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Research Topic: Exercise and Stress in young adults

Effects of physical inactivity and obesity on morbidity and mortality: current

evidence and research issues

Blair, S.N. & Brodney, S. (1999). Effects of physical inactivity and obesity on morbidity and
mortality: current evidence and research issues. Medicine & Science in Sports & Exercise, 31(11),
646-662. Retrieved from:
http://www.uoguelph.ca/hhns/grad/pdf_grad/HBNS6710W08BlairandBrodney.pdf

In this systematic review, the authors observed the effects of physical inactivity and obesity on
disease development and mortality. The overall review was based on 24 carefully selected studies
from an original 700 articles (excluding reviews and cross-sectional analysis reports), that looked at
overweight, obesity and physical inactivity as exposure variables and all-cause mortality, cancer,
hypertension, coronary heart disease (CHD) and type 2 diabetes mellitus as outcome variables. Comment [s1]: Topic and methods

The authors aimed to answer three questions: 1) whether being physically active can lower the
increased health risks of obese people 2) whether people who are obese, but physically active, have
lower risk of disease and death than normal weight, sedentary people and 3) whether being
overweight or being inactive was a more crucial predictor of mortality. It was found that people in
the high BMI category who were physically active had a lower risk of all-cause mortality than
sedentary people in the same category and in lower BMI groups. Physically active men had lower
rates of CHD than inactive men across all studies and BMI categories. Regular PA was protective
against CHD. Similar relationships were detailed for type 2 diabetes and hypertension, yet data for
cancer was inconsistent and unclear. The authors concluded that 1) active, obese individuals have Comment [s2]: Findings

lower rates of morbidity than inactive, obese people 2) active, obese individuals are at lower risk of
developing chronic diseases related to obesity than inactive, normal weight people 3) being
physically inactive is an equally crucial predictor of death as obesity, especially in men. Although Comment [s3]: Conclusions

results were consistent, conclusions must be considered carefully as different studies employed
different measures of activity, physique and populations. Most conclusions were based on men so
the relevance of the findings to women is questionable. Additionally, self-reported PA through
questionnaires may have potentially resulted in misclassification and is also a limitation of the
studies addressed in the review. This review is highly useful for our research as it convincingly Comment [s4]: Limitations

specifies the benefits of exercise to various facets of health status. Comment [s5]: Relevance to your
topic and literature review

Physical Inactivity and Obesity: A Vicious Circle

Pietiläinen, K. H., Kaprio, J., Borg, P., Plasqui, G., Yki‐Järvinen, H., Kujala, U. M., ... & Rissanen,
A. (2008). Physical inactivity and obesity: a vicious circle. Obesity, 16(2), 409-414. doi:
10.1038/oby.2007.72

This study followed a longitudinal, population-based sample of Finnish twins to evaluate how PA
and inactivity in adolescence (16-18 years) impacts on the development of obesity in adulthood (25
years). Further, monozygotic (MZ) twin pairs discordant for obesity, were selected from the sample
to establish the effects of obesity development on factors of energy expenditure. It was concluded Comment [s6]: Topic, participants,
method
that PA should be strongly recommended for obesity prevention in young individuals as physical
inactivity in adolescence was found to be a convincing and independent predictor of obesity and
abdominal obesity in young adulthood. The authors also devised that the development of obesity
amongst inactive individuals creates a self-perpetuating cycle of obesity and physical inactivity,
independent of genetic factors. Prior to this study, the authors identified that there was weak and
inconsistent evidence for the relationship between adolescent PA and the development of obesity in
the existing longitudinal studies. This study successfully added to the literature, pointing out the
causal role of low PA as a risk factor for obesity and to a greater extent, abdominal obesity. It was
able to show that a sedentary lifestyle leads to obesity, independent of genetic factors through the
MZ co-twin design. The main limitations of the study were the self-reported data provided by the Comment [s7]: Findings

population sample and the small number of discordant pairs in the MZ twin study. This is not a
significant issue as measures of PA and body composition were assessed at age 25 to enhance the
quality of the prospective questionnaire data. The methods employed in the study were relatively Comment [s8]: Limitations/critiques

complex, carefully though out and efficient with the relationships identified in the MZ study being
free from genetic confounding factors. The study added noteworthy evidence to the literature and
findings are relevant to our topic, highlighting the importance for adolescent PA in ensuring health
in adulthood. Comment [s9]: Relevance to topic and
literature review
 Physical activity, exercise, depression and anxiety disorders
Ströhle, A. (2009). Physical activity, exercise, depression and anxiety disorders. Journal of Neural
Transmission, 116(6), 777-784. doi: 10.1007/s00702-008-0092-x

This paper analysed the relationship between PA, depression and anxiety disorders described in
various cross-sectional and prospective-longitudinal studies. The authors concluded that there was Comment [s10]: Topic

moderate evidence to suggest that PA and exercise can be used in the treatment of anxiety and
depression disorders. The authors did not find a conclusive model to explain the anti-depressant and
anxiolytic effects that exercise has, yet acknowledged that many factors (developmental,
psychological and neurobiological) may strongly underlie, mediate or moderate the association of
PA and mental disorders. Although exercise may result in higher resilience to stress-associated
disorders, the evidence suggesting exercise can prevent the onset of mental disorders was not clear
and further intervention studies are required to deliver a conclusive review of literature. The authors Comment [s11]: Findings

specified that only a few studies explored the relationship between PA and specific mental disorders
prospectively and purposed to critically review the available literature. They also aimed to observe
the therapeutic role of exercise in reducing depression and anxiety in diagnosed patients. The
collective results suggested that depressive symptoms might be reduced by exercise training in
normal populations and in people with major depression. Anxiety was less frequently studied, yet
the existing evidence indicated that PA may be used therapeutically in people with anxiety-related
disorders. It was also acknowledged that exercise may induce panic attacks in individuals suffering Comment [s12]: Conclusions

from panic disorders. The article was useful in highlighting the potential for conflicting outcomes
from different study designs, yet because of this, the overall conclusions made were relatively weak
and implementation of interventional programmes are required to provide a conclusive summary. Comment [s13]: Overall relevance for
your topic and literature review