Chronic Disease - Diabetes/Obesity Flashcards
how is obesity defined
abnormal or excessive fat accumulation that may impair health
BMI is most common measure - weight /height per metres squared
outline the WHO BMI classification of obesity in adults
from 30 to >40kg/ metre squared
how is BMI classified in children (5-19 years)
overweight = BMI for age greater than 1 standard deviation above the WHO growth reference median
obesity = greater than 2 standard deviations above WHO growth reference median
is BMI a good measure for children?
not good but allows comparison of obesity prevalence in populations
does not account for fact body sizes have gone up in past decades
also children height increases differently
what may be a better measure of health risk?
distribution of adipose tissue - upper/abdominal fat, lower body fat
men and women have different adipose phenotype
what are other measures of total fat distribution
BIA (bioimpedance analysis)
DXA (dual X ray absorptiometry)
what is the global prevalence of excess weight
38% were overweight or obese in 2020 - expected to rise to 51% in 2035
what is the global prevalence of obesity
14% obese in 2020, expected to rise to 24% in 2035
what is the prevalence of obesity in children
8-10% obese in 2020
expected to rise to 18-20% in 2035
outline childhood obesity in under 5s
once considered a high income country problem but now on the rise in low and middle income countries
almost half the children under 5 overweight or obese in 2019 lived in asia
how has childhood obesity increased
340 million children overweight or obese in 2016
the rise has occurred similarly in boys and girls
what cause obesity / excess body fat
energy imbalance between calories consumed and calories expended - input and output
increased consumption of ‘energy dense’ foods
decrease in physical activity and increase in sedentary behaviour
what are health problems associated with obesity
type 2 diabetes
high blood pressure
coronary heart disease
asthma
reduced fertility
osteoarthiritis
sleep apnoea
how has cause of death changed from 1900 to now
from infectious disease to chronic disease - heart disease and cancer
which country is the most obesogenic
mexico
what is diabetes
condition in which the body cannot control blood sugar levels because of problems with insulin
- impaired insulin-mediated glucose uptake by peripheral muscles
- insulin sensitivity -> insulin resistance
what is meant by insulin resistance
insulin is not able to become sensitive so muscles cannot take up blood sugar to provide energy to the muscles
what are the 3 types of diabetes
gestational - in pregnancy
type I diabetes - autoimmune condition - body thinks pancreas is foreign agent
type II diabetes - lifestyle influenced
what are risk factors for gestational diabetes
obesity
gestational diabetes in previous pregnancy
type II diabetes in parent or sibling
ethnicity - highest in south asian and black people
what are consequences of gestational diabetes
high birth weight (macrosomia)
premature delivery
pre-eclampsia
jaundice
outline type I diabetes
immune system attacks pancreatic beta cells that secrete insulin
tends to affect people before 40
patients require insulin and blood glucose control
10% of people with diabetes have type I in UK
is the cause of type I diabetes known
exact cause is unknown
what are potential risk factors for type I diabetes
genetics
family history
viruses
other environmental factors
what are consequences of type I diabetes
heart disease, nerve damage, kidney damage
SYSTEMIC effect on body
skin and mouth conditions
pregnancy complications
outline type II diabetes
chronic condition causing excess glucose in blood
control measures are diet, exercise, medication +insulin
suggested to be reversible via weight loss and drugs
has there been an increase in the prevalence of diabetes
huge increase in global prevalence
1980 = 108 million
2014 = 422 million
90% of which is type II
outline the time trends of diabetes prevalence
type 1 is static but type II is rising
how could we prevent this from happening
prevent those with high blood sugar (hyperglycaemia) reaching threshold for diabetes
what are risk factors for type II diabetes
genetic predisposition
ethnicity - higher risk in south asians linked to body fat distribution
increasing age - lifestyle changes, seen in younger people
energy dense diet
low physical activity
abdominal fat
overweight or obese
what % of the risk for type II diabetes does central obesity account for
80-85%
what is the trend with diabetes and obesity
they mirror eachother
it is a very important risk factor
what are consequences of type II diabetes
similar to type 1
heart disease
nerve damage
sleep apnoea
slow healing
skin conditions
