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Physical activity and obesity prevention: a review of the current evidence

Published online by Cambridge University Press:  07 March 2007

Nicholas J. Wareham ,
Esther M. F. van Sluijs  and
Ulf Ekelund
Nicholas J. Wareham*
Affiliation:
Medical Research Council Epidemiology Unit, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
Esther M. F. van Sluijs
Affiliation:
Medical Research Council Epidemiology Unit, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
Ulf Ekelund
Affiliation:
Medical Research Council Epidemiology Unit, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK
*
Corresponding author: Dr Nicholas J. Wareham, fax +44 1223 330316, email nick.wareham@mrc-epid.cam.ac.uk
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Abstract

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Ecological data on temporal trends suggest that the rising prevalence of obesity is, at least in part, attributable to declining population energy expenditure. However, population-level data on trends in physical activity are scarce. In longitudinal cohort studies individuals who report higher levels of leisure-time physical activity tend to be less likely to gain weight, but studies vary in their conclusions because of issues of confounding, reverse causality and measurement error. The majority of studies suggest that low levels of activity are only weakly associated with future weight gain. Questions about dose–response can only be properly addressed by studies including objective measures of activity with known measurement error. The observational studies leave uncertainties about the direction of causality, as individuals who are overweight are less likely to stay active. Adjustment for confounding can diminish the impact of known confounders, but only randomisation can deal with issues of unmeasured confounding. Although there are a large number of clinical trials on the treatment of individuals with obesity or the prevention of weight regain among weight losers, the updated review of trials to prevent weight gain de novo only reveals six trials published since 2000 in adults and eleven in children. Not only are these trials relatively few in number but, for various methodological reasons, they are uncertain in their conclusions about whether increasing activity will be effective in preventing obesity. Whilst efforts should continue to enhance the evidence base it is wise, in the meantime, to stick to the consensus public health advice of advocating 45–60 min moderate intensity activity daily to prevent obesity.

Keywords

Physical activityWeight gainCritical reviewObesity

Information

Type
Symposium on ‘Prevention of obesity’
Information
Proceedings of the Nutrition Society , Volume 64 , Issue 2 , May 2005 , pp. 229 - 247
Copyright
Copyright © The Nutrition Society 2005

References

Ball, K, Brown, W & Crawford, D (2002) Who does not gain weight? Prevalence and predictors of weight maintenance in young women. International Journal of Obesity and Related Metabolic Disorders 26, 1570–1578.CrossRefGoogle ScholarPubMed
Baranowski, T, Baranowski, JC, Cullen, KW, Thompson, DI, Nicklas, T, Zakeri, IE & Rochon, J (2003) The Fun, Food, and Fitness Project (FFFP): the Baylor GEMS pilot study. Ethnicity and Disease 13, S30–S39.Google Scholar
Bell, AC, Ge, K & Popkin, BM (2001) Weight gain and its predictors in Chinese adults. International Journal of Obesity and Related Metabolic Disorders 25, 1079–1086.CrossRefGoogle ScholarPubMed
Berkey, CS, Rockett, HR, Field, AE, Gillman, MW, Frazier, AL, Camargo, CA Jr & Colditz, GA (2000) Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics 105 E56.Google Scholar
Berkey, CS, Rockett, HR, Gillman, MW & Colditz, GA (2003) One-year changes in activity and in inactivity among 10- to 15-year-old boys and girls: relationship to change in body mass index. Pediatrics 111, 836–843.Google Scholar
Bogaert, N, Steinbeck, KS, Baur, LA, Brock, K & Bermingham, MA (2003) Food, activity and family – environmental vs biochemical predictors of weight gain in children. European Journal of Clinical Nutrition 57, 1242–1249.Google Scholar
Burke, V, Giangiulio, N, Gillam, HF, Beilin, LJ & Houghton, S (2003) Physical activity and nutrition programs for couples: a randomized controlled trial. Journal of Clinical Epidemiology 56, 421–432.CrossRefGoogle ScholarPubMed
Caballero, B, Clay, T, Davis, SM, Ethelbah, B, Rock, BH, Lohman, T, Norman, J, Story, M, Stone, EJ, Stephenson, L & Stevens, J (2003) Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren. American Journal of Clinical Nutrition 78, 1030–1038.CrossRefGoogle ScholarPubMed
Campbell, K, Waters, E, O'Meara, S & Summerbell, C (2001) Interventions for preventing obesity in childhood. A systematic review. Obesity Reviews 2, 149–157.CrossRefGoogle ScholarPubMed
Davison, KK & Birch, LL (2001) Child and parent characteristics as predictors of change in girls' body mass index. International Journal of Obesity and Related Metabolic Disorders 25, 1834–1842.CrossRefGoogle ScholarPubMed
Dennison, BA, Russo, TJ, Burdick, PA & Jenkins, PL (2004) An intervention to reduce television viewing by preschool children. Archives of Pediatric and Adolescent Medicine 158, 170–176.Google Scholar
Department of Health (2004a) At Least Five a Week: Evidence on the Impact of Physical Activity and its Relationship to Health London Department of HealthGoogle Scholar
Department of Health (2003b) Health Survey for England 2003, latest trends. http://www.dh.gov.uk/PublicationsAndStatistics/PublishedSurvey/HealthSurveyForEngland/fs/enGoogle Scholar
Department for Transport (2004) National Travel Survey: 2002. http://www.dft.gov.uk/stellent/groups/dft_transstats/documents/divisionhomepage/028941.hcspGoogle Scholar
Droyvold, WB, Holmen, J, Midthjell, K & Lydersen, S (2004) BMI change and leisure time physical activity (LTPA): an 11-y follow-up study in apparently healthy men aged 20–69 y with normal weight at baseline. International Journal of Obesity and Related Metabolic Disorders 28, 410–417.CrossRefGoogle ScholarPubMed
Ekelund, U, Brage, S, Franks, PW, Hennings, S, Emms, S, Wong, MY & Wareham, NJ (2005) Physical activity energy expenditure predicts change in body composition in healthy Caucasians: effect modification by age. American Journal of Clinical Nutrition.Google Scholar
Ekelund, U, Poortvliet, E, Nilsson, A, Yngve, A, Holmberg, A, Sjöström, M (2001) Physical activity in relation to aerobic fitness and body fat in 14- to 15-year-old boys and girls. European Journal of Applied Physiology 85, 195–201.CrossRefGoogle ScholarPubMed
Figueroa-Colon, R, Arani, RB, Goran, MI & Weinsier, RL (2000) Paternal body fat is a longitudinal predictor of changes in body fat in premenarcheal girls. American Journal of Clinical Nutrition 71, 829–834.CrossRefGoogle ScholarPubMed
Fogelholm, M, Kukkonen-Harjula, K (2000) Does physical activity prevent weight gain – a systematic review. Obesity Reviews 1, 95–111.CrossRefGoogle ScholarPubMed
Francis, LA, Lee, Y & Birch, LL (2003) Parental weight status and girls' television viewing, snacking, and body mass indexes. Obesity Research 11, 143–151.CrossRefGoogle ScholarPubMed
Ham, SA, Yore, MM, Fulton, JE & Kohl, HW (2004) Prevalence of no leisure-time physical activity – 35 states and the district of Columbia, 1988–2002. Morbidity and Mortality Weekly Report 53, 82–86.Google Scholar
Hancox, RJ, Milne, BJ & Poulton, R (2004) Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. Lancet 364, 257–262.CrossRefGoogle Scholar
Hardeman, W, Griffin, S, Johnston, M, Kinmonth, A & Wareham, NJ (2000) Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. International Journal of Obesity and Related Metabolic Disorders 24, 131–143.Google Scholar
Horn, OK, Paradis, G, Potvin, L, Macaulay, AC & Desrosiers, S (2001) Correlates and predictors of adiposity among Mohawk children. Preventive Medicine 33, 274–281.CrossRefGoogle ScholarPubMed
Hu, FB, Li, TY, Colditz, GA, Willett, WC & Manson, JE (2003) Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. Journal of the American Medical Association 289, 1785–1791.CrossRefGoogle ScholarPubMed
Johnson, MS, Figueroa-Colon, R, Herd, SL, Fields, DA, Sun, M, Hunter, GR & Goran, MI (2000) Aerobic fitness, not energy expenditure, influences subsequent increase in adiposity in black and white children. Pediatrics 106 E50.CrossRefGoogle Scholar
Kain, J, Uauy, R, Albala Vio, F, Cerda, R, Leyton, B (2004) School-based obesity prevention in Chilean primary school children: methodology and evaluation of a controlled study. International Journal of Obesity and Related Metabolic Disorders 28, 483–493.CrossRefGoogle ScholarPubMed
Kimm, SY, Barton, BA, Obarzanek, E, McMahon, RP, Sabry, ZI, Waclawiw, MA, Schreiber, GB, Morrison, JA, Similo, S & Daniels, SR (2001) Racial divergence in adiposity during adolescence: The NHLBI Growth and Health Study. Pediatrics 107 E34.Google Scholar
Koh-Banerjee, P, Chu, NF, Spiegelman, D, Rosner, B, Colditz, G, Willett, W & Rimm, E (2003) Prospective study of the association of changes in dietary intake, physical activity, alcohol consumption, and smoking with 9-y gain in waist circumference among 16 587 US men. American Journal of Clinical Nutrition 78, 719–727.CrossRefGoogle Scholar
Litterell, K, Hilligoss, N, Kirshner, C, Petty, R & Johnson, C (2003) The effects of an educational intervention on antipsychotic-induced weight gain. Journal of Nursing Scholarship 35, 237–241.CrossRefGoogle Scholar
Macdonald, HM, New, SA, Campbell, MK & Reid, DM (2003) Longitudinal changes in weight in perimenopausal and early postmenopausal women: effects of dietary energy intake, energy expenditure, dietary calcium intake and hormone replacement therapy. International Journal of Obesity and Related Metabolic Disorders 27, 669–676.CrossRefGoogle ScholarPubMed
McMurray, RG, Harrell, JS, Bangdiwala, SI, Bradley, CB, Deng, S & Levine, A (2002) A school-based intervention can reduce body fat and blood pressure in young adolescents. Journal of Adolescent Health 31, 125–132.CrossRefGoogle ScholarPubMed
Mamalakis, G, Kafatos, A, Manios, Y, Anagnostopoulou, T & Apostolaki, I (2000) Obesity indices in a cohort of primary school children in Crete: a six year prospective study. International Journal of Obesity and Related Metabolic Disorders 24, 765–771.CrossRefGoogle Scholar
Mokdad, AH, Ford, ES, Bowman, BA, Dietz, WH, Vinicor, F, Bales, VS & Marks, JS (2003) Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Journal of the American Medical Association 289, 76–79.CrossRefGoogle ScholarPubMed
Molnar, D & Livingstone, B (2000) Physical activity in relation to overweight and obesity in children and adolescents. European Journal of Pediatrics 159 Suppl. 1, S45–S55.Google Scholar
Moore, LL, Gao, D, Bradlee, ML, Cupples, LA, Sundarajan-Ramamurti, A, Proctor, MH, Hood, MY, Singer, MR & Ellison, RC (2003) Does early physical activity predict body fat change throughout childhood. Preventive Medicine 37, 10–17.Google Scholar
Muto, T & Yamauchi, K (2001) Evaluation of a multicomponent workplace health promotion program conducted in Japan for improving employees' cardiovascular disease risk factors. Preventive Medicine 33, 571–577.CrossRefGoogle ScholarPubMed
Neumark-Sztainer, D, Story, M, Hannan, PJ & Rex, J (2003) New Moves: a school-based obesity prevention program for adolescent girls. Preventive Medicine 37, 41–51.CrossRefGoogle ScholarPubMed
O'Loughlin, J, Gray-Donald, K, Paradis, G & Meshefedjian, G (2000) One- and two-year predictors of excess weight gain among elementary schoolchildren in multiethnic, low-income, inner-city neighborhoods. American Journal of Epidemiology 152, 739–746.CrossRefGoogle ScholarPubMed
Pangrazi, RP, Beighle, A, Vehige, T & Vack, C (2003) Impact of Promoting Lifestyle Activity for Youth (PLAY) on children's physical activity. Journal of School Health 73, 317–321.CrossRefGoogle ScholarPubMed
Petersen, L, Schnohr, P & Sorensen, TI (2004) Longitudinal study of the long-term relation between physical activity and obesity in adults. International Journal of Obesity and Related Metabolic Disorders 28, 105–112.Google Scholar
Polley, BA, Wing, RR & Sims, CJ (2002) Randomized controlled trial to prevent excessive weight gain in pregnant women. International Journal of Obesity and Related Metabolic Disorders 26, 1494–1502.Google Scholar
Proctor, MH, Moore, LL, Gao, D, Cupples, LA, Bradlee, ML, Hood, MY & Ellison, RC (2003) Television viewing and change in body fat from preschool to early adolescence: The Framingham Children's Study. International Journal of Obesity and Related Metabolic Disorders 27, 827–833.CrossRefGoogle ScholarPubMed
Proper, KI, Hildebrandt, VH, Van der, Beek, AJ, Twisk, JW, Van & Mechelen, W (2003) Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting. American Journal of Preventive Medicine 24, 218–226.CrossRefGoogle Scholar
Rainwater, DL, Mitchell, BD, Comuzzie, AG, VandeBerg, JL, Stern, MP & MacCluer, JW (2000) Association among 5-year changes in weight, physical activity, and cardiovascular disease risk factors in Mexican Americans. American Journal of Epidemiology 152, 974–982.CrossRefGoogle ScholarPubMed
Rennie, KL & Wareham, NJ (1998) The validation of physical activity instruments for measuring energy expenditure: problems and pitfalls. Public Health Nutrition 1, 265–271.Google Scholar
Rickards, L, Fox, K, Roberts, C, Fletcher, L & & Goddard, E (2004) Living in Britain: results from the 2002 General Household Survey. www.statistics.gov.uk/libGoogle Scholar
Robinson, TN, Killen, JD, Kraemer, HC, Wilson, DM, Matheson, DM, Haskell, WL et al. (2003) Dance and reducing television viewing to prevent weight gain in African-American girls: the Stanford GEMS pilot study. Ethnicity and Disease 13, S65–S77.Google ScholarPubMed
Sahota, P, Rudolf, MC, Dixey, R, Hill, AJ, Barth, JH & Cade, J (2001) Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. British Medical Journal 323, 1029–1032.Google Scholar
Sallis, JF, McKenzie, TL, Conway, TL, Elder, JP, Prochaska, JJ, Brown, M, Zive, MM, Marshall, SJ & Alcaraz, JE (2003) Environmental interventions for eating and physical activity: a randomized controlled trial in middle schools. American Journal of Preventive Medicine 24, 209–217.CrossRefGoogle ScholarPubMed
Saris, WH, Blair, SN, van Baak, MA, Eaton, SB, Davies, PS, Di Pietro, L et al. (2003) How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement. Obesity Reviews 4, 101–114.Google Scholar
Schmitz, KH, Jacobs, DR Jr, Leon, AS, Schreiner, PJ & Sternfeld, B (2000) Physical activity and body weight: associations over ten years in the CARDIA study. Coronary Artery Risk Development in Young Adults. International Journal of Obesity and Related Metabolic Disorders 24, 1475–1487.CrossRefGoogle ScholarPubMed
Sherwood, NE, Jeffery, RW, French, SA, Hannan, PJ & Murray, DM (2000) Predictors of weight gain in the Pound of Prevention study. International Journal of Obesity and Related Metabolic Disorders 24, 395–403.CrossRefGoogle ScholarPubMed
Simkin-Silverman, LR, Wing, RR, Boraz, MA & Kuller, LH (2003) Lifestyle intervention can prevent weight gain during menopause: results from a 5-year randomized clinical trial. Annals of Behavioral Medicine 26, 212–220.Google Scholar
Sports Council and Health Education Authority (1992) Allied Dunbar National Fitness Survey: Technical Report London Health Education AuthorityGoogle Scholar
Tanner, JM (1962) Growth at Adolescence. Oxford: Blackwell.Google Scholar
Tammelin, T, Laitinen, J & Nayha, S (2004) Change in the level of physical activity from adolescence into adulthood and obesity at the age of 31 years. International Journal of Obesity and Related Metabolic Disorders 28, 775–782.CrossRefGoogle Scholar
Tataranni, PA, Harper, IT, Snitker, S, Del, Parigi, A, Vozarova, B, Bunt, J, Bogardus, Ravussin, E (2003) Body weight gain in free-living Pima Indians: effect of energy intake vs expenditure. International Journal of Obesity and Related Metabolic Disorders 27, 1578–1583.Google Scholar
Treuth, MS, Butte, NF & Sorkin, JD (2003) Predictors of body fat gain in nonobese girls with a familial predisposition to obesity. American Journal of Clinical Nutrition 78, 1212–1218.Google Scholar
Wagner, A, Simon, C, Ducimetiere, P, Montaye, M, Bongard, V, Yarnell, J et al. (2001) Leisure-time physical activity and regular walking or cycling to work are associated with adiposity and 5 y weight gain in middle-aged men: the PRIME Study. International Journal of Obesity and Related Metabolic Disorders 25, 940–948.CrossRefGoogle ScholarPubMed
Wareham, NJ, Jakes, RW, Rennie, KL, Mitchell, J, Hennings, S & Day, NE (2002) Validity and repeatability of the EPIC-Norfolk Physical Activity Questionnaire. International Journal of Epidemiology 31, 168–174.Google Scholar
Wareham, NJ & Rennie, KL (1998) The assessment of physical activity in individuals and populations: Why try to be more precise about how physical activity is assessed. International Journal of Obesity and Related Metabolic Disorders 22, S30–S38.Google Scholar
Warren, JM, Henry, CJ, Lightowler, HJ, Bradshaw, SM & Perwaiz, S (2003) Evaluation of a pilot school programme aimed at the prevention of obesity in children. Health Promotion International 18, 287–296.Google Scholar
Wells, JC & Ritz, P (2001) Physical activity at 9–12 months and fatness at 2 years of age. American Journal of Human Biology 13, 384–389.Google Scholar
Wenche, DB, Holmen, J, Kruger, O & Midthjell, K (2004) Leisure time physical activity and change in body mass index: an 11-year follow-up study of 9357 normal weight health women 20–49 years old. Journal of Women's Health 13, 55–62.Google Scholar