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Interventions

Interventions. Weight Loss. The first place people turn to in an attempt to lose weight is dieting. Weight Loss. Physical activity is an integral part of weight control programs, but recommended amounts vary (Kruger et al., 2005). How Much?.

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Interventions

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  1. Interventions

  2. Weight Loss • The first place people turn to in an attempt to lose weight is dieting.

  3. Weight Loss • Physical activity is an integral part of weight control programs, but recommended amounts vary (Kruger et al., 2005).

  4. How Much? • The optimal amount of physical activity necessary for weight loss, maintenance of weight, and prevention of weight gain is unknown, and likely differs for each person depending on caloric intake and phenotypic expression (Kruger et al., 2005).

  5. How Much? • Now it appears that adults need at least 60 minutes of physical activity of at least moderate intensity at least 5 days per week to reduce weight and 90 minutes of physical activity of at least moderate intensity at least 5 days per week keep it off.

  6. How Much? • The time and motivational commitment needed for this may present a significant challenge for most adults (Kruger et al., 2005).

  7. Weight Loss • Despite the importance of physical activity in a weight loss program, only about half of the people trying to lose weight reported using exercise (Kruger et al., 2005).

  8. Weight Loss • The prevalence of using exercise as a weight loss strategy is directly related with educational level and inversely related with age and BMI level (Kruger et al., 2005).

  9. Weight Loss • Even among those, only slightly more than half met the minimal recommendations for physical activity (Kruger et al., 2005).

  10. Weight Loss • The literature suggests that the negative energy balance induced by most physical activity is not sufficient to contribute to substantial weight loss (Noel and Pugh, 2002).

  11. Weight Loss • In reviews that examined the role of physical activity in weight loss, it appears to make a modest contribution (King & Tribble, 1991; NIH, 1996).

  12. Weight Loss • Compared with physical activity alone, calorie reduction alone is more effective in inducing weight loss (Ravussin, 2008; Blair, 1993; King et al., 1989).

  13. Weight Loss • And findings show that physical activity combined with reduced caloric intake appears to be the most effective strategy for initial weight loss (Miller et al, 1997) and weight loss maintenance (USDHHS, 1998).

  14. Weight Loss • Although physical activity may make only a small contribution to weight loss, it is important in the long-term maintenance of weight (Kruger et al., 2005).

  15. Weight Loss • In a review of the role of exercise in weight regulation (King & Tribble, 1991), physical activity was found to play a greater role in promoting post-weight loss stability than was dietary restriction.

  16. Weight Loss • Efforts are needed to aid those trying to lose weight to incorporate appropriate levels of physical activity into their weight loss strategy (Kruger et al., 2005).

  17. Successful Weight Loss • Eat a diet low in fat • Self-monitor weight and food intake • Very high level of physical activity • Ravusssin, 2008, ACSM

  18. Interventions With Children and Youth • The recommended treatment for children who have already accumulated an excess of body fat is a combination of an increase in physical activity and dieting (Shephard, 2005).

  19. Interventions With Children and Youth • The benefit of adding exercise to dieting is less firmly established than for adults although available combined therapy is generally more effective than dieting alone (Shephard, 2005).

  20. Interventions With Children and Youth • Weight-supported activities, such as swimming and cycling, might be helpful for those who are severely obese (Shephard, 2005).

  21. Interventions With Children and Youth • A severely obese child is unlikely to accept exercise of sufficient intensity to have a major impact on energy balance, but nevertheless, exercise helps to conserve lean tissue and might counter the decrease of metabolic rate associated with dieting alone (Shephard, 2005).

  22. Interventions With Children and Youth • Vigorous physical activity might also increase blood sugar temporarily, reducing hunger and countering the depression often associated with rigorous dieting (Shephard, 2005).

  23. Guiding Principles • 1. Establish individual treatment goals and approaches based on the child’s age, degree of overweight, and presence of comorbidities.

  24. Guiding Principles • 2. Involve the family or major caregivers in the treatment. • 3. Provide assessment and monitoring frequently.

  25. Guiding Principles • 4. Consider behavioral, psychological, and social correlates of weight gain in the treatment plan.

  26. Guiding Principles • 5. Provide recommendations for dietary changes and increases in physical activity that can be implemented within the family environment and that foster optimal health, growth, and development (Daniels et al., 2005).

  27. Residential Camps • Often obesity can be corrected temporarily by sending a child to a residential camp where physical activity and dietary schedules are rigorously enforced (Shephard, 2005).

  28. Residential Camps • Unfortunately, the problem of obesity tends to recur when the child returns to the home environment (Shephard, 2005).

  29. School-Based Programs • School-based treatment programs are often too short-lived (<6 months) to assess their potential effectiveness (Shephard, 2005).

  30. School-Based Programs • Over a long period (5-10 years), the reinforcement of a reduction in sedentary behavior seems more effective than encouraging an increase in physical activity (Shephard, 2005).

  31. Clinical Exercise Programs • Clinical exercise and/or dietary programs have achieved some success in decreasing the prevalence of overweight individuals (Shephard, 2005).

  32. Clinical Exercise Programs • The best results are usually obtained from long duration programs (Shephard, 2005).

  33. Clinical Exercise Programs • Such results, however, are achieved in individuals who are motivated to seek treatment, and the findings might not apply to children with no strong desire to reduce food consumption or increase their physical activity (Shephard, 2005).

  34. Selected Interventions • There is ample evidence that theory-based interventions that include classroom curricula, PE curricula, changes in school meals, vending machines, and cafeterias, and after-school programs, can increase physical activity and improve dietary patterns in children and adolescents (Daniels et al, 2005).

  35. Review of Selected Interventions • CLOCC • http://www.clocc.net/ • PEOPLE • CATCH • http://www.catchinfo.org/ • SPARK • http://www.sparkpe.org/

  36. Review of Selected Interventions • PAAC • http://www.ibridgenetwork.org/ku/physical-activity-across-the-curriculum-paac • SMART • http://notv.stanford.edu/

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