Hello, and welcome to Wonderfully Made. 00:00:38.06\00:00:40.82 My name is Don Morgan 00:00:41.40\00:00:43.17 and I teach in the department of health and human performance 00:00:43.41\00:00:46.47 at Middle Tennessee State University. 00:00:46.86\00:00:49.39 This is the fifth 00:00:50.11\00:00:51.89 in a series of programs focusing on the health benefits 00:00:51.95\00:00:55.52 which come from following a physically active lifestyle. 00:00:55.56\00:00:59.10 As an exercise physiologist for over 20 years, 00:00:59.73\00:01:03.04 I have seen first hand 00:01:03.43\00:01:05.48 the positive changes that occur when individuals begin 00:01:05.52\00:01:09.64 to incorporate physical activity into their lives. 00:01:09.67\00:01:13.76 Today we're going to be looking at how physical activity 00:01:14.20\00:01:18.45 can help in the battle against obesity, 00:01:18.80\00:01:21.46 one of the major causes of death and disease in the US today. 00:01:21.73\00:01:27.13 About 1 year ago "Time" magazine put out a special issue 00:01:28.23\00:01:32.67 called "Overcoming Obesity in America". 00:01:33.03\00:01:35.90 In the cover story, which was entitled 00:01:36.73\00:01:39.48 "How We Grew so Big" a majority of Americans 00:01:39.89\00:01:43.16 who were polled indicated that they would like 00:01:43.19\00:01:46.43 to lose weight. 00:01:46.46\00:01:48.22 And 86% said that not getting enough physical exercise 00:01:48.42\00:01:52.74 was one of the most important causes of obesity in the US. 00:01:53.28\00:01:56.99 However, only about a fourth of the respondents stated 00:01:57.68\00:02:01.80 that they exercise at least 3 times a week. 00:02:02.27\00:02:04.98 87% of the sample also noted that the predominant reasons 00:02:06.04\00:02:10.89 for the nation's obesity problem were poor 00:02:10.92\00:02:14.26 dietary choices and a lack of exercise. 00:02:14.29\00:02:17.60 Given this scenario 00:02:18.88\00:02:20.52 it would appear that one of the challenges 00:02:20.84\00:02:23.71 in helping people lose weight is to motivate 00:02:23.81\00:02:27.11 and encourage them to be more physically active 00:02:27.15\00:02:30.42 on a regular basis. 00:02:30.45\00:02:31.97 Later in the program 00:02:32.95\00:02:34.48 I want to spend some time addressing this specific issue, 00:02:34.66\00:02:38.16 but I'd like to begin today by laying out some of 00:02:38.83\00:02:41.67 the statistics related to obesity in our country 00:02:41.70\00:02:44.51 and then follow up by examining the role 00:02:45.28\00:02:47.97 that physical activity can play 00:02:48.35\00:02:50.50 in fighting this chronic health condition. 00:02:50.60\00:02:53.33 Obesity has increased very much in our country 00:02:54.82\00:02:58.82 over the past 20 years 00:02:59.35\00:03:01.31 and the US currently has the highest prevalence 00:03:01.74\00:03:04.95 of obesity in the entire world. 00:03:04.98\00:03:07.67 Overweightness and obesity affect about 100 million 00:03:08.77\00:03:12.56 American adults aged 24-74, 00:03:12.59\00:03:17.06 with the highest rates seen among the poor 00:03:17.53\00:03:20.21 and in minority groups. 00:03:20.41\00:03:22.10 Based on some of the latest data available 00:03:23.18\00:03:25.46 from the Centers For Disease Control 00:03:25.49\00:03:27.45 nearly two thirds of Americans are officially overweight. 00:03:28.27\00:03:31.89 Of those who are overweight close to 50% are obese 00:03:32.65\00:03:37.85 and about 5% are morbidly obese, 00:03:38.15\00:03:41.90 that's a condition that requires significant medical attention. 00:03:42.03\00:03:46.01 While the incidents of obesity in the US is significant 00:03:47.03\00:03:50.66 what is particularly alarming is the rapid rate 00:03:51.46\00:03:55.21 at which obesity levels have increased over the past 00:03:55.48\00:03:58.61 10-15 years. 00:03:58.64\00:04:00.75 According to the Centers For Disease Control, 00:04:01.42\00:04:03.56 obesity has increased 50% or more 00:04:04.43\00:04:07.91 over the past decade in each of the 50 states. 00:04:08.13\00:04:11.44 In view of these findings it is not surprising why some 00:04:12.22\00:04:16.12 have described the growing rate of obesity in our country 00:04:16.15\00:04:20.02 as nothing short of epidemic. 00:04:20.26\00:04:24.09 From a mortality standpoint, it has been reported 00:04:24.55\00:04:27.90 that approximately 280,000 adult deaths in the US each year 00:04:27.94\00:04:33.73 are attributable to obesity. 00:04:34.24\00:04:37.14 In terms of financial costs, 00:04:37.53\00:04:39.48 the annual monetary drain to the US economy 00:04:39.80\00:04:43.50 that is associated with being overweight and obese 00:04:43.54\00:04:46.41 is $117 billion. 00:04:46.53\00:04:49.42 Over 39 million work days are lost annually 00:04:49.78\00:04:53.00 to obesity related causes. 00:04:53.20\00:04:55.38 In our next program I'm going to focus on the role 00:04:56.84\00:05:00.38 that physical activity can play in reducing childhood obesity, 00:05:00.42\00:05:04.76 but just in case you miss that program, 00:05:05.36\00:05:07.55 I want to highlight the results of one study 00:05:08.15\00:05:11.12 that was published in the journal 00:05:11.51\00:05:13.00 "Preventive Medicine". 00:05:13.03\00:05:14.97 In this study it was reported that the chance of an obese 00:05:15.37\00:05:18.98 child becoming an obese adult increases with age. 00:05:19.01\00:05:22.90 Specifically, about one third of obese preschool children 00:05:23.58\00:05:27.84 became obese adults. 00:05:27.87\00:05:30.33 50% of obese school age children ended up obese as adults. 00:05:30.60\00:05:35.04 What was even more disconcerting was that 80% of obese 00:05:35.55\00:05:39.19 adolescents carried their obesity with them 00:05:39.22\00:05:42.60 into their adult years. 00:05:43.03\00:05:45.11 Now, what is the take home message from this data? 00:05:46.17\00:05:49.32 In my view, these results suggest 00:05:49.35\00:05:52.05 that early on in a child's life 00:05:52.09\00:05:54.76 aggressive measures should be implemented and instituted 00:05:54.95\00:05:58.18 to promote physical activity 00:05:58.21\00:06:00.05 as a means of managing excessive weight gain. 00:06:00.09\00:06:03.62 As I mentioned earlier, we'll talk more 00:06:04.94\00:06:07.49 in our next program about how vital physical 00:06:07.53\00:06:10.70 activity can be in decreasing 00:06:10.73\00:06:12.99 the incidents childhood obesity. 00:06:13.02\00:06:15.25 What are some of the health problems and risks 00:06:17.03\00:06:20.29 associated with obesity? 00:06:20.32\00:06:22.31 The risk of developing high blood pressure, 00:06:23.45\00:06:25.71 or hypertension rises sharply with an increase in body weight. 00:06:25.75\00:06:30.15 Conversely, weight reduction is the single most effective 00:06:31.14\00:06:35.79 non-drug method of controlling high blood pressure. 00:06:35.82\00:06:39.22 And increasing physical activity is certainly one way 00:06:40.18\00:06:43.25 to promote weight loss. 00:06:43.28\00:06:45.56 Another health risk of obesity is an increase in cholesterol 00:06:46.07\00:06:50.03 and other blood fats which can contribute 00:06:50.06\00:06:52.52 to heart disease. 00:06:52.55\00:06:54.28 In this regard, even loosing a few pounds 00:06:54.75\00:06:57.82 can have significant beneficial effects on reducing 00:06:57.86\00:07:01.79 blood lipid levels. 00:07:01.82\00:07:03.61 Obesity can bring a greater risk of osteoarthritis 00:07:04.58\00:07:08.08 especially in the knees and hips, 00:07:08.44\00:07:10.70 which then will cause pain and limitations 00:07:11.12\00:07:13.09 in range of motion. 00:07:13.12\00:07:15.25 Along with heart disease and high blood pressure, 00:07:15.76\00:07:18.62 obesity is linked 00:07:19.16\00:07:20.65 to an increased risk of type 2 diabetes. 00:07:20.69\00:07:24.43 Those that are most vulnerable to this triad of health 00:07:25.40\00:07:28.94 conditions, tend to have more of their fat deposited 00:07:28.97\00:07:32.48 in the abdominal areas rather than in the hip 00:07:32.51\00:07:35.92 and thigh regions. 00:07:35.95\00:07:37.77 Obese individuals can experience greater psychological burdens 00:07:38.63\00:07:42.55 with many having unflattering self images of themselves, 00:07:42.84\00:07:46.23 which can then lead to feelings of guilt, depression, 00:07:46.65\00:07:50.24 and low self-esteem. 00:07:50.41\00:07:52.45 This can be a particularly tough burden for children 00:07:53.45\00:07:56.71 who can be on the receiving end of teasing or jokes 00:07:57.34\00:08:00.26 from classmates and acquaintances. 00:08:00.36\00:08:02.35 Recent data also suggests that middle age obesity 00:08:04.10\00:08:08.03 may raise the risk of developing dementia later in life. 00:08:08.07\00:08:13.29 Given the fact that being overweight and obese 00:08:14.94\00:08:19.13 is associated with a number of adverse health conditions, 00:08:19.42\00:08:22.55 a reasonable question to ask is: 00:08:23.36\00:08:25.71 how does one quantify overweightness and obesity? 00:08:25.84\00:08:29.58 While there are many laboratory based methods of assessing 00:08:29.62\00:08:32.85 body composition a simple and inexpensive method 00:08:32.88\00:08:36.94 is to determine Body Mass Index or BMI. 00:08:36.97\00:08:41.07 The BMI, which indicates how heavy you are relative 00:08:41.68\00:08:45.30 to your weight, has been shown 00:08:45.33\00:08:47.76 to be more accurate than using weight alone 00:08:47.80\00:08:50.45 to estimate obesity and it also correlates 00:08:50.48\00:08:52.99 reasonably well to direct measurements 00:08:53.03\00:08:55.51 of body fat. 00:08:55.54\00:08:57.24 The following graphic demonstrates how to calculate 00:08:57.46\00:09:00.55 BMI. 00:09:00.58\00:09:02.34 In this example we have [text on screen]. 00:09:02.84\00:09:05.87 The first thing we need to do is convert his height 00:09:12.34\00:09:15.32 to inches. 00:09:15.35\00:09:16.70 So to do that, 00:09:16.74\00:09:18.02 we multiply 5 feet by 12 since there are 12 inches 00:09:18.06\00:09:21.74 in a foot, and add 8 more inches to arrive at 68 inches. 00:09:21.78\00:09:26.56 In step two we multiply 68 by 68 00:09:27.47\00:09:31.62 to get 4624, which is his height squared. 00:09:31.71\00:09:37.27 Then, in step three, we divide his weight 00:09:38.01\00:09:41.70 which is 154 pounds by his height squared, 00:09:41.97\00:09:45.84 which is 4624 to yield a very small number. 00:09:46.04\00:09:51.11 In this case, the number is 0.333044. 00:09:51.14\00:09:56.36 In our last step, [text on screen] 00:09:57.82\00:10:00.96 Now I know that that was a lot to digest. 00:10:18.41\00:10:21.15 So if you want an easier route to follow 00:10:21.55\00:10:24.21 and you have internet access you can navigate to the website 00:10:24.73\00:10:28.72 shown on the next graphic. 00:10:28.75\00:10:30.90 The graphic shows that the site is 00:10:32.05\00:10:35.14 [information on screen] 00:10:35.17\00:10:37.17 Now that you've determined your BMI value 00:10:54.47\00:10:57.00 you're probably interested in knowing where you fit 00:10:57.53\00:11:00.67 relative to existing BMI standards. 00:11:01.28\00:11:04.43 As shown in the next graphic, if your BMI value 00:11:05.36\00:11:09.48 is less than 18.5 kg per meter squared, 00:11:09.51\00:11:13.76 you're considered underweight for your height. 00:11:13.95\00:11:16.96 A normal BMI range for adults is [information on screen]. 00:11:17.39\00:11:21.56 A BMI corresponding to being overweight ranges from 00:11:27.27\00:11:31.10 [information on screen]. 00:11:31.13\00:11:33.22 An Obesity Class I ranges from [information on screen]. 00:11:36.50\00:11:41.34 As you can seen, Class II and Class llI obesity levels 00:11:46.36\00:11:50.98 begin at [information on screen] 00:11:51.37\00:11:53.51 Before we leave this topic it is important to note 00:11:58.62\00:12:02.27 that there are limitations to using the BMI. 00:12:02.30\00:12:05.42 For instance, people who are very muscular, like a 6 foot 00:12:05.46\00:12:10.16 2 inch, 00:12:10.19\00:12:11.16 230 pound football linebacker would display a relatively 00:12:11.20\00:12:15.27 high BMI value, but would likely have relatively 00:12:15.30\00:12:18.75 low levels of body fat. 00:12:18.78\00:12:20.80 In this case BMI would overestimate 00:12:21.32\00:12:24.69 body fat percentage. 00:12:24.72\00:12:26.58 Conversely, elderly persons may display a lower 00:12:27.01\00:12:30.72 than usually BMI, which would reflect a loss 00:12:30.75\00:12:34.43 in muscle mass, but could have elevated 00:12:34.46\00:12:37.39 levels of body fat, 00:12:37.42\00:12:39.16 and as you might imagine, 00:12:39.91\00:12:42.74 very short adults are sometimes penalized 00:12:42.80\00:12:45.94 when using BMI, since their height squared value 00:12:45.98\00:12:49.69 would still be lower relative to the average person's. 00:12:50.01\00:12:53.50 Not withstanding these potential drawbacks, 00:12:54.50\00:12:57.26 the BMI has been widely used in large population studies 00:12:57.59\00:13:01.49 because it is easier to obtain and because higher values 00:13:01.86\00:13:05.96 have been tied to a greater risk for cardiovascular disease. 00:13:06.23\00:13:10.30 The ability to predict disease risk can be strengthened 00:13:11.42\00:13:15.16 by combining measures of BMI and waist circumference. 00:13:15.20\00:13:18.91 If your BMI is between 25 and 29.9, 00:13:19.49\00:13:23.75 which would put you in the overweight category 00:13:24.13\00:13:26.85 and your waist circumference is greater than 40 inches 00:13:26.89\00:13:30.04 for men or greater than 35 inches 00:13:30.07\00:13:33.37 for women, 00:13:33.58\00:13:35.21 your risk for type 2 diabetes, hypertension, 00:13:35.51\00:13:39.01 and cardiovascular disease is high 00:13:39.20\00:13:41.97 compared to having a normal BMI value 00:13:42.01\00:13:44.75 and a lower waist circumference. 00:13:44.88\00:13:47.33 Likewise, if your BMI is between 30 and 34.9, 00:13:47.58\00:13:52.67 which would put you in Obesity Class I, 00:13:53.23\00:13:56.91 your disease risk would be very high 00:13:57.31\00:13:59.60 relative to individuals 00:13:59.80\00:14:01.57 with a normal BMI and a smaller waist girth. 00:14:01.61\00:14:05.18 The fact that waist circumference can be used 00:14:06.12\00:14:08.37 to predict disease risk suggests that the location 00:14:08.41\00:14:12.20 of body fat is an important health concern. 00:14:12.23\00:14:15.89 Upper body obesity characterized by a predominance 00:14:16.62\00:14:20.03 of fat in the trunk and abdominal regions, 00:14:20.06\00:14:22.49 is associated with higher levels of heart disease, diabetes, 00:14:23.10\00:14:26.74 high blood pressure and cholesterol. 00:14:27.05\00:14:29.86 This relationship has been found in studies which demonstrate 00:14:30.71\00:14:34.63 that the risk from cardiovascular disease, stroke, 00:14:34.66\00:14:38.10 diabetes and cancer rises as the ratio between 00:14:38.21\00:14:42.80 waist and hip circumference increases. 00:14:43.14\00:14:45.65 From physiological perspective, the association between 00:14:46.66\00:14:50.57 higher abdominal fat and increased diseased risk 00:14:50.60\00:14:54.48 is linked to the observation that fat cells 00:14:54.72\00:14:57.67 in the abdominal area tend to be more active 00:14:57.70\00:15:00.58 in releasing fat compared to the buttock 00:15:00.62\00:15:03.47 and thigh regions. 00:15:03.95\00:15:05.62 What is known regarding the influence 00:15:07.25\00:15:09.10 of hereditary on body fat? 00:15:09.13\00:15:11.12 While studies have shown that genetic factors 00:15:11.90\00:15:15.15 account for about 25%-40% of the variability 00:15:15.19\00:15:18.41 in human obesity, much of the increase 00:15:18.44\00:15:21.38 in obesity in the past 20 years has been associated 00:15:21.42\00:15:24.78 with changes in lifestyle. 00:15:24.81\00:15:26.72 Some of these factors include less physical activity, 00:15:27.19\00:15:30.49 more time spent in sedentary pursuits, 00:15:31.01\00:15:33.21 like watching TV, surfing the internet, 00:15:33.24\00:15:35.37 and playing video games, less walking in neighborhoods, 00:15:35.41\00:15:39.84 a lack of active time at schools and the work place, 00:15:40.11\00:15:43.63 eating larger portion sizes, 00:15:43.94\00:15:46.38 and consuming refined carbohydrates. 00:15:46.55\00:15:49.33 How important then, are lifestyle choices 00:15:50.03\00:15:52.87 in counteracting a genetic inclination towards weight gain 00:15:52.91\00:15:56.19 and obesity? 00:15:56.32\00:15:57.84 To answer this question, researchers 00:15:58.21\00:16:00.39 have looked at the Pima Indians, a group who has lived 00:16:00.43\00:16:03.60 for at least 2000 years near the Gila River 00:16:03.63\00:16:06.77 in the Sonora Desert of Arizona. 00:16:06.87\00:16:09.08 Up until about 100 years ago, the Pima Indians were farmers 00:16:09.64\00:16:13.52 who apparently were lean and healthy, 00:16:13.55\00:16:16.47 and ate a diet high in complex carbohydrates 00:16:16.57\00:16:19.03 and low in fat. 00:16:19.06\00:16:20.61 However, once they moved onto reservations, 00:16:21.37\00:16:23.92 they stopped farming and began consuming 00:16:23.95\00:16:26.47 a high fat diet. 00:16:26.50\00:16:28.19 With these changes in lifestyle the rate of obesity 00:16:29.06\00:16:32.43 in this population has climbed to approximately 70% 00:16:32.47\00:16:35.81 and diabetes has become quite prevalent. 00:16:36.49\00:16:39.20 Interestingly, there's another group of Pima Indians 00:16:39.88\00:16:43.20 living in Northern Mexico, who have continued to labor 00:16:43.24\00:16:46.35 as farmers and to eat a diet high in carbohydrates 00:16:46.39\00:16:49.47 and low in fat. 00:16:49.67\00:16:51.14 Guess what you find when you compare the BMI values 00:16:51.73\00:16:54.50 of the Northern Mexico Pima Indians, with those 00:16:54.54\00:16:57.28 of the Arizona Pima Indians. 00:16:57.31\00:16:59.15 That's right, the Northern Mexican 00:16:59.65\00:17:02.75 Pima Indians display much lower BMI values compared 00:17:02.79\00:17:06.23 to their Arizona counterparts. 00:17:06.26\00:17:08.26 Viewed collectively, these findings suggest 00:17:08.82\00:17:11.83 that environment can either promote or diminish 00:17:11.87\00:17:14.82 the expression of one's genetic predisposition 00:17:14.86\00:17:17.78 towards weight gain and obesity. 00:17:17.81\00:17:20.16 What is the impact of physical activity 00:17:21.24\00:17:23.24 or weight gain? 00:17:23.27\00:17:25.09 It has been showed that the incidents of obesity 00:17:25.13\00:17:27.45 is highest in men and women who are not physically active 00:17:27.49\00:17:30.67 on a regular basis. 00:17:30.70\00:17:32.34 In contrast, individuals who reported 00:17:32.92\00:17:35.63 participation in non-intense physical activity 00:17:35.67\00:17:38.52 were much less likely to be overweight. 00:17:39.02\00:17:41.29 In one study that followed over 79,000 people for 10 years, 00:17:42.26\00:17:46.25 it was found that those who walked for more 00:17:46.69\00:17:49.30 than 4 hours per week fended off weight gain 00:17:49.34\00:17:51.88 much more effectively than did sedentary subjects. 00:17:51.92\00:17:55.44 In a similar fashion, another study of over 9000 women 00:17:55.87\00:17:59.77 and men who were tracked for longer than a decade 00:17:59.80\00:18:02.86 revealed that substantial weight gain 00:18:03.35\00:18:05.24 was much more likely among people who engaged 00:18:05.28\00:18:08.52 in low versus high amounts of physical activity. 00:18:08.55\00:18:11.76 In fact, over a 2 year period the risk of becoming 00:18:12.31\00:18:16.13 overweight was shown to be reduced 00:18:16.16\00:18:17.84 by accumulating just 30 minutes a day of moderate 00:18:18.10\00:18:21.77 physical activity. 00:18:21.80\00:18:23.60 Overall, 00:18:24.91\00:18:26.27 there seems to be a strong evidence 00:18:26.52\00:18:28.93 that suggests that regular physical activity is associated 00:18:29.11\00:18:32.04 with a lower risk of long term weight gain. 00:18:32.07\00:18:34.72 Indeed, regular physical activity 00:18:35.11\00:18:38.06 and exercise are some of the best predictors 00:18:38.12\00:18:40.43 of weight loss maintenance and should be an important part 00:18:40.47\00:18:43.73 of any weight management program. 00:18:43.76\00:18:45.80 While many people begin an exercise program 00:18:46.80\00:18:49.06 to lose substantial amounts of weight, 00:18:49.09\00:18:51.27 it is important to recognize that physical activity 00:18:52.19\00:18:55.00 can also help to prevent what is known as 00:18:55.03\00:18:57.95 "Creeping Obesity" 00:18:58.06\00:18:59.83 or the slow, gradual increase in weight 00:18:59.88\00:19:02.47 that many adults experience between the ages of 25 and 65. 00:19:02.75\00:19:06.71 As your fitness level increases, you'll be able to rely 00:19:07.67\00:19:11.41 more and more on physical activity 00:19:11.44\00:19:13.80 and exercise to produce the caloric deficit necessary 00:19:13.84\00:19:17.60 to lose weight. 00:19:17.63\00:19:19.33 Once excess weight has been lost, it is vital 00:19:19.72\00:19:22.45 that you continue being physically active 00:19:22.48\00:19:25.14 as part of your daily routine, so that you can maintain 00:19:25.18\00:19:28.64 your new body weight. 00:19:28.67\00:19:30.17 In this regard, engaging in regular 00:19:30.93\00:19:33.38 physical activity is a good predictor 00:19:33.42\00:19:35.84 of being able to sustain weight loss over the long term. 00:19:35.97\00:19:39.54 The validity of this statement is supported 00:19:40.39\00:19:42.63 by data obtained from a registry of people 00:19:42.66\00:19:44.87 who have been successful in losing more than 30 pounds 00:19:44.90\00:19:48.33 and maintaining this weight loss for more than 1 year. 00:19:48.50\00:19:51.65 While 98% of these "successful" weight losers 00:19:52.14\00:19:55.33 decreased their caloric intake, 94% increased their 00:19:55.58\00:19:59.43 physical activity level and 92% reported 00:19:59.46\00:20:03.03 that they were continuing to remain active 00:20:03.19\00:20:05.31 to keep their weight steady. Interestingly, 00:20:05.50\00:20:09.07 those people who were most successful in preventing 00:20:09.11\00:20:12.14 weight gain from reoccurring were now exercising 00:20:12.17\00:20:15.17 for at least 1 hour a day. 00:20:15.20\00:20:17.70 What are some of the benefits of regular physical activity 00:20:18.98\00:20:21.58 and aerobic exercise for people who are overweight 00:20:21.61\00:20:24.53 or obese? 00:20:24.56\00:20:26.02 First, cardio respiratory endurance improves, 00:20:26.44\00:20:29.84 meaning that there is less strain on your heart 00:20:30.15\00:20:32.01 and lungs. 00:20:32.04\00:20:33.25 Second, weight loss leads to a healthier cholesterol 00:20:33.80\00:20:37.58 and triglyceride profile. 00:20:37.61\00:20:39.99 Third, regular exercise results in an increase 00:20:40.05\00:20:43.62 in positive self concept and mood state, 00:20:43.65\00:20:46.19 and decreases anxiety and depression. 00:20:46.70\00:20:49.41 These psychological benefits can be of special importance 00:20:49.84\00:20:53.02 to those who are overweight given the societal pressures 00:20:53.26\00:20:56.49 to be thin. 00:20:56.52\00:20:58.10 Fourth, as pointed out earlier, moderate physical activity 00:20:58.38\00:21:02.39 can decrease the risk of a variety of obesity 00:21:02.42\00:21:04.91 related health problems like heart disease, 00:21:04.94\00:21:07.40 hypertension and cancer. 00:21:07.43\00:21:09.75 With respect for diabetes, the negative caloric 00:21:10.07\00:21:12.55 balance that results from physical activity 00:21:12.58\00:21:15.03 and exercise is known to cause 00:21:15.06\00:21:17.24 a rapid reversal of insulin resistance, 00:21:17.28\00:21:20.00 even before changes in body composition 00:21:20.45\00:21:22.66 can be measured. 00:21:22.69\00:21:24.43 Performing exercise or physical activity with others 00:21:24.92\00:21:27.97 can also serve to enhance the long term maintenance 00:21:28.15\00:21:30.86 of weight loss. 00:21:31.06\00:21:32.71 The next topic that I want to talk about 00:21:33.69\00:21:36.41 is setting up a physical activity program 00:21:36.59\00:21:39.35 for overweight and obese individuals. 00:21:39.39\00:21:42.08 As with anybody starting a regular program 00:21:42.12\00:21:44.41 of physical activity, the emphasis should be placed 00:21:44.45\00:21:47.64 on accumulating a minimum of 30 minutes of moderate 00:21:47.68\00:21:50.84 physical activity nearly every day. 00:21:50.87\00:21:53.34 Start by taking advantages of opportunities to incorporate 00:21:53.91\00:21:57.00 physical activity into your daily schedule. 00:21:57.03\00:21:59.92 As you continue with your physical activity program, 00:22:00.46\00:22:03.43 you'll begin to lose weight and improve your strength 00:22:03.68\00:22:06.50 and fitness. 00:22:06.53\00:22:08.02 As this occurs, you'll also be able to gradually increase 00:22:08.06\00:22:11.83 the length and intensity of your activity 00:22:11.86\00:22:14.36 to secure even more benefits. 00:22:14.48\00:22:17.03 In this regard, walking is a good 00:22:17.46\00:22:20.15 physical activity choice for those who are overweight. 00:22:20.19\00:22:23.93 If you wish to begin a formal walking program 00:22:24.83\00:22:27.93 and you've been inactive for a while, 00:22:27.96\00:22:30.28 one approach would be to walk for 10 minutes 00:22:30.65\00:22:32.95 3 per week, and slowly increase the duration of activity. 00:22:32.99\00:22:37.06 At some point, you'll be able to walk 00:22:37.81\00:22:39.68 for 30-45 minutes at least 3 days per week 00:22:39.72\00:22:42.95 and you'll be well on your way to eventually being 00:22:43.23\00:22:45.73 active on a daily basis. 00:22:45.76\00:22:48.42 Individuals with BMI values of 35 of higher, 00:22:48.91\00:22:52.42 might want to consider performing low to moderate 00:22:52.74\00:22:54.98 intensity, non weight bearing activities, 00:22:55.01\00:22:57.73 like cycling and swimming, or other water exercises, 00:22:57.77\00:23:00.96 until progress has been made in losing weight 00:23:01.37\00:23:03.86 and your functional capacity has been improved. 00:23:04.19\00:23:06.88 Because those who are obese are at higher risk 00:23:07.14\00:23:09.55 for cardiovascular disease, diabetes, and hypertension, 00:23:09.59\00:23:13.51 experts advise that these individuals 00:23:13.88\00:23:16.02 should consult with a physician 00:23:16.05\00:23:17.84 before beginning a program of physical activity. 00:23:17.88\00:23:20.80 In the realm of exercise precautions, potential concerns 00:23:21.23\00:23:24.65 for obese individuals include heat intolerance, 00:23:24.68\00:23:27.61 movement restrictions, muscular-skeletal pain 00:23:27.84\00:23:31.36 and injury, muscle weakness and balance anxiety. 00:23:31.40\00:23:34.89 Given these issues avoid exercise when 00:23:35.54\00:23:38.21 heat-stress is high, wear comfortable, 00:23:38.25\00:23:40.65 lose fitting clothing that breathes, 00:23:40.68\00:23:43.05 start slowly and progress gradually, 00:23:43.35\00:23:45.93 and purchase good pair of walking or workout shoes. 00:23:45.99\00:23:49.68 In recent study of obese women 00:23:51.02\00:23:53.62 who had lost weight over a 4 month period, 00:23:54.18\00:23:56.80 the 33% most active participants continued losing weight, 00:23:57.03\00:24:01.43 the middle 33% maintained their weight loss, 00:24:01.63\00:24:04.82 and the 33% least active subjects gained weight 00:24:04.86\00:24:08.02 steadily throughout the year. 00:24:08.05\00:24:10.02 These data highlight the importance 00:24:10.34\00:24:12.21 of regular physical activity in producing long term 00:24:12.25\00:24:15.07 success in weight reduction. 00:24:15.10\00:24:17.29 Knowledge of the health benefits that come 00:24:18.38\00:24:20.40 from engaging in daily physical activity 00:24:20.44\00:24:22.43 and exercise however, 00:24:22.46\00:24:24.44 must be coupled with the motivation and desire to start 00:24:24.57\00:24:28.42 and maintain a regular program of physical activity. 00:24:28.45\00:24:32.27 I believe what is most important for each person, 00:24:33.69\00:24:37.52 is that you have to find a personally meaningful reason 00:24:38.15\00:24:41.65 to adopt and maintain a physically active lifestyle. 00:24:41.68\00:24:45.15 As I've mentioned in previous programs, 00:24:46.09\00:24:48.71 for some, it may be that as you watch 00:24:48.74\00:24:51.33 this series of programs you'll come to realize 00:24:51.36\00:24:54.95 the sheer magnitude of health blessings 00:24:54.98\00:24:57.79 that results from being active on a daily basis, 00:24:57.83\00:25:00.64 or maybe you're not functioning as well as you used to 00:25:01.50\00:25:04.99 and you want to be able to perform everyday living tasks 00:25:05.46\00:25:08.86 in a more effective manner. 00:25:09.06\00:25:11.35 A recent health crisis, or scare 00:25:11.77\00:25:13.70 may have gotten your attention, 00:25:13.73\00:25:15.63 and you've begun to search for a natural way 00:25:16.25\00:25:19.19 to become healthier and more fit. 00:25:19.22\00:25:22.00 Maybe you're not happy with the way you look and feel, 00:25:23.19\00:25:26.12 and you're finally ready to do something about it, 00:25:26.73\00:25:29.56 or perhaps it's finally dawned on you 00:25:30.19\00:25:32.93 that not only is your health important to yourself, 00:25:32.97\00:25:35.79 but it's also important to those who love you 00:25:36.50\00:25:38.92 and depend on you. 00:25:39.31\00:25:41.08 Personally speaking, 00:25:41.92\00:25:43.33 there are a number of reasons why I like to be 00:25:43.77\00:25:47.00 physically active: it's fun, it's enjoyable, 00:25:47.03\00:25:50.23 and you know form the earlier programs that I'm a runner, 00:25:51.27\00:25:53.59 I'm not a very fast runner, but I enjoy running 00:25:53.62\00:25:56.48 up and down the roads in Middle Tennessee, 00:25:56.51\00:25:58.70 getting out into the sunshine and enjoying 00:25:58.74\00:26:00.90 God's creation. 00:26:00.93\00:26:02.47 But I can tell you that one of the most 00:26:02.67\00:26:04.85 important reasons that motivates me to be physically active, 00:26:04.89\00:26:07.84 that gets me out the door each day, 00:26:07.87\00:26:10.23 is that my father died prematurely of a heart attack 00:26:11.40\00:26:14.54 at the age of 55. He was very young, 00:26:14.57\00:26:16.96 he had so much more to live for. 00:26:17.10\00:26:19.09 And so, I think about that each day as I get ready 00:26:19.87\00:26:22.53 to run and realize that that's something 00:26:22.56\00:26:24.62 that drives me to be active. 00:26:24.65\00:26:27.82 I'm pretty close to that age, not quite there yet, 00:26:28.43\00:26:31.14 but I'm moving closer and closer each year, so my plan 00:26:31.17\00:26:33.85 is to get to 55, look at 55, and to keep 00:26:33.88\00:26:37.92 moving forward because I've got a tremendous amount 00:26:37.96\00:26:40.55 to live for. 00:26:40.82\00:26:42.30 So I hope today, that the things 00:26:42.34\00:26:44.32 that I've mentioned, perhaps have touched the chord 00:26:44.36\00:26:47.38 in your life and will act as a catalyst to motivate you 00:26:47.42\00:26:50.41 to adopt a more physically active lifestyle. 00:26:50.44\00:26:53.18 In 1 Corinthians 6:19,20 00:26:54.23\00:26:58.98 Paul says the following words: 00:26:59.02\00:27:01.60 "Do you not know that your body is a temple of the Holy Spirit" 00:27:01.99\00:27:05.38 "within you, which you have from God. " 00:27:05.41\00:27:09.06 "You are not your own, you were bought with a price," 00:27:09.10\00:27:12.67 "so glorify God in your body. " 00:27:13.19\00:27:15.70 What these verses say to me is that we must 00:27:16.30\00:27:19.45 treat our bodies with care 00:27:19.48\00:27:21.32 because we are God's creation, 00:27:21.85\00:27:24.08 His special creation, 00:27:24.11\00:27:26.07 we mean everything to Him 00:27:26.10\00:27:28.03 and because of that 00:27:28.06\00:27:29.55 it is God's desire that our bodies remain strong and fit 00:27:29.58\00:27:33.69 so that His Spirit can live in us 00:27:34.12\00:27:36.32 and guide our decisions. 00:27:36.35\00:27:37.95 God has given each of us the power of free choice. 00:27:38.24\00:27:41.35 We can decide to make changes in our lives 00:27:41.38\00:27:43.38 for the better if we want to. 00:27:43.41\00:27:45.35 I pray that the message that you've heard today 00:27:45.69\00:27:48.82 will help you to take that first step towards achieving 00:27:49.08\00:27:51.82 higher levels of wellness and health. 00:27:51.85\00:27:54.19 Remember that ordinary life is full of fitness 00:27:54.36\00:27:57.19 and activity opportunities, all we have to do 00:27:57.23\00:28:00.03 is to take hold of them. 00:28:00.08\00:28:02.10 In our next program we'll be talking about 00:28:02.95\00:28:04.80 the impact of physical activity in childhood obesity, 00:28:04.84\00:28:08.77 until then keep moving step by step 00:28:08.87\00:28:12.34 towards better health and fitness. 00:28:12.56\00:28:14.81