The first World Obesity Day takes place on 4 March 2020.
Obesity is now a global crisis that affects 650 million people worldwide, but is poorly understood.
The complexity of the disease, the challenge of developing sustainable solutions and the burden of stigma means researchers and practitioners around the world need to work together to address the challenge.
Here at UQ, researchers like Dr Shelly Keating at the UQ School of Human Movement and Nutrition Sciences, are exploring the ways to manage obesity and obesity-related chronic disease.
Dr Keating explains:
"Obesity affects people differently – and therefore there is no ‘one-size-fits-all’ solution for the management of obesity and related health conditions. Importantly, many of the health benefits of lifestyle therapy extend beyond weight loss. With exercise alone, significant weight loss is difficult to achieve and requires large volumes of exercise (e.g. 60 or more minutes per day of moderate intensity exercise). Our research explores targeted exercise therapies that improve body composition and health without a focus on body weight.
Not all body fat is created equally- we now know that the location of excess body fat, rather than the total quantity of fat, is more important when determining the health risks associated with obesity. Excess fat stored in and around the internal organs (e.g. abdominal visceral fat, liver fat, pancreatic fat and fat stored inside the muscles) are particularly detrimental to health.
Interestingly, our research has found that you can lose dangerous abdominal visceral and liver fat with exercise programs that fall within the current physical activity guidelines of 150-300 min per week of moderate intensity exercise or 75-150 minutes per week of vigorous intensity exercise. This is important as it shows that just eight weeks of exercise can reduce these metabolically-detrimental fat depots, despite no significant changes on the scales.
As up to one third of adults in Australia have non-alcoholic fatty liver disease (NAFLD, a condition characterised by excess liver fat and linked with obesity and the development of cardiovascular disease), lifestyle intervention comes to the forefront as both a preventative and management strategy.
With the view of ‘exercise as medicine’, our team is aiming to better establish the ‘doses’ of exercise (i.e. what types and how much) that are particularly beneficial in obesity and NAFLD.
For example, while moderate intensity exercise is effective in reducing liver and abdominal fat, we believe that a higher ‘dose’ of exercise is needed to improve health in the more severe form of NAFLD known as non-alcoholic steatohepatitis (NASH). The prevalence of NASH is also increasing worldwide and it is predicted to be the leading indication for liver transplantation by 2025. With the support of Diabetes Australia and Exercise and Sports Science Australia, we are investigating whether high-intensity interval training (HIIT) is both safe and effective for improving health in adults with NASH.
For people with obesity, regular exercise can improve cardiorespiratory fitness. Cardiorespiratory fitness is so important for health and longevity that leading physicians in the USA have called for it to be measured in routine check-ups as a vital sign. We are conducting the first study to explore whether high levels of cardiorespiratory fitness may protect against cardiovascular disease risk in people with high levels of liver and abdominal fat. These findings will allow us to develop targeted exercise strategies to reduce cardiovascular disease risk in people with obesity.
The bottom line is that research consistently shows the benefits of exercise in obesity management beyond weight loss. This message needs to be better communicated so that people seek the true rewards of exercise and ultimately help people commit to exercise in their daily lives in the long-term."
Dr Shelley Keating is an NHMRC Early Career Fellow at the UQ School of Human Movement and Nutrition Sciences. Her program of research examines the role of exercise in the management of obesity and related cardiometabolic conditions, notably non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes.