Globally, Greece ranks 3rd in childhood obesity after South Africa and Kuwait. In 20 years, more children will die from poor nutrition than from drugs or AIDS, according to research by the Consumer Institute. In Europe, childhood obesity has… the first place! It is very sad to see the descendants of famous athletes and philosophers, the descendants of the Mediterranean diet, the best in the world, holding such records nowadays.
Today, obesity at all ages is the most important nutritional disorder in industrialized countries.
Obesity is defined as the excess of fat in the body and is considered a disease which is accompanied by physical, psychological and social effects on the affected individuals . All scientific data suggests that obesity with abdominal fat distribution (intra-abdominal fat) is accompanied by metabolic and cardiovascular complications.
| Increased risk | Very increased risk | |
| Men (waist circumference) | >94cm > 0,85 |
>102cm > 1,0 |
| Women (waist circumference) | >80cm > 0,70 |
>88cm > 0,85 |
The main causes of the problem
1) Nutrition
Excess calories that cause weight gain. Fat consumption primarily contributes to increased caloric intake. An important role in weight gain is played by the number and distribution of meals, as well as the intake of food outside of the main meals.
A moderate but continuous increase in calories each day (50-200 kcal) leads over a period of 4-10 years to a slow but progressive weight gain of 2-20 kg. Usually the weight gain occurs in the 20-40 years period with the maximum weight gain in middle age.
2) Physical Activity
There is an association between obesity and a sedentary lifestyle as assessed by indicators such as time in front of the television.
3) Genetic Predisposition genetically determined.
4) Psychological, social and cultural parameters. Undoubtedly, lifestyle affects eating habits and physical activity.
Effects of Obesity on Health
The main complications are:
Cardiovascular:
Coronary heart disease, arterial hypertension, ischemic stroke, thrombophlebitis, pulmonary embolism, left and right heart failure
Metabolic:
Hyperinsulinemia, insulin resistance, diabetes mellitus type II, dyslipidemia (increased triglycerides, decreased HDL-cholesterol, increased LDL-cholesterol), increased uric acid, hemostasis disorders
Respiratory
Respiratory failure, sleep apnea syndrome, pulmonary hypertension
Musculoskeletal:
Knee osteoarthritis, back pain, gout
Digestive:
Cholelithiasis, fatty liver infiltration, gastroesophageal reflux
Cancers:
(Men) Prostate, colon, biliary tract
(Women) Endometrium, cervix, ovaries, breast, colon, biliary
Psycho-social:
Impaired quality of life, social stigma and prejudice, body image disturbance.
Other complications Endocrine, dermatological, nephrological, obstetrical complications, risks during and after the administration of anesthesia, postoperative complications
What can we do
1).The best Treatment is Prevention in the general population
Prevention in high-risk individuals
- People with obese first-degree relatives, children with early obesity (before the age of 6).
- Conditions favoring weight gain such as smoking cessation, cessation of physical activity and sports, medication (neuroleptics, antidepressants, antiepileptics, corticoids, estrogens, progesterones), endocrine diseases (hypothyroidism, Cushing’s syndrome), change of occupation and residence, pregnancy, menopause , periods of psychological or social weakness.
- People with rapid weight gain ( > > 5% of their usual weight).
- People who have or are predisposed to have a disease that is aggravated by weight gain (eg diabetes mellitus, arterial hypertension).
2) Reduction of body weight in Overweight – Obese people
In practice, for the majority, a loss of 5 – 15% of initial weight is a realistic goal and improves health. A loss of 20% or more should be pursued if it does not affect the individual’s nutritional, physical, psychological and social balance.
Why; – What can we achieve?
- Weight reduction by 5-10 kg improves musculoskeletal symptoms (back pain, arthralgias), respiratory symptoms and reduces the frequency of sleep apnea episodes.
- Studies lasting a few weeks show that for every 1% reduction in weight, there is a drop of 1 unit in systolic and 2 units in diastolic blood pressure.
- Insulin sensitivity and impaired glucose tolerance improve with weight loss. In patients with diabetes mellitus, weight loss of 10-20 kg can result in normal glucose levels. However, significant benefits arise in diabetics even with a weight loss of 3-8 kg.
- The blood lipid disturbances that accompany obesity, mainly high triglycerides, high total cholesterol, and low HDL cholesterol, are usually reversed after moderate weight loss. Losing 1 kg of body weight results in a 1% reduction in LDL cholesterol. Triglycerides and HDL cholesterol show the most marked changes with weight loss in people with increased visceral fat.
- Weight control during pregnancy is important. Women who are overweight or obese before pregnancy, and do not gain any more weight during pregnancy appear to have healthy children.
BIBLIOGRAPHY
1. Recommedations pour le Diagnostic, la Prevention et la Traitement de l’ Obesite Association Francaise pour l’etude du diabete et des maladies metaboliques (ALFEDIAM). Societe de nutrition et de dietetique de langue francaise (SNDLF) Diabetes & Metabolism, suppl 2, vol. 24, 1998 : 48p
2. Scottish Intercollegiate Guidelines Network. Obesity in Scotland ‘‘Integrating prevention with weight management.” Scottish Intercollegiate Guidelines Network. Edinburgh, Royal College of Physicians 1996.
3. World Health Organisation ” Obesity: preventing and managing the global epidemic.” Report of WHO Consultation on Obesity. Geneva, 3-5 June 1997 (WHO/NUT/NCD/98.1), 1998 : 276p.
By Katerina Kiousi
Clinical dietitian – nutritionist, MSc
Head of the Scientific Dietetic Center ‘Diet Now’
55 Agias Triados, Peania, phone: 2106641371 / 6972 88 77 50
