Database: Ovid MEDLINE(R) <1966 to January Week 4 2004>
Search Strategy:
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1 exp Obesity/ (54206)
2 exp EXERCISE/ or exp EXERCISE THERAPY/ (40066)
3 1 and 2 (2764)
4 limit 3 to (human and english language) (2379)
5 exp *Obesity/ and 4 (1713)
6 (exp *EXERCISE/ or exp *EXERCISE THERAPY/) and 5 (823)
7 limit 6 to yr=1996-2004 (569)
8 limit 7 to yr=2000-2004 (358)
9 limit 8 to review (59)
10 limit 7 to review (98)
11 limit 10 to ovid full text available (8)
12 9 (59)
13 limit 12 to local holdings (14)
14 11 or 13 (22)
15 12 not 14 (42)
16 from 15 keep 3,6,13-16,19,21,27-28,30-31,33-34,36,40 (16)
17 15 not 16 (26)
18 14 or 17 (48)
19 from 18 keep 1-48 (48)
20 from 19 keep 1-48 (48)
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<1>
Unique Identifier
10929704
Authors
Berke EM. Morden NE.
Institution
University of Massachusetts Medical School, Worcester 01610, USA.
Title
Medical management of obesity.[erratum appears in Am Fam Physician 2001 Aug 15;64(4):570]. [Review] [26 refs]
Source
American Family Physician. 62(2):419-26, 2000 Jul 15.
Abstract
Obesity is one of the most common medical problems in the United States and a risk factor for illnesses such as hypertension, diabetes, degenerative arthritis and myocardial infarction. It is a cause of significant morbidity and mortality and generates great social and financial costs. Obesity is defined as a body mass index greater than 30. Many patients accomplish weight loss with diet, exercise and lifestyle modification. Others require more aggressive therapy. Weight loss medications may be appropriate for use in selected patients who meet the definition of obesity or who are overweight with comorbid conditions. Medications are formulated to reduce energy intake, increase energy output or decrease the absorption of nutrients. Drugs cannot replace diet, exercise and lifestyle modification, which remain the cornerstones of obesity treatment. Two new agents, sibutramine and orlistat, exhibit novel mechanisms of action and avoid some of the side effects that occurred with earlier drugs. Sibutramine acts to block uptake of serotonin, norepinephrine and dopamine, while orlistat decreases fat absorption in the intestines. [References: 26]
<2>
Unique Identifier
12674453
Authors
McInnis KJ. Franklin BA. Rippe JM.
Institution
Dept of Exercise Science and Physical Education, University of Massachusetts, Boston, Massachusetts 02125, USA.
Title
Counseling for physical activity in overweight and obese patients.[see comment]. [Review] [33 refs]
Comments
Comment in: Am Fam Physician. 2003 Mar 15;67(6):1199-200, 1202; PMID: 12674450, Comment in: Am Fam Physician. 2003 Mar 15;67(6):1266-8; PMID: 12674454
Source
American Family Physician. 67(6):1249-56, 2003 Mar 15.
Abstract
Obesity has reached epidemic proportions in the United States. More than 60 percent of U.S. adults are now overweight or obese (defined as at least 30 lb [13.6 kg] overweight), predisposing more than 97 million Americans to a host of chronic diseases and conditions. Physical activity has a positive effect on weight loss, total body fat, and body fat distribution, as well as maintenance of favorable body weight and change in body composition. Many of the protective aspects of exercise and activity appear to occur in overweight persons who gain fitness but remain overweight. Despite the well-known health and quality-of-life benefits of regular physical activity, few Americans are routinely active. Results of research studies have shown that physician intervention to discuss physical activity (including the wide array of health benefits and the potential barriers to being active) need not take more than three to five minutes during an office visit but can play a critical role in patient implementation. This article describes elements of effective counseling for physical activity and presents guidelines for developing physical activity programs for overweight and obese patients. [References: 33]
<3>
Unique Identifier
12240709
Authors
Dubbert PM. Carithers T. Sumner AE. Barbour KA. Clark BL. Hall JE. Crook ED.
Institution
University of Mississippi School of Medicine, Jackson, USA.
Title
Obesity, physical inactivity, and risk for cardiovascular disease. [Review] [99 refs]
Source
American Journal of the Medical Sciences. 324(3):116-26, 2002 Sep.
Abstract
Despite considerable progress in understanding disease mechanisms and risk factors, improved treatments, and public education efforts, cardiovascular disease (CVD) remains the leading cause of death in the United States. Obesity and physical inactivity, 2 important lifestyle-related risk factors for CVD, are prevalent in the southeastern United States and are becoming more prevalent in all racial groups and areas of the country. In reviewing these risk factors, we explored topics including prevalence and trends in population data; associated psychosocial and environmental factors; and some of the mechanisms through which these risk factors are thought to contribute to CVD. We identified significant, but as yet poorly understood, racial disparities in prevalence of obesity, low levels of physical activity, and correlates of these risk factors and examined important differences in the complex relationship between obesity, diabetes, and cardiovascular disease risk between African American and European American women. The Jackson Heart Study will provide important and unique information relevant to many unanswered questions about obesity, physical inactivity, and obesity in African Americans. [References: 99]
<4>
Unique Identifier
12626686
Authors
Costacou T. Mayer-Davis EJ.
Institution
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Title
Nutrition and prevention of type 2 diabetes. [Review] [121 refs]
Source
Annual Review of Nutrition. 23:147-70, 2003.
Abstract
In recent years, the prevalence of type 2 diabetes has increased alarmingly worldwide, giving diabetes the dimension of an epidemic. Striking parallel increases in the prevalence of obesity reflect the importance of body fatness as a contributing factor to diabetes incidence. Moreover, it has been estimated that up to 75% of the risk of type 2 diabetes is attributable to obesity. Recent clinical trials and observational epidemiologic studies demonstrate the efficacy of lifestyle changes, including decreased energy intake, decreased fat intake, and weight loss, as well as regular participation in physical activity, in improving insulin sensitivity (SI) and reducing the risk of diabetes. This review evaluates evidence of the effect of diet on insulin resistance, insulin secretion, and glucose tolerance, and reflects on directions for future work toward primary prevention of type 2 diabetes. [References: 121]
<5>
Unique Identifier
11274524
Authors
French SA. Story M. Jeffery RW.
Institution
Division of Epidemiology, University of Minnesota, 1300 South Second Street, Minneapolis, Minnesota 55454, USA.
Title
Environmental influences on eating and physical activity. [Review] [100 refs]
Source
Annual Review of Public Health. 22:309-35, 2001.
Abstract
Obesity has increased dramatically over the past two decades and currently about 50% of US adults and 25% of US children are overweight. The current epidemic of obesity is caused largely by an environment that promotes excessive food intake and discourages physical activity. This chapter reviews what is known about environmental influences on physical activity and eating behaviors. Recent trends in food supply, eating out, physical activity, and inactivity are reviewed, as are the effects of advertising, promotion, and pricing on eating and physical activity. Public health interventions, opportunities, and potential strategies to combat the obesity epidemic by promoting an environment that supports healthy eating and physical activity are discussed. [References: 100]
<6>
Unique Identifier
12468414
Authors
Blaak EE. Saris WH.
Institution
Department of Human Biology, Nutrition Research Centre, Maastricht University, The Netherlands.
Title
Substrate oxidation, obesity and exercise training. [Review] [74 refs]
Source
Best Practice & Research Clinical Endocrinology & Metabolism. 16(4):667-78, 2002 Dec.
Abstract
Regular physical exercise is of the utmost importance in the treatment of obesity because exercise is one of the factors determining long-term weight maintenance in weight reduction programmes and because exercise has been associated with a reduced risk for developing type 2 diabetes mellitus and cardiovascular disease. Obesity is associated with an impaired utilization of fat as a fuel during post-absorptive conditions, during beta-adrenergic stimulation and possibly during exercise, although the latter data are controversial.One of the underlying mechanisms for the positive effect of exercise training in obesity may be related to its effects on fat utilization because exercise training has been shown to increase basal fat oxidation and exercise fat oxidation in lean volunteers. Data on the effect of aerobic exercise training on exercise fat oxidation are controversial, whereas the available data indicate that exercise training may not be able to increase resting fat oxidation or 24-hour fat oxidation in obese subjects. Because disturbed muscle fat oxidation may be a primary event in the aetiology of obesity it is of the utmost importance to obtain more information on how and whether exercise training may be able to compensate for these impairments. [References: 74]
<7>
Unique Identifier
11103212
Authors
Schrauwen P. Westerterp KR.
Institution
Department of Human Biology, Maastricht University, The Netherlands.
Title
The role of high-fat diets and physical activity in the regulation of body weight. [Review] [92 refs]
Source
British Journal of Nutrition. 84(4):417-27, 2000 Oct.
Abstract
The prevalence of obesity is increasing in westernized societies. In the USA the age-adjusted prevalence of BMI > 30 kg/m2 increased between 1960 and 1994 from 13% to 23% for people over 20 years of age. This increase in the prevalence of obesity has been attributed to an increased fat intake and a decreased physical activity. However, the role of the impact of the level of dietary fat intake on human obesity has been challenged. High-fat diets, due to their high energy density, stimulate voluntary energy intake. An increased fat intake does not stimulate its own oxidation but the fat is stored in the human body. When diet composition is isoenergetically switched from low to high fat, fat oxidation only slowly increases, resulting in positive fat balances on the short term. Together with a diminished fat oxidation capacity in pre-obese subjects, high-fat diets can therefore be considered to be fattening. Another environmental factor which could explain the increasing prevalence of obesity is a decrease in physical activity. The percentage of body fat is negatively associated with physical activity and exercise has pronounced effects on energy expenditure and substrate oxidation. High-intensity exercise, due to a lowering of glycogen stores, can lead to a rapid increase in fat oxidation, which could compensate for the consumption of high-fat diets in westernized societies. Although the consumption of high-fat diets and low physical activity will easily lead to the development of obesity, there is still considerable inter-individual variability in body composition in individuals on similar diets. This can be attributed to the genetic background, and some candidate genes have been discovered recently. Both leptin and uncoupling protein have been suggested to play a role in the prevention of diet-induced obesity. Indeed, leptin levels are increased on a high-fat diet but this effect can be attributed to the increased fat mass observed on the high-fat diet. No effect of a high-fat diet per se on leptin levels is observed. Uncoupling proteins are increased by high-fat diets in rats but no data are available in human subjects yet. In conclusion, the increased intake of dietary fat and a decreasing physical activity level are the most important environmental factors explaining the increased prevalence of obesity in westernized societies. [References: 92]
<8>
Unique Identifier
10786862
Authors
Pescatello LS. VanHeest JL.
Institution
University of Connecticut, School of Allied Health Professions, Storrs 06269-2102, USA.
Title
Physical activity mediates a healthier body weight in the presence of obesity. [Review] [39 refs]
Source
British Journal of Sports Medicine. 34(2):86-93, 2000 Apr.
<9>
Unique Identifier
10683597
Authors
Ross R. Janssen I. Tremblay A.
Institution
School of Physical and Health Education, Queen's University, Kingston, Ontario K7L 3N6.
Title
Obesity reduction through lifestyle modification. [Review] [72 refs]
Source
Canadian Journal of Applied Physiology. 25(1):1-18, 2000 Feb.
Abstract
Obesity is a worldwide public health problem. One in three Canadians is overweight, a prevalence that is already high and increasing. Moreover, 54% of men and 37% of Canadian women are characterized as abdominally obese, the phenotype that is strongly associated with cardiovascular disease and type II diabetes. These observations underscore the importance of considering the efficacy of methods commonly used to reduce total and abdominal obesity. These strategies include a decrease in energy intake (diet), an increase in energy expenditure (exercise), or pharmacological intervention. The combination of diet and exercise is more commonly prescribed, with pharmacological intervention suggested only when lifestyle changes fail to achieve weight loss.The aim of this report is to review current knowledge regarding the influence of diet and exercise as treatment strategies for obesity reduction and provide recommendations for attaining and maintaining a healthy weight. The importance of diet composition in the treatment of obesity is also considered. [References: 72]
<10>
Unique Identifier
11570117
Authors
Poirier P. Despres JP.
Institution
Department of Pharmacy, Laval University School of Pharmacy, Sainte-Foy, Quebec, Canada.
Title
Exercise in weight management of obesity. [Review] [115 refs]
Source
Cardiology Clinics. 19(3):459-70, 2001 Aug.
Abstract
Obesity is a chronic metabolic disorder associated with CVD and increased morbidity and mortality. When the BMI is > or = 30 kg/m2, mortality rates from all causes, and especially CVD, are increased by 50% to 100%. There is strong evidence that weight loss in overweight and obese individuals improves risk factors for diabetes and CVD. Additional evidence indicates that weight loss and the associated diuresis reduce blood pressure in both overweight hypertensive and nonhypertensive individuals, reduce serum TG levels, increase high-density lipoprotein cholesterol levels, and may produce some reduction in low-density lipoprotein cholesterol concentrations. Of interest, even if weight loss is minimal, obese individuals showing a good level of cardiorespiratory fitness are at reduced risk for cardiovascular mortality than lean but poorly fit subjects. Insulin and catecholamines have pronounced metabolic effects on human adipose tissue metabolism. Insulin stimulates LPL and inhibits HSL; the opposite is true for catecholamines. There is regional variation in adipocyte TG turnover favoring lipid mobilization in the visceral fat depots and lipid storage in the peripheral subcutaneous sites. The hormonal regulation of adipocyte TG turnover is altered in obesity and is most marked in central obesity. There is resistance to insulin stimulation of LPL; however, LPL activity in fasted obese subjects is increased and remains so following weight reduction. Catecholamine-induced lipolysis is enhanced in visceral fat but decreased in subcutaneous fat. Numerous adaptive responses take place with physical training. These adaptations result in a more efficient system for oxygen transfer to muscle, which is now able to better utilize the unlimited lipid stores instead of the limited carbohydrate reserves available. In addition, the reduced adipose tissue mass represents an important mechanical advantage, allowing better long-term work. Gender differences have been reported in the adaptation of adipose tissue metabolism to aerobic exercise training. Physical training helps counteract the permissive and affluent environment that predisposes reduced-obese subjects to regain weight. An exercise program using weight resistance modalities may also be included safely, and it improved program retention in a multidisciplinary weight management program that was designed for obese children. Thirty to 45 minutes of physical activity of moderate intensity, performed 3 to 5 days a week, should be encouraged. All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all days. Public health interventions promoting walking are likely to be the most successful. Indeed, walking is unique because of its safety, accessibility, and popularity. It is noteworthy that there is a clear dissociation between the adaptation of cardiorespiratory fitness and the improvements in the metabolic risk profile that can be induced by endurance training programs. It appears that as long as the increase in energy expenditure is sufficient, low-intensity endurance exercise is likely to generate beneficial metabolic effects that would be essentially similar to those produced by high-intensity exercise. The clinician should therefore focus on the improvement of the metabolic profile rather than on weight loss alone. Realistic goals should be set between the clinician and the patient, with a weight loss of approximately of 0.5 to 1 pound per week. It should be kept in mind that since it generally takes years to become overweight or obese, a weight loss pattern of 0.5 or 1 pound per week will require time and perseverance to reach the proposed target. However, the use of physical activity as a method to lose weight seems inversely related to patients' age and BMI and directly related to the level of education. Thus, public health interventions helping these groups to become physically active remain a challenge and further emphasize the importance of the one-on-one interaction between the clinician/health care professional with the obese individual "at risk" of CVD. This notion is critical, as it has been shown that less than half of obese adults have reported being advised to lose weight under the guidance of health care professionals. [References: 115]
<11>
Unique Identifier
12613089
Authors
MacKnight JM.
Institution
University Physicians Clinic, University of Virginia Health System, Box 800671, Charlottesville, VA 22908, USA.
Title
Exercise considerations in hypertension, obesity, and dyslipidemia. [Review] [150 refs]
Source
Clinics in Sports Medicine. 22(1):101-21, vii, 2003 Jan.
Abstract
Sports medicine practitioners who care for a wide array of athletes and active individuals will consistently face issues regarding chronic cardiovascular diseases and their associated risk factors. Among these, hypertension, obesity, and dyslipidemia are common clinical conditions that may be encountered even amongst elite caliber athletes. Consequently, those entrusted with the care of this active population must recognize the presence of these disorders and feel comfortable with their management in the face of continued sports or exercise participation. This article reviews the pathophysiology of these conditions as they relate to athletes and outlines the value of continued exercise in the management of each of these entities while addressing the specific and unique treatment needs of active individuals. [References: 150]
<12>
Unique Identifier
11507324
Authors
Liu S. Manson JE.