ABC of obesity by Naveed Sattar; Mike Lean

By Naveed Sattar; Mike Lean

Weight problems is a highly dear and extending challenge world wide, resulting in incapacity, reproductive difficulties, melancholy and speeded up metabolic and vascular ailments in a wide percentage of fellows, girls and kids. The ABC of Obesity is a brand new advisor with a purpose to reduction its powerful administration, addressing matters equivalent to eating regimen, workout, self worth, drug remedy and surgical procedure. fresh proof is used to spotlight widespread difficulties, winning therapies, and the commonest causes.

Written by way of best specialists, this can be a broadly obtainable textual content and an essential consultant for all basic practitioners, junior medical professionals, nurses, and different healthcare execs who're interested by the remedy and study of this universal

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A prospective study in Korean men. Stroke 2004;35:831-6. x Murphy NF, MacIntyre K, Stewart S, Hart CL, Hole D, McMurray JJ. Long-term cardiovascular consequences of obesity: 20-year follow-up of more than 15 000 middle-aged men and women (the Renfrew-Paisley study). Eur Heart J 2006;27:96-106. x Whitmer RA, Gunderson EP, Barrett-Connor E, Quesenberry CP Jr, Yaffe K. Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study. BMJ 2005;330:1360-5. x British Cardiac Society et al.

Definitions of insulin resistance Broad definition Insulin resistance is a clinical state in which a normal or raised insulin level produces an impaired biological response. As insulin has a number of physiological actions—including a central role in acute metabolic actions and growth and development—insulin resistance could mean impairment in any of these actions Specific definition in relation to metabolic syndrome Insulin resistance, when used to identify those at risk of type 2 diabetes and as a component of the metabolic syndrome, usually refers to resistance to insulin’s ability to stimulate glucose uptake in insulin sensitive peripheral tissues and its ability to suppress hepatic glucose production, promote glucose storage, inhibit ketogenesis, and suppress lipolysis Ethnic and sex specific definitions of obesity (based on waist circumference) used in the International Diabetes Federation’s definition of metabolic syndrome Ethnic group Waist circumference (women; men) Europids South Asians, Chinese, Japanese Ethnic south and central Americans ≥ 80 cm; ≥ 94 cm ≥ 80 cm; ≥ 90 cm Use data for South Asians pending more specific research data Use data for Europids pending more specific research data Sub-Saharan Africans; eastern Mediterranean and middle eastern (Arab) populations There are several problems with using a “diagnosis” of the metabolic syndrome (on the basis of the three definitions) as a screening test to identify people who would benefit from an intervention to improve cardiovascular health (such as weight management).

Measures directed at changing the price, availability, and nutritional characteristics of food may have a positive effect across social groups. Over 90% of the weight gain seen in US adults results from a positive energy balance of <100 kcal a day Childhood overweight and obesity x Overweight and obesity are increasing in children of all ages, and “obese” teenagers enter adult life already with a BMI > 25 x Although obese children do not often have immediate health problems, and most obese adults were not obese as children, many obese children become obese adults x Efforts to prevent obesity in childhood and its progression into adulthood are fuelled by a belief that it might be possible to influence lifelong behavioural patterns The World Health Organization has convened a ministerial conference on “counteracting obesity” in Istanbul, Turkey, in November this year, where a charter on counteracting obesity will be signed Core actions proposed by WHO x Reducing commercial pressure on people (particularly children) to consume high energy products x Reducing fat, sugar, and salt in manufactured products x Enabling easier and cheaper access to healthy food x Introducing measures to improve food and increase physical activity in schools and the workplace x Promoting cycling and walking by better urban design and transport policies x Creating opportunities in local environments for people to be more physically active in their leisure time x Encouraging health services to provide advice on diet and physical activity, and promote exclusive breast feeding WHO has advocated the involvement of the different government sectors, as well as the private sector and civil society.

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