Chronic diseases Flashcards

Question

What are some potential drawbacks of labeling obesity as a disease?

Answer 1

Some cons include potentially taking the burden away from the individual, increasing stigma for some, overemphasizing surgery and drugs over behavior change, and potential hiring hesitancy by employers due to healthcare costs.

Answer 2

The Body Mass Index (BMI) is the most commonly used measure. It is calculated as weight in kilograms divided by height in meters squared (wt(kg)/ht(m)²). BMI is simple, inexpensive, and noninvasive, acting as an indirect measure correlated with body fat and future health risk

Answer 3

BMI does not distinguish between excess fat, muscle, or bone mass. It also does not indicate fat distribution, and factors like age, sex, and muscle mass can influence the relationship between BMI and body fat

Answer 4

There are three widely used classifications for children: * Centre for Disease Control (CDC) growth charts (2000): Overweight is a BMI above the 85th percentile, and obesity is a BMI above the 95th percentile of the reference population. * WHO Criteria (2007): Overweight is a BMI > 1 SD, and obesity is a BMI > 2 SD from the mean of the WHO reference population. * International Obesity Task Force (IOTF) 2005: These cut-points are mathematically extrapolated from adult cut-offs (overweight 25, obese 30) to children age 2 and correspond with them

Answer 5

Adult BMI classifications cannot be directly used for children because their BMI varies/changes largely as they grow.

Answer 6

Obesity is associated with a greatly increased risk (RR > 3) for Type 2 diabetes (T2D). It also carries a moderately increased risk (RR = 2-3) for Coronary heart disease (CHD) and Cancer, and a slightly increased risk (RR = 1-2) for Hypertension.

Answer 7

This increased risk of chronic diseases was a significant reason why obesity was initially recognized and classified as a risk factor before later being recognized as a disease

Answer 8

In 1985, the prevalence of obesity (BMI ≥ 30) among Canadian adults was less than 10% in many regions, with some areas showing 10-14%.

Answer 9

By 2004, the prevalence of obesity (BMI ≥ 30) in Canadian adults had increased significantly compared to 1985, with many regions falling into the 15-19% and 20-25% ranges. The period between 1985 and 2004 saw a considerable increase in BMI.

Answer 10

In 2018, 26.8% of Canadians (7.3 million) reported a BMI that classified them as obese. An additional 36.3% (9.9 million) were classified as overweight. This means that in 2018, 63.1% of the total population had increased health risks due to overweight or obesity, an increase from 61.9% in 2015

Answer 11

Trends indicate that females have lower rates of obesity compared to males, and obesity increases with age.

Answer 12

* Factors contributing to the rise in obesity include less activity and more sedentary behavior leading to insufficient energy expenditure. * Increased access to ultra-processed foods (UPF) can lead to an increase in calories eaten, alongside a decrease in the consumption of whole foods and fruits. * The availability and portion sizes of food also play a role. Furthermore, changes in how we store and utilize fat may have occurred. A rise in sedentary occupations has led to a reduction of 100-150 kcal expended per day, which aligns with measured weight gain. * Increased energy availability in the food supply, along with increased availability, marketing, and consumption of ultra-processed foods, is likely an important driver of obesity. * Obesity is a complex disease with several causes, primarily an energy imbalance impacted by individual factors (like genetics) and several factors outside the individual (obeseogenic environment)

Answer 13

While twin studies suggest a high heritability of BMI in the 50-90% range, the environment still plays an important role. * Under conditions of normal energy intake and expenditure, the body weight of susceptible individuals may barely differ from normal individuals. * However, under conditions of high energy intake OR reduced energy expenditure, body weight in a susceptible population increases. * Changes in genetic predisposition do not happen over a few years, nor do they affect all age groups simultaneously, suggesting that environmental factors are significant in the rapid rise of obesity. * Genetics begins to play a role in the extent of weight gain under obesogenic conditions. What is around individuals is very important for the prevalence of obesity/overweight.

Answer 14

A key cause of weight gain is an energy imbalance. There has been a decline in high activity occupations and an increase in sedentary occupations, leading to a reduction in energy expenditure. At very low levels of energy expenditure (EE) in sedentary work, there can be a dissociation between EE and energy intake (EI), where dietary intake increases disproportionately to energy expended. The rise in sedentary occupations has led to an estimated reduction of 100-150 kcal expended per day, which matches observed weight gain. Changes in physical activity are likely an important part of the conversation regarding the obesity epidemic. More physically active individuals may have bodies that are better at responding to signals to eat and stop eating, helping to match expenditure to intake.

Answer 15

Increasing the amount of food available for consumption increases ad libitum energy intake. Globally, the increase in energy per capita is positively correlated with observed weight gain, and the magnitude of this increase is sufficient to account for the observed weight gain in 80% of nations. Increased energy availability in the food supply is likely an important driver of obesity. The increased availability, marketing, and consumption of ultra-processed foods have been associated with rising obesity prevalence

Answer 16

A key cause of energy imbalance is impacted by several factors outside of the individual, described as the "obeseogenic environment". While the sources don't explicitly detail social/environmental determinants in relation to energy expenditure and intake, we can infer connections. For example, urban planning that prioritizes cars over active transportation can lead to reduced physical activity (reduced energy expenditure). Similarly, the availability and affordability of ultra-processed, calorie-dense foods in certain neighborhoods (increased energy intake) are influenced by social and economic factors and the food environment. Access to safe and appealing spaces for recreation and the marketing of unhealthy foods are other examples of social/environmental determinants influencing energy balance

Answer 17

Weight bias is common among students in physical education, kinesiology, and exercise science programs. Obese persons are subject to severe societal discrimination in ways that those with seemingly similar chronic conditions are not. This bias can lead to increased medical visits, avoidance of health care, negative feelings, and unhealthy behaviors and poor self-care, contributing to a cycle involving obesity and bias in health care. The idea of simply telling people to "move more, eat less" is an oversimplification in the face of this cycle

Answer 18

These diseases fall under the physical aspect of health. The source then notes that physical activity can positively impact physical, mental, and social health.

Answer 19

PA leads to changes in brain structure and function at cellular, systems, and behavioral levels. The impact of SB on the brain is not yet as well understood but is likely detrimental. The mechanisms of SB's impact are not fully known.

Answer 20

The three key behavioral brain health outcomes are likely: * Cognitive Performance / Executive Function / Academic Achievement * Dementia Risk (including Alzheimer's disease) * Depression / Mental Illness

Answer 21

Higher TV viewing and screen time were associated with poorer cognitive development. Higher physical activity was associated with better cognitive development. Physical activity can enhance cognitive functions, which improves academic achievement

Answer 22

Executive function (or cognitive control) refers to a set of cognitive skills critical for advanced development and the execution of complex tasks. Situations requiring executive function include novel tasks, planning, problem-solving, and conscious choices among alternatives. Short-term memory is one skill related to executive function. The other two specific skills that comprise executive function are not explicitly listed in the provided excerpts, though the concept is introduced.

Answer 23

Early years are critical for brain development, characterized by significant growth. By age 2, the human brain reaches about 80% of its adult weight, and by age 5, about 90%. This period is sensitive to environmental influences, and we must optimize development by ensuring children are exposed to developmentally enriching and enhancing environments. Cannabis reduces executive function and decreases brain health.

Answer 24

Dementia is a general or overall term for a decline in mental ability severe enough to interfere with daily life. Alzheimer's disease is the most common type of dementia, accounting for 60-80% of dementia cases. Therefore, Alzheimer's is a type of dementia.

Answer 25

Research suggests a reduced risk for cognitive decline with both low/moderate (35%) and high duration (38%) of physical activity in older adults. High duration of physical activity is also linked to a reduced risk of Alzheimer's disease (39-82%) and all-cause dementia (39%). Aerobic physical activity training in older adults has shown to increase the volume of the hippocampus, a brain component associated with long-term memory, which normally declines with age

Answer 26

Mental illness is defined as a serious disturbance in thoughts, feelings, and perceptions severe enough to affect day-to-day functioning. Depression is a common type of mental illness characterized by intense feelings of sadness and worthlessness that can lead to a loss of interest in life. Approximately 8-9% of Canadians will experience depression in their lifetime

Answer 27

review of 30 population-based studies reported a nearly universal inverse relationship between physical activity and depression. This suggests that higher levels of physical activity are associated with lower rates of depression. Physical activity is considered a tool to help with depression, although more serious cases may require therapy. Reviews also indicate that physical activity has potentially beneficial effects for reduced depression and a small beneficial effect for reduced anxiety.

Answer 28

There are consistent detrimental associations between sedentary behavior and mental health

Answer 29

Social media can have positive features like providing communities and social support, but also negative features such as social comparisons, promoting maladaptive behavior, online discrimination, digital stress, negative peer influence/pressure, and impacts on brain development

Answer 30

Diabetes is a chronic disease where the body cannot produce insulin or cannot properly use the insulin it produces. Insulin is a hormone that controls blood glucose (blood sugar), and the body needs it for energy. Diabetes leads to high blood glucose levels, which can damage organs, blood vessels, and nerves. Diabetes is an umbrella term encompassing different types of the disease

Answer 31

T2DM occurs when the body does not effectively use the insulin that is produced, and/or when the pancreas does not produce enough insulin. It usually develops in adulthood, but is increasingly diagnosed in children and adolescents. 90-95% of people with diabetes have T2DM, making it the focus. T2DM is strongly linked to several behavioral risk factors

Answer 32

The graph shows five stages: * Stage 1: Normal: Normal insulin production, no insulin resistance, stable and low blood glucose. * Stage 2: Impaired glucose intolerance (pre-diabetic): Insulin resistance begins, leading to increased blood glucose. Insulin production increases to compensate (hyperinsulinemia). * Stage 3: Peak insulin production: Insulin production reaches its maximum in an attempt to counteract high blood glucose due to insulin resistance. * Stage 4: Pancreatic adjustment: The pancreas may have reduced ability to produce insulin, leading to decreased insulin production alongside high insulin resistance, both contributing to increased blood glucose. * Stage 5: Type 2 Diabetes: Clinically diagnosed with high blood glucose and low insulin production.

Answer 33

The rise in T2DM in children is thought to be partly due to rising obesity in children and youth. Obesity is a strong risk factor for developing T2DM with a greatly increased risk (RR > 3). While the increase in obesity rates has slowed in recent years, rates are still high, with a large percentage (~63%) of the population at increased health risks due to overweight and obesity. The link between behavioral aspects and T2DM also contributes to diagnoses in younger populations.

Answer 34

Diabetes is having a significant impact on Indigenous Peoples in Canada. Apart from the Inuit population, all other Indigenous populations (First Nations on and off-reserve, and Métis) have a higher prevalence rate of diabetes compared to non-Indigenous populations. These prevalence rates are age-standardized to account for the younger age structure of Indigenous populations. It's also noted that these are self-reported data, and under-reporting is likely, suggesting an even higher prevalence.

Answer 35

Several overlapping and compounding risk factors contribute to the higher prevalence in Indigenous Peoples: * Genetics: The "Thrifty gene effect" suggests a genetic predisposition to conserve calories as a response to historical periods of starvation. * Biological: Females are listed as a biological risk factor. * Environment (Social Determinants of Health): Living in rural/remote areas leads to: ◦ Reduced opportunities for education and employment. ◦ Less access to health care. ◦ Changing environments, displacement, hunting and fishing costs or restrictions, and a loss of harvesting capabilities, impacting traditional food sources. * Lifestyle (Behavioral Determinants of Health): Physical inactivity and unhealthy eating patterns, partly due to the disappearance of traditional lifestyles and changing environments. These factors are a result of Canada’s historic and continued colonial policies, lack of access to healthy, nutritious, and affordable food, and a strong genetic risk. These intersecting factors have undermined Indigenous values, culture, and spiritual practices, creating lasting physical, mental, emotional, and social harms.

Answer 36

The major non-modifiable risk factors for T2DM are: * Age: The risk increases with age as chronic diseases develop over a lifetime. * Ethnicity: Individuals of Indigenous, Hispanic, Asian, South Asian, or African descent have a higher genetic risk. * Family history: A family history of diabetes is a strong risk factor; for example, 90% of children diagnosed with T2DM have a family history of it.

Answer 37

The major modifiable risk factors for T2DM are: **Behavioral:** * Physical inactivity * Unhealthy diet (sugar, saturated fats) * Sedentary behavior * Tobacco use **Intermediate:** * Raised blood pressure (hypertension) * Raised blood lipids (e.g., cholesterol) * Overweight and obesity (especially in the abdominal area) Addressing these modifiable risk factors through population-level approaches is important for preventing T2DM. Many of these risk factors are similar to those for Coronary Heart Disease (CHD) and stroke, and diabetes is a determinant of CHD. People with diabetes are 2.5 to more than 3 times as likely to suffer heart attacks.