Getting In Gear

Multiple research studies once again demonstrate the connection between levels of physical activity and degrees of obesity.

According to data from the National Institute of Diabetes, Digestive and Kidney Diseases printed in IHRSA's IIEH Wellness Research Newsletter, obesity is a major public health problem in the United States, where 97 million adults--55% of the population--are overweight. Many of the world's industrialized nations face similar prospects. These individuals are at risk of developing a wide range of chronic or acute illnesses including hypertension, type II diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, asthma and even certain types of cancers. In the U.S. alone, the cost of obesity-related diseases reaches $100 billion annually.

Health risks associated with obesity are also a growing problem among youth. Severely overweight adults have often been overweight as children, and studies show obese individuals frequently have at least one obese parent. Regrettably, the public sector--many elementary and middle schools in particular--has eliminated or cut funding for physical education programs. This decision comes at a time when there is a dramatic need for public awareness regarding proper nutrition and eating patterns.

As an industry, we've known weight management is the number one reason women of all ages and men under 55 are working out in clubs. Now club operators have an historic opportunity to step up to the plate and become primary players in the reconditioning of millions who still haven't filled out their first fitness profile card. For managers interested in making a difference, the following summaries of the medical research on obesity provide information about two important subjects:

   1. Maintaining a healthy body composition to reduce risk factors and arrest
   disease processes

   2. Managing body composition through caloric reduction, increased physical
   activity patterns, nutritional education and psychological support

Lead Study

Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults.

National Institutes of Health, June 1998.

This year marked the release of the first definitive federal obesity clinical guidelines by the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK). The guidelines indicate three key measures must be used for assessing obesity:

   1. Body mass index (BMI)--describes body weight relative to height

   2. Waist circumference

   3. Factors for diseases and conditions associated with obesity

The basis for these guidelines comes from research that specifically correlated body mass to the risk of illness and death.

People are classified as "overweight" when they have a BMI of 25 to 29.9, and as "obese" when they have a BMI of 30 or more (see "BMI Index"). The formula for BMI is: (Weight x 703) / (Height in [Inches.sup.2]).

Extremely muscular individuals may have a high BMI without health risks. Therefore, the second key variable, waist circumference, must be taken into account along with BMI. Regardless of height, a waist circumference of over 40 inches in men and over 35 inches in women is indicative of excess abdominal fat and predictive of increased health risk when combined with a BMI of 25 to 34.9.

Follow these guidelines to begin a weight management program:

* Engage in physical activity as recommended by the Surgeon General's Report (i.e., 30 minutes a day on most days of the week).

* Reduce both dietary fat and caloric intake.

* Initially reduce body weight by 10% from baseline to reduce risk factors, then maintain a weight loss goal of one to two pounds per week.

* Suggest patient referrals try lifestyle therapy for six months before considering pharmacological interventions.

* Counsel overweight patients who do not wish to lose weight--or otherwise are not candidates for weight loss treatment--on strategies to avoid further weight gain.

Copies of the guidelines are available from NHBI Information Center, P.O. Box 30105, Bethesda, MD 20824-0105, or call (310) 251-1222 for more information.

Other Significant Findings

Effects of Strength or Aerobic Training on Body Composition, Resting Metabolic Rare and Peak Oxygen Consumption in Obese Dieting Subjects.

A Geliebter, et al. American Journal of Clinical Nutrition, 1997: 66: 557-63.

Subjects received a nutritional formula with an energy content of 70% of their resting metabolic rate during an eight-week intervention and received weekly nutritional counseling. They exercised three times a week in one of two groups. The strength training group performed progressive resistance exercises while the aerobic group performed alternate leg and arm cycling. Results showed similar weight loss in both groups, but the strength training group lost significantly less body mass and showed an increase in strength.

Conclusion: Strength training reduced the loss of muscle during dieting and did not significantly impact the resting metabolic rate.