American College of Sports Medicine position stand
01 Jan 1997-Vol. 29, Iss: 5, pp 1669-1671
About: The article was published on 1997-01-01 and is currently open access. It has received 2945 citations till now. The article focuses on the topics: Sports medicine.
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TL;DR: The extent of the obesity epidemic, its risk factors—known and novel—, sequelae, and economic impact across the globe are discussed.
Abstract: The epidemic of overweight and obesity presents a major challenge to chronic disease prevention and health across the life course around the world. Fueled by economic growth, industrialization, mechanized transport, urbanization, an increasingly sedentary lifestyle, and a nutritional transition to processed foods and high-calorie diets over the last 30 years, many countries have witnessed the prevalence of obesity in its citizens double and even quadruple. A rising prevalence of childhood obesity, in particular, forebodes a staggering burden of disease in individuals and healthcare systems in the decades to come. A complex, multifactorial disease, with genetic, behavioral, socioeconomic, and environmental origins, obesity raises the risk of debilitating morbidity and mortality. Relying primarily on epidemiologic evidence published within the last decade, this non-exhaustive review discusses the extent of the obesity epidemic, its risk factors-known and novel-, sequelae, and economic impact across the globe.
1,841 citations
TL;DR: Physical inactivity is a primary cause of most chronic diseases as discussed by the authors, and the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life.
Abstract: Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause vs. treatment; physical activity and inactivity mechanisms differ; gene-environment interaction [including aerobic training adaptations, personalized medicine, and co-twin physical activity]; and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [Accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, non-alcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, preeclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life.
1,753 citations
TL;DR: The evidence for prescribing exercise therapy in the treatment of metabolic syndrome‐related disorders (insulin resistance, type 2 diabetes, dyslipidemia, hypertension, obesity), heart and pulmonary diseases, muscle, bone and joint diseases, and cancer, depression, asthma and type 1 diabetes is presented.
Abstract: Considerable knowledge has accumulated in recent decades concerning the significance of physical activity in the treatment of a number of diseases, including diseases that do not primarily manifest as disorders of the locomotive apparatus. In this review we present the evidence for prescribing exercise therapy in the treatment of metabolic syndrome-related disorders (insulin resistance, type 2 diabetes, dyslipidemia, hypertension, obesity), heart and pulmonary diseases (chronic obstructive pulmonary disease, coronary heart disease, chronic heart failure, intermittent claudication), muscle, bone and joint diseases (osteoarthritis, rheumatoid arthritis, osteoporosis, fibromyalgia, chronic fatigue syndrome) and cancer, depression, asthma and type 1 diabetes. For each disease, we review the effect of exercise therapy on disease pathogenesis, on symptoms specific to the diagnosis, on physical fitness or strength and on quality of life. The possible mechanisms of action are briefly examined and the principles for prescribing exercise therapy are discussed, focusing on the type and amount of exercise and possible contraindications.
1,317 citations
TL;DR: To estimate the healthcare costs of sarcopenia in the United States and to examine the effect that a reduced sarc Openia prevalence would have on healthcare expenditures.
Abstract: Objectives: To estimate the healthcare costs of sarcopenia in the United States and to examine the effect that a reduced sarcopenia prevalence would have on healthcare expenditures.
Design: Cross-sectional surveys.
Setting: Nationally representative surveys using data from the U.S. Census, Third National Health and Nutrition Examination Survey, and National Medical Care and Utilization Expenditure Survey.
Participants: Representative samples of U.S. adults aged 60 and older.
Measurements: The healthcare costs of sarcopenia were estimated based on the effect of sarcopenia on increasing physical disability risk in older persons. In the first step, the healthcare cost of disability in older Americans was estimated from national surveys. In the second step, the proportion of the disability cost due to sarcopenia (population-attributable risk) was calculated to determine the healthcare costs of sarcopenia. These calculations relied upon previously published relative risk values for disability in sarcopenic individuals and sarcopenia prevalence rates in the older population.
Results: The estimated direct healthcare cost attributable to sarcopenia in the United States in 2000 was $18.5 billion ($10.8 billion in men, $7.7 billion in women), which represented about 1.5% of total healthcare expenditures for that year. A sensitivity analysis indicated that the costs could be as low as $11.8 billion and as high as $26.2 billion. The excess healthcare expenditures were $860 for every sarcopenic man and $933 for every sarcopenic woman. A 10% reduction in sarcopenia prevalence would result in savings of $1.1 billion (dollars adjusted to 2000 rate) per year in U.S. healthcare costs.
Conclusion: Sarcopenia imposes a significant but modifiable economic burden on government-reimbursed healthcare services in the United States. Because the number of older Americans is increasing, the economic costs of sarcopenia will escalate unless effective public health campaigns aimed at reducing the occurrence of sarcopenia are implemented.
1,290 citations
TL;DR: Physical activities and movement intensity in patients with chronic obstructive pulmonary disease are assessed with the DynaPort activity monitor and functional exercise capacity is the strongest correlate of physical activities in daily life.
Abstract: Quantification of physical activities in daily life in patients with chronic obstructive pulmonary disease has increasing clinical interest.However,detailedcomparisonwithhealthysubjectsisnotavailable.Furthermore,itisunknownwhethertimespentactivelyduring daily life is related to lung function, muscle force, or maximal and functional exercise capacity. We assessed physical activities and movement intensity with the DynaPort activity monitor in 50 patients (age 64 7 years; FEV1 43 18% predicted) and 25 healthy elderly individuals (age 66 5 years). Patients showed lower walking time (44 26 vs. 81 26 minutes/day), standing time (191 99 vs. 295 109 minutes/day), and movement intensity during walking (1.8 0.3 vs. 2.4 0.5 m/second 2 ;p 0.0001 for all), as well as higher sitting time (374 139 vs. 306 108 minutes/day; p 0.04) and lying time (87 97 vs. 29 33 minutes/day; p 0.004). Walking time was highly correlated with the 6-minute walking test (r 0.76, p 0.0001) and more modestly to maximal exercise capacity, lung function, and muscle force (0.28 r 0.64, p 0.05). Patients with chronic obstructive pulmonary disease are
1,185 citations