Adequacy of Evidence for Physical Activity Guidelines Development Workshop Summary (2007) / Chapter Skim
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8 Closing Session
8 Closing Session
Pages 141-158
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Dr. Morrow illustrated this point with a graph such as that shown in Figure 8-1 -- a graph in which the specific risk could be any one of many adverse health conditions, including cardiovascular disease, type 2 diabetes, osteoporosis, and many other conditions.
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Dr. Haskell summarized the amount and strength of the evidence relating physical activity to selected outcomes for unspecified demographic groups as shown in Table 8-1.
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a 1 = considerable data; 2 = some data; 3 = limited data. b 1 = high; 2 = moderate; 3 = low.
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Dishman noted that strong evidence from observational studies and randomized controlled trials indicates that moderate to vigorous physical activity is associated with a reduced risk of developing type 2 diabetes, even among persons with impaired glucose tolerance, and that the effects usually are independent of weight loss. Moreover, some evidence indicates that physical activity and/or cardiorespiratory fitness favorably modifies cardiovascular events and mortality among persons with type 2 diabetes.
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Nonetheless, evidence appears to be sufficient to support roles of physical activity for weight loss, the maintenance of weight loss, and the prevention of weight gain. Notably, a clinically significant weight loss of approximately 5 percent of body weight generally represents less weight loss than would be calculated based on energy balance models and much less than the client expects.
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Regular physical activity may lower one's risk for gestational diabetes. Older Persons Considerable evidence points to the benefits of physical activity among persons ages 65 years and older, as shown in Table 8-3.
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A wide variety of physical activities improve muscle mass and strength, bone, balance, and functional performance. Falls prevention A moderate amount of moderate to strong evidence addresses physical activity and the prevention of falls.
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A moderate amount of evidence documents that increases in physical activity lead to beneficial changes in body composition, improved physical functioning, decreased fatigue, improved cardiovascular disease risk profile, and improved ventilation and decreased dyspnea (shortness of breath) among persons with heart failure and chronic obstructive pulmonary disease.
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• A sedentary lifestyle is associated with an elevated risk of injury when actually engaging in physical activity. • In military settings with a standard exercise training protocol, women have higher injury rates than men; this effect diminishes when adjusted for fitness.
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More information is needed on specific injury risks associated with special populations, long-term effects of acute as well as overuse injuries, and effects of excessive physical activity on eating disorders and joint problems In summary, a strong body of evidence about physical activityrelated injuries and sudden cardiac events can be evaluated as a component of a process to develop physical activity guidelines. Most modifiable risk factors for injury are related to frequency, intensity, duration, and type of activity.
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. Health Benefits of Physical Activity for Children and Adolescents Preschool children, in particular, are an understudied group.
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regarding a trial of aerobic and resistance exercise related to diabetes • FitzGerald (2004) regarding strength training and all-cause mor tality • Meyer (2006)
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Lack of such guidelines is a deterrent to the implementation of an effective national physical activity plan. Scientific data collected over the past five or six decades strongly support numerous health benefits of a physically active lifestyle throughout the life span.
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2002. High-intensity progressive resis tance exercise training in Hispanic older adults with type 2 diabetes: A ran domized controlled trial.
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Med Sci Sports Exerc 35(1)
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2005. A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults.
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157 CLOSING SESSION van Praag H, Christie BR, Sejnowski TJ, Gage FH.
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