Participants: Don Morgan
Series Code: WM
Program Code: WM000356
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00:38 Hello, and welcome to Wonderfully Made.
00:41 My name is Don Morgan 00:43 and I teach in the department of health and human performance 00:46 at Middle Tennessee State University. 00:50 This is the fifth 00:51 in a series of programs focusing on the health benefits 00:55 which come from following a physically active lifestyle. 00:59 As an exercise physiologist for over 20 years, 01:03 I have seen first hand 01:05 the positive changes that occur when individuals begin 01:09 to incorporate physical activity into their lives. 01:14 Today we're going to be looking at how physical activity 01:18 can help in the battle against obesity, 01:21 one of the major causes of death and disease in the US today. 01:28 About 1 year ago "Time" magazine put out a special issue 01:33 called "Overcoming Obesity in America". 01:36 In the cover story, which was entitled 01:39 "How We Grew so Big" a majority of Americans 01:43 who were polled indicated that they would like 01:46 to lose weight. 01:48 And 86% said that not getting enough physical exercise 01:53 was one of the most important causes of obesity in the US. 01:57 However, only about a fourth of the respondents stated 02:02 that they exercise at least 3 times a week. 02:06 87% of the sample also noted that the predominant reasons 02:10 for the nation's obesity problem were poor 02:14 dietary choices and a lack of exercise. 02:18 Given this scenario 02:20 it would appear that one of the challenges 02:23 in helping people lose weight is to motivate 02:27 and encourage them to be more physically active 02:30 on a regular basis. 02:32 Later in the program 02:34 I want to spend some time addressing this specific issue, 02:38 but I'd like to begin today by laying out some of 02:41 the statistics related to obesity in our country 02:45 and then follow up by examining the role 02:48 that physical activity can play 02:50 in fighting this chronic health condition. 02:54 Obesity has increased very much in our country 02:59 over the past 20 years 03:01 and the US currently has the highest prevalence 03:04 of obesity in the entire world. 03:08 Overweightness and obesity affect about 100 million 03:12 American adults aged 24-74, 03:17 with the highest rates seen among the poor 03:20 and in minority groups. 03:23 Based on some of the latest data available 03:25 from the Centers For Disease Control 03:28 nearly two thirds of Americans are officially overweight. 03:32 Of those who are overweight close to 50% are obese 03:38 and about 5% are morbidly obese, 03:42 that's a condition that requires significant medical attention. 03:47 While the incidents of obesity in the US is significant 03:51 what is particularly alarming is the rapid rate 03:55 at which obesity levels have increased over the past 03:58 10-15 years. 04:01 According to the Centers For Disease Control, 04:04 obesity has increased 50% or more 04:08 over the past decade in each of the 50 states. 04:12 In view of these findings it is not surprising why some 04:16 have described the growing rate of obesity in our country 04:20 as nothing short of epidemic. 04:24 From a mortality standpoint, it has been reported 04:27 that approximately 280,000 adult deaths in the US each year 04:34 are attributable to obesity. 04:37 In terms of financial costs, 04:39 the annual monetary drain to the US economy 04:43 that is associated with being overweight and obese 04:46 is $117 billion. 04:49 Over 39 million work days are lost annually 04:53 to obesity related causes. 04:56 In our next program I'm going to focus on the role 05:00 that physical activity can play in reducing childhood obesity, 05:05 but just in case you miss that program, 05:08 I want to highlight the results of one study 05:11 that was published in the journal 05:13 "Preventive Medicine". 05:15 In this study it was reported that the chance of an obese 05:19 child becoming an obese adult increases with age. 05:23 Specifically, about one third of obese preschool children 05:27 became obese adults. 05:30 50% of obese school age children ended up obese as adults. 05:35 What was even more disconcerting was that 80% of obese 05:39 adolescents carried their obesity with them 05:43 into their adult years. 05:46 Now, what is the take home message from this data? 05:49 In my view, these results suggest 05:52 that early on in a child's life 05:54 aggressive measures should be implemented and instituted 05:58 to promote physical activity 06:00 as a means of managing excessive weight gain. 06:04 As I mentioned earlier, we'll talk more 06:07 in our next program about how vital physical 06:10 activity can be in decreasing 06:13 the incidents childhood obesity. 06:17 What are some of the health problems and risks 06:20 associated with obesity? 06:23 The risk of developing high blood pressure, 06:25 or hypertension rises sharply with an increase in body weight. 06:31 Conversely, weight reduction is the single most effective 06:35 non-drug method of controlling high blood pressure. 06:40 And increasing physical activity is certainly one way 06:43 to promote weight loss. 06:46 Another health risk of obesity is an increase in cholesterol 06:50 and other blood fats which can contribute 06:52 to heart disease. 06:54 In this regard, even loosing a few pounds 06:57 can have significant beneficial effects on reducing 07:01 blood lipid levels. 07:04 Obesity can bring a greater risk of osteoarthritis 07:08 especially in the knees and hips, 07:11 which then will cause pain and limitations 07:13 in range of motion. 07:15 Along with heart disease and high blood pressure, 07:19 obesity is linked 07:20 to an increased risk of type 2 diabetes. 07:25 Those that are most vulnerable to this triad of health 07:28 conditions, tend to have more of their fat deposited 07:32 in the abdominal areas rather than in the hip 07:35 and thigh regions. 07:38 Obese individuals can experience greater psychological burdens 07:42 with many having unflattering self images of themselves, 07:46 which can then lead to feelings of guilt, depression, 07:50 and low self-esteem. 07:53 This can be a particularly tough burden for children 07:57 who can be on the receiving end of teasing or jokes 08:00 from classmates and acquaintances. 08:04 Recent data also suggests that middle age obesity 08:08 may raise the risk of developing dementia later in life. 08:14 Given the fact that being overweight and obese 08:19 is associated with a number of adverse health conditions, 08:23 a reasonable question to ask is: 08:25 how does one quantify overweightness and obesity? 08:29 While there are many laboratory based methods of assessing 08:32 body composition a simple and inexpensive method 08:36 is to determine Body Mass Index or BMI. 08:41 The BMI, which indicates how heavy you are relative 08:45 to your weight, has been shown 08:47 to be more accurate than using weight alone 08:50 to estimate obesity and it also correlates 08:53 reasonably well to direct measurements 08:55 of body fat. 08:57 The following graphic demonstrates how to calculate 09:00 BMI. 09:02 In this example we have [text on screen]. 09:12 The first thing we need to do is convert his height 09:15 to inches. 09:16 So to do that, 09:18 we multiply 5 feet by 12 since there are 12 inches 09:21 in a foot, and add 8 more inches to arrive at 68 inches. 09:27 In step two we multiply 68 by 68 09:31 to get 4624, which is his height squared. 09:38 Then, in step three, we divide his weight 09:41 which is 154 pounds by his height squared, 09:46 which is 4624 to yield a very small number. 09:51 In this case, the number is 0.333044. 09:57 In our last step, [text on screen] 10:18 Now I know that that was a lot to digest. 10:21 So if you want an easier route to follow 10:24 and you have internet access you can navigate to the website 10:28 shown on the next graphic. 10:32 The graphic shows that the site is 10:35 [information on screen] 10:54 Now that you've determined your BMI value 10:57 you're probably interested in knowing where you fit 11:01 relative to existing BMI standards. 11:05 As shown in the next graphic, if your BMI value 11:09 is less than 18.5 kg per meter squared, 11:13 you're considered underweight for your height. 11:17 A normal BMI range for adults is [information on screen]. 11:27 A BMI corresponding to being overweight ranges from 11:31 [information on screen]. 11:36 An Obesity Class I ranges from [information on screen]. 11:46 As you can seen, Class II and Class llI obesity levels 11:51 begin at [information on screen] 11:58 Before we leave this topic it is important to note 12:02 that there are limitations to using the BMI. 12:05 For instance, people who are very muscular, like a 6 foot 12:10 2 inch, 12:11 230 pound football linebacker would display a relatively 12:15 high BMI value, but would likely have relatively 12:18 low levels of body fat. 12:21 In this case BMI would overestimate 12:24 body fat percentage. 12:27 Conversely, elderly persons may display a lower 12:30 than usually BMI, which would reflect a loss 12:34 in muscle mass, but could have elevated 12:37 levels of body fat, 12:39 and as you might imagine, 12:42 very short adults are sometimes penalized 12:45 when using BMI, since their height squared value 12:50 would still be lower relative to the average person's. 12:54 Not withstanding these potential drawbacks, 12:57 the BMI has been widely used in large population studies 13:01 because it is easier to obtain and because higher values 13:06 have been tied to a greater risk for cardiovascular disease. 13:11 The ability to predict disease risk can be strengthened 13:15 by combining measures of BMI and waist circumference. 13:19 If your BMI is between 25 and 29.9, 13:24 which would put you in the overweight category 13:26 and your waist circumference is greater than 40 inches 13:30 for men or greater than 35 inches 13:33 for women, 13:35 your risk for type 2 diabetes, hypertension, 13:39 and cardiovascular disease is high 13:42 compared to having a normal BMI value 13:44 and a lower waist circumference. 13:47 Likewise, if your BMI is between 30 and 34.9, 13:53 which would put you in Obesity Class I, 13:57 your disease risk would be very high 13:59 relative to individuals 14:01 with a normal BMI and a smaller waist girth. 14:06 The fact that waist circumference can be used 14:08 to predict disease risk suggests that the location 14:12 of body fat is an important health concern. 14:16 Upper body obesity characterized by a predominance 14:20 of fat in the trunk and abdominal regions, 14:23 is associated with higher levels of heart disease, diabetes, 14:27 high blood pressure and cholesterol. 14:30 This relationship has been found in studies which demonstrate 14:34 that the risk from cardiovascular disease, stroke, 14:38 diabetes and cancer rises as the ratio between 14:43 waist and hip circumference increases. 14:46 From physiological perspective, the association between 14:50 higher abdominal fat and increased diseased risk 14:54 is linked to the observation that fat cells 14:57 in the abdominal area tend to be more active 15:00 in releasing fat compared to the buttock 15:03 and thigh regions. 15:07 What is known regarding the influence 15:09 of hereditary on body fat? 15:11 While studies have shown that genetic factors 15:15 account for about 25%-40% of the variability 15:18 in human obesity, much of the increase 15:21 in obesity in the past 20 years has been associated 15:24 with changes in lifestyle. 15:27 Some of these factors include less physical activity, 15:31 more time spent in sedentary pursuits, 15:33 like watching TV, surfing the internet, 15:35 and playing video games, less walking in neighborhoods, 15:40 a lack of active time at schools and the work place, 15:43 eating larger portion sizes, 15:46 and consuming refined carbohydrates. 15:50 How important then, are lifestyle choices 15:52 in counteracting a genetic inclination towards weight gain 15:56 and obesity? 15:58 To answer this question, researchers 16:00 have looked at the Pima Indians, a group who has lived 16:03 for at least 2000 years near the Gila River 16:06 in the Sonora Desert of Arizona. 16:09 Up until about 100 years ago, the Pima Indians were farmers 16:13 who apparently were lean and healthy, 16:16 and ate a diet high in complex carbohydrates 16:19 and low in fat. 16:21 However, once they moved onto reservations, 16:23 they stopped farming and began consuming 16:26 a high fat diet. 16:29 With these changes in lifestyle the rate of obesity 16:32 in this population has climbed to approximately 70% 16:36 and diabetes has become quite prevalent. 16:39 Interestingly, there's another group of Pima Indians 16:43 living in Northern Mexico, who have continued to labor 16:46 as farmers and to eat a diet high in carbohydrates 16:49 and low in fat. 16:51 Guess what you find when you compare the BMI values 16:54 of the Northern Mexico Pima Indians, with those 16:57 of the Arizona Pima Indians. 16:59 That's right, the Northern Mexican 17:02 Pima Indians display much lower BMI values compared 17:06 to their Arizona counterparts. 17:08 Viewed collectively, these findings suggest 17:11 that environment can either promote or diminish 17:14 the expression of one's genetic predisposition 17:17 towards weight gain and obesity. 17:21 What is the impact of physical activity 17:23 or weight gain? 17:25 It has been showed that the incidents of obesity 17:27 is highest in men and women who are not physically active 17:30 on a regular basis. 17:32 In contrast, individuals who reported 17:35 participation in non-intense physical activity 17:39 were much less likely to be overweight. 17:42 In one study that followed over 79,000 people for 10 years, 17:46 it was found that those who walked for more 17:49 than 4 hours per week fended off weight gain 17:51 much more effectively than did sedentary subjects. 17:55 In a similar fashion, another study of over 9000 women 17:59 and men who were tracked for longer than a decade 18:03 revealed that substantial weight gain 18:05 was much more likely among people who engaged 18:08 in low versus high amounts of physical activity. 18:12 In fact, over a 2 year period the risk of becoming 18:16 overweight was shown to be reduced 18:18 by accumulating just 30 minutes a day of moderate 18:21 physical activity. 18:24 Overall, 18:26 there seems to be a strong evidence 18:29 that suggests that regular physical activity is associated 18:32 with a lower risk of long term weight gain. 18:35 Indeed, regular physical activity 18:38 and exercise are some of the best predictors 18:40 of weight loss maintenance and should be an important part 18:43 of any weight management program. 18:46 While many people begin an exercise program 18:49 to lose substantial amounts of weight, 18:52 it is important to recognize that physical activity 18:55 can also help to prevent what is known as 18:58 "Creeping Obesity" 18:59 or the slow, gradual increase in weight 19:02 that many adults experience between the ages of 25 and 65. 19:07 As your fitness level increases, you'll be able to rely 19:11 more and more on physical activity 19:13 and exercise to produce the caloric deficit necessary 19:17 to lose weight. 19:19 Once excess weight has been lost, it is vital 19:22 that you continue being physically active 19:25 as part of your daily routine, so that you can maintain 19:28 your new body weight. 19:30 In this regard, engaging in regular 19:33 physical activity is a good predictor 19:35 of being able to sustain weight loss over the long term. 19:40 The validity of this statement is supported 19:42 by data obtained from a registry of people 19:44 who have been successful in losing more than 30 pounds 19:48 and maintaining this weight loss for more than 1 year. 19:52 While 98% of these "successful" weight losers 19:55 decreased their caloric intake, 94% increased their 19:59 physical activity level and 92% reported 20:03 that they were continuing to remain active 20:05 to keep their weight steady. Interestingly, 20:09 those people who were most successful in preventing 20:12 weight gain from reoccurring were now exercising 20:15 for at least 1 hour a day. 20:18 What are some of the benefits of regular physical activity 20:21 and aerobic exercise for people who are overweight 20:24 or obese? 20:26 First, cardio respiratory endurance improves, 20:30 meaning that there is less strain on your heart 20:32 and lungs. 20:33 Second, weight loss leads to a healthier cholesterol 20:37 and triglyceride profile. 20:40 Third, regular exercise results in an increase 20:43 in positive self concept and mood state, 20:46 and decreases anxiety and depression. 20:49 These psychological benefits can be of special importance 20:53 to those who are overweight given the societal pressures 20:56 to be thin. 20:58 Fourth, as pointed out earlier, moderate physical activity 21:02 can decrease the risk of a variety of obesity 21:04 related health problems like heart disease, 21:07 hypertension and cancer. 21:10 With respect for diabetes, the negative caloric 21:12 balance that results from physical activity 21:15 and exercise is known to cause 21:17 a rapid reversal of insulin resistance, 21:20 even before changes in body composition 21:22 can be measured. 21:24 Performing exercise or physical activity with others 21:28 can also serve to enhance the long term maintenance 21:31 of weight loss. 21:33 The next topic that I want to talk about 21:36 is setting up a physical activity program 21:39 for overweight and obese individuals. 21:42 As with anybody starting a regular program 21:44 of physical activity, the emphasis should be placed 21:47 on accumulating a minimum of 30 minutes of moderate 21:50 physical activity nearly every day. 21:53 Start by taking advantages of opportunities to incorporate 21:57 physical activity into your daily schedule. 22:00 As you continue with your physical activity program, 22:03 you'll begin to lose weight and improve your strength 22:06 and fitness. 22:08 As this occurs, you'll also be able to gradually increase 22:11 the length and intensity of your activity 22:14 to secure even more benefits. 22:17 In this regard, walking is a good 22:20 physical activity choice for those who are overweight. 22:24 If you wish to begin a formal walking program 22:27 and you've been inactive for a while, 22:30 one approach would be to walk for 10 minutes 22:32 3 per week, and slowly increase the duration of activity. 22:37 At some point, you'll be able to walk 22:39 for 30-45 minutes at least 3 days per week 22:43 and you'll be well on your way to eventually being 22:45 active on a daily basis. 22:48 Individuals with BMI values of 35 of higher, 22:52 might want to consider performing low to moderate 22:55 intensity, non weight bearing activities, 22:57 like cycling and swimming, or other water exercises, 23:01 until progress has been made in losing weight 23:04 and your functional capacity has been improved. 23:07 Because those who are obese are at higher risk 23:09 for cardiovascular disease, diabetes, and hypertension, 23:13 experts advise that these individuals 23:16 should consult with a physician 23:17 before beginning a program of physical activity. 23:21 In the realm of exercise precautions, potential concerns 23:24 for obese individuals include heat intolerance, 23:27 movement restrictions, muscular-skeletal pain 23:31 and injury, muscle weakness and balance anxiety. 23:35 Given these issues avoid exercise when 23:38 heat-stress is high, wear comfortable, 23:40 lose fitting clothing that breathes, 23:43 start slowly and progress gradually, 23:45 and purchase good pair of walking or workout shoes. 23:51 In recent study of obese women 23:54 who had lost weight over a 4 month period, 23:57 the 33% most active participants continued losing weight, 24:01 the middle 33% maintained their weight loss, 24:04 and the 33% least active subjects gained weight 24:08 steadily throughout the year. 24:10 These data highlight the importance 24:12 of regular physical activity in producing long term 24:15 success in weight reduction. 24:18 Knowledge of the health benefits that come 24:20 from engaging in daily physical activity 24:22 and exercise however, 24:24 must be coupled with the motivation and desire to start 24:28 and maintain a regular program of physical activity. 24:33 I believe what is most important for each person, 24:38 is that you have to find a personally meaningful reason 24:41 to adopt and maintain a physically active lifestyle. 24:46 As I've mentioned in previous programs, 24:48 for some, it may be that as you watch 24:51 this series of programs you'll come to realize 24:54 the sheer magnitude of health blessings 24:57 that results from being active on a daily basis, 25:01 or maybe you're not functioning as well as you used to 25:05 and you want to be able to perform everyday living tasks 25:09 in a more effective manner. 25:11 A recent health crisis, or scare 25:13 may have gotten your attention, 25:16 and you've begun to search for a natural way 25:19 to become healthier and more fit. 25:23 Maybe you're not happy with the way you look and feel, 25:26 and you're finally ready to do something about it, 25:30 or perhaps it's finally dawned on you 25:32 that not only is your health important to yourself, 25:36 but it's also important to those who love you 25:39 and depend on you. 25:41 Personally speaking, 25:43 there are a number of reasons why I like to be 25:47 physically active: it's fun, it's enjoyable, 25:51 and you know form the earlier programs that I'm a runner, 25:53 I'm not a very fast runner, but I enjoy running 25:56 up and down the roads in Middle Tennessee, 25:58 getting out into the sunshine and enjoying 26:00 God's creation. 26:02 But I can tell you that one of the most 26:04 important reasons that motivates me to be physically active, 26:07 that gets me out the door each day, 26:11 is that my father died prematurely of a heart attack 26:14 at the age of 55. He was very young, 26:17 he had so much more to live for. 26:19 And so, I think about that each day as I get ready 26:22 to run and realize that that's something 26:24 that drives me to be active. 26:28 I'm pretty close to that age, not quite there yet, 26:31 but I'm moving closer and closer each year, so my plan 26:33 is to get to 55, look at 55, and to keep 26:37 moving forward because I've got a tremendous amount 26:40 to live for. 26:42 So I hope today, that the things 26:44 that I've mentioned, perhaps have touched the chord 26:47 in your life and will act as a catalyst to motivate you 26:50 to adopt a more physically active lifestyle. 26:54 In 1 Corinthians 6:19,20 26:59 Paul says the following words: 27:01 "Do you not know that your body is a temple of the Holy Spirit" 27:05 "within you, which you have from God. " 27:09 "You are not your own, you were bought with a price," 27:13 "so glorify God in your body. " 27:16 What these verses say to me is that we must 27:19 treat our bodies with care 27:21 because we are God's creation, 27:24 His special creation, 27:26 we mean everything to Him 27:28 and because of that 27:29 it is God's desire that our bodies remain strong and fit 27:34 so that His Spirit can live in us 27:36 and guide our decisions. 27:38 God has given each of us the power of free choice. 27:41 We can decide to make changes in our lives 27:43 for the better if we want to. 27:45 I pray that the message that you've heard today 27:49 will help you to take that first step towards achieving 27:51 higher levels of wellness and health. 27:54 Remember that ordinary life is full of fitness 27:57 and activity opportunities, all we have to do 28:00 is to take hold of them. 28:02 In our next program we'll be talking about 28:04 the impact of physical activity in childhood obesity, 28:08 until then keep moving step by step 28:12 towards better health and fitness. |
Revised 2014-12-17