Friday 30 August 2013

Alarming epidemic of obesity

Statistics & figures

Obesity, today, is now regarded by many as “silent killer”

The global number of people who is suffering from overweight in adult population is approximately 1.6 billion people (age more than 15 years) and at least 400 million of that are obese. Similarly, with respect to global childhood obesity, there are at least 20 million children under 5 that either have overweight or, that can turn into obesity if their parents don't take the necessary measures. The projection of the WHO by the year 2015 is that approximately 2.3 billion adults will be overweight and more than 700 million will be obese.

While globally, there have been significant increases in obesity prevalence rates over the last 20 years, the following statistics indicate the alarming threat of obesity with respect to specific North American & European countries.

Obesity in USA

Over two-thirds of adults in the United States are overweight or obese, and over one-third are obese, according to data from the National Health and Nutrition Examination Survey (NHANES) 2003–2006and 2007–2008. According to the same estimate:

•    68 percent of all adults in US are overweight
•    64.1 percent of all women in US are overweight
•    72.3 percent of all men in US are overweight
Similarly, according to the same statistics, over one-third of U.S. adults are obese which means:
•    33.8 percent of all adults in US are obese
•    35.5 percent of all women in US are obese
•    32.2 percent of all men in US are obese

Obesity in UK

Within the UK, English obesity prevalence rates in adults have increased by three- to four-fold since the 1980s. The most recent available data from England and Scotland indicate obesity prevalence rates are similar in men and boys at 22 percent and 18 percent respectively. The obesity prevalence rate in Scottish women is 19 percent higher than in English women (26 percent compared to 21.9 percent). Among girls, the prevalence rate of obesity is 30 percent higher in England (18.1 percent) than in Scotland (13.8 percent).

Some of the biggest causes of the increasing obese population in high-income countries and nations include:

•    The global shift in diet towards increased intake of energy-dense-foods
•    The decreasing physical activity due to the increasingly sedentary nature of many types of work
•    Changing ways of transportation and increasingly urbanization
•    More dependency on fast food as daily meals

In addition, these days is also dramatically changing the situation in low and middle-income countries, particularly in urban settings, lead to the tendency to consume more food rich in fat and sugar and to the insufficient access to sport and fitness facilities.

In short, it is clear from the above discussion that obesity is now growing almost as an epidemic with rapidly growing rates especially among developed nations. Unfortunately, medical drug treatment or surgery has been unable to address the underlying causes of obesity even among affordable population.

Measuring your body weight & fat…

Choices other than the BMI!

Why do we need alternatives?

The Body Mass Index (BMI), a measure of weight in relation to height, is commonly used for classifying overweight and obesity. The risks of cardiovascular disease and type 2 diabetes tend to increase on a continuum with increasing BMI, but for practical purposes a person with a BMI of over 25 is considered overweight, while someone with a BMI of over 30 is obese. But one size does not fit all. In women, a BMI as low as 21 may be associated with the greatest protection from coronary heart disease death. The BMI for observed risk in different Asian populations varies from 22 to 25 kg/m2. Therefore, dieticians, nutritionists and weight loss experts believe that other methods should also be used to evaluate a person’s overall health risk and the associated grade of obesity.

Alternatives to Body Mass Index


There are two main and common alternatives to Body Mass Index:

1-    Waist-Hip Ratio (Pears” vs. “Apples”)

Health care providers are concerned not only with how much fat a person has, but also where the fat is located on the body. Women typically collect fat in their hips and buttocks, giving them a “pear” shape. Men usually build up fat around their bellies, giving them more of an “apple” shape. Of course some men are pear-shaped and some women become apple-shaped, especially after menopause. If you carry fat mainly around your waist, you are more likely to develop obesity-related health problems. Women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches have a higher health risk because of their fat distribution.

2-    Waist circumference


Circumference is the perimeter of, or the distance around a circle. So waist circumference is a measure of the distance around the abdomen. Waist circumference is one of the most practical tools to assess abdominal fat for chronic disease risk and during weight loss treatment. A high waist circumference or a greater level of abdominal fat is associated with an increased risk for type 2 diabetes, high cholesterol, high blood pressure and heart disease.

According to the United States Department of Health and Human Services the following individuals are at increased risk for developing chronic diseases:

• Women with a waist circumference of more than 35 inches.
• Men with a waist circumference of more than 40 inches.

However, however, lower thresholds for waist circumference have been recommended for Asian populations by the World Health Organization due to recent research findings. Therefore, those at increased risk for developing chronic disease include:

• Asian women with a waist circumference of more than 31 inches.
• Asian men with a waist circumference of more than 35 inches.

To measure waist circumference locate the top of the hip bone. Place the tape measure evenly around the bare abdomen at the level of this bone. Read the tape measure and record the waist circumference in inches. Ensure that the tape is sung but does not push tightly into the skin and you measure waist circumference after breathing out normally.

Is waist circumference better indicator than BMI?


Waist circumference may be a better indicator of health risk than BMI alone, especially when used in combination with BMI. Waist circumference is particularly useful for individuals with a BMI of 25-34.9. For individuals with a BMI > than 35, waist circumference adds little predictive power on the disease risk classification of BMI.

Studies have shown that the distribution of body fat is associated with an increased prevalence of diabetes, hypertension, high cholesterol and cardiovascular disease. Generally, the association between health risks and body fat distribution is as follows:

• Least risk – slim (no pot belly)
• Moderate risk – overweight with no pot belly
• Moderate to high risk – slim with pot belly
• High risk – overweight with pot belly.

Waist circumference and health risks

Waist circumference can be used to indicate health risk.

For men:

• 94cm or more – increased risk
• 102cm or more – substantially increased risk.

For women:

• 80cm or more – increased risk
• 88cm or more – substantially increased risk.

Conclusion

It is crystal clear from the above discussion that no single measure including BMI is 100 accurate in determining the exact health risk due to your body weight. You should, therefore, reply on , multiple methods such as BMI, wait to hip ratio and waist circumference to evaluate such risks and their link with your body weight and body fat.
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