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3 AUTHORS:
Antonio Paoli
Tatiana Moro
University of Padova
University of Padova
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Antonino Bianco
Universit degli Studi di Palermo
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doi: 10.1111/cpf.12136
INVITED REVIEW
Department of Biomedical Sciences, University of Padova, Padova, and 2Department of Sports and Exercise Science (DISMOT), University of Palermo, Palermo,
Italy
Summary
Correspondence
Antonio Paoli MD, Department of Biomedical Sciences, The physiological Laboratory, via Marzolo,
3 35131 University of Padova, Padova, Italy.
E-mail: antonio.paoli@unipd.it
Key words
excess postexercise oxygen consumption; exercise;
metabolism; overweight; resistance training; weight
control
Although resistance training (RT) has long been accepted as a means for developing and maintaining muscular strength, endurance, power and muscle mass, its
beneficial relationship with health factors and chronic disease has only recently
been recognized in the scientific literature. Prior to 1990, resistance training was
not a part of the recommended guidelines for exercise training and rehabilitation
for either the American Heart Association or the American College of Sports Medicine (ACSM). In 1990, the ACSM recognized resistance training as a significant
component of a comprehensive fitness programme for healthy adults of all ages, a
position subsequently confirmed few years after. At present, even though interest
in clinical applications of RT is increasing, there are still some concerns, among
physicians, about the use of this exercise methodology in weight control programmes. This review aims to explore the metabolic effects of RT and its efficacy
and feasibility in overweight subjects.
Introduction
Health organizations report a worldwide increase in the prevalence of overweight and obesity (Olshansky et al., 2005). This
increase is a great source of concern considering the fact that
obesity and in particular abdominal obesity is one of the principle risk factors for cardiovascular disease, and it is strongly
related to dyslipidaemia, hypertension, diabetes and metabolic
syndrome (Koh-Banerjee et al., 2004). Diet and exercise are
considered the main tools to control body weight and body
fat (Paoli et al., 2008), but nevertheless the exact dose and
quality of diet (Paoli et al., 2013a,b) and exercise is still a
subject of debate (Paoli et al., 2012a,b). The correct dose and
quality of exercise, that is, the knowledge of how and how
much should be suggested to patients is of importance for
clinicians and medicine practitioners. The main question about
the effect of exercise on body weight regards the influence it
has on energy expenditure. Overall, daily energy expenditure
may be briefly divided into three different components that
can be categorized as (i) resting metabolism, (ii) thermic
effects of food and (iii) the energy expenditure of physical
activity associated with exercise and non-exercise movement
(Jequier, 2002). It has been demonstrated that in Western
countries, the mean ratio of daily energy expenditure and
resting energy expenditure (REE) is 166; in other words,
only 40% of energy is expended on activity while the remaining
60% is expended at rest (Black et al., 1996). Despite the recommendations of national and international health organizations for at least three 30-min sessions of vigorous exercise
per week, it has been calculated, as a general example, that
this would increase energy demands by only 1000 Kcal per
week (i.e. 5% of the average weekly expenditure about
20 000 Kcal per week) (Black et al., 1996). Notwithstanding
these considerations, clinical practice and data from the literature consistently point to the beneficial effect of exercise on
fat loss (Jakicic & Gallagher, 2003). The only way to reconcile
this apparently contradictory evidence between experimental
and clinical data is to hypothesize the existence of other exercise-related factors involved in the fat loss effect other than
the simple increase in energy expenditure during exercise.
2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd
2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd
Figure 1 Changes in resting energy expenditure (REE) and respiratory exchange ratio
(RER) at basal condition and 22 h after a session of traditional resistance training or
high-intensity interval resistance training.
** P<0.005. (Modified from Paoli et al.,
2012b)
Conclusions
Taken together, these recent findings suggest that resistance
training could positively affect body composition and that it
could usefully be included in lifestyle weight control programmes. In our opinion, the general medicine practitioner
should become familiar with this kind of training and its metabolic effects in order to recommend it to patients with
weight problems.
Acknowledgments
The authors thank Keith Grimaldi for improving English
language of this article. The authors have no disclosures and
no conflict of interests.
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