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Why exercise is an important component of risk reduction in obesity management

Daniel J Green and Andrew J Maiorana
Med J Aust 2012; 196 (3): . || doi: 10.5694/mja11.11055
Published online: 20 February 2012

Non-surgical intervention has many benefits

A recent article published in the Journal1 was widely reported in the popular press,2,3 with statements such as the following being quoted:


  • 1 School of Sports Science, Exercise and Health, University of Western Australia, Perth, WA.
  • 2 School of Physiotherapy, Curtin University, Perth, WA.


Correspondence: d.j.green@ljmu.ac.uk
Competing interests:

Daniel Green receives grant support from the National Heart Foundation of Australia and the Australian Research Council.

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  • 2. Hagan K. Obesity campaign ‘waste of cash’. The Age 2011; 1 Aug. http://www.theage.com.au/lifestyle/diet-and-fitness/obesity-campaigns-waste-of-cash-20110731-1i6e0.html (accessed Jan 2012).
  • 3. Exercise and diet no use for obese, claim researchers. The Australian 2011; 1 Aug. http://www.theaustralian.com.au/news/health-science/exercise-and-diet-no-use-for-obese-claim-researchers/story-e6frg8y6-1226105580445 (accessed Jan 2012).
  • 4. Gelber RP, Gaziano JM, Orav EJ, et al. Measures of obesity and cardiovascular risk among men and women. J Am Coll Cardiol 2008; 52: 605-615.
  • 5. Green DJ. Is body mass index really the best measure of obesity in individuals? J Am Coll Cardiol 2009; 53: 526.
  • 6. Watts K, Beye P, Siafarikas A, et al. Exercise training normalises vascular dysfunction and improves central adiposity in obese adolescents. J Am Coll Cardiol 2004; 43: 1823-1827.
  • 7. Watts K, Jones TW, Davis EA, Green D. Exercise training in obese children and adolescents: current concepts. Sports Med 2005; 35: 375-392.
  • 8. Blair SN, Morris JN. Healthy hearts — and the universal benefits of being physically active: physical activity and health. Ann Epidemiol 2009; 19: 253-256.
  • 9. Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004; 116: 682-692.
  • 10. Mora S, Cook N, Buring JE, et al. Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms. Circulation 2007; 116: 2110-2118.
  • 11. Joyner MJ, Green DJ. Exercise protects the cardiovascular system: effects beyond traditional risk factors. J Physiol (Lond) 2009; 587: 5551-5558.
  • 12. Blair SN, Kampert JB, Kohl HW, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996; 276: 205-210.
  • 13. Blair SN, Kohl HW, Barlow CE, et al. Changes in physical fitness and all-cause mortality: a prospective study of healthy and unhealthy men. JAMA 1995; 273: 1093-1098.
  • 14. Lee CD, Blair SN, Jackson AS. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 1999; 69: 373-380.
  • 15. Wessel TR, Arant CB, Olson MB, et al. Relationship of physical fitness vs body mass index with coronary artery disease and cardiovascular events in women. JAMA 2004; 292: 1179-1187.
  • 16. Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403.
  • 17. Knowler WC, Fowler SE, Hamman RF, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 2009; 374: 1677-1686.
  • 18. Crandall JP, Knowler WC, Kahn SE, et al. The prevention of type 2 diabetes. Nat Clin Pract Endocrinol Metab 2008; 4: 382-393.
  • 19. Misra A. Prevention of type 2 diabetes: the long and winding road. Lancet 2009; 374: 1655-1656.
  • 20. Booth FW, Chakravarthy MV, Spangenburg EE. Exercise and gene expression: physiological regulation of the human genome through physical activity. J Physiol 2002; 543: 399-411.
  • 21. Chakravarthy MV, Booth FW. Eating, exercise, and "thrifty" genotypes: connecting the dots toward an evolutionary understanding of modern chronic diseases. J Appl Physiol 2004; 96: 3-10.
  • 22. Maciejewski ML, Livingston EH, Smith VA, et al. Survival among high-risk patients after bariatric surgery. JAMA 2011; 305: 2419-2426.
  • 23. Weiler R, Feldschreiber P, Stamatakis E. Medicolegal neglect? The case for physical activity promotion and exercise medicine. Br J Sports Med 2011; 2 Jun [Epub ahead of print].
  • 24. Zimmet P, Campbell L, Toomath R, et al. Bariatric surgery to treat severely obese patients with type 2 diabetes: a consensus statement. Obes Res Clin Pract 2011; 5: e71-e78.
  • 25. Dixon JB, O’Brien PE, Proietto J. Surgical vs behavioural therapy for weight loss in patients with type 2 diabetes. JAMA 2008; 299: 2146-2147.

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