Salans, L.B., et al. Journal of Clinical Investigation 50:1005-1011, 1971. OVEREATING STUDIES (individual subjects)

Baseline Peak Reduction0

5

10

15

20

25

30

35

Perc

ent B

ody

Fat (

%)

Salans, L.B., et al. Journal of Clinical Investigation 50:1005-1011, 1971.

OVEREATING STUDIES(individual subjects)


101520253035

Perc

ent B

ody

Fat

(%)




0.20.40.60.8

11.2

Glu

teal

Fat

Cel

l Siz

e (u

g TG

/cel

l)


0.20.40.60.8

11.2

Glu

teal

Fat

Cel

l Siz

e (u

g TG

/cel

l)


0.20.40.60.8

11.2

Abd

omin

al F

at C

ell S

ize

(ug

TG/c

ell)




0.2

0.4

0.6

0.8

1

1.2G

lute

al F

at C

ell S

ize

(ug

TG/c

ell)




0.2

0.4

0.6

0.8

1

1.2A

bdom

inal

Fat

Cel

l Siz

e (u

g TG

/cel

l)




5

10

15

20

25

30

35

40

45Fa

t Cel

l Num

ber (

x109

)




0.2

0.4

0.6

0.8

1

1.2Tr

icep

s F

at C

ell S

ize

(ug

TG/c

ell)

TNF αIL-6

Angiotensin

Vasoconstriction

↓ NO

Adiponectin

↓ Fibrinolysis

PAI-1

Insulin Resistance

Insulin Resistance

Resistin

InflammationInsulin Resistance

Insulin Resistance

NUTRITION IN OBESITYNUTRITION IN OBESITY

440

460

480

500

520

540

560

580

600

Control Hi F & S Hi FAT Hi Sugar0

10

20

30

40

50

Control Hi F & S Hi Fat Hi Sugar

Caloric IntakeCaloric Intake Percent FatPercent Fat

OBESITYOBESITY

Oscai et al J Lipid Research 13:588-592, 1972.

Sedentary Free EatersSedentary Free Eaters

Sedentary Pair

Weighted

Sedentary Pair

WeightedExerciseExercise

0

10

20

30

40

50

60

Calo

ries

per

Day

Calo

ries

per

Day

OBESITYOBESITY

0

5

10

15

20

25

Sed-Free Sed-Pair Exercise0

50

100

150

200

250

300

350

400

Sed-Free Sed-Pair Exercise

Percent Fat (%)Percent Fat (%)

Body Weight (g)Body Weight (g)

OBESITYOBESITY


0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

0.45


1

2

3

4

5

6

7

Fat Cell SizeFat Cell Size Fat Cell NumberFat Cell Number

Wilmore JH, Research Quarterly for Exercise and Sport 54:415-425, 1983.

Pre Post50

55

60

65

70

75

80

85

90

Fat Mass

Lean Mass

Kilo

gram

s

Changes in Lean & Fat Mass with Training - Men

Wilmore JH, Research Quarterly for Exercise and Sport 54:415-425, 1983.

Pre Post30

35

40

45

50

55

60

65

70

Fat MassLean MassKi

logr

ams

Changes in Lean & Fat Mass with Training - Women

Diet Exercise Diet + Exercise-12

-10

-8

-6

-4

-2

0

2

Total Wt

Fat Wt

Lean Wt

Kilo

gram

s

Total weight, fat mass & lean mass changes with diet and exercise

Miller, WC et al International Journal of Obesity 21:941-947, 1997

Diet Exercise Diet + Ex-14-12-10-8-6-4-2024

Lean

Fat

Zuti & Golding, Physician & SportsMedicine 4:49-55, 1978

Wei

ght C

hang

e (lb

s)Lean vs. Fat Mass Loss with Diet & Exercise

Normal Wt Overweight-6

-5

-4

-3

-2

-1

0

1

2

LeanFat

Franklin, B., et al. Research Quarterly 1976.

Wei

ght C

hang

e (lb

s)Lean vs. Fat Mass Loss In Overweight Adults

Jakicic, et al. JAMA 282:1554-1560, 1999

SHORT vs. LONG BOUTS OF EXERICSESHORT vs. LONG BOUTS OF EXERICSE


1-4 wks 5-8 wks 9-24 wks

7-12 Mo 13-18 Mo

0

50

100

150

200

250

ShortLongShort Eq

ADHERENCEADHERENCEM

inut

es p

er w

eek

Min

utes

per

wee

k


0 6 12 18

Long 0 -8 -7.5 -6

Short 0 -7.5 -5.5 -4

Short Eq 0 -9 -10 -8

-11

-9

-7

-5

-3

-1

Months

Wei

ght C

hang

e (k

g)

Weight Loss

Weight % Fat-3

-2.5

-2

-1.5

-1

-0.5

0

0.5

1

Exercise

Physical Activ-ity

Wei

ght (

kg)o

r Per

cent

Fat

(%)

Lifestyle Activity vs. Exercise is Weight Loss

Dunn, A.L. et al JAMA 281:327-334, 1999

MORBID OBESITYMORBID OBESITY

Reduce body fat in obese: Hill JO et al Physical Activity, Fitness, and Health: International Proceedings and Consensus statement, p 684-694, 1994.

No Wt LossNo Wt Loss

TrendTrend

Wt LossWt Loss

Body Weight Fat Mass Waist Circumference-3

-2

-1

0

1

2

3

Control

Walk 1

Walk 2Chan

ge (k

g or

cm

)

Fogelholm, et al. Arch Int Medicine 160:2177-2184, 2000

PHYSICAL ACTIVITY & WEIGHT MAINTENANCE

Wald

en

et

al, A

m J C

lin N

utr

47

:22

9-2

34

, 1

98

8.

N= 20 upperN= 20 lowerN= 20 upperN= 20 lower

LOWER:

• Lost Abd & Glut

LOWER:

• Lost Abd & Glut

UPPER:

• Lost more on WHR• Lost only from Abd• Lost more weight

UPPER:

• Lost more on WHR• Lost only from Abd• Lost more weight


101520253035

Perc

ent B

ody

Fat

(%)




0.20.40.60.8

11.2

Glu

teal

Fat

Cel

l Siz

e (u

g TG

/cel

l)


0.20.40.60.8

11.2

Abd

omin

al F

at C

ell S

ize

(ug

TG/c

ell)


1020304050

Fat C

ell N

umbe

r (x1

09)

0

10

20

30

40

50

60

70

80

90

% Fat Fat Cell Size

Ex Obese

Elite

Sed Control

Tremblay, A., Int J Obesity 8:641-648, 1984.Tremblay, A., Int J Obesity 8:641-648, 1984.

EXERCISE & THE FAT CELLEXERCISE & THE FAT CELL

Lean Normal Obese0

0.5

1

1.5

2

2.5

UnfitFitRe

lativ

e Ri

sk

Lee, C.D., et al. American Journal of Clinical Nutrition 69:373-380, 1999

Fitness & Fatness

EXERCISE & NUTRITIONEXERCISE & NUTRITION

0

5

10

15

20

25

30

35

40

Sed-Low Sed-High Ex-High

Perc

ent

Body F

at

(%)

Pitts, et al Am J Physiol 246:R495, 1984

EXERCISE & METABOLIC RATEEXERCISE & METABOLIC RATE

0

10

20

30

40

50

60

70

80

90

0.8 0.9 1 1.1 1.2

RMR/kg hr

VO

2 m

ax (m

l/min

kg)

Poehlman, E.T., Med Sci Sports Exerc 21:515-525, 1989Poehlman, E.T., Med Sci Sports Exerc 21:515-525, 1989

EXERCISE & FOOD INTAKEEXERCISE & FOOD INTAKE

Neiman, D.C., J A, Dietetic Assoc 90: 1557-1562, 1990Neiman, D.C., J A, Dietetic Assoc 90: 1557-1562, 1990

1400

1600

1800

2000

2200

0 3 5 9 12 15

Kca

l int

ake

Control

Exercise

0 1 2 3 4 5 60

0.5

1

1.5

2

2.5

3

Control

Time (hrs)

Trig

lyce

ride

s (m

Mol

/L

Postprandial Lipemia and Exercise

Aldred, H.E, et al Metabolism 43:836-841, 1994

Control Diet Exercise Diet & Exercise

808284868890929496

Body

Wei

ght (

kg)


20

21

22

23

24

25

26

Perc

ent F

at (%

)

Baseline

1 year


0

2

4

6

8

10

12

Lepti

n (n

g/m

L)


02468

10121416

Adi

pone

ctin

(ug/

mL)

* ** *

**

*


808284868890929496

Body

Wei

ght (

kg)


20

21

22

23

24

25

26

Perc

ent F

at (%

)

Baseline

1 year

Control Diet Exercise Diet & Ex0

0.51

1.52

2.53

3.54

IL-6

(pg/

mL)


0

1

2

3

4

5

6

TNF-

α (p

g/m

L)

*interaction


0123456789

Resi

stin

(ng/

mL)


0

5

10

15

20

25

30

PAI-1

(U/m

L)


808284868890929496

Body

Wei

ght (

kg)


20

21

22

23

24

25

26

Perc

ent F

at (%

)

Baseline

1 year

Control Diet Exercise Diet & Ex0

0.51

1.52

2.53

3.54

IL-6

(pg/

mL)


0

2

4

6

8

10

12Le

ptin

(ng/

mL)


02468

10121416

Adi

pone

ctin

(ug/

mL)


0

1

2

3

4

5

6

TNF-

α (p

g/m

L)

Documents

Salans, L.B., et al. Journal of Clinical Investigation 50:1005-1011, 1971. OVEREATING STUDIES (individual subjects)