March 25, 2010 at 5:41 am #33671
No wonder you’ve got middle-aged spread: Women need hour of exercise a day to keep it off
CHICAGO – Rev up the treadmill: Sobering new research spells out just how much exercise women need to keep the flab off as they age – and it’s a lot.
At least an hour of moderate activity a day is needed for older women at a healthy weight who aren’t dieting. For those who are already overweight – and that’s most American women – even more exercise is called for to avoid gaining weight without eating less, the study results suggest.
“We all have to work at it. If it were easy to be skinny, we would all be skinny,” said John Foreyt, a behavioural medicine expert who reviewed the study but wasn’t involved in the research.
Brisk walking, leisurely bicycling and golfing are all examples of moderate exercise. But don’t throw in the towel if you can’t do those things for at least an hour a day. Even a little exercise is good for your health even if it won’t make you thin, the researchers said.
Their findings are based on 34,079 non-dieting middle-aged women followed for about 13 years. The women gained an average of almost 6 pounds during the study.
Those who started out at a healthy weight, with a body mass index less than 25, and who gained little or no weight during the study consistently got the equivalent of about an hour of moderate activity daily. Few women – only 13 per cent – were in this category.
Few already overweight women got that amount of exercise, and the results suggest it wasn’t enough to stop them from gaining weight.
The results echo what gymfuls of middle-aged American women see every time they step off the treadmill and onto the scale.
“Talk to any group of women and they all say the same thing,” said Janet Katzin, 61, a “slightly overweight” marketing director from Long Island who exercises for an hour twice a week.
Thin as a younger adult, Katzin said the pounds started creeping up after she had her two children in the 1980s, despite exercising and watching what she eats. “It’s just extremely frustrating and discouraging.”
The study appears in Wednesday’s Journal of the American Medical Association. Only women were studied, so the researchers from Harvard’s Brigham and Women Hospital said it’s uncertain whether the results would apply to men.
The research “reinforces in a nice, clear way the idea of how difficult it is to maintain a healthy weight in our society,” said Foreyt, of the Baylor College of Medicine in Texas.
The results bolster a 2002 Institute of Medicine report that emphasized the importance of balancing diet and exercise and recommended at least 60 minutes daily of moderate activity for adults and children. But the study also indicates that the 2008 U.S. guidelines urging about a half-hour of exercise five days a week won’t stop weight gain while getting older without cutting calories, said Dr. I-Min Lee, the study’s lead author.
The study underscores some inevitabilities about aging. Men and women often put on weight, partly because their metabolism slows down. But that probably has less to do with it than people’s natural tendency to become more sedentary, without changing their eating habits, Lee said.
Hormonal changes in menopause also can make women prone to weight gain, especially around the belly.
Still, Lee emphasized that the benefits of exercise extend beyond what you see in the mirror, helping keep the heart healthy and protecting against chronic disease even if you don’t get enough activity to lose weight.
The researchers analyzed data on women who took part in a long-running federal study. Participants were 54 on average at the start and periodically reported how much they exercised and weighed. They also reported eating habits at the start, but not throughout, a limitation the authors acknowledged. Lee said the women’s eating habits were thought to be typical of American women who aren’t dieting.
Dr. Howard Eisenson, who heads Duke University’s diet and fitness centre, said it’s likely some women underestimated what they ate and overestimated how much they exercised, which could have skewed the results.
Still, Eisenson said he doesn’t encourage anybody to try to lose weight by exercise alone. To combat age-related weight gain, “you’re fighting in many cases a losing battle” if you don’t also cut calories, he said.
That doesn’t mean you have to starve yourself, but it does mean watching what you eat and avoiding frequent indulgences. People often don’t realize how quickly a bag of chips, an extra piece of cheese, a few glasses of wine or a candy bar add up.
“You can eat a candy bar in two minutes. Most are at least 200 calories,” and to burn that off requires walking for about an hour, Lee said. Knowing that equation can help people make wise decisions about activity and food choices, she said.March 28, 2010 at 12:29 pm #33672
Dr. Vincent Felitti, founder of Kaiser Permanente’s Department of Preventive Medicine and director of its obesity-treatment program, was seeing some good results. His patients were losing 50, 80, even hundreds of pounds. He might have considered the program a success, if not for the fact that the participants who were doing the best those who were both the most obese and losing the most weight kept dropping out.
Felitti was baffled. Why, invariably, did so many patients quit just as they approached their healthy goal weight? Ella, for instance, a middle-aged woman who entered the program in the mid-1980s morbidly obese at 295 lb., had managed to whittle her frame by 150 lb. over six months. “Instead of being happy, she was having anxiety attacks and was terrified,” Felitti says.
(See “The Year in Health 2009: From A to Z.”)
He asked Ella what she thought was going on. “Finally, the story comes out,” he says. “She had been molested as a child, both within her family and outside it. She tried to escape by marrying at 15, at her mother’s urging. It was a disastrous marriage her husband was crazy jealous. They divorced in two years. She remarried. Her new husband was also jealous. He was convinced that when she was out hanging the laundry, she was sexually posturing to attract the neighbors.”
When Ella was overweight, Felitti learned, her husband was less suspicious. And her fear of his rage perhaps he saw her new slimmer weight as a provocation? was probably spurring her anxiety.
Felitti wondered if there was something similar barring weight loss in other patients or causing obesity itself. In the late ’80s, he began a systematic study of 286 obese people, and discovered that 50% had been sexually abused as children. That rate is more than 50% higher than the rate normally reported by women, and more than triple the average rate in men. Indeed, the average rates of sexual abuse are themselves unsettling: according to a large 2003 study conducted by John Briere and Diana Elliott of the University of Southern California, 14% of men and 32% of women said they were molested at least once as children.
In recent years, studies by both Felitti and others have largely confirmed the association between sexual abuse as well as other types of traumatic childhood experience and eating disorders or obesity. A 2007 study of more than 11,000 California women found that those who had been abused as children were 27% more likely to be obese as adults, compared with those who had not, after adjusting for other factors. A 2009 study of more than 15,000 adolescents found that sexual abuse in childhood raised the risk of obesity 66% in males in adulthood. That study found no such effect in women, but did find a higher risk of eating disorders in sexually abused girls.
Discoveries by Felitti and colleagues have also helped give rise to broader work linking stressful experiences early in life as early as in the womb to effects on health and behavior later on, such as an increased risk of heart disease or becoming addicted to drugs. Scientists are finding that such effects are not only long-lasting, but can even be inherited by future generations.
In decades of experiments with rats, for instance, neuroscientist Michael Meaney at McGill University in Canada and his colleagues have shown how such environmentally induced traits can be passed down then undone, also by environment. Meaney studied rats with differing maternal styles some were naturally nurturing (they licked and groomed their pups constantly), others were less attentive and even neglectful (mother rats placed in stressful environments like isolation had greatly decreased capacity for nurture). What researchers found was that these behavioral traits were passed down to future generations: pups born to neglectful mothers endured stressful childhoods and grew up to become neglectful mothers themselves. But when babies born to stressed or less attentive mothers were instead placed with nurturing, affectionate mothers, that early experience changed the pups. They adapted quickly to the new mothering style and grew up to tend carefully to their own offspring. These pups’ adaptation was then passed to successive generations as well.
When Felitti first presented his Kaiser Permanente data connecting obesity with child molestation at a national meeting on obesity in 1990, most colleagues dismissed him immediately (one even claimed that obese people made up such stories to justify their “failed lives”). David Williamson, an epidemiologist at the Centers for Disease Control and Prevention (CDC), was the lone exception. He said that a large epidemiological study was needed to determine whether there were any implications of Felitti’s findings for public health.
Felitti knew that he had just the right data set: Kaiser Permanente has the largest medical-evaluation facility in the developed world, diagnosing some 58,000 patients annually. Even if only a minority agreed to discuss their childhoods and allow anonymous use of their medical records, that would be a huge sample. And so the Adverse Childhood Experiences (ACE) study was born, as a collaboration of Felitti and another CDC researcher, Dr. Robert Anda.
For the past several decades, the ACE study has recorded reports of negative childhood experiences in more than 17,000 patients. Adverse experiences include ongoing child neglect, living with one or no biological parent, having a mentally ill, incarcerated or drug-addicted parent, witnessing domestic violence, and sexual, physical or emotional abuse. The researchers then searched for correlations between these experiences and adult health and the risk of disease.March 28, 2010 at 2:08 pm #33674
And makes sense . . . You wound your heart and it can’t “feed” your earth as well,
so you look to outside sources; also the extra weight acts as a protective
mechanism keeping your core more insulated inside from the outside world.
Maybe this also explains why people tend to gain weight as they age . . .
SApril 2, 2010 at 11:46 pm #33676
My mother does body work at a place that helps very obese lose wait and they found a pattern of sexual abuse, especially in women.
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