,

,
,

....

 (1)





( ,
- / physical fitness)

 (2)

:


(, , -jogging,
).
( ):



( ,
).

.
.
.
.



( )



. (
)

70%
.
30%
(exercise activity
thermogenesis - EAT)

(non-exercise activity thermogenesis - NEAT)
,
,

(Levine 2007)

Healthy lifestyle
?

NEAT,
, ,
, ,
,
, .

J. A. HUBEK, Physiol. Res. 58 (Suppl. 1): S1-S6, 2009




,
Hebebrant and Hinney 2008

,


Hill et al. 2003


(1)


(exercise-induced anorexia)



(CKK, GLP-1, PP, PYY)
. ,


Martins et al, International Journal of Obesity (2008)


(2)


.


.

Martins et al, International Journal of Obesity (2008)

(3 )

(9000 10
),
(>13kg).
2. ,
(10.000 7 )
(>5%
).
3. (5000 10 )

(>5%
).
1.

NHANES 1,1993
MRFIT, 1993
Finnish Study, 1997


2005


.
.
, , 2000,
6 11
.
, ,

45-60 min

Wareham et al, 2005



20
0.3-0.6% 5.58.4% .
2-3%.
,


(1-2 ).
(>12-18 )
,


Hagan et al, 1986
Wing et al, 1998
Jakicic et al, 2006

Klem et al, Am J C/in Nutr 1997

13.6kg 30kg 5
- 1kcals=4.184kjoules





12 18
.

2
, 0-60min/d
5 (1500-2000kcal/week)

Jakicic, JAMA 2003

Jakicic, Nutritional Rev, 2006

 &

( 40%
)

(10% 65%)

20



GLUT4

Coker et al, JCEM 2009

Coker et al, JCEM 2009

Coker et al, JCEM 2009

:

(lean)

Coker et al, JCEM 2009

 2 ( 100.000/)
(/)
400
350

369

300
279

250
200

225

214

2.4

150
100
50
0

<1

 DPP

>5%.

<30%
.

<10%
.

>15g/1.000cal.

>4 /.

:
3-5% 1-2

:
6-11% 1-2

43%,
86%.
DPP:

50%,
74%.
N Engl J Med 2001;344:1343-50
N Engl J Med 2002;346:393-403

Teixeira-Lemos et al, Cardiovascular Diabetology 2011

Physical Activity in the Prevention of the Most Frequent

Chronic Diseases: an Analysis of the Recent Evidence
Joanna Kruk, 2007

Fat but Fit

Lee et al, Am J Clin Nutr 1999

Obesity Paradoxes
1. Classic obesity paradox: Obesity is protective
in chronic disease states.
2. Pre-obesity: Overweight is protective in normal
populations.

3. Fat but fit: Obesity is not a risk factor for

mortality in fit individuals.
4. Healthy obesity: A sizeable population of
obese adults has normal cardiometabolic risk
profiles

McAuley & Blair, Journal of Sports Sciences, 2011

.
.
.
- .
.
.

<3000

3000-6000

15

>10.000

30

12.000-15.000

60