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Sept 25 - obesity.doc

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Physical Education and Sport
Scott Forbes

Sept 25 – Obesity – Excess adiposity in adults and children: metabolic consequences Whats wrong with having too much fat? How can we detect and treat those with a risky fat profile? Note slide 4 Obesity is multifactorial One factor is genes (susceptibility genes) – some people may have these genes but may never become obese Monogenic syndromes – platter willy syndrome (associated with upper body obersity) bardett – associatied with gene mutation that causes obesity Obesity Is starting to increase, and this is due to environmental factors Its hard to measure food intake of a person, so its hard to say if food intake is the main cause of obesity An increase in BMI correlates with an increased relative risk of certain diseases increases Obesity: definition • Increased body weight due to excessive accumulation of fat: • Disease in which excess body fat has accumulated such that health may be adversely affected (kopelman, 2000) • Must be able to measure fat content and health status Definitions • Risk factor: a variable which improves your chance of another event occurring • Major risk factor: significant chance of event occurring • Contributing risk factor: less significant chance of event occurring • Researchers usually talk about risk factors in terms of “relative risk” Obesity and Risk • Obesity wont kill you, however obesity will enhance your risk of obtaining other diseases • Obesity will shorten the average life by at least 4-9 months • Childhood obesity continues to increase, it could cut 2-5 years from the average life Definitions Risk Factor: a variable which improves your chance of another event occurring Relative risk: a measure of how much a particular risk factor (obesity) influences the risk of a specified outcome (CVD) Relative risk uses a reference population to determine the risk (in our case *non obese) Example: if you are obese, your likelihood of getting CVD is “x” times more likely than non-obese Obesity Risk Factor For: Major dysfunction: • Cardiovascular system (CVD, hypertension, stroke) • glucose metabolism (insulin resistance, type 2 diabetes) • lipid metabolism (TG, cholesterol, lipoproteins) Dangers of excess adiposity determined by: 1.) Total amount 2.).distribution Body Fat Topography – Vague (1947) Android obesity (“apple”) • Typical male pattern obesity • Revealed by increased Waist to Hip Ratio • Excess accumulation of trunk fat • Frequently present in patients with hypertension, diabetes, or CHD (more severe metabolic complications) Gynoid Obesity “Pear” • Typical female pattern obesity • Excess accumulation of hip fat • Not associated with increased metabolic complications • Females are at less risk to get CVD than males Limitation of WHR in defining obesity • Waist circumference provides crude index of absolute amount of abdominal adipose tissue whereas waist:hip ratio provides index of relative accumulation of abdominal fat • WHR has been used in the past to identify obesity • Using WHR isn’t the best indicator for obesity VAT • Visceral obesity vs. Excess total body fat?? • VAT higher correlation to metabolic complications in obese • If you store fat within the thoracic and abdominal cavity, that is visceral adipose tissue Waist Circumference • Powerful independent predictor of VAT (better than WHR) • WHR <50% variance; waist only >70% • Simple, convenient, inexpensive • Best anthropometric correlate of VAT Wasit Circumference Gender
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