Obesity Flashcards
When was obesity recognized as a major health problem?
In the US surgeon general report of 2001
What did WHO say about obesity in 2011?
WHO stated that obesity had more than doubled from 1980-2011
What % of the world’s population live in countries where obesity kills more than being underweight?
65%
Who created the BMI formula?
Belgium statistician Adolphe Quelet
When was Adolphe Quelet alive?
1796-1874
What is BMI
Body mass indicator used to measure obesity
Who does BMI not work for?
- Muscular people
2. Kids
What is the ratio for BMI?
Weight to height
What is the metric BMI formula?
Weight in kg / height in m ^2
What are the units for the metric BMI formula?
Kg / m^2
What is the imperial BMI formula?
Weight in lbs x 703 / height in inches ^2
What are the units for the imperial BMI formula?
Lbs / inches ^2
What is the conversion factor of inches to m?
1m = 39.37 inches
What is the conversion factor of kg to lbs?
1kg = 2.2lbs
What is the ponderal index?
A more fair comparison between individuals of different stature
How do you calculate the ponderal index?
Weight in kg / height in m ^3
What are the units for the ponderal index?
Kg / m^3
What is a BMI healthy range?
Approximately 19 - 25
What is BMI higher risk?
Approximately 26 - 40
Who uses the BMI chart?
Pediatricans and PE teachers use BMI charts
Who created BMI charts?
WHO and Centers for Disease Control
What does it mean if a child is in the 95th percentile of weight for a given age?
It means that they have increased risk of obesity due to the fact that 95% of people lie below their weight and only 5% of people lie above
What would a typical BMI be for a short child who weighs more than normal?
They would have a high risk BMI
What would be a typical BMI for a tall child with the same weight as the short child?
They would have a normal BMI - body parts are proportional
What is underweight classified as?
<18.5
What percentile is underweight in?
Less than the 5th percentile
What is normal range classified as?
18.5 - 24.9
What percentile is normal range in?
Between 5th and 85th percentile
What is overweight range classified as?
> 25.0
What percentile is overweight in?
Between 85th and 95th percentile
What is pre-obese range classified as?
25.0 - 29.9
What is obese range classified as?
> 30.0
What percentile is obesity in?
Greater than the 95th percentile
What is obese class I range classified as?
30.0 - 34.9
What is obese class II range classified as?
35.0 - 39.9
What is obese class III range classified as?
> 40.0
What is severe thinness range classified as?
> 16.0
What is moderate thinness range classified as?
16.0 - 16.9
What is mild thinness range classified as?
17.0 - 18.49
What is a protective factor for a population in regards to BMI?
Being within a healthy range of weight to height
What BMI constitutes bariatric surgery candidates?
> 40.0
Who is Herschel Walker?
- World champ at 100m
2. Fullback for the Eagles
What is Herschel Walker’s height and weight?
6’2” and 240lbs
What is Herschel Walker’s BMI?
32.5
What would HW’s BMI imply about his life?
It implies that he is in the obese class I category
How much body fat does HW have?
4%
What is the discrepancy between BMI and HW?
He is technically considered in a high risk, obese class I range but when you look at his muscle vs. fat mass, he is nowhere near being too fat
Do women or men tend to have higher BMI’s when looking at the same age category?
Women - more BF generally
Explain the trend of the BMI curve in men and women between 2-20 years old.
It starts off at a higher BMI because children tend to have more BF, and then it dips as they grow out of baby fat, and then it continually increases as age increases due to height, adipose tissue, and muscle changes
What kind of relationship exists between obesity and all cause mortality?
A U or J shaped curve
What does the U or J shaped curve indicate?
It implies that as BMI is on the lower range (underweight) and on the higher range (overweight), there is more of a chance for premature death/all cause mortality
What is the nadir of the curve?
Lowest level of something being measured
What is the nadir of the curve in obesity vs. all cause mortality?
The people who have the lowest risk of mortality because they have a normal range of BMI
What do the U and J shape curves already account for?
Smokers - with or without history of disease
Non smokers - with or without history of disease
What does it mean if smokers and non smokers including their family histories are taken into account?
It means that despite whether someone smokes or does not or has a family history of disease or does not, their own individual BMI still correlates to a certain depiction of mortality rate
Do men tend to have all cause mortality rates higher at underweight or overweight end?
Overweight end
Do women tend to have all cause mortality rates higher at underweight or overweight end?
It is about equal
What kind of trend has been noticed in media coverage regarding obesity?
Media coverage on obesity epidemic has escalated as shown from 2000-2003 in a 4000 case increase
How much BF do men normally have?
12-20%
How much BF do obese men have?
Over 25%
How much BF does a man need to survive?
At least 4%
How much BF do women normally have?
20-30%
How much BF do obese women have?
Over 30%
How much BF does a woman need to survive?
8-9%
What kind of profession would someone with the minimum amount of BF be doing?
Elite running
What is overweight defined as?
Too much body weight for a given height and frame
What is obesity defined as?
An overeat level that brings with it an increased risk of serious and fatal disease
Can a person be overweight without being obese?
Yes
Give 2 examples of when someone can be overweight but not obese
- Muscle mass is greater than adipose mass
2. Low waist circumference but has a high BMI
Who is an example of being overweight but not obese?
Herschel Walker
What do you typically see in older people?
Someone who is not overweight but is overfat
What is it called when someone is not overweight but is overfat?
Sarcopenic obesity
What is sarcopenia?
Loss of muscle
What is sarcopenic obesity?
Losing a lot of muscle which procures a larger amount of adipose tissue/fat
Are people with sarcopenic obesity overweight?
No they are not overweight but they do have an over abundancy of fat
What kind of characteristics does someone with sarcopenic obesity have?
Fat and frail
What are the greatest health risks to sarcopenic obesity?
- Osteoporosis and falls
2. Metabolic syndrome and HD
What are the symptoms of frailty?
Osteoporosis
Are older people generally advised to retain some body fat?
Yes for BMR purposes but not when the fat becomes in excess
What % of people over 20 are overweight in the US?
67%
What % of youth between 2-19 are overweight?
16.3%
What % increase has the prevalence of overweightness been seen in 2-5yo?
5 to 12.4%
What % increase has the prevalence of overweightness been seen in 6-11yo?
6.5 to 17%
What % increase has the prevalence of overweightness seen in 12-19yo?
5 to 17.6%
What 3 things does PIA and excess weight when combined do to revenue in society?
- Increases health care medical costs
- Increases worker compensation
- Increases a loss of productivity
What other diseases are you at an increased risk for if you have obesity?
- CHD
- Type II diabetes
- Certain cancers
- HT
- High cholesterol
- Stroke
- Liver and gall bladder diseases
- Sleep apnea and respiratory problems
- OA
- Gynaecological problems
What kinds of cancers do you have increases risks for when you are obese?
- Endometrium
- Colon
- Breast
What constitutes a gynaecological problem?
Issues with menses and fertility
What is type I diabetes?
An auto-immune disorder where the body cannot produce insulin in the pancreas
What is type I diabetes also known as?
Juvenile diabetes
What is type II diabetes?
A metabolic disorder where the body can create insulin but there is too much glucose and so little space to bind that the body becomes insulin resistant and you retain glucose
What is type II diabetes also known as?
Adult diabetes
Is type II diabetes becoming prevalent in children nowadays?
Yes
What are modifiable risk factors for obesity?
- PIA
- Excess caloric intake
- Low socio-economic status
What are non modifiable risk factors for obesity?
- Age
- Heredity
- Ethnicity
- Culture
- Metabolism
What kind of PA best targets weight maintenance?
Aerobic activity is preferred over resistance training
What is the volume of PA needed for weight maintenance?
13 to 26 MET hours per week
What does 13 to 26 MET hours equate to?
- Walking 4 mph for 150 minutes of the week
2. Jogging 6mph for 75 minutes of the week
What is the best combination for weight maintenance?
Diet and exercise
What volume is needed to prevent weight regain?
30 MET hours or more per week
What is 30 MET hours equating to?
Walking 4 miles per hour for 50 minutes daily
How much PA should children acquire to prevent the risk of obesity?
At least 30 minutes of MVPA
What is an epidemiological measure?
The frequency at which an event occurs in terms of injury, disease, and cause of death
What was the issue with Grow Up Fertilizer?
Farmers had an increased prevalence to get ill due to toxins inside the fertilizer
What is an incident case?
New occurrences of these events during a time period of interest
What is a prevalent case?
Diseases that are developed and diagnosed already during a time period of interest
What are 2 examples of incident cases?
- Deaths from a certain disease
2. Not injured becoming injured
What trend is seen in adult overweight and obese categories at greater than 20yo in 1988 to 2003?
Overweight: 55% to 65%
Obesity: 22% to 32%
Are obese people categorized into the overweight portion?
Yes - because obese people also have >25 BMI alike overweight
Are overweight people categorized into the obese portion?
No - because overweight people do not have >30 BMI
Which group has a higher total % - overweight + obese or just obese?
Overweight + obese
What trend is seen in adult overweight and obese categories at greater than 20yo between specifically 1999 and 2003?
A smaller increase in the prevalence of overweightness and obesity compared to the increase from 1988 - 2003
Where is the prevalence of metabolic syndrome noted?
- Italy
- US
- Omani
- Porto
- Indian Americas
What typically occurs when people have arthritis or other rheumatic conditions?
They have reduced levels of leisure time PA due to these disabilities
How many people does arthritis and rheumatic conditions affect in the USA as of 1995?
About 40 million
How many people are arthritis and rheumatic conditions projected to affect in the USA as of 2020?
About 60 million
Are arthritis and rheumatic conditions the leading cause of disability in the US?
Yes
Why is PA leisure time down in people with arthritic disabilities?
They become less likely to do PA
What is a rate in epidemiology?
Number of events, cases, or deaths per population of interest across some period of time
What is a rate also described as in epidemiology?
The progression of disease statistics in terms of numbers in a specific population
What amount of children <12yo had medically attended injuries?
3835 - 8% of their population
What amount of children between 12-17yo had medically attended injuries?
2889 - about 12% of their population
How many people in Canada are obese?
7.6 million
What percentage of Canadians is this total?
7.6/33 = 0.231 = 23.1%
What is the approximate fraction of obesity in Canada?
About 1 in 4
What is the BRFSS?
Behavioural Risk Factor Surveillance System
What was considered as the obesity epidemic in America?
People with a BMI over 30 or people who were 30lbs overweight for a person at 5’4”
What is the typical trend of obesity in America between 1985-1990?
- A lot of states were not surveyed
- Most states began in the <10%
- As the years went on, the ratio of states went closer to most being in the 10-14% range
What happened in 1991 with the obesity epidemic in America?
An addition of a new colour was founded for mapping out states with 15-19% obesity rates
What is the typical trend of obesity from 1990-1995?
- Colorado was the last state to move to 10-14%
- All states are at 10-14% or higher
- Increasing proportion of 15-19%
What happened in 1997 with the obesity epidemic in America?
An addition of a new colour was founded for mapping out states with >20% obesity rates
What is the typical trend of obesity from 1995-2000?
- Increasing amount of 15-19%
- After 1997, most states are now at >20%
- Colorado was the last state to move out of 10-14%
What happened in 2001 with the obesity epidemic in America?
An addition of a new colour was founded for mapping out states with >25% obesity rates
What is the typical trend of obesity from 2000-2005?
- Most states sit at >25% obesity
2. 1 in 4 Americans have obesity
What happened in 2005 with the obesity epidemic in America?
An addition of a new colour was founded for mapping out states with >30% obesity rates
What is the typical trend from 2005-2010?
- Most states are at 25-29% of obesity rates
- The South is sitting primarily at >30%
- Colorado is the last state to change to 25-29%
What is the age adjusted obesity rate as of 2015?
USA is >26% obese
What is the age adjusted diabetes rate as of 2015?
USA in >9.0% diabetic in cases where obese is prevalent
What kind of obesity trend did Canada see in 1990?
Most provinces sat between 10-14% except for AB, BC, and QC
What kind of obesity trend did Canada see in 1994?
All provinces were at 10-14% obesity but now SK, MB, and the Maritimes were at 15-19% obese
What kind of obesity trend did Canada see in 1998?
All provinces were at 15-19% obese except for BC and QC
What kind of obesity trend did Canada see in 2000?
- BC and QC at 10-14%
- Yukon and central provinces are at 15-19%
- NW, NU, and Maritimes are >20% obese
When CDC measured the prevalence of BMI at 30+ in Canada between 1978 and 2010, what techniques did they use?
- Self reporting - telephone survey
2. Measuring - bringing people in
What was the general trend of BMI being at 30+ between 1978-2010 in Canada?
There was a steep almost doubling in the prevalence of obesity
Is self reporting accurate?
No
How does CDC’s study on BMI of over 30+ prove that self reporting is not accurate?
Measured BMI over 30 at 25% of people
Self reported BMI over 30 at 17% of people
Why is self reporting inaccurate?
- Non reliance of survey
2. Under/over reporting
What do men tend to over report?
Height
What do women tend to under report?
Weight
What do seriously obese people tend to not do?
Weigh themselves because they are fearful of what they might see
What are the trends of changing Canadian obesity rates between 1978-2004 in young adults (25-34)?
A tripling of obesity
What are the trends of changing Canadian obesity rates between 1978-2004 in children (12-17)?
A doubling of obesity
What are the trends of changing Canadian obesity rates between 1978-2004 in elderly (75+)?
A more than doubling of obesity
What percentage of elderly have sarcopenic obesity as of 2004?
About 30-40% of elderly people
What is a common trend seen in obese young adults?
They are likely to become obese older adults
Were genetic influences hard to measure 30 years ago?
Yes
What do they use to measure genes nowadays?
Genomic readers
Who is Dr. Stuntgart?
Father of Psychiatry
What did Dr. Stuntgart do?
He found separated identical twins and that the circumference of the children had identical profiles to a BMI closer related to their birth parents and to each other than their adoptive parents
What is a typical comparison between Canadian and American obesity rates?
Canadian women and men tend to be less obese
By what % are Canadian men less obese than American men?
About 5%
By what % are Canadian women less obese than American women?
About 10%
Who accounts for a large proportion of obese women in America?
African American women
What is the ratio of AA women who are obese in USA?
About 1 in 2
When looking at the % distribution of household population above 18 in Canada, where do most people sit?
In the normal weight range between 18.5 - 24.9 BMI
When looking at the % distribution of household population above 18 in Canada in 2004, who is included in the underweight group?
- Cancer patients
- Anorectic individuals
- Lean athletes
When looking at the % distribution of household population above 18 in Canada in 2004, are men more overweight and obese class I than women?
Yes
When looking at the % distribution of household population above 18 in Canada in 2004, are women more obese class II and III than men?
Yes
When looking at the % distribution of household population above 18 in Canada in 2004, are there more women or men at a normal weight?
There are more women sitting at a normal weight than men are
When looking at the % distribution of household population above 18 in Canada in 2004, what could the high number of overweight men be due to?
It could be due to discrepancies of muscle mass exclusion in the BMI ratio
In which country, outside of Canada and US, are female obesity rates the highest as of 1992?
England
What problem do developed countries have similar to USA and Canada?
Increasing obesity rate
What 3 countries have increased female obesity rates as of 1980 to 1992?
- Australia
- Brazil
- England
Has the prevalence of female obesity gone down in Brazil since the study of female obesity rates done in 1980 to 1992?
Yes - they have created better promotions of PA including Move for Health on World Health Day
What happened to Japanese female obesity rates in 1980-1992?
They maintained and even decreased slightly in the amount of female obesity
What happened to Swedish female obesity rates in 1980-1992?
They maintained and only slightly increased in the amount of female obesity
Why would Japan and Sweden have lower female obesity rates?
- Diet of F/V
2. Active commuters
What kinds of modifiable factors contribute to less obesity?
- Higher level education
2. Socio-economic status
At what age does the obesity epidemic start as seen in Canada in 2004?
It moves the greatest amount for men from 18-24 into 25-34 and it moves the greatest amount for women from 35-44 into 45-54
What happens to the rate and numbers of obesity as you age?
- Rate will drop off
2. Numbers continue to increase
When does the numbers of obesity stop increasing and start decreasing on the age spectrum?
After the age of 64 for both men and women
Why would the prevalence of obesity start to decrease after the age of 64?
- Obese people get sick and die early
- Older people do not get the same enjoyment of food due to a loss of smell and taste buds which causes minimized intake
What could be 1 reason why 35-44yo men have lower risks of obesity than 25-34yo men?
Plainly due to their age - most men between 25 and 34 are finishing university and starting to live life on their own again
What race did CDC find to have the least prevalence of obesity?
White non hispanics
What race did CDC find to have the second most prevalence of obesity?
Hispanics
What race did CDC find to have the most prevalence of obesity?
AA non hispanics
Of these AA non hispanics that are obese, what gender is it mainly?
Women
At the current rate of increase in obesity, what is the stat said to be by 2059?
All Americans will be overweight
According to the races that are most likely to become obese, who is most likely to become diabetic?
- AA non hispanics and Native Americans
- Hispanics
- White non Hispanics
Are people obsessed with weight?
Yes
Is thin waist and high BMI ideal?
No
What gender has the most problems with optimal BW?
Women - typically Caucasian women
Why are AA women more realistic with their weight than Caucasian women?
There is not as much of a stigma on weight in the AA population
What is the magnitude of obesity in accordance with?
The prevalence of obesity in society
Which age category has the worst magnitude of obesity?
45 to 54 year olds and 55 to 64 year olds
What causes decreases in the magnitude of obesity at 75+?
- Death
- Decrease in enjoyment of food
- Decrease in intake of food
- Sarcopenic obesity (appearing to be over fat but do not have a high BMI)
What is the optimal BW?
BMI at 18.5 - 24.9
What is a weight optimal for appearances?
- Individually decided
2. Based largely on beauty standards
What is a weight optimal for peak performances?
Based on the sport or performance that the individual is looking for
What 3 layers of the body are there?
- Outer- skin and fat
- Middle - muscles
- Inner - bones
What are the 2 typical body composition changes in Canadian people from 25 to 55 years old?
- Gaining 1 pound per year = 30lb increase
2. Losing 1/2 pound per year = 15lb decrease