FITT

For exercise prescription for overweight and obese individuals, according to ACSM guidelines they
recommend exercising for 5 or more days per week. Doing this will help to maximize the caloric
expenditure in the individuals and help with weight loss.
The recommended intensity level is moderate to vigorous. Initially you want to aim for an intensity
between 40 to 60% of their Vo2 or HRR and eventually progress to greater than 60%. So you want to
start off with moderate intensity and then progress to more vigorous intensity for further health benefits
Obese individuals should aim to exercise between 30-60 minutes per day. Initially start with 30 minutes
and progress to 60 minutes. This should correspond to 150 to 300 minutes of exercise per week of
moderate-vigorous intesity aerobic exercise.
To accumulate the aforementioned exercise times, an individual can exercise in bouts of 10 minutes if
they are unable to tolerate continuous exercise.
In terms of type of exercises it should be aerobic activities that target the large muscle groups of the
body. ACSM recommends incorporating flexibility and resistance training as part of a balanced exercise
program. The parameters for resistance and flexibility are as follows.

ARTICLE 1
Now we will present to you two articles that have looked into exercise as an intervention for obese
individuals. The first article was a randomized controlled trial by Fencki et al. that looked into comparing
the effects of aerobic and resistance exercise on various parameters such as BMI, weight, fat mass, lipid
profile, and insulin resistance in women who cannot adhere to energy-restricted diets.
So this was a longitudinal study that involved a 12 week exercise program and 60 obese women. These
women were split into 3 groups. One group did aerobic exercise, the other group did resistance exercise
and the control group did not participate in any exercise program. And so the experimenters measured
BMI, waist and weight measurements, triglyceride and cholesterol levels, LDL, and fat mass.
The aerobic exercise group were instructed to do a brisk 15 minute walk after which they exercised on a
cycle ergometer at 50-85% of their HRR. As you can see, the frequency and duration of their exercise
sessions were gradually increased from the first to the third month. (READ SLIDE)
The resistance group exercised 3 days/week on six exercise stations that each targeted a large muscle
group for example: READ SLIDE. The number of sets and intensity were also ramped up for this group.
READ SLIDE
So what the experimenters found was that both groups showed a significant decrease in BMI, waist,
weight, SBP, DBP, cholesterol and triglycerides measurements. They found that LDL-C and fat mass
were only significantly decreased in the aerobic group.
It can also be noted that aerobic exercise might be superior when it comes to reducing fat mass and LDL-
C. But the general point of this study is that both aerobic and resistance exercise can have effects on
metabolism and body fat composition. Exercise can help obese individuals lose weight and decrease BMI
which will have positive effects on their risk factors that we mentioned previously.
ARTICLE 2
This second study is by Slentz et al. and deals with how varying exercise amount and intensity can affect
body weight, composition and central obesity. So this study was also a randomized controlled trial.
This was a longer study that took place over the course of 8 months with 120 sedentary, overweight
adults. They were randomized into 4 groups that had exercise programs of different amounts and
intensities READ SLIDE The high amount groups had a caloric exercise equivalent of 20 miles of jogging
per week while the low amount had an equivalent of 12 miles of jogging or walking in the low intesity
group per week.
The equivalents were shown in walking or jogging but the actual exercise modes included cycle
ergometers, treadmills, and elliptical trainers. The vigorous intensity groups exercise at 65%-80% of VO2
max and the moderate intensity group at 40%-55%. The study subjects were asked not to change their
diet and were to maintain body weight. This was done to see whether obese individuals can accumulate
enough physical activity to achieve weight loss even without reducing their caloric intake.
Their measurement were waist circumference, body weight and composition (using 4 skinfolds).
This study found that there is a clear dose- response relationship observed between amount of exercise
and weight and fat loss. That is to say that the high amount group lost more body mass and fat mass than
any other group. It was interesting to note that all 3 exercise groups showed decrease abdominal, waist,
and hip circumference measurements compared to controls.
So as you can see in the A and B sections (first bar) of the figure the controls actually gained body weight
and fat while each of the exercise groups lost a significant amount of weight and fat. The asterisks
indicate that the groups were significantly different from the controls and the cross indicates a comparison
with the high amount/intensity group.
This figure shows the clear dose-response relationship between amount of exercise and amount of
weight change. The nearly linear relationship suggests that sedentary overweight individuals may need to
accumulate the equivalent of 6 to 7 miles of walking or jogging each week just to prevent weight gain.
Since you can see the x intercept is around 6-7 miles per week. So to have maintain body weight or have
a no change in weight, an obese individual must walk or jog 6-7 miles per week.
So this study has clearly shown that exercise can help obese individuals lose weight and fat in a dose-
response relationship. The experimenters commented that only minimal activity is needed for weight
control such as walking 30 minutes a day while more exercise would help with weight loss in obese
indivuduals.







and focus our seminar on how obesity (aka. an individuals BMI) is associated with risks..so decreasing
someones BMI ultimately puts them at a decreased risk of everything
Ciaren- for your section she said she wants to be spoon fed the FITT principles
ACSM
and then chose two articles that are done well and provide practical, relevant info. IE., how exercise
decreases BMI therefore lowering risk, etc. and/or the effects of exercise and nutrition..or whatever juicy
articles you come across

I think the main co-morbidities to stick too are : cancer, diabetes, metabolic disorder, hypertension, stroke,
OA, dyslipidemia and CVD?
.she said for sure we should mention cancer, diabetes, metabolic syndrome, hypertension, Stroke