illinois state university body composition and disease

Illinois State University

Body Composition and Disease



Abnormalities in any of the components of body composition can lead to dysfunction



Abnormally low water levels can lead to dehydration and heat stress



Low bone density may lead to increased risk of fracture

Poor muscular fitness can lead to increased risk of muscle and joint injury



Too much fat, or too little fat can lead to obesity or anorexia



In our society, both extremes cause problems.

Eating disordered behavior is common in certain groups.

Over-consumption is common in others.


Current Problem

Of the two (malnourishment and over-nourishment), over-nourishment is the bigger problem from a population impact point of view.


Obesity

The Epidemic of the 21st Century?


Definition of Obesity

Obese comes from the Latin, obesus, "having eaten well," past participle of ob-edeer, to eat thoroughly, to devour, to chow down. (Klein, 1994)

– Note eating focus


Definition of Epidemic

According to the New Merriam-Webster Dictionary, epidemic means affecting many persons at one time; excessively prevalent.


Pandemic

Pandemic is defined as a world-wide epidemic.


Scope of the problem.

How big a problem is obesity?



The term "epidemic" appropriately underscores the fact that obesity is a disease - a chronic, complex disease that has stubbornly defied most efforts at prevention and treatment.

(Atkinson Jr., et al., 1995)


Epidemic

See slides on F as in Fat: How Obesity Threatens America's Future, a report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).


CDC Study Finds No Increase in Obesity Among Adults; But Levels Still High, 2005–2006 After a quarter century of increases, obesity prevalence has not measurably increased in the past few years but levels are still high — at 34 percent of U.S. adults aged 20 and over.


Obesity by Race/Ethnicity 2006-2008

New Obesity Data Shows Blacks Have the Highest Rates of Obesity


Blacks had 51 percent higher prevalence of obesity, and Hispanics had 21 percent higher obesity prevalence compared with whites.

Greater prevalence of obesity for blacks and whites were found in the South and Midwest than in the West and Northeast.

Hispanics in the Northeast had lower obesity prevalence than Hispanics in the Midwest, South or West.


White Non-Hispanic


Hispanic


Black Non-Hispanic


Obesity


Diabetes


Obesity and Diabetes


Trends in Childhood Obesity

Data from NHANES surveys (1976–1980 and 2003–2006) show that the prevalence of obesity has increased:» for children aged 2–5 years, prevalence increased

from 5.0% to 12.4%;» for those aged 6–11 years, prevalence increased

from 6.5% to 17.0%; » and for those aged 12–19 years, prevalence

increased from 5.0% to 17.6%


Obesity Prevalence Among Low-Income, Preschool-Aged Children 1998–2008

One of 7 low-income, preschool-aged children is obese, but the obesity epidemic may be stabilizing.



An estimated 107 million adults in the United States are overweight or obese. » (Healthy People 2010)


Changes in Weight

We have seen significant increases in weight over the last 20 years.

In this same period, mean height increased less than 1 cm.

– (Kuczmarski, 1994)


Scope of the Problem

Last estimate (2003), overweight and obesity cost the US, $117 billion.


The Epidemic of Overweight and

Obesity

Body Mass Index (BMI) is the most commonly used measure to define overweight and obesity.

U.S. Department of Health and Human Services


Research on Obesity

A body mass index increase was noted in all demographic groups.

– (Kuczmarski, 1994)

BMI equals body weight in kilograms divided by height in meters (squared).

BMI = kg/m2



Obesity

BMI can also be calculated as weight in pounds divided by the square of the height in inches, multiplied by 703.



Research on Obesity

In research, BMIs at these levels mean

BMI = 25-29.9 overweight BMI = 30-35 obese BMI >35 severely obese

– NIH, 2004



Obesity

These definitions are based on evidence that suggests that health risks are greater at or above a BMI of 25 lbs/in2 compared to those at a BMI below that level.




Obesity

The risk of premature death increases with an increasing BMI.

A BMI > 27 is the breakpoint for significantly increased disease risk » (Ribisl, 1999).

This increase in mortality exponentially increases once a BMI of 30 lbs/in2 is reached.



Health Risks of High BMI

30.0-34.9 30.0-34.9 >40 >40

Medical Condition

Men Women Men Women

Type II Diabetes

10.10 7.24 10.65 19.89

CHD 16.01 12.56 13.97 19.22

High BP 48.95 47.95 64.53 63.16

Osteo-arthritis

4.66 9.94 10.04 17.19

Relative Risk – 2 = twice as likely as normal BMI

2004 – American Obesity Association, American Cancer Society and the New England Journal of Medicine


Health Risks of High BMI

Selected 30-34.9 30-34.9 35.0-39.9

35.0-39.9

Types of Cancer

Men Women Men Women

Breast ----------- 1.63 ----------- 1.70

Colon 1.47 1.33 1.84 1.36

Kidney 1.36 1.66 1.70 1.70**

Liver 1.90 1.40 4.52 1.68

Prostate 1.20 ----------- 1.34 ----------** Risk rises to 4.75 in women with BMI > 40


Age-Related Changes

The overweight and obesity epidemic is not limited to adults.

What is particularly alarming is that the percentage of young people who are overweight has almost doubled in the last 20 years for children aged 6-11 and almost tripled for adolescents aged 12-19.



Age-Related Changes

In children and adolescents, overweight has been defined as a sex- and age- specific BMI at or above the 95th percentile for a reference population, based on Centers for Disease Control and Prevention (CDC) growth charts.



Age-Related Changes

Since 1980 there has been a 42% increase in childhood obesity rates.

Overweight is also more prevalent in those aged 6-11. » (Troiano, et al., 1995)


Age-Related Changes

The news is no better among adolescents:

20% of adolescent boys aged 12-19

and 22% of girls are overweight, up from 15% for both a decade

ago.


Age-Related Changes

Three out of four obese adolescents grow up to become obese adults.

– (Atkinson Jr., et al., 1995)


Age-Related Changes


Sex and Ethnicity Related Changes

Overweight and obesity are increasing in both genders and among all population groups.

Obesity cuts across all age, sex, and ethnic groups.


Healthy People 2000

We did not meet the national health goals for the year 2000 - an obesity prevalence of 20% among adults and 15% among adolescents.



Healthy People 2010

19.1 Increase the proportion of adults who are at a healthy weight.» Target = 60%» Baseline = 42%

Healthy weight is defined as a BMI between 18.5 and 25.


Healthy People 2010

19.2 Reduce the proportion of adults who are obese.

Target = 15% Baseline = 23% at a BMI >30

» 25% for women» 20% for men


Healthy People 2010

19.3 Reduce the proportion of children and adolescents who are overweight or obese (>95th percentile in BMI).

Target and Baseline

Objective Age 88-94 Baseline 2010 Target

19.3 a 6-11 11% 5%

19.3 b 12-19 10% 5%

19.3 c 6-19 11% 5%


Healthy People 2010

Website

http://www.health.gov/healthypeople


Healthy People 2010

Percentages of Adults (20+) with Healthy Body Weights (BMI 18-25)

Men Women Total

Black 40 29 34

White 37 47 42

Hispanic 30 31 30


Healthy People 2010

Percentages of Adults (20+) with Healthy Body Weights (BMI 18-25)

Men Women Total

20-39 48 55 51

40-59 31 40 36

60 plus 33 37 36


Fostering Change

There is a need to change public perceptions of obesity from an appearance problem to a disease that can be prevented, treated and successfully managed. » (SUA, 1997)


Obstacles to Change

It is estimated that Americans are taking in 100-300 calories more per day than they did 10 years ago.

They are burning fewer: Only 1 in 5 adults gets enough exercise, creating a perfect opportunity for additional pounds to creep on.



Obstacles to Change

Dr. Jules Hirsch estimates that there were about 500 foodstuffs available to Americans 100 years ago, compared with more than 50,000, ranging from pop-tarts to Portobello mushrooms, today.


Obstacles to Change

Food, which once served primarily as a cure for hypoglycemia, has become an entertainment medium.

The problem is that we have lost the ability to distinguish appetite from fullness, and hunger from boredom.

– (Ehrenreich, 1995)


Federal Initiatives

The new health reform law, the Patient Protection and Affordable Care Act of 2010, has the potential to address the obesity epidemic through a number of prevention and wellness provisions, expand coverage to millions of uninsured Americans, and create a reliable funding stream through the creation of the Prevention and Public Health Fund;


Federal Initiatives

Community Transformation grants have the potential to help leverage the success of existing evidence-based disease prevention programs;


Federal Initiatives

President Barack Obama created a White House Task Force on Childhood Obesity, which issued a new national obesity strategy that contained concrete measures and roles for every agency in the federal government;

First Lady Michelle Obama launched the "Let's Move" initiative to solve childhood obesity within a generation.


State Initiatives

Twenty states and D.C. set nutritional standards for school lunches, breakfasts and snacks that are stricter than current USDA.» Five years ago, only four states had legislation

requiring stricter standards.


State Initiatives

Twenty-eight states and D.C. have nutritional standards for competitive foods sold in schools on à la carte lines, in vending machines, in school stores, or through school bake sales. » Five years ago, only six states had nutritional

standards for competitive foods.


State Initiatives

Every state has some form of physical education requirement for schools, but these requirements are often limited, not enforced or do not meet adequate quality standards.


State Initiatives

Twenty states have passed requirements for body mass index screenings of children and adolescents or have passed legislation requiring other forms of weight and/or fitness related assessments in schools. » Five years ago, only four states had passed

screening requirements.


Recommendations

Support obesity- and disease-prevention programs through the new health reform law's Prevention and Public Health Fund, which provides $15 billion in mandatory appropriations for public health and prevention programs over the next 10 years.


Recommendations

Align federal policies and legislation with the goals of the forthcoming National Prevention and Health Promotion Strategy. Opportunities to do this can be found through key pieces of federal legislation that are up for reauthorization in the next few years, including the Child Nutrition and WIC Reauthorization Act; the Elementary and Secondary Education Act; and the Surface Transportation Authorization Act.


Recommendations

Expand the commitment to community-based prevention programs initiated under the American Recovery and Reinvestment Act of 2009 through new provisions in the health reform law, such as Community Transformation grants and the National Diabetes Prevention Program.


Recommendations

Continue to invest in research and evaluation on nutrition, physical activity, obesity and obesity-related health outcomes and associated interventions.


Conclusions

The nationally representative data document a substantial increase in obesity among US adults with similar trends found in youth.


Conclusions

One factor that coincides with the increased rate of obesity worldwide in the last decade is the increased incidence of inactivity.

illinois state university body composition and disease

Documents

disease slide

focus slide

anorexia slide

dysfunction slide

highest rates of obesity

joint injury slide

heat stress slide

lower obesity prevalence