Overnutrition Flashcards
Obesity
- look at waist/hip ratio in people with BMI <35kg/m^2
- BMI>25kg/m^2 is overweight
- BMI>30kg/m^2
Asian population:
- BMI: >23kg/m^2 = overweight
- BMI: >27.5 kg/m^2
Central obesity:
waist circumference: >94cm/37 inches in men (90cm in asian men)
waist circumference: >80cm/31.5 inches in women (77cm in asian women)
what are the 2 patterns of obesity?
- general obesity: fat is distributed over the whole body
- central abdominal obesity: fat is distributed mainly in
the chest and abdomen
Central abdominal obesity is associated with
higher risks of diabetes, raised blood lipids, greater cardiovascular morbidity, mortality compared to general obesity
Definition of obesity in children under the age of 5 years:
- overweight is weight for height greater than 2sd
above WHO child growth median - obesity is weight-for-height greater than 3 standard
deviations above the WHO child growth standards
median
Obesity definition in children aged between 5-19 years
- overweight is BMI for age greater than 1 sd above
WHO growth reference median - obesity is greater than 2sd above the WHO growth
reference median
Factors associated with gaining weight:
- low income consumes less fruit and veg but more cals
- education
- married men weigh more than single men
- weight increases with each child; mainly affecting
women - older people who live alone are more likely to be
underweight - mental health
Global epidemiology of obesity:
- worldwide obesity has nearly tripled since 1975
- 2016: 39% adults aged 18yrs and over were
overweight, 13% obese - overweight and obesity are rising in lowe and middle
income countries particularly in urban settings
obesity is highest in which age groups:
- 55-64 men 82%
- 65-74: 70% women
Obesity prevalence is how much higher for those living in the most deprived aread
more than double
Health impact of obesity
- increased mass of fat causes changes at cellular and
metabolic levels - increased weight causes increased wear and tear in
joints - increased fat around the airway - asthma, sleep
apnoea - increased fat in blood alters the insulin response
- associated inactivity has independent effects
Health impact of obesity: childrem:
- overweight and obesity increases asthma risk by 40-
50% - cardiovascular damage in childhood increases risk of
hypertension in adult life - mental health: low self esteem, emotional and
behavioural problems
Health impact of obesity: adults:
- cancer
- reproductive and urological problems
- respiratory system: sleep apnoea, asthma
- liver disease
- GI: gastro-oesophageal reflux, gallstones, pancreatitis
- psychological and social problems
obesity is a disease linked to
- genetic, psychological, physical, metabolic,
neurological, and hormonal impariments - intimately linked to heart disease, sleep apnoea,
certain cancers - not just a lifestyle choice
obesity strategy:
- motivational interviewing and behavioural change
- diets
- drugs
- bariatric surgery
Decision around treatment of obesity
