for treatment based on the gender of the participant groups for any of the treatment intervention options. However there was a trend for women utilizing ET in combination with diet for having a great effect in the changes in HDL levels versus those seen in men (χ 2 = 2.0, p = 0.12).
Similar to the changes seen with blood lipids, effectiveness for eliciting positive changes to adipokines (adiponectin and leptin) or cytokines (c-reactive protein (CRP), TNF-α) of interest were noted occurring from all treatment interventions. Furthermore, there were very few differences in the pooled effect size versus the diet only intervention, with difference in ES for changes of adiponectin and leptin being elicited by the use of RT, either with or without diet, trending toward significant difference, χ 2 = 3.085 (p = 0.07) and χ 2 = 3.45 (p = 0.06), respectively. While there were no differences noted between the therapeutic effectiveness for treatment in the responses to either CRP or TNF-α between any of the combinations for interventions.
In comparison of body compositional changes based on the method of intervention, as would be expected, there are effect size differences in treatment responses that favor the combination of intervention methods. While a diet alone treatment did induce a beneficial treatment effect following intervention. It was not more effective than other treatments at inducing changes in FM, see Figure 2 . While the combination of diet and ET was not as effective as any of the other treatments with respect to changing of body composition. ET appears to be effective at inducing a larger loss of FFM relative to diet with combination of RT (χ 2 = 6.531, p = 0.01). With respect to the combination of diet and RT, this intervention appears to be able to induce favorable adaptions in, measurements of both FM and FFM (χ 2 = 9.24 and χ 2 = 8.02, p < 0.01, respectively). While producing equivalent ES for body mass changes as either diet alone, or diet in combination with ET, see Figure 2 . Interestingly, there were no differences noted showing a favor toward the combination of diet with both ET and RT versus the other intervention methods. In continuation with what was noted in the pooled therapeutic effect size, a trend toward gender difference for effectiveness of treatment was noted in the change in FFM for the utilization of diet with RT only in male groups versus female counterparts (χ 2 = 3.3, p = 0.06).
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of ET, or versus diet with combination of RT) methods for changes in either Body Mass (BM), Fat Mass (Fat), and Fat-Free Mass (FFM). Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.
Eliciting energetic imbalance indicates a pattern that favors an intervention that is a combination of diet with any type of exercise versus that of either diet, or exercise, alone, Figure 3 . Furthermore, the treatment ES for energetic imbalance for the combination of diet and ET were more favorable than any other treatment intervention combinations. Interestingly, while the combination of diet with ET and RT was more effective then either a diet alone or exercise alone it was less effective then either ET or RT in combination with diet at inducing an energetic imbalance. Additionally, there were no differences between gender groups that would indicate a greater effectiveness of a treatment methodology for a specific gender grouping.
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of either ET, RT, or combination of ET and RT) methods for changes in energetic imbalance as assumed established within the intervention protocol. Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.
In regards to changes in the blood lipid profiles, there were not only indications for difference between treatments, there is also a very interesting finding that therapeutic interventions may actually induce elevations in certain lipids. While the diet only intervention did have a positive impact on TC and HDL levels, it has only minimal impact on either LDL or TG levels, Figures 4 , ,5 5 and and6. 6 . Additionally, the treatment interventions that combined diet with ET induced a much larger ES, Figure 4 , for measures TC and LDL. And diet in combination with RT induces a larger ES in TC, HDL, LDL and TG changes relative to those changes seen in diet only treatments, Figures 4 , ,5 5 and and6. 6 . Moreover, diet with combination of RT was able to produce a much lager ES for these measures in comparison to those induced by diet with combination of ET, for each of these measures, see Figures 4 , ,5 5 and and6. 6 . As far as changes in TG, diet with combination of RT appears be the least effective for inducing changes relative to either the diet only or the diet with combination of ET, Figures 4 , ,5 5 and and6. 6 . Additionally, there appears to be a pattern where the induction for changes in lipid profiles cannot be established through the use of ET only for all measures. While RT is the only intervention that appears to be slightly more effective than diet alone or diet in combination of ET for changes in HDL and TG, Figures 4 , ,5 5 and and6. 6 . There were gender differences noted for effectiveness of treatment for HDL and TG but not for LDL or TC, both of which indicate a larger effectiveness for treatment in female grouping versus male counterparts.
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination ET) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of RT) methods for response related to changes in blood lipid profiles TC, HDL, LDL, and TG. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
The most prominently reported hormones and cytokine signal throughout the studies was insulin, followed by adiponectin, leptin, IL-6, CRP, and TNF-α. And as such are the hormone and cytokines reported on here as they provide a large enough N-size to allow for comparison of a pooled ES and CI for ES based on treatment intervention. In which ES for eliciting changes in insulin, Figure 7 , indicates that ET in combination with diet (or as a stand-alone intervention) induces a lower effect than diet alone. While the use of RT either alone, or in combination with diet, was more effective than diet alone it was less effective than ET or the combination of diet with ET and RT, see Figure 7 . There was a gender difference to response and effectiveness indicated within the analysis for insulin changes, with treatments appearing to be more effective in male groupings than in female groups.
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone or versus diet with combination of ET, or versus diet with combination of RT) methods for response related to changes in Insulin. Note that the comparisons are labeled as “treatment-to-comparison”, with D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, D(E + R) indicating diet with ET and RT, ET indicating ET-only, and RT indicating RT-only for the various intervention methods within the comparisons.
There were highly variable responses for effectiveness for each treatment method to induce changes to circulating levels of adiponectin, leptin, TNF-α, or CRP (Figures 8 , ,9 9 and and10). 10 ). In which, diet alone and in combination with ET, were more effective than what was seen with changes induced by the incorporation of RT for changes to adiponectin and leptin, Figures 8 , ,9 9 and and10. 10 . While the changes induced in CRP and TNF-α, Figures 8 , ,9 9 and and10, 10 , were nearly identical, i.e. ES that crosses 0, for differences in effectiveness for changes between diet alone, or diet in combination with exercise (either ET, RT or combination of ET and RT). And all were more effective than the exercise alone treatments. Further there were no indication for a more effective means to change cytokine or adipokine levels with the utilization of diet in combination with both ET and RT. Interestingly, there were no gender differences indicated throughout the analysis of ES for any of the changes to the level of cytokines or adipokines following treatments, regardless of the methodology employed.
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet alone) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of ET) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Description of the pooled ES for treatment response and the range of CI for ES between intervention (versus diet with combination of RT) methods for response related to changes in Adiponectin, Leptin, CRP, TNF- α and IL-6. Note that labeled groups go as follows: D indicating diet-only, D(E) indicating diet with ET, D(R) indicating diet with RT, and D(E + R) indicating diet with ET and RT for the various intervention methods within the comparisons.
Not only were there differences indicated between the treatment options, but also within the various treatment methods. First is the differences based on diet method. With the use of a high protein diet, indicated here as a diet with >1.5 g protein*kg −1 body mass (>25% of total kcal/d), in a hypocaloric model inducing a larger effect for body compositional changes relative to any of the other diet methods, ES of 0.60, 0.54, 0.38 for loss of body mass, FM and retention of FFM respectively. Further, lower fat diet was less effective when compared to either a glycemically controlled diet, or the high protein/low carbohydrate diet for the change of any body compositional measures, ES of −0.64. Especially in relation to the high protein/low carbohydrate diet, ES of −1.04. Similarly, the lower carbohydrate and higher protein model lead to a greater effect in changes to blood lipids and cytokines (adiponectin and leptin) with an ES of 0.60, 2.14, 0.59, and 0.77, for TC, HDL, adiponectin and leptin respectively.
Also exercise of high intensity (indicted as with RT training intensities ≥75% of 1RM at a training volume of 2–4 sets of 6–10 reps and when free-weight resistance is utilized or ET utilizing interval intensities or a steady-state with intensities ≥70% VO 2max or HR max ) elicited greater effectiveness at inducing changes to body composition, insulin levels, blood lipids, and cytokines (adiponectin, CRP, IL-6), with an ES of 0.49, 0.66, 0.37, 0.50, 0.75, 0.78, 0.75, 0.66, 1.15, and 0.92 for BM, FM, FFM, Insulin, TC, LDL, TG, adiponectin, CRP, and IL-6 respectively. As should be of no surprise, the combination of a high level of training intensity (regardless of method of exercise, ET or RT or ET and RT, or in combination with diet or not) induced a greater effect on the level of energetic imbalance than a lower level of training intensity. When comparisons based on training intensity indicate a clear preference towards use of higher levels of training intensity. Where higher intensity training once again elicited a greater effect in the responses than lower intensities (ES of 0.66, 0.3, 0.42, 1.15, 0.92 for adiponectin, leptin, TNF-α, CRP and IL-6 respectively). And is better than the diet only option for treatment (ES of 0.26, 0.59, 0.29, 0.86, 0.33 for adiponectin, leptin, TNF-α, CRP and IL-6 respectively). Comparison between exercise modalities indicates RT protocols produced a greater ES for changes in adiponectin for higher intensities (ES of 0.74), but not for lower (ES of −1.14) with no differences noted for changes in leptin, relative to ET. Likewise, RT induced a greater ES for changes in IL-6 and CRP relative to ET, at higher (ES of 0.27 and 1.34, respectively) and lower intensities (ES of 0.36 and 0.76, respectively). Furthermore there is an indication for favoring higher intensity RT at an ES of 0.47 for BM, of 0.30 for FM and 0.40 for FFM, respectively to any of the ET protocols, ET and RT combination or lower intensity RT. And favor higher intensity ET at an ES for 0.35 for BM and 0.39 for FM but not for retention of FFM 0.13 relative to lower intensity ET. Where comparisons between exercise intensities within the ET and the RT protocols, indicated favor toward ET (ES of 0.66, 1.13, 0.61, and 0.96 for TC, HDL, LDL, and TG respectively), and RT (ES of 0.85, 0.86, and 0.60 for TC, LDL, and TG respectively).
Given that any change in behavior in highly sedentary individuals who are overfat should result in an immediate effective means for altering both body composition and health status. That occurs regardless of the methods utilized for the adult who is overfat. And given that all studies in publication indicate an ability to produce a positive effect to both body composition and health status. It should not be surprising to find ES across studies that indicate and effective treatment regardless of methodology utilized. Yet, while all treatment options show a favor for effective treatment for inducing changes in body mass. The effectiveness by which the body composition measures changed was highly variable based on the specific methodology being utilized. Moreover, they varied widely in the effectiveness for the biomarkers of health status of the adult who is overfat, Table 2 . Moreover, the analysis of ES pooled across studies in aggregate indicate here is that what has been the general classically recommend treatment for overfatness, and associated diseases, may not actually be the most effective. Where the methodological, and sociological, bias towards said programs may be the inherent rationale for continued praise and high recommendation to individuals who are overfat. And may promote the reoccurring cycles of repetitive diets and exercise programs for changes in body morphology and health status [ 13 , 14 , 15 , 16 ].
As evident in the fact that classically recommended, and routinely cited in popular press, lower fat diet was less effective for changing any body compositional measures relative to the other dietary only options. With the higher protein diets being more effective than the glycemic controlled diets relative to the lower fat diets. Therefore, should a diet-only intervention be recommended, and in agreement with previous reviews on the topic [ 61 - 64 ], a hypocaloric high-protein/low carbohydrate diet appears to generate the greatest ES for change relative to all hypocaloric, and low fat, diets. This effectiveness appears within diet interventions that utilized a level >1.5 g protein*kg −1 body mass (>25% of total kcal/d), within the hypocaloric diet with a CI for ES induced always favoring the high protein diet, while not with diets with lower protein, ~1.0 g of protein*kg −1 BM (<20% of total kcal/d), and higher carbohydrate (regardless of glycemic load) threshold for ES induced a CI .95 that crosses into the area of having no effect (i.e. ES ≤ 0) at changing of body composition.
Further, the addition of exercise provided stimulus for responses that are at least as effective as any diet-only method for altering body composition, see Table 2 and Figure 2 . And analysis of effectiveness showed preference of favor toward RT rather than the classically recommended ET at being more effective to elicit beneficial changes. When combined with diet, exercise interventions were more effective at inducing responses in body compositional changes than either an exercise, or diet, alone option for intervention. The effectiveness for exercise becomes more pronounced with higher levels of intensity of exercise regardless of the methodology employed (i.e. ET, RT, or combination therein) within the intervention protocol. Additionally, there is a clear delineation between the modes of exercise used and the effectiveness at inducing responses. While heavy recommended by a number of organizations and through a variety of position stands [ 17 , 55 , 65 ], or stated in previous reviews on the subject [ 4 , 7 - 10 , 12 ], as being more effective at inducing changes in body composition the use of a ET alone, or in combination with RT, and in combination with diet interventions were not more effect than the combination of RT with diet, Figure 2 .
Within this difference of effectiveness for treatment, diet with RT was not only more effective at altering BM in the most beneficial pattern (i.e. reduction of FM with retention of FFM), without regard to level of training, versus any of the other categorization of the methods for exercise. And when employed at even lower levels of stimulation (e.g., <70% 1RM, single set for at least 12 repetitions, use of pneumatic or selectorized machines, and performance of circuit resistance training) RT provides responses that mimic the ES from ET, or the combination to ET and RT. Where responses mirror each other, whether or not diet is involved in the treatment. And becomes more effective at higher levels of stimulation RT (e.g., >75-80% 1RM for at least 3 sets with repetition ranges of 5-to-10 with 60-to-90 second rest intervals) at inducing changes in body composition that leads to the reduction of BM and FM, while retaining (and in some cases increases of) FFM for the individual who is overfat. Further, ET appeared to have its greatest effect when either in an interval style of ET, or at higher intensities of at ≥75% VO 2max (or HR max/peak ), while not at the traditionally recommended moderate (e.g., 55-75% VO 2max , or HR max/peak ) steady-state ET for response to changes in BM and FM, but not for changes in FFM.
There is also the classically held view of the relationship between caloric imbalance and the altering body composition for adults who are overfat. Where if the assumption is correct, there should be a relationship of equivalence in effectiveness for changing caloric balance with body compositional changes between treatment methods. However, based on analysis here, the effectiveness for inducing changes in caloric imbalance does not match the effectiveness to induce body compositional changes for the adult that is overfat. This alternate view to the equation indicates, as previously speculated [ 19 , 27 ], that the issue of overfatness is one that is highly complex. Where there a variety of interconnected factors at play beyond the simplistic caloric balance issue relative to not only body composition but also the alteration of health status for the adult who is overfat. And hints at a possible problem for continually linking these two factors in relationship to changes, not only body compositional changes but also the health status change. As there are number of problem rationales for such an argument, namely changes in hormonal functions related to energetic balance (i.e. leptin, ghrelin) and tightly associated with metabolic markers of exertional stress (i.e. AMPK) [ 5 , 12 , 66 , 67 ]. Along with the inherent problem related to measuring the absolute of energetic imbalance that may be incurred from any intervention. Principally that the indicated energetic imbalances are an assumed difference in energetic balance. As very few protocols directly measure the imbalance and no study reviewed on the topic directly measured the energetic shift from either the exercise sessions, the recovery from said sessions. With only a few indicated changes in resting metabolic rate related to either the hypocaloric diet or exercise or combination therein. Thus it becomes troubling that such relationships are continually stated as an absolute as opposed to the assumption that it appears to be. Therefore, it may be more beneficial to discuss intervention methods based on metabolic stress (and demand) rather than on the energetic imbalance, based on the assumed difference, for the adult who is overfat.
While changes to body composition appear to be key in the reinforcement necessary for continual use of the treatment protocols over long periods of time, providing the cheerleader effect for continuation of an intervention. The changes elicited in humoral factors (e.g., hormone/cytokines, blood lipids and biomarkers of inflammation) are necessary for improvement in health status that many have previously discussed in a number of reviews on this topic [ 18 - 21 , 26 , 31 , 32 , 34 , 42 ]. As one of the key indicators for metabolic health issues for adults that are overfat is high levels of circulating insulin, it would be expected that an effective therapeutic treatment would elicit reductions in fasting levels of insulin would indicate improvements in metabolic and immune conditions [ 19 , 26 , 28 , 31 - 34 , 42 ].
In such, there are patterns of responses indicating a spectrum of effectiveness, within and across the various methods of diet, exercise or combination of diet with exercise. As indicated with inducing changes in fasting levels of insulin, where dieting alone is shown to be overall less effective than any of the exercise or diet in combination with exercise modalities. Once again the high-protein (regardless of carbohydrate modification) diet was more effective than the simply having a hypocaloric, or the traditional low fat, diet within the spectrum of diet options examined, ES of 0.49. And is seen even more so when combined with an exercise programs, ES of 0.77. Lending further support to the evolving opinion regarding the employment of higher protein diets for adults who are overfat.
Additionally, exercise was more effective at inducing changes in fasting insulin levels than diet. And in congruence with many of the position stands offered and classically recommend [ 1 , 17 , 55 ], the use of ET (both alone and in combination with diet or in conjunction of diet and RT) was more effective than RT (either when used alone or in combination with diet) for eliciting changes in insulin. This difference in treatment effectiveness is reversed with incorporation of the high protein/low carbohydrate diet with combination of exercise where RT is more effective than ET, regardless of intensity (ES of 3.5). It should also be noted that the combination of diet with RT was only intervention that provided a pooled therapeutic ES that did not elicit the possibility of no response (i.e. crosses a point of ES = 0) from treatment relative to the control. And not surprisingly, the use of higher-intensity exercise was more effective than lower-intensity exercise without regard to diet selection. While these findings support the use of ET within treatment protocols, there is an indication that RT is a viable option for the adult who is overfat and does not self-select towards an ET mode of exercise [ 13 , 15 , 27 , 28 ]. Thus given the findings here, utilizing RT can be a more effective treatment for reversing insulin resistance, as the psychological adherence to the program may provide additional reinforcement for continual use of exercise within a treatment regimen. And when combined with the combination of a high protein/low carbohydrate diet, RT exercise (regardless of level of intensity) can be significantly more effective than the standard ET recommendations.
There is also a spectrum effectiveness to elicit responses in blood lipids form the various treatments indicates trends in the data towards the use of exercise (ET, RT or combination thereof) either alone or in combination with diet for effectiveness of treatment over the use of simple dietary interventions. In which all treatments offer a small degree of effectiveness for altering lipid profiles for the individual who is overfat. With the combination of diet and exercise was more effective than diet alone or exercise alone. And as indicated here, there is a favor toward use of RT is seen with eliciting reductions of blood lipids levels, TC, LDL and TG, relative to either dieting alone, or in combination of diet with ET. Which lends further support toward using RT within the treatment methods. As previously noted, this difference in effectiveness becomes even more pronounced in favor of the higher intensity exercise protocols (regardless of using ET or RT).
This spectrum for a continuum of effectiveness continues as related to the levels of cytokines (e.g., TNF-α, CRP, leptin and adiponectin) related to inflammation and chronic immune response. Where any treatment is able to produce an effective change that leads toward a normal “healthy” range, thus leading to a reduced risk for development of cardiovascular disease and improvements in work capacity and overall health [ 18 , 26 , 32 , 34 , 42 , 68 ]. However, these responses were highly variable and most of the indications for effectiveness, both as a therapeutic effect and treatment effect, near that point of zero difference in effect (i.e. ES = 0). Most interesting were responses seen in changes to levels of CRP, found in relation to diet alone and diet with RT. Where diet combined with RT induced an almost equal level of effectiveness to that of diet alone. With both indicated as being less effective than the combination of diet with ET or the combination of diet with ET and RT. Indicating a possible metabolic difference between exercise modalities that might induce the differential cardiovascular adaptations noted following these distinct intervention protocols.
Moreover, there are differences in effectiveness noted between RT and ET. This is seen regardless of being utilized alone or with modification to diet, or based on the intensities of training. Based on such stratification there is an indication for the role of the metabolic demand of treatment eliciting differential response to cytokine and adipokine signals that alter whole body metabolism. Where it appears that the better means for prescription of exercise is at the higher levels of training intensities. And when associated with the concept of self-selection toward distinct exercise modes leading to greater utilization [ 13 , 15 , 56 ], supports the indication for practitioners to recommend and prescribe the use of RT within treatment options that have been speculated about previously [ 28 , 47 - 50 ]. As incorporating RT may provide the metabolic stimulus to not only the means for improvement of health status but as it may be more readily self-selected lead to longer periods of utilization such activities throughout one’s remaining lifespan as been previously suggested [ 15 , 69 ]. Especially if RT is prescribed at the higher levels of training intensities than what has been previously recommended and closer to what is traditionally utilized for hypertophication responses in lean and active individuals.
While one intention of the study here was to examine the changes in anabolic hormones that have shown reduced levels with overfatness (e.g., testosterone (T) and growth hormone (GH)) in particular relative to the therapeutic interventions of diet, exercise or combination of diet and exercise. There were too few studies that looked at these changes in relation to the treatments that were used, that did not involve a pharmaceutical intervention. From the few studies that examined this change, the relative changes in absolute values note an increase in testosterone and growth hormone that seem to not be related to the intervention used, but instead changes in FM following treatment. While a number of studies have examined the issue in responses acutely either to exercise relative to differences between the normal fat control and the overfat population, or in relation to a pharmaceutical treatment option without use of exercise. Given the current opinions [ 36 , 70 - 72 ] regarding the role of such hormones in relation to body composition and disease it seems that studying such changes may prove to be a very fruitful avenue for future research in the various intervention programs. Especially given the previously noted changes in GH from hypocaloric diets and within various exercise treatments utilized [ 73 , 74 ]. Which is matched with the changes in levels of T, binding proteins and peripheral receptors for T that are associated with exercise, in particular RT in a fasting state (which should relate well with a hypocaloric model), and may mirror the hormone replacement therapy treatment application for some individuals with this population [ 45 , 46 , 132 , 75 - 78 ]. However, there is limited analysis to speculate either to the extent, beyond expected changes toward normal levels, or time frame for changes within anabolic hormones for adults who are overfat. But given the compatibility of immunological and metabolic profiles between the overfat and the elderly populations, it can be speculated that use of exercise, in particular RT should mimic what has been shown with elderly populations [ 79 - 82 ].
Analysis of effectiveness of responses both within and between interventions differences for treatment options modalities (e.g., diet, exercise, or combination therein) along with submodality of treatment (e.g., high intensity versus low intensity, high protein/low carbohydrate diets) indicate a continuum of effectiveness. Most importantly is that protocols utilizing exercise were more effective than those that employed just a hypocaloric diet. With the combination of diet with exercise (especially RT) being more effective than diet or diet with ET in reduction of body mass and fat mass while retaining of FFM following treatment. And are at least as effective for changing hormonal levels and blood lipid profiles. Also, while popular ideas suggest the necessity for acute energetic imbalance, there appears to be no relationship between any treatments effectiveness for inducing acute changes in energetic balance with the effectiveness for induced responses to body composition or biomarkers of health from said treatment program. All of which reinforces the idea of a more complex network of factors that influence overall body composition and health issues for the adult who is overfat, and further stresses the idea to focus treatment on generating a metabolic stress to induce chronic endocrinological (and cytokine) changes as opposed to the focus on the kcal/d (kJ/d) ratios of intake to expenditure.
Further, based on ES for responses to RT (in combination with diet, or with diet and ET), one would be able to expect that at the very least 55% of any population of overfat adults should have beneficial responses in all body compositional measures from the incorporation of RT into a treatment play, along with an even greater percentage having a favorable response to altering fasting levels of insulin, total cholesterol, low-density lipoproteins and triglycerides. Additionally, when exercise is utilized at appropriate intensities (i.e. higher levels) both ET and RT provides an effective stimulus to alter TNF-α, CRP, leptin and adiponectin levels that all indicate a reduction in the risk for cardiovascular disease and improved metabolic flexibility for the adult who is overfat. With RT producing a greater level of effectiveness for altering these measures, especially when RT is progressive and periodized with a training volume of 2-to-3 sets at 6-to-10 reps with an intensity of ≥75% 1RM and a rest interval of 60–90 seconds, and utilizes whole body (and free-weight) exercises. And thus indicates that RT should be more readily recommended as an appropriate treatment option to adults who are overfat than what has been recommended currently.
Yet, however the effectiveness of this combination of diet and RT might be for inducing changes, the concept of self-selection of exercise patterns means that some adults who are overfat may select toward protocols of ET for exercise. For those who self-select toward ET, it appears that ET is more effective when performed at high intensity (e.g., ≥70% VO 2max , or HR max ) steady-state method or as an interval training style (based on ES calculated gives an expectations of at least 40% of the population showing beneficial responses to intervention). Likewise, some may select away from exercise altogether, which based on overall effectiveness should be discouraged but if utilized as a stand alone intervention, diets can be effective if hypocaloric and comprised of a higher percentage of total caloric intake from protein, with an expectation for at least 55% of the population showing a beneficial response from the intervention.
Lastly, there needs to be further examination of findings noted here. First, related to the ongoing understanding of the anabolic dysregulation that accompanies the situation of being overfat. In this light there is a need to examine the relationship of changes in said hormones based on intervention within populations of individuals who are overfat. Not with simply acute comparison to lean active population, but within the concept of altering levels of anabolic hormones, responses at peripheral tissues and the relative timeframe for seeing such hormonal responses based on the various interventions utilized. And how the impact of periodization and concurrent exercise exposure has on these responses. Second, related to the issues of differential response between genders to identify if there may be a more beneficial response for males versus those for females, and vice versa. Third, based on the current understanding of application of exercise modalities if there are differential responses to programs based on location for intervention and professional associated with overseeing intervention (e.g., in hospital versus out-patient physical therapy clinic versus community health center/gymnasium or for-profit health center/gymnasium). Additionally, and as noted earlier, there needs to be an evaluation of programs and protocols readily available to the populous or utilized within studies for this population. Most exercise programs seem to be highly elaborate for the sake of complexity. In what appears as an effort of marketing the program as being different, as opposed to being elaborate for the sake of progressive periodization. Where the elaboration for periodization of exercise is meant to provide stimulus for continual adaptations within the exerciser. Finally, most programs that have been established based on the idea of energetic imbalance need to be careful with establishing such an idea, as the energetic imbalance is based on an assumption that might not be held in all cases. As changes to not only body composition but also health status comes from manipulation of highly elaborate network of factors that interact, compliment and confound the impact of each other for the adult who is overfat leading to not only body compositional changes, but reversal of the deleterious health outcome of being overfat.
D | Diet |
ET | Endurance Training |
RT | Resistance Training |
E + R | Combination of ET and RT |
D(E) | Diet with ET |
D(ER) | Diet with combination of ET and RT |
D(R) | Diet with RT |
BM | Body mass (kg) |
BMI | Body mass index (kg*m ) |
%BF | The percent of body mass comprised on fat mass |
FM | Fat mass (kg, or as determined by %body fat) |
FFM | Fat-free mass (kg, or as determined by %fat-free mass) |
TG | Plasmal triglycerides |
TC | Plasmal total cholesterol |
HDL | High-density lipoproteins |
LDL | Low-density lipoproteins |
ES | Effect size as determined by pooled effect size via random effect computation |
T2DM | Type 2 diabetes mellitus or metabolic syndrome |
T | Testosterone |
GH | Growth hormone |
CRP | C-reactive protein |
TNF-α | Tumor necrotic factor-alpha |
VO | Maximal aerobic capacity |
HR | Maximal sustainable heart rate |
1RM | Maximal level of resistance for a single repetition (i.e. maximal strength) |
Competing interests
The author declares that he has no competing interests.
500 words essay on exercise essay.
Exercise is basically any physical activity that we perform on a repetitive basis for relaxing our body and taking away all the mental stress. It is important to do regular exercise. When you do this on a daily basis, you become fit both physically and mentally. Moreover, not exercising daily can make a person susceptible to different diseases. Thus, just like eating food daily, we must also exercise daily. The importance of exercise essay will throw more light on it.
Exercising is most essential for proper health and fitness. Moreover, it is essential for every sphere of life. Especially today’s youth need to exercise more than ever. It is because the junk food they consume every day can hamper their quality of life.
If you are not healthy, you cannot lead a happy life and won’t be able to contribute to the expansion of society. Thus, one needs to exercise to beat all these problems. But, it is not just about the youth but also about every member of the society.
These days, physical activities take places in colleges more than often. The professionals are called to the campus for organizing physical exercises. Thus, it is a great opportunity for everyone who wishes to do it.
Just like exercise is important for college kids, it is also essential for office workers. The desk job requires the person to sit at the desk for long hours without breaks. This gives rise to a very unhealthy lifestyle.
They get a limited amount of exercise as they just sit all day then come back home and sleep. Therefore, it is essential to exercise to adopt a healthy lifestyle that can also prevent any damaging diseases .
Exercise has a lot of benefits in today’s world. First of all, it helps in maintaining your weight. Moreover, it also helps you reduce weight if you are overweight. It is because you burn calories when you exercise.
Further, it helps in developing your muscles. Thus, the rate of your body will increases which helps to burn calories. Moreover, it also helps in improving the oxygen level and blood flow of the body.
When you exercise daily, your brain cells will release frequently. This helps in producing cells in the hippocampus. Moreover, it is the part of the brain which helps to learn and control memory.
The concentration level in your body will improve which will ultimately lower the danger of disease like Alzheimer’s. In addition, you can also reduce the strain on your heart through exercise. Finally, it controls the blood sugar levels of your body so it helps to prevent or delay diabetes.
Get the huge list of more than 500 Essay Topics and Ideas
In order to live life healthily, it is essential to exercise for mental and physical development. Thus, exercise is important for the overall growth of a person. It is essential to maintain a balance between work, rest and activities. So, make sure to exercise daily.
Question 1: What is the importance of exercise?
Answer 1: Exercise helps people lose weight and lower the risk of some diseases. When you exercise daily, you lower the risk of developing some diseases like obesity, type 2 diabetes, high blood pressure and more. It also helps to keep your body at a healthy weight.
Question 2: Why is exercising important for students?
Answer 2: Exercising is important for students because it helps students to enhance their cardiorespiratory fitness and build strong bones and muscles. In addition, it also controls weight and reduces the symptoms of anxiety and depression. Further, it can also reduce the risk of health conditions like heart diseases and more.
Which class are you in.
Your email address will not be published. Required fields are marked *
Advertisement
Supported by
Your body changes during the menopause transition. So should your fitness routine.
By Christine Yu
When Alison Gittelman turned 49, she found that she couldn’t run as fast or as long as she had before. She was an experienced marathoner and triathlete, but suddenly, as she entered menopause, her heart rate was unusually elevated while running. Her joints hurt. She gained weight. She started experiencing debilitating menstrual cramps.
“I hadn’t anticipated this at all,” said Ms. Gittelman, now 51. “I thought I would breeze through menopause.”
Soon, Ms. Gittelman realized that she had to adjust her exercise routine. She started to run less and rededicated herself to strength training and mobility exercises.
Whether you work out regularly or you’re just building a fitness habit, exercise can feel harder as you reach menopause, which typically occurs in your 40s or 50s . But that doesn’t mean you should hang up your sneakers. “Exercise can be a tool to build up your resilience to the shifts that are going to happen,” said Dr. Alyssa Olenick, an exercise physiologist who studies metabolism and menopause.
In your mid-40s, your ovaries start producing less estrogen and other reproductive hormones. This transitional phase, called perimenopause, lasts between four and eight years on average. Then, your estrogen plummets.
Beyond regulating reproductive function, estrogen plays an important role in preserving muscle mass and in protecting the heart, blood vessels, metabolic function and bone health. With less estrogen circulating in the body, a woman’s risk for diabetes and cardiovascular disease increases. Bone density declines too, leaving women at greater risk for fractures and osteoporosis.
We are having trouble retrieving the article content.
Please enable JavaScript in your browser settings.
Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.
Thank you for your patience while we verify access.
Already a subscriber? Log in .
Want all of The Times? Subscribe .
IMAGES
VIDEO
COMMENTS
Benefits of diet. While both diet and exercise are important for weight loss, it's generally easier to manage your calorie intake by modifying your diet than it is to burn significantly more ...
Proper nutrition is imperative to maximize athletic performance. Without enough carbohydrates, proteins, and fats, athletes may feel sluggish during a workout or ravenously hungry. Athletes may also need to focus on specific vitamins and minerals for fitness performance, such as iron, vitamin D, and zinc. Nutrition for physical activity is ...
Reason #2: Healthy Diet and Exercise Both Reduce the Risk of Disease. Aside from fueling your body, a healthy diet and adequate amounts of exercise can boost your immune system and help your body ward off diseases and other health conditions. Proper nutrition and adequate amounts of exercise can help reduce the risk of:
Introduction. As we all know that nutrition plays an important role in very individual's life. Proper physical activity and proper intake of nutrition are important in maintaining overall health and quality of life. As the research Centers for Disease Control and Prevention, regular exercise and proper nutrition can help maintain a proper weight and reduce the risk of cardiovascular disease ...
Nutrition is very important during childhood. The reason for this is that children require more energy than adults. The macronutrients and micronutrients that the body needs are absorbed according to the body size. The smaller the body size the more nutrients the body will need. Children also have a higher growth rate.
Another topic in the area of exercise nutrition that is heavily debated involves protein requirements for exercisers. Isenmann et al. demonstrate the importance of adequate protein and carbohydrate intake from foodstuffs following an exercise bout for the facilitation of muscle regeneration while minimizing the inflammatory response . Reckmann ...
Unhealthy eating and physical inactivity are leading causes of death in the U.S. Unhealthy diet contributes to approximately 678,000 deaths each year in the U.S., due to nutrition- and obesity-related diseases, such as heart disease, cancer, and type 2 diabetes. 1 In the last 30 years, obesity rates have doubled in adults, tripled in children ...
Diet vs. exercise. The key to weight loss is consuming fewer calories than your body burns. You technically can reach that calorie deficit through exercise alone, but it is much more difficult to achieve — and maintain. "It's a lot easier to not eat the 500-calorie slice of cake than to burn 500 calories," says Imus.
Nutritional composition and dietary intake are important in weight loss and maintenance and in providing the human body with the fuel it needs to survive. Exercise or regular physical activity pro-vides many more bene ts than nutrition alone. We. fi. have solid scienti c proof that participating in 150. fi.
Your body's use of calories through building more lean body tissue. Your body's use of important hormones like insulin. Hormones that control your appetite, like ghrelin. Cardiovascular exercise, or aerobic exercise, raises your heart rate and your breathing rate. It exercises your heart and lungs while you burn energy.
Today, good nutrition is more important than ever and must be a daily habit to maintain a healthy lifestyle. Understanding Nutrition. Good nutrition involves consuming the right balance of carbohydrates, fats, and proteins, the three main components of nutrition. Additionally, the body needs vitamins, minerals, and other substances from various ...
The vast majority of those surveyed believe that both monitoring food and beverage consumption and physical activity are equally important in weight maintenance and weight loss. After equally important, people go with exercise, and then diet. As you can see in my 2-min. video Diet vs. Exercise for Weight Loss, most people get it wrong.
By consuming the same amount of food and beverage while exercising more, a sustainable energy deficit (where the calories consumed are less than calories burnt) can be created. Regular exercise can also help increase your metabolic rate so you'll burn those calories at rest a lot more efficiently. Just a daily energy deficit of 500 to 1,000 ...
This isn't to say that exercise plays no role. There are many studies that show that adding exercise to diets can be beneficial. A 1999 review identified three key meta-analyses and other ...
Introduction to the importance and influence of nutrition on exercise. Nutrition is increasingly recognized as a key component of optimal sporting performance, with both the science and practice of sports nutrition developing rapidly.1 Recent studies have found that a planned scientific nutritional strategy (consisting of fluid, carbohydrate, sodium, and caffeine) compared with a self-chosen ...
When combined with diet, exercise interventions were more effective at inducing responses in body compositional changes than either an exercise, or diet, alone option for intervention. The effectiveness for exercise becomes more pronounced with higher levels of intensity of exercise regardless of the methodology employed (i.e. ET, RT, or ...
Being more active may help you: Lower your blood pressure. Boost your levels of good cholesterol. Improve blood flow (circulation) Keep your weight under control. Prevent bone loss that can lead to osteoporosis. This can add up to fewer medical expenses, interventions and medications later in life!
Exercise helps you lose weight by burning mostly fat; diet alone won't do that. And because muscles takes up less space than fat, exercise will help your cloths fit better. Exercise also helps boost your metabolism, meaning you burn more calories all day long. Research shows that you don't have to hit the gym for hours at a time to see the ...
Follow these tips: Aim to make breakfast a part of your routine. Choose complex carbohydrates, lean protein sources, healthy fats, and a wide variety of fruits and veggies. Stock your fridge and ...
4 Pages. Open Document. Exercise and eating healthy are two of the most important things you need to do to take care of your body properly. Both exercise, and eating healthy, have many advantages and benefits. They help with multiple things needed throughout your life. These things include growing physically, mentally, and if you are religious ...
Most people know good nutrition and physical activity can help maintain a healthy weight. However, the benefits of good nutrition go way beyond weight. Having good nutrition can help: reduce the risk of different diseases such as diabetes, heart disease, stroke, various types of cancers, and osteoporosis. Good Nutrition also reduces high blood ...
This may not be easy for everyone, but one can get support from family and friends in order for it to be easy. Good nutrition is more important than regular exercise because it helps in losing weight, helps to fuel the body, prevent the risk of getting diseases, and helps building muscles. First, losing weight happens faster through a proper ...
Get the huge list of more than 500 Essay Topics and Ideas. Conclusion of Importance of Exercise Essay. In order to live life healthily, it is essential to exercise for mental and physical development. Thus, exercise is important for the overall growth of a person. It is essential to maintain a balance between work, rest and activities.
"Your body needs more T.L.C.," Dr. DiGirolamo said, so don't skimp on your warm-up or cool down, take rest days and fuel your body before and after exercise, especially with protein.
With the assistance of my cat, Piper — and a few guest judges, my outdoor cats, on some toys — I tested more than two dozen cat toys, ranging from inexpensive catnip mice to automatic laser ...