Trends over 5 decades in U.S. occupation-related physical activity and their associations with obesity.
TL;DR: It is estimated that daily occupation-related energy expenditure has decreased by more than 100 calories, and this reduction in energy expenditure accounts for a significant portion of the increase in mean U.S. body weights for women and men over the last 50 years.
Abstract: Background The true causes of the obesity epidemic are not well understood and there are few longitudinal population-based data published examining this issue The objective of this analysis was to examine trends in occupational physical activity during the past 5 decades and explore how these trends relate to concurrent changes in body weight in the US Methodology/Principal Findings Analysis of energy expenditure for occupations in US private industry since 1960 using data from the US Bureau of Labor Statistics Mean body weight was derived from the US National Health and Nutrition Examination Surveys (NHANES) In the early 1960's almost half the jobs in private industry in the US required at least moderate intensity physical activity whereas now less than 20% demand this level of energy expenditure Since 1960 the estimated mean daily energy expenditure due to work related physical activity has dropped by more than 100 calories in both women and men Energy balance model predicted weights based on change in occupation-related daily energy expenditure since 1960 for each NHANES examination period closely matched the actual change in weight for 40–50 year old men and women For example from 1960–62 to 2003–06 we estimated that the occupation-related daily energy expenditure decreased by 142 calories in men Given a baseline weight of 769 kg in 1960–02, we estimated that a 142 calories reduction would result in an increase in mean weight to 897 kg, which closely matched the mean NHANES weight of 918 kg in 2003–06 The results were similar for women Conclusion Over the last 50 years in the US we estimate that daily occupation-related energy expenditure has decreased by more than 100 calories, and this reduction in energy expenditure accounts for a significant portion of the increase in mean US body weights for women and men
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Marie Ng1, Tom P Fleming1, Margaret Robinson1, Blake Thomson1, Nicholas Graetz1, Christopher Margono1, Erin C Mullany1, Stan Biryukov1, Cristiana Abbafati2, Semaw Ferede Abera3, Jerry Abraham4, Niveen M E Abu-Rmeileh, Tom Achoki1, Fadia AlBuhairan5, Zewdie Aderaw Alemu6, Rafael Alfonso1, Mohammed K. Ali7, Raghib Ali8, Nelson Alvis Guzmán9, Walid Ammar, Palwasha Anwari10, Amitava Banerjee11, Simón Barquera, Sanjay Basu12, Derrick A Bennett8, Zulfiqar A Bhutta13, Jed D. Blore14, N Cabral, Ismael Ricardo Campos Nonato, Jung-Chen Chang15, Rajiv Chowdhury16, Karen J. Courville, Michael H. Criqui17, David K. Cundiff, Kaustubh Dabhadkar7, Lalit Dandona1, Lalit Dandona18, Adrian Davis19, Anand Dayama7, Samath D Dharmaratne20, Eric L. Ding21, Adnan M. Durrani22, Alireza Esteghamati23, Farshad Farzadfar23, Derek F J Fay19, Valery L. Feigin24, Abraham D. Flaxman1, Mohammad H. Forouzanfar1, Atsushi Goto, Mark A. Green25, Rajeev Gupta, Nima Hafezi-Nejad23, Graeme J. Hankey26, Heather Harewood, Rasmus Havmoeller27, Simon I. Hay8, Lucia Hernandez, Abdullatif Husseini28, Bulat Idrisov29, Nayu Ikeda, Farhad Islami30, Eiman Jahangir31, Simerjot K. Jassal17, Sun Ha Jee32, Mona Jeffreys33, Jost B. Jonas34, Edmond K. Kabagambe35, Shams Eldin Ali Hassan Khalifa, Andre Pascal Kengne36, Yousef Khader37, Young-Ho Khang38, Daniel Kim39, Ruth W Kimokoti40, Jonas Minet Kinge41, Yoshihiro Kokubo, Soewarta Kosen, Gene F. Kwan42, Taavi Lai, Mall Leinsalu22, Yichong Li, Xiaofeng Liang43, Shiwei Liu43, Giancarlo Logroscino44, Paulo A. Lotufo45, Yuan Qiang Lu21, Jixiang Ma43, Nana Kwaku Mainoo, George A. Mensah22, Tony R. Merriman46, Ali H. Mokdad1, Joanna Moschandreas47, Mohsen Naghavi1, Aliya Naheed48, Devina Nand, K.M. Venkat Narayan7, Erica Leigh Nelson1, Marian L. Neuhouser49, Muhammad Imran Nisar13, Takayoshi Ohkubo50, Samuel Oti, Andrea Pedroza, Dorairaj Prabhakaran, Nobhojit Roy51, Uchechukwu K.A. Sampson35, Hyeyoung Seo, Sadaf G. Sepanlou23, Kenji Shibuya52, Rahman Shiri53, Ivy Shiue54, Gitanjali M Singh21, Jasvinder A. Singh55, Vegard Skirbekk41, Nicolas J. C. Stapelberg56, Lela Sturua57, Bryan L. Sykes58, Martin Tobias1, Bach Xuan Tran59, Leonardo Trasande60, Hideaki Toyoshima, Steven van de Vijver, Tommi Vasankari, J. Lennert Veerman61, Gustavo Velasquez-Melendez62, Vasiliy Victorovich Vlassov63, Stein Emil Vollset64, Stein Emil Vollset41, Theo Vos1, Claire L. Wang65, Xiao Rong Wang66, Elisabete Weiderpass, Andrea Werdecker, Jonathan L. Wright1, Y Claire Yang67, Hiroshi Yatsuya68, Jihyun Yoon, Seok Jun Yoon69, Yong Zhao70, Maigeng Zhou, Shankuan Zhu71, Alan D. Lopez14, Christopher J L Murray1, Emmanuela Gakidou1 •
University of Washington1, Sapienza University of Rome2, Mekelle University3, University of Texas at San Antonio4, King Saud bin Abdulaziz University for Health Sciences5, Debre markos University6, Emory University7, University of Oxford8, University of Cartagena9, United Nations Population Fund10, University of Birmingham11, Stanford University12, Aga Khan University13, University of Melbourne14, National Taiwan University15, University of Cambridge16, University of California, San Diego17, Public Health Foundation of India18, Public Health England19, University of Peradeniya20, Harvard University21, National Institutes of Health22, Tehran University of Medical Sciences23, Auckland University of Technology24, University of Sheffield25, University of Western Australia26, Karolinska Institutet27, Birzeit University28, Brandeis University29, American Cancer Society30, Ochsner Medical Center31, Yonsei University32, University of Bristol33, Heidelberg University34, Vanderbilt University35, South African Medical Research Council36, Jordan University of Science and Technology37, New Generation University College38, Northeastern University39, Simmons College40, Norwegian Institute of Public Health41, Boston University42, Chinese Center for Disease Control and Prevention43, University of Bari44, University of São Paulo45, University of Otago46, University of Crete47, International Centre for Diarrhoeal Disease Research, Bangladesh48, Fred Hutchinson Cancer Research Center49, Teikyo University50, Bhabha Atomic Research Centre51, University of Tokyo52, Finnish Institute of Occupational Health53, Heriot-Watt University54, University of Alabama at Birmingham55, Griffith University56, National Center for Disease Control and Public Health57, University of California, Irvine58, Johns Hopkins University59, New York University60, University of Queensland61, Universidade Federal de Minas Gerais62, National Research University – Higher School of Economics63, University of Bergen64, Columbia University65, Shandong University66, University of North Carolina at Chapel Hill67, Fujita Health University68, Korea University69, Chongqing Medical University70, Zhejiang University71
TL;DR: The global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013 is estimated using a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs).
9,180 citations
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TL;DR: In this article, a broad view of health behaviour causation, with the social and physical environment included as contributors to physical inactivity, particularly those outside the health sector, such as urban planning, transportation systems, and parks and trails, is presented.
3,063 citations
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TL;DR: These guidelines are a revision of the 1995 standards of the AHA that addressed the issues of exercise testing and training and current issues of practical importance in the clinical use of these standards are considered.
Abstract: The purpose of this report is to provide revised standards and guidelines for the exercise testing and training of individuals who are free from clinical manifestations of cardiovascular disease and those with known cardiovascular disease. These guidelines are intended for physicians, nurses, exercise physiologists, specialists, technologists, and other healthcare professionals involved in exercise testing and training of these populations. This report is in accord with the “Statement on Exercise” published by the American Heart Association (AHA).1
These guidelines are a revision of the 1995 standards of the AHA that addressed the issues of exercise testing and training.2 An update of background, scientific rationale, and selected references is provided, and current issues of practical importance in the clinical use of these standards are considered. These guidelines are in accord with the American College of Cardiology (ACC)/AHA Guidelines for Exercise Testing.3
### The Cardiovascular Response to Exercise
Exercise, a common physiological stress, can elicit cardiovascular abnormalities that are not present at rest, and it can be used to determine the adequacy of cardiac function. Because exercise is only one of many stresses to which humans can be exposed, it is more appropriate to call an exercise test exactly that and not a “stress test.” This is particularly relevant considering the increased use of nonexercise stress tests.
### Types of Exercise
Three types of muscular contraction or exercise can be applied as a stress to the cardiovascular system: isometric (static), isotonic (dynamic or locomotory), and resistance (a combination of isometric and isotonic).4,5 Isotonic exercise, which is defined as a muscular contraction resulting in movement, primarily provides a volume load to the left ventricle, and the response is proportional to the size of the working muscle mass and the intensity of exercise. Isometric exercise is defined as a muscular contraction without movement (eg, handgrip) and imposes greater pressure than volume …
2,964 citations
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TL;DR: In this article, the authors summarise present global efforts to counteract this problem and point the way forward to address the pandemic of physical inactivity, concluding that, although evidence for the benefits of physical activity for health has been available since the 1950s, promotion to improve the health of populations has lagged in relation to the available evidence.
2,186 citations
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TL;DR: Treatments for obesity include behavioral therapy, pharmacotherapy, and bariatric surgery, and some sequelae of obesity are reversed with weight loss.
Abstract: Obesity is prevalent in the U.S. population and contributes significantly to morbidity and mortality. Treatments include behavioral therapy, pharmacotherapy, and bariatric surgery. Some sequelae of obesity are reversed with weight loss. Maintaining weight loss is a challenge.
1,093 citations
References
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01 Jan 2014TL;DR: In this paper, the authors discuss the benefits and risks associated with physical activity and propose a general principles of exercise prescription for healthy populations with special consideration and environmental consideration, as well as a prescription for patients with chronic diseases and health conditions.
Abstract: SECTION I: HEALTH APPRAISAL AND RISK ASSESSMENT 1 Benefits and Risks Associated with Physical Activity 2 Preparticipation Health Screening SECTION II: EXERCISE TESTING 3 Preexercise Evaluation 4 Health-Related Physical Fitness Testing and Interpretation 5 Clinical Exercise Testing 6 Interpretation of Clinical Exercise Test Results SECTION III: EXERCISE PRESCRIPTION 7 General Principles of Exercise Prescription 8 Exercise Prescription for Healthy Populations With Special Considerations and Environmental Considerations 9 Exercise Prescription For Patients With Cardiovascular and Cerebrovascular Disease 10 Exercise Prescription for Populations With Other Chronic Diseases and Health Conditions 11 Behavioral Theories and Strategies for Promoting Exercise SECTION IV: APPENDICES Appendix A Common Medications Appendix B Medical Emergency Management Appendix C Electrocardiogram Interpretation Appendix D American College of Sports Medicine Certifications Appendix E Contributing Authors to the Previous Two Editions
10,477 citations
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TL;DR: The increases in the prevalence of obesity previously observed do not appear to be continuing at the same rate over the past 10 years, particularly for women and possibly for men.
Abstract: Results In 2007-2008, the age-adjusted prevalence of obesity was 33.8% (95% confidence interval [CI], 31.6%-36.0%) overall, 32.2% (95% CI, 29.5%-35.0%) among men, and 35.5% (95% CI, 33.2%-37.7%) among women. The corresponding prevalence estimates for overweight and obesity combined (BMI 25) were 68.0% (95% CI, 66.3%-69.8%), 72.3% (95% CI, 70.4%-74.1%), and 64.1% (95% CI, 61.3%66.9%). Obesity prevalence varied by age group and by racial and ethnic group for both men and women. Over the 10-year period, obesity showed no significant trend among women (adjusted odds ratio [AOR] for 2007-2008 vs 1999-2000, 1.12 [95% CI, 0.89-1.32]). For men, there was a significant linear trend (AOR for 2007-2008 vs 1999-2000, 1.32 [95% CI, 1.12-1.58]); however, the 3 most recent data points did not differ significantly from each other.
7,730 citations
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...are well documented [1,2]....
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Russell R. Pate1, Michael Pratt1, Steven N. Blair1, William L. Haskell1, Caroline A. Macera1, Claude Bouchard1, David Buchner1, Walter H. Ettinger1, Gregory W. Heath1, Abby C. King1, Andrea M. Kriska1, Arther S. Leon, Bess H. Marcus1, Jeremy N. Morris1, Ralph S. Paffenbarger1, Kevin Patrick1, Michael L. Pollock1, James Rippe1, James F. Sallis1, Jack H. Wilmore1 •
TL;DR: Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week.
Abstract: Objective. —To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. Participants. —A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. Evidence. —The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. Consensus Process. —Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. Conclusion. —Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week. ( JAMA . 1995;273:402-407)
7,519 citations
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...9 METs) [12–14]....
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TL;DR: Objective and subjective measures of physical activity give qualitatively similar results regarding gender and age patterns of activity, however, adherence to physical activity recommendations according to accelerometer-measured activity is substantially lower than according to self-report.
Abstract: Purpose:To describe physical activity levels of children (6-11 yr), adolescents (12-19 yr), and adults (20+ yr), using objective data obtained with accelerometers from a representative sample of the U.S. population.Methods:These results were obtained from the 2003-2004 National Health and Nu
6,762 citations
"Trends over 5 decades in U.S. occup..." refers background in this paper
...It is important to note that when physical activity is assessed with accelerometers the number of Americans that achieve the physical activity recommendations falls to 1 in 20 [20]....
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TL;DR: The increases in the prevalences of obesity and overweight previously observed continued in 1999-2000, and increases occurred for both men and women in all age groups and for non-Hispanic whites, non- Hispanic blacks, and Mexican Americans.
Abstract: ContextThe prevalence of obesity and overweight increased in the United States
between 1978 and 1991. More recent reports have suggested continued increases
but are based on self-reported data.ObjectiveTo examine trends and prevalences of overweight (body mass index [BMI]
≥25) and obesity (BMI ≥30), using measured height and weight data.Design, Setting, and ParticipantsSurvey of 4115 adult men and women conducted in 1999 and 2000 as part
of the National Health and Nutrition Examination Survey (NHANES), a nationally
representative sample of the US population.Main Outcome MeasureAge-adjusted prevalence of overweight, obesity, and extreme obesity
compared with prior surveys, and sex-, age-, and race/ethnicity–specific
estimates.ResultsThe age-adjusted prevalence of obesity was 30.5% in 1999-2000 compared
with 22.9% in NHANES III (1988-1994; P<.001).
The prevalence of overweight also increased during this period from 55.9%
to 64.5% (P<.001). Extreme obesity (BMI ≥40)
also increased significantly in the population, from 2.9% to 4.7% (P = .002). Although not all changes were statistically significant,
increases occurred for both men and women in all age groups and for non-Hispanic
whites, non-Hispanic blacks, and Mexican Americans. Racial/ethnic groups did
not differ significantly in the prevalence of obesity or overweight for men.
Among women, obesity and overweight prevalences were highest among non-Hispanic
black women. More than half of non-Hispanic black women aged 40 years or older
were obese and more than 80% were overweight.ConclusionsThe increases in the prevalences of obesity and overweight previously
observed continued in 1999-2000. The potential health benefits from reduction
in overweight and obesity are of considerable public health importance.
6,523 citations