King A C, Tribble D L
Department of Medicine, Stanford University School of Medicine, Palo Alto, California.
Sports Med. 1991 May;11(5):331-49. doi: 10.2165/00007256-199111050-00004.
Obesity is an extremely prevalent condition that is associated with a range of deleterious health effects. While traditionally considered a disorder primarily of energy intake, accumulating evidence underscores the importance of energy expenditure in the development and treatment of obesity. As the most variable component of energy expenditure, physical activity can influence the development of obesity as well as success in achieving both initial and long term weight loss. Among the types of exercise-related physiological and behavioural factors most likely to be involved in the development of obesity are reductions in the amount of physical activity actually performed, differences in the effect of physical activity on diet-induced thermogenesis, and modeling of deleterious dietary and exercise patterns on the part of the family and other facets of the environment. In contrast, there is relatively little evidence supporting the common belief that obese individuals have a significantly greater energy intake than nonobese individuals. With respect to weight reduction in the already obese, while increased physical activity levels often augment caloric restriction programmes in aiding initial weight loss, evidence suggests that physical activity may be particularly important in helping to sustain initial losses through increased total energy output, preservation of lean body mass, and changes in substrate utilisation. The psychological benefits received from regular participation in a physical activity programme may serve as an additional impetus for engaging in such activities over the long run. Developing programmes to aid in long term adherence to physical activity regimens remains the most critical challenge. Recent results suggest the utility of regular, brief contacts in aiding sustained physical activity participation in individuals attempting to control their weight.
肥胖是一种极为普遍的状况，与一系列有害的健康影响相关。虽然传统上认为肥胖主要是能量摄入紊乱，但越来越多的证据强调了能量消耗在肥胖发生和治疗中的重要性。作为能量消耗中最具变化性的组成部分，身体活动会影响肥胖的发生以及实现初始和长期体重减轻的成功率。在与运动相关的最有可能参与肥胖发生的生理和行为因素类型中，包括实际进行的身体活动量减少、身体活动对饮食诱导产热的影响差异，以及家庭和其他环境因素对有害饮食和运动模式的模仿。相比之下，相对较少的证据支持普遍观点，即肥胖个体的能量摄入量比非肥胖个体显著更高。对于已经肥胖者的体重减轻而言，虽然增加身体活动水平通常会增强热量限制计划以帮助初始体重减轻，但有证据表明，身体活动在通过增加总能量输出、保留瘦体重和改变底物利用来帮助维持初始体重减轻方面可能特别重要。长期定期参与体育活动计划所获得的心理益处可能会成为长期参与此类活动的额外动力。制定有助于长期坚持体育活动方案的计划仍然是最关键的挑战。最近的结果表明，定期进行简短接触有助于试图控制体重的个体持续参与体育活动。
