Obesity - non communicable diseases ppt.

obesity

1. Obesity -Dr Vishnu C S 1

2. Contents Introduction Prevalence Epidemiological determinants Assessment of Obesity Hazards of obesity Prevention and control 2

3. Introduction Definition “ abnormal growth of the adipose tissue due to an enlargement of fat cell size (hypertrophic obesity) or an increase in fat cell number (hyperplastic obesity) or a combination of both. ” 3

4. Android Vs Gynoid obesity 4 Reference: https://www.resilienthuman.co.uk/post/types-of-fat-and-the-role-it-plays-in-our-health

5. Prevalence Most prevalent form of malnutrition Overweight and obesity-fifth leading cause of global deaths In 2019-more than 38.2 million children under 5 years were overweight and obese Developing countries-30 million Developed countries-10 million 3.4 million die each year-overweight or obesity Linked to more deaths worldwide than underweight. 5

6. Prevalence –India NFHS 5 data Women age(15-49yrs) Overweight/obese-24% Men)15-49) Overweight/obese-23% 6

7. Epidemiological determinants Age Sex Genetic factors Physical inactivity Socioeconomic status Eating habilts 7. Psycho-social factors 8.Familial tendancy 9.Endocrine factors 10.Alcohol 11.Education 12.Smoking 13. Ethnicity 14. Drugs 7

8. 1. Age Obesity can occur at any age, and generally increases with age. Infants with excessive weight gain have an increased incidence of obesity in later life . About one-third of obese adults have been so since childhood Most adipose cells are formed early in life-hyperplastic obesity Hyperplastic obesity in adults-Extremely difficult to treat 8

9. 2. Sex Women-higher rate compared to men Framingham study-Most weight gain Men-25-35 years Women-45-49 years Womens BMI-Increases with successive pregnancies(1kg/pregnancy) 9

10. Genetic factors Twin Studies-Shown correlation between weights of identical twins Profile of fat distribution-50 percent due to genetics Recent studies-Amount of abdominal fat influenced by genetic factors 10

11. Physical inactivity Regular physical activity-protective against obesity Sedentary lifestyle-occupation and inactive recreation Physical activity and fitness –modifiers of mortality and morbidity related to obesity Some individuals-reduced activity without calories restriction-Obesity Vicious cycle 11

12. SOCIO-ECONOMIC STATUS Clear relationship between socioeconomic status and obesity More prevalent in lower socioeconomic groups 12

13. EATING HABITS Composition of diet, periodicity with which its eaten-obesity Diet with more energy-prolonged post prandial hyperlipidemia -Obesity Role of television and social media-Fast food advertisements. Child-Energy requirement-2000kcal/day Consumes 100kcal/day-gain of 5 kg/year 13

14. PSYCHOSOCIAL FACTORS Psychosocial factors- aetiology of obesity Overeating-symptom of depression, anxiety, frustration and loneliness in childhood. Excessively obese individuals are usually withdrawn, self-conscious, lonely and secret eaters. An insight into the circumstances in which the obesity has developed is essential for planning the most suitable management 14

15. Other factors Familial tendency: obese parents frequently having obese children Endocrine factors : e.g., Cushing's syndrome , growth hormone deficiency Education Smoking Ethnicity Drugs- cortico-steroids, contraceptives, insulin, adrenergic blockers 15

16. Assessment of Obesity Body composition Active mass(muscle, liver, heart) Fatty mass(fat) Extracellular fluid(blood, lymph etc.) Connnective tissue(skins, bone,connective tissue) State of obesity- increase in the fatty mass 16

17. Body weight Body weight-not an accurate measure of excess fat, Widely used -In epidemiological studies Indicators Body mass index ( Quetelet's index) Ponderal index Brocca’s index Lorentz's formula Corpulence index 17

18. Body Mass Index Also called Quetelet's index BMI = Weight(kg)/Height^2(m) Limitations:BMI doesn't differentiate between muscle and fat Reference: https://hwin.infprojects.fhsu.edu/final_project/obesity.html 18

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20. Other indicators Ponderal index =Height (cm)/Cube root of body weight (kg) Brocca index = Height (cm) minus 100 Corpulence index =Actual weight /Desirable weight Lorentz's formula = Ht (cm) - 100 – Ht (cm)-150/2 (women) or 4 (men) 20

21. 2.SkinFold Thickness A large proportion of total body fat the skin. Most accessible-skinfold thickness. rapid and "non- invasive" method-uses Harpendens Calipers Four sites Measurements- mid-triceps, biceps, subscapular and suprailiac regions. The sum-less than 40 mm in boys and 50 mm in girls 21

22. 3. WAIST CIRCUMFERENCE AND WAIST: HIP RATIO (WHR) Waist circumference is measured at the mid point between the lower border of the rib cage and the iliac crest. It is a convenient and simple measurement WHR and is an approximate index of intra-abdominal fat mass and total body fat. Changes in waist circumference reflect changes in risk factors for cardiovascular disease A high WHR (> 1.0 in men and > 0.85 in women) indicates abdominal fat accumulation. 22

23. 4. OTHERS Total body water, of total body potassium and of body density. The introduction of measuring fat cells has opened up a new field in obesity research. 23

24. Hazards of Obesity Increased morbidity increased mortality 24

25. Prevention and Control DIETARY CHANGES. INCREASED PHYSICAL ACTIVITY. OTHERS. 25

26. Dietary changes The proportion of energy-dense foods such as simple carbohydrates and fats should be reduced the fibre content in the diet should be increased the food energy intake should not be greater than energy expenditure. Patient's behaviour and strong motivation -lose weight and maintain ideal weight. Unfortunately, most attempts to reduce weight in obese persons by dietary advice remain unsuccessful. 26

27. INCREASED PHYSICAL ACTIVITY This is an important part of weight reducing programme. Regular physical exercise is the key to an increased energy expenditure. 27

28. OTHERS: Appetite suppressing drugs have been tried in the control of obesity. Surgical treatment -e.g., gastric bypass, gastroplasty, jaw-wiring Health education -important role. A fruitful approach -identify those children who are at risk of becoming obese and find way of preventing it. 28

29. References Park K. Park’s textbook of preventive and social medicine. 28 th edition. Jabalpur. Banarsidas bhanot publishers:2024 Community Medicine with recent advances 7th edition by A H Suryakantha WHO bulletin of the World Health Organization, 2016. 29

30. Thank You 30