What physical exercises should you practice, and for what benefits?

2023-10-20 06:47:37

Overweight and obesity today affect nearly one in two people in France and they continue to increase, regardless of age and social background. Overweight is defined by a body mass index (BMI) greater than or equal to 25 and obesity by a BMI greater than or equal to 30 (note that BMI is calculated by taking the ratio of weight to height squared ).

Excess weight imposes a burden on health since it is responsible for numerous complications such as high blood pressure, diabetes, dyslipidemia, etc. These pathologies associated with obesity reduce healthy life expectancy and expose people to premature mortality.

Physical activity to prevent complications of obesity

It is now widely accepted that physical activity protects against these pathologies. Since 2016, doctors can also prescribe physical activity as a prevention therapy and treatment for a number of chronic non-communicable diseases, including obesity and diabetes.

A collective expertise from the National Institute of Health and Medical Research (Inserm), submitted in 2019 to the Ministry of Sports, recommends that physical activity be prescribed as first intention, before any drug treatment, in the treatment of obesity and its complications.

An interest in limiting cardiovascular risk

The benefits of practicing physical activity undoubtedly outweigh the risks involved, whatever the age and state of health of the person. According to data from the “Aerobics Center Longitudinal Study” cohort (longitudinal follow-up of 6.4 years), when physical condition improves, mortality decreases.

In numerical terms, this study explains that an increase in physical condition of 1 metabolic equivalent (or 1 MET for “metabolic equivalent of task”), which corresponds to energy expenditure at seated rest, is associated with a decrease of 15 % of all-cause mortality and a 19% reduction in cardiovascular mortality.

Prescribing physical exercise also improves the metabolic status of people who are overweight and obese by reducing blood pressure, “bad” cholesterol and blood sugar levels. In people with obesity and diabetes, physical activity (150 minutes per week) leads to a reduction in mortality between 30% and 40%, all causes combined, and a reduction in cardiovascular mortality between 25% and 40%.

​Benefits on the waistline

Prescribed physical activity alone does not seem sufficient to induce significant weight loss, due to compensation through food intake. However, in combination with calorie restriction, physical activity potentiates weight loss and facilitates long-term maintenance of weight loss.

One study suggests that physical activity programs should focus on reducing waist circumference, which reflects visceral fat mass, rather than weight.

Physical activity programs for people with obesity should focus on reducing waist circumference, which reflects visceral fat mass, rather than weight – Tom Wang / Shutterstock

And data from meta-analyses (systematic analyzes combining the results of dozens of randomized controlled studies) also indicate that moderate to intense aerobic or endurance exercises (such as hiking, Nordic walking, running, cycling, aquagym…) continuous, or high intensity intervals, reduce waist circumference and the quantity of visceral fat.

​Choose the appropriate programs and time of day

Programs combining aerobic and resistance or muscle strengthening exercises (squat type, bench press, rowing machine, the bodybuilding machine called press, etc.) practiced alternately, that is to say on different days, provide benefits. maximum benefits in people with obesity and diabetes, by increasing muscle strength and improving glycemic balance (i.e. decreasing glycated hemoglobin).

(Glycated hemoglobin, or HbA1c, is a reflection of average blood sugar levels over 2 or 3 months and a marker of the risk of long-term diabetes complications)

In the case of obesity and diabetes, programs should aim for volumes of 2.5 hours of moderate to vigorous physical activity per week to achieve the best health benefits.

Recent studies also indicate that the time of day during which physical exercise is practiced influences health benefits. Exercise performed in the morning would promote weight loss while exercise performed in the afternoon would be beneficial for glycemic balance.

Various physiological mechanisms at play

Physical activity induces adaptations that facilitate the mobilization of fats (a process called lipolysis) by adipose tissues and their use (a process called lipid oxidation) by locomotor muscles. Our team has shown that endurance training improves the sensitivity of adipose tissue to the main lipolytic hormones (these are lipid-degrading hormones, such as catecholamines and atrial natriuretic peptide) and partly restores lipolysis defects, i.e. that is to say, difficulties in mobilizing fat in overweight or obese subjects.

Physical exercise has long been known to stimulate the use of fats (lipids) by muscles. This phenomenon is observed in endurance-trained individuals compared to untrained individuals, as well as in obese individuals subjected to a two-month endurance training program, with three sessions per week.

In summary, physical activity can be used as an effective treatment for obesity and its complications. Regular practice of 30 minutes to 1 hour of physical activity per day provides numerous health benefits and extends healthy life expectancy.

This article was produced by The Conversation and hosted by 20 Minutes.

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