1. Exercise: How Much Is Needed to Keep the Weight Off? Provided Courtesy of RD411.com Where health care professionals go for information G-1263Contributed by Jessica Kendrick, MS, RD/LD Review Date 1/10

2. Weight Loss vs Weight Maintenance Exercise is not required to achieve weight lossonly a calorie deficit is needed Exercise is essential for weight maintenance

3. Confusing Recommendations CDC/ACSM: All adults should do at least 30 minutes of moderate-intensity physical activity on most, preferably all, days of the week IOM: One hour per day of moderate- intensity physical activity to help maintain weight in the normal BMI range, and for full health benefits BMI=body mass index, CDC/ACSM=Centers for Disease Control and Prevention/American College of Sports Medicine; IOM=Institute of Medicine of the National Academies of Science

4. What Is Moderate Intensity? 3-6 metabolic equivalents (METs) of physical activity, such as: –3.0: Canoeing, rowing, light effort –3.0: Walking, 2.5 miles per hour, firm surface –4.0: Swimming, treading water, moderate effort –4.5: Basketball, shooting baskets –5.0: Kayaking –6.0: Downhill skiing, moderate effort

5. Confusing Recommendations At moderate intensities, free fatty acids are mobilized from the periphery to provide the majority of fuel used and to help with maintaining fat balance Fat burning is not restricted to low- intensity activities Fat and calories also are used during high- intensity exercise (65%-85% VO 2 max) Training programs using intermittent high-intensity exercise are most beneficial VO 2 =oxygen consumption

6. National Weight Control Registry Formed in 1993 to gain insights into what made successful losers Successful losers defined as having lost a minimum of 30 pounds (lb) and having kept it off for at least 1 year Most participants reduced fat intake to 25% of calories and expended 400 calories/day through physical activity

7. Key Strategies of Successful Losers Engaging in high-level physical activity Eating a diet low in calories and fat Eating breakfast Self-monitoring weight on a regular basis Maintaining a consistent eating pattern Catching slips before they result in larger weight gains

8. New Recommendations Position Stand from the ACSM: An initial goal of 150 minutes/week of moderate physical activity, progressing to 200-300 minutes/week This position is consistent with the observations from the study of successful losers and original recommendations from the CDC/ACSM and IOM

9. 2005 Dietary Guidelines At least 30 minutes of physical activity to reduce risk of chronic disease Up to 60 minutes of moderate to vigorous physical activity sometimes needed to prevent gradual weight gain that occurs over time 60-90 minutes of moderate-intensity physical activity to sustain weight loss

10. 2005 Dietary Guidelines (contd) For weight maintenance after loss, 60-90 minutes of moderate- intensity physical activity/day to sustain weight loss

11. Dose-Response Curve It is difficult to provide a single exercise prescription to address all issues related to weight loss and weight maintenance Moving up a level has the greatest benefits

12. The Bottom Line Translating science into practice is not easy Recommendation are confusing for the majority of adults The bottom line: Any amount of exercise is beneficial, but clearly more is better JUST DO IT!

13. References Hill JO, Wyatt H, Phelan S, Wing R. The National Weight Control Registry: Is it useful in helping deal with our obesity epidemic? J Nutr Educ Behav. 2005;37:206-210. Institute of Medicine of the National Academies of Science. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, DC: National Academy Press; 2002. Jakicic JM, Clark K, Coleman E, et al. American College of Sports Medicine position stand: appropriate intervention strategies for weight loss and prevention of weight regain in adults. Med Sci Sports Exerc 2001;33:2145-2156.

14. References (contd) Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402-407. US Dept of Agriculture and US Dept of Health and Human Services. Dietary Guidelines for Americans 2005. Washington, DC: US Printing Office; 2005. US Dept of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: US Dept of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996.