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Understanding Obesity and Its Implications

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The US department of Health and Human Services says the most common way to determine, if a person is overweight or obese is to calculate body mass index (BMI), which is an estimate of body fat, based on comparing a person’s weight to his or her height. However, BMI can be flawed with more lean muscle weight, such as the case with a fit person or athlete.

The Centers for Disease Control and Prevention (CDC) comments that, “BMI does not measure body fat directly, but research has shown that BMI is moderately correlated with more direct measures of body fat obtained from skinfold thickness measurements, bioelectrical impedance, underwater weighing, dual energy x-ray absorptiometry (DXA) and other methods.”

When BMI is added to a person’s potential health comorbidities (high blood pressure, cardiovascular, liver, or kidney disease), there can be a higher risk to complications associated with viral-associated diseases, such as Covid-19. “BMI appears to be strongly correlated with various adverse health outcomes consistent with these more direct measures of body fatness,” notes the CDC.

For adults, a BMI of 18.5 to 24.9 is considered normal weight; 25.0 to 29.9 is considered overweight; 30.0 to 39.9 is considered obese, and 40.0 and higher is considered extremely obese.

The World Health Organization (WHO) states that the number of obese people has tripled worldwide in the last twenty years—reaching the status of a global epidemic—mainly associated with improper dietary habits and a sedentary lifestyle.

According to April 2020 research—Obesity, Bioactive Lipids, and Adipose Tissue in Insulin Resistance—published in the online, peer reviewed journal Nutrients, “obesity is a state of pathological increase in the amount of adipose tissue, which boosts the risk of numerous diseases, such as cardiovascular disease, some types of cancer, and type 2 diabetes.”

The study authors from the Department of Hygiene, Epidemiology and Metabolic Disorders, Medical University of Bialystok, Poland, stress that “there are a number of causes leading to the development of obesity, including genetic and environmental factors. The contribution of genetic factors to obesity is very important and is thought to be responsible for 40—70% of obesity cases.”

However, note the Polish researchers, “it appears that non-genetic factors, especially environmental factors such as unhealthy eating habits and lack of physical activity, also play a substantial role in generating obesity.”

Let’s add sleep duration and daytime sleepiness to the list of complications that may affect being overweight and obese.

When insulin resistant—a precursor to type 2 diabetes and obesity—insulin stimulates fat storage and inhibits fat breakdown for energy. Under normal conditions, insulin is an anabolic (building) hormone that increases the uptake of amino acids by muscle tissue and enhances protein synthesis (making muscle).

The American Diabetes Association (ADA) defines insulin resistance as, “a condition in which the response of cells to insulin is impaired with respect to carbohydrates, lipids, and proteins, resulting in elevated blood glucose levels.”

The ADA further states that, “insulin has a wide spectrum of effects on metabolic processes in adipocytes (fat cells); therefore, it is considered the most important hormone regulating anti-lipolytic processes, and deterioration of cell sensitivity to this hormone or impairment of the insulin pathway may affect the metabolism of adipose (fat) tissue.”

The central accumulation of fat tissue—known as an android visceral fat—is consistent with a male fat pattern. Female fat accumulation—known as a gynoid fat pattern—is the increase of subcutaneous (under the skin) fat in the hip and thigh regions.

After menopause, women can be at risk to adopting a male fat pattern, which may increase their risk to cancer and cardiovascular disease without intervention.

The Polish researchers comment that android visceral obesity, “has been shown to be associated with a three-fold higher risk of cardiovascular disease compared to gynoid obesity.”

It’s also recognized that obesity causes inflammation—generated by the dis-regulation of certain molecules called adipokines and cytokines—with some good and not so good.

The Polish researchers stress that, “although studies have revealed that inflammation caused by excessive fat accumulation and abnormalities in lipid metabolism can contribute to the development of obesity-related insulin resistance, further research is needed to determine the exact mechanism by which obesity-related insulin resistance is induced.”

Until then, it makes good sense to take control of your eating habits and movement pattern—upping your game to survive the next pandemic in our path, much less the one that sits in our house now.