Kukkonen-Harjula K
President Urho Kaleva Kekkonen Institute for Health Promotion Research, Tampere, Finland.
Ann Clin Res. 1988;20(1-2):67-70.
Increased physical activity has usually not been considered a successful means to treat obesity because of the small and slowly occurring weight loss and bad compliance with exercise programs. Exercise has been advocated because it prevents the loss of fat-free tissues induced by hypocaloric diets. Muscular work may also elevate the metabolic rate for some hours after the cessation of exercise, but this requires high-intensity exercise. Instead, aerobic exercise may have more importance in ameliorating metabolic and hemodynamic disturbances often associated with obesity. Aerobic exercise of moderate intensity may increase serum high-density and decrease very-low-density lipoproteins, decrease serum insulin, and decrease blood pressure, especially during exertion. Similar alterations may also be achieved with a prudent diet alone, but inclusion of exercise provides more possibilities to vary the diet. A multifactorial approach (nutrition education, behavior modification and exercise) is needed to improve adherence to diet in mild and moderate obesity and to maintain weight loss. More than a formal physical exercise program for a couple of months, the obese need to include physical activity permanently as a part of everyday life.
由于体重减轻幅度小且缓慢，以及对运动计划的依从性差，增加体力活动通常不被认为是治疗肥胖的成功方法。提倡运动是因为它能防止低热量饮食引起的无脂肪组织流失。肌肉运动在运动停止后的几个小时内也可能提高代谢率，但这需要高强度运动。相反，有氧运动在改善通常与肥胖相关的代谢和血液动力学紊乱方面可能更重要。中等强度的有氧运动可能会增加血清高密度脂蛋白并降低极低密度脂蛋白，降低血清胰岛素，并降低血压，尤其是在运动期间。仅通过合理饮食也可能实现类似的改变，但加入运动可以提供更多改变饮食的可能性。需要采取多因素方法（营养教育、行为改变和运动）来提高轻度和中度肥胖者对饮食的依从性并维持体重减轻。肥胖者需要将体力活动永久纳入日常生活，而不仅仅是几个月的正式体育锻炼计划。
