How Much Exercise Is Enough?

According to data from the Behavioral Risk Factor Surveillance System in 2005, less than 50 percent of the United States population participates in “recommended” levels of physical activity. You may be wondering what exactly the “recommended” levels of physical activity are. The recommended levels of physical activity (including both the amount and intensity) differ per person’s individual needs and their exercise goals. In other words, is the goal weight loss or maintenance, increasing one’s energy levels, controlling blood pressure, or blood sugar, etc.?  Activity is not a one-size-fits-all prescription.

            There is a common misconception that if you are thin then you are fit. That is false. Regular activity is what defines fitness, not thinness. The benefits of exercise can only be achieved by engaging in REGULAR activity on a consistent basis. Current exercise recommendations from the United States Department of Health And Human Services for adults aged 18 and older are 150 minutes of moderate-intensity cardiovascular activity (brisk walking) per week, or 75 minutes of vigorous activity (jogging) per week plus 2 or more nonconsecutive days of muscle strengthening activity. A person can achieve the same benefits from exercising 30 minutes a day, regardless of how they incorporate that 30-minute exercise routine into their schedule. For example, a study by Jakicic et al. showed that splitting long exercise bouts into small bouts of at least 10 minutes over the day, improved patient adherence to regular activity and was just as effective in achieving weight loss, compared to a patient who engaged in a long exercise bout at one time.

            The National Weight Control Registry has routinely showed that over 60 minutes of activity per day is critical for long-term weight loss success and maintenance. It is believed by many that variety is the key for not only improving strength and fitness from working different muscles in multiple ways, but also for keeping patients engaged and motivated.

            There are currently limited studies looking at the impact of activity in post-bariatric surgery patients. A study done by Bond et al. discovered that patients, who were inactive pre-operatively but became active post-operatively, not only lost an additional 13 pounds, but also had greater improvements in quality-of-life scores in relation to mental health, general health, and vitality. Regardless of the limited research for post-bariatric surgery patients, it is still recommended that for long term health, fitness, and weight management benefits, these patients need to be active.

            In conclusion, every person, whether obese or thin, healthy or unhealthy, needs to engage in regular activity on a daily basis, since there are many long-term risks from inactivity.

Peraino, A.M., M.D. Physical Activity for Health and Weight Loss: How Much is Enough? Bariatric Times. 2011; 8(2):13-15

Gastric Banding Pays for Itself…

A new study published in the journal Surgery for Obesity and Related Diseases concluded that the cost of Gastric Banding weight loss surgery was cost effective in roughly two years post-op by reductions in obesity-related medical costs in those with a history of Diabetes and in roughly four years post-op in those patients without Diabetes. Currently, obesity costs the U.S. roughly $70 billion a year. The nation’s total medical bill as a result of obesity is currently estimated at $147 billion a year and represents about 10% of all medical expenses in the U.S. That 10% is estimated to increase to 16-18% of all U.S. healthcare costs in the next 20 years.

Whey Protein May Affect Weight

A study published in The Journal of Nutrition June 2011 showed that whey protein may be helpful in weight loss.

They assigned 90 overweight and obese men and women with an average weight for men of 218 pounds and 190 pounds for the women to 1 of 3 groups. All the groups had an average daily caloric intake of 2,200 calories per day.

The first group added whey protein drinks to their normal diets, the second soy protein, and the third group added carbohydrate drinks. All the drinks had 52 grams per packet of protein or carbohydrates and all the drinks totaled 200 calories each. They were to be drunk at breakfast and dinner. None of the participants knew which type of shake they were drinking. Participants were also to keep a food diary.

After 6 months, they observed that those who drank the carbohydrate shakes gained 2 pounds, the weight of those who drank the soy shakes remained about the same, and those who drank the whey protein shakes lost 2 pounds but also lost about 1 inch around their waistlines.

The soy protein group was found to have higher levels of thyroid hormones, which may have accounted for the maintenance of their weight despite the added calories. Thyroid hormones are known to increase metabolism.

The whey protein group had significantly lower levels of the hormone that regulates food intake, ghrelin. Higher blood concentration of ghrelin correlates with increased hunger. An inexplicable finding was those on whey protein shakes ate less carbohydrates by the end of the study though their total caloric intake did not change.

Be advised to read labels as whey products are high in fat and calories.

Migraines May Lead to Stroke

Migraine could be a risk factor for stroke. The probability of stroke increases if the patient also has hypertension.  Those 40-49 years old who suffered from migraines and hypertension had a 5% more chance of getting a stroke than those with hypertension alone. This study was done in Italy and included almost 3,000 subjects. The findings were presented in 2011 at the   European Meeting on Hypertension 2011 by Dr. Enrico Agabiti-Rosei.  He concluded that further studies need to be done on whether early migraine treatment can reduce the risk of stroke.

PCOS and Infertility Resolved After Weight-Loss Surgery

A study analyzed medical records of women who underwent Roux-en-Y gastric bypass surgery between 2000 and 2009. Of the 566 women, 31 (5.5%) had Polycystic Ovarian Syndrome (PCOS) prior to their surgery. The women had a mean age of 32 and had suffered from PCOS for roughly 8 years.

Improvement in PCOS symptoms (including infertility, hirsutism, and menstrual dysfunction) roughly occurred during the first year after surgery. Furthermore, improvement or resolution in symptoms increased over time with excess weight loss.

Every woman suffering from infertility prior to surgery, who wanted to conceive, was able to conceive either naturally or by assisted reproduction within 3 years of their surgery.

Ironically, in 2009, the American College of Obstetricians and Gynecologists published new guidelines for the recommendations and treatment of infertility and Bariatric surgery is not listed as one of the components of treatment despite this study’s positive findings of weight loss surgery helping conception.