Which is the best strategy of aerobic exercise prescription to increase energy expenditure in sedentary patients?

Abstract

Aerobic exercise is an important complementary strategy for weight control, but there are questions about the optimal dose of exercise with this purpose. This review describes the methodological bases of aerobic exercise prescription, with emphasis on the optimization of energy expenditure (EE) and weight reduction in sedentary subjects. In this context, the study focused mainly on the intensity of aerobic exercise prescription. The percentage of oxygen uptake reserve (%VO2R) – along with the American College of Sports Medicine to calculate training workloads –, have been used to define the exercise intensity and estimate EE, due to its hypothetical 1:1 relationship with the percentage of heart rate reserve (%HRR). However, there are limitations in the application of this method, since studies applying continuous bouts of exercise with different intensities have reported that such hypothetical 1:1 relationship between ‘%HRR-%VO2R’ may overestimate or underestimate EE. Another issue refers to the optimal training intensity. High-intensity short-term exercises have been recommended to promote greater benefits on cardiorespiratory fitness, body composition, and cardiovascular risk factors compared to long-term moderate exercise bouts. However, aspects related to adherence to exercise routines cast doubt over the effectiveness of this strategy, which should be considered when designing exercise programs in the context of weight reduction and health promotion.