exercise and body composition the health cost of obesity and overweight
TRANSCRIPT
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Exercise and Body Exercise and Body CompositionComposition
The Health Cost of Obesity and Overweight
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
Overweight and obesity are associated with an increased risk for developing various medical conditions including: cardiovascular disease, certain cancers (endometrial, colon,
postmenopausal breast, kidney, and esophageal)5,
high blood pressure, arthritis-related disabilities and type 2 diabetes.7
U.S. Department of Health and Human Services
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Consequences of Childhood Consequences of Childhood and Adolescent Obesityand Adolescent ObesityConsequences of Childhood Consequences of Childhood and Adolescent Obesityand Adolescent Obesity
GrowthGrowth PsychosocialPsychosocial HyperlipidemiaHyperlipidemia Hepatic stenosisHepatic stenosis Abnormal glucose Abnormal glucose
metabolismmetabolism Persistence into Persistence into
adulthoodadulthood
GrowthGrowth PsychosocialPsychosocial HyperlipidemiaHyperlipidemia Hepatic stenosisHepatic stenosis Abnormal glucose Abnormal glucose
metabolismmetabolism Persistence into Persistence into
adulthoodadulthood
HypertensionHypertension Sleep apneaSleep apnea PseudotumorPseudotumor PCODPCOD CholelithiasisCholelithiasis OrthopedicOrthopedic
HypertensionHypertension Sleep apneaSleep apnea PseudotumorPseudotumor PCODPCOD CholelithiasisCholelithiasis OrthopedicOrthopedic
CommonCommonCommonCommon UncommonUncommonUncommonUncommon
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Consequences of Adult ObesityConsequences of Adult ObesityConsequences of Adult ObesityConsequences of Adult Obesity
PsychosocialPsychosocial CardiovascularCardiovascular
HyperlipidemiaHyperlipidemia Diabetes Diabetes
mellitusmellitus HypertensionHypertension RespiratoryRespiratory CardiacCardiac
PsychosocialPsychosocial CardiovascularCardiovascular
HyperlipidemiaHyperlipidemia Diabetes Diabetes
mellitusmellitus HypertensionHypertension RespiratoryRespiratory CardiacCardiac
MedicalMedical Polycystic ovary diseasePolycystic ovary disease Gall bladder diseaseGall bladder disease OsteoarthritisOsteoarthritis CancerCancer
Pregnancy and Pregnancy and postpartum complicationspostpartum complications
MortalityMortality
MedicalMedical Polycystic ovary diseasePolycystic ovary disease Gall bladder diseaseGall bladder disease OsteoarthritisOsteoarthritis CancerCancer
Pregnancy and Pregnancy and postpartum complicationspostpartum complications
MortalityMortality
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Medical ConditionsMedical Conditions 88 to 97% of all cases of Type II
(non-insulin dependent) diabetes, 57 to 70% of coronary heart
disease cases, 11% of breast cancers, and 10% of colon cancers that are
diagnosed are related to obesity.
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Medical ConditionsMedical Conditions 1/3 of all cases of hypertension
and 70% of gallstone cases are related to being obese.
Unhealthy weight is also associated with osteoarthritis and gout, along with a number of other disabling conditions.
(SUA, 1997)
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Exercise and Body Exercise and Body CompositionComposition
Other less understood risks of obesity include: difficulties in surgical anesthesia and
delivery gallbladder disease, infertility, osteoarthritis, etc...
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Physical Activity and a Physical Activity and a Nutritious Diet are Key to Nutritious Diet are Key to Maintaining Energy Balance Maintaining Energy Balance and a Healthy Weightand a Healthy Weight
Regular physical activity along with a nutritious diet is key to maintaining a healthy weight.
In order to maintain a healthy weight,
there must be a balance between calories consumed and calories expended through metabolic and physical activity.
U.S. Department of Health and Human Services
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Physical Activity and a Physical Activity and a Nutritious Diet are Key to Nutritious Diet are Key to Maintaining Energy Balance Maintaining Energy Balance and a Healthy Weightand a Healthy Weight
Although overweight and obesity are caused by many factors, in most individuals, weight gain results from a combination of excess calorie consumption and inadequate physical activity.
U.S. Department of Health and Human Services
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Maintaining Energy Balance Maintaining Energy Balance and a Healthy Weightand a Healthy Weight
Even though a large portion of a person’s total caloric requirement is used for basal metabolism and processing food, an individual’s various physical activities may account for as much as 15 to 40 percent of the calories he or she burns each day.
While vigorous exercise uses calories at a higher rate, any physical activity will burn calories.
U.S. Department of Health and Human Services
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Maintaining Energy Balance Maintaining Energy Balance and a Healthy Weightand a Healthy Weight
For example, a 140-pound person can burn 175 calories in 30 minutes of moderate bicycling, and 322 calories in 30 minutes of moderate jogging.
The same person can also burn 105 calories by vacuuming or raking leaves for the same amount of time.
U.S. Department of Health and Human Services
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
Epidemiological studies show an increase in mortality associated with overweight and obesity.
Approximately 300,000 deaths (predicted to be 360,000 in 2004) a year in this country are currently associated with overweight/obesity and related comorbidities.29
U.S. Department of Health and Human Services
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
It is also important for individuals who are currently at a healthy weight to strive to maintain it since both modest and large weight gains are associated with significantly increased risk of disease.
U.S. Department of Health and Human Services
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
For example, a weight gain of 11 to 18 pounds increases a person’s risk for developing type 2 diabetes to twice that of individuals who have not gained weight, while those who gain 44 pounds or more have four times the risk of type 2 diabetes.30
U.S. Department of Health and Human Services
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
Recent research studies have shown that a gain of 10 to 20 pounds resulted in an increased risk of coronary heart disease (which can result in nonfatal heart attacks and death) of 1.25 times in women31 and 1.6 times in men.32
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
In these studies, weight increases of 22 pounds in men and 44 pounds in women resulted in a increased coronary heart disease risk of 1.75 and 2.65, respectively.
U.S. Department of Health and Human Services
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
In one study among women with a BMI of 34 or greater, the risk of developing endometrial cancer was increased by more than 6 times.33
Overweight and obesity are also known to exacerbate many chronic conditions such as hypertension and elevated cholesterol.
U.S. Department of Health and Human Services
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
Overweight and obese individuals also may suffer from social stigmatization, discrimination, and poor body image.
U.S. Department of Health and Human Services
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
Although obesity-associated morbidities occur most frequently in adults, important consequences of excess weight as well as antecedents of adult disease occur in overweight children and adolescents.
Overweight children and adolescents are more likely to become overweight or obese adults.
U.S. Department of Health and Human Services
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Health Risks of Not Health Risks of Not Maintaining a Healthy Maintaining a Healthy WeightWeight
As the prevalence of overweight and obesity increases in children and adolescents, type 2 diabetes, high blood lipids, and hypertension as well as early maturation and orthopedic problems are occurring with increased frequency.
A common consequence of childhood overweight is psychosocial specifically discrimination.34
U.S. Department of Health and Human Services
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Metabolic SyndromeMetabolic Syndrome
Syndrome X
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Metabolic SyndromeMetabolic Syndrome
Visceral adiposity Elevated blood pressure Insulin resistance Low HDL/High Triglycerides Systemic pro-inflammatory state
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Metabolic SyndromeMetabolic Syndrome
Identified by Three of the Following (NCEP):
Waist girth > 102 cm (40 in) for men > 88 cm (35 in) for women
Fasting glucose > 110 mg/dl
Triglycerides > 150 mg/dl
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Metabolic SyndromeMetabolic Syndrome
Blood pressure > 130/85 Use of bp medications
HDL < 40 mg/dl for men < 50 mg/dl for women
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Metabolic SyndromeMetabolic Syndrome
>87% of patients who experienced a fatal coronary event had exposure to > 1 risk factor.
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Metabolic SyndromeMetabolic Syndrome
Received ICD-9 code (277.7) in 2001 What physicians use to bill insurance
company
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Metabolic SyndromeMetabolic Syndrome
May be identified by elevated waist circumference and elevated triglycerides alone Depprees
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Metabolic SyndromeMetabolic Syndrome
From NHANES III (1988-1994) data, prevalence is 24% of population.
86 million Americans will have by 2025
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Metabolic SyndromeMetabolic Syndrome
2600 American each day die from cardiovascular disease
That’s an equivalent death rate as a 9/11 everyday
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Metabolic SyndromeMetabolic Syndrome
Perhaps it should be called physical inactivity syndrome
When PA or PF is considered, metabolic syndrome is not a great predictor of all-cause or CHD caused mortality. Lakka, et al., MSSE 2002, 35:1279-
1286
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ImprovementImprovement Among the morbidly obese (150-
200% overweight), moderate weight loss can mean a 20-75% reduction in risk factors for several chronic diseases.
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ImprovementImprovement Significantly overweight patients
who lost 10-20% of their body weight - and kept it off during a three-year follow-up period - reduced their risk factors for hypertension (by 70-75%, on average), Type II diabetes mellitus (40-60%), and cardiovascular disease (25-50%).
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Radical TreatmentRadical Treatment
Gastric bypass is a major surgery that shrinks the stomach's capacity from win bottle to shot glass size and reconfigures the small intestine.
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Gastric BypassGastric Bypass
Most patients lose about 2/3rds of their excess weight in a year after surgery.
Some patients can subvert the surgery by snacking continuously.
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Gastric BypassGastric Bypass
The list of complications includes blood clots in the lung, pneumonia, infection, leakage from the reshaped intestinal tract, and - in one out of a hundred cases - death.
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Gastric BypassGastric Bypass
Over 100,000 gastric bypass surgeries were conducted in the US in 2003.
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Key QuestionKey Question
Is the problem obesity/overweight, or is it the sedentary lifestyle and poor nutrition associated with OB/OW that is the problem.
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AnswerAnswer
Mounting evidence indicates that the problem is the sedentary lifestyle and poor nutrition that causes the problem.
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Recent ResearchRecent Research
Demonstrates that being slightly overweight might be healthier than being slightly underweight.
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Recent ResearchRecent Research
Those who are overweight (and even obese) and yet have higher cardiovascular fitness (VO2) than leaner cohorts have lower risk for morbidity and mortality.
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Key to Solving the Key to Solving the ProblemProblem
Focus on the process of living rather than the product (symptoms) of death.
Increase physical activity and eat in a nutritionally sound way, and weight problems, disease, and death will be reduced