Prevention of Obesity

Question 1

Consequences of obesity?

Answer 1

Doubles the odds of being unable to live a normal, active life

With severe obesity, 8-10 year reduction in life expectancy

Question 2

Medical complications of obesity?

Answer 2

• Diabetes, dyslipidaemia and hypertension
• Stroke and CHD
• Idiopathic intracranial hypertension
• Pulmonary disease (obstructive sleep apnoea can lead to hypoventilation syndrome)
• NAFLD (steatosis, steatohepatitis and cirrhosis) and gall bladder disease
• Cancer (breast, uterus, kidney, colon, oesophagus, pancreas and gall bladder)
• Skin problems and cataracts
• Gout and OA
• Phlebitis (due to venous stasis)
• Gynecologic abnormalities, e.g: abnormal menses/infertility, PCOS, numerous pregnancy complications

Question 3

BMIs (Kg/m2) that equate to different risk levels in different populations?

Answer 3

White-European population:
• Underweight (<18.5)
• Increasing but acceptable risk (<18.5-24.9)
• Increased risk (25-29.9)
• High risk (≥30)

In asian populations, increased risk is considered to be 23-27.5 and high risk is considered ≥27.5

Question 4

Male and female thresholds for waist circumference (cm) in different population?

Answer 4

European, Sub-Saharan Africans, Eastern Mediterranean, middle east (Arab):
• Male - ≥94
• Female - ≥80

South Asians, Chinese, Japanese, Ethnic south and central Americans:
• Male - ≥90
• Female - ≥80

Question 5

Increased risks with different BMIs?

Answer 5

ADD TABLE

Question 6

Centile cut-offs for weight status in children (2-18 years)?

Answer 6

99. 6th: individual ‘severely obese’
    98th: individual ‘obese’ (95th used for population)
    91st: individual ‘overweight’ (85th used for population)

2nd - <91st: healthy range (2nd - <85th used for population)

Question 7

High risk population sub-groups?

Answer 7

• Socioeconomically deprived

• Post-obese
• Obese children or children with obese parents
• Rapid weight gainers
• Physically inactive
• Smoking quitters

• Pregnant

• Ethnic groups
• Genetic markers of susceptbility

Question 8

Causes of obesity?

Answer 8

• Heritability (60% of weight variance)
• Environment
• Genetic mutation/polymorphisms (<5% of weight variance)

Question 9

Factors that decrease risk of weight gain, being overweight and obese?

Answer 9

Convincing evidence for regular physical activity

Probable evidence for:
• Low-energy density foods
• Having been breast-fed

Question 10

Factors that decrease risk of weight gain, being overweight and obese?

Answer 10

Convincing evidence for sedentary living

Probable evidence for:
• Energy-dense foods
• Sugary foods
• TV viewing (sedentary behaviour)

Question 11

Main drivers (environmental factors) of obesity?

Answer 11

Certain foods:
• Increased supply of cheap, palatable and energy-dense foods
• Increased distribution of food (access and convenience)
• Increased persuasive and pervasive food marketing

Question 12

7 major factors that affect obesity?

Answer 12

• Societal influences
• Food production
• Food consumption
• Biology
• Individual psychology
• Individual activity
• Activity environment

Question 13

3 government policy targets for change?

Answer 13

1. Consumer food environment:
• Processed food composition 
• Food availability
• Pricing strategies
• Informational/promotional environment more consistent with dietary advice

2. Food systems:
   • Incentives to produce, distribute and sell healthier products
   • Opportunities for producers to enter alternative marketing channels for healthier products
3. Consumers/behaviour systems:
   • Educating
   • Building skills