Escolar Documentos
Profissional Documentos
Cultura Documentos
Obesity
Storage of energy for periods of fasting Cushioning to protect organs and bones from injury Important for maintaining body temperature Endocrine functions: production of hormones such as leptin, adiponectin, angiotensin, estradiol Involved in production of other important proteins: aromatase, cytokines
Not all body fat is equal: visceral fat may be more metabolically active than subcutaneous
Idiopathic intracranial hypertension Stroke Cataracts Coronary heart disease Diabetes Dyslipidemia Hypertension Severe pancreatitis Cancer
breast, uterus, cervix colon, esophagus, pancreas kidney, prostate
Gynecologic abnormalities
abnormal menses infertility polycystic ovarian syndrome
Osteoarthritis Skin
Gout
Phlebitis
venous stasis
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2010
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http://www.nhlbisupport.com/bmi
BMI < 18.5
Healthy weight
Overweight Obese I Obese II Extreme obesity
18.5 24.9
25.0 29.9 30.0 34.9 35.0 39.9 40.0
BMI
Strengths: Provides a more accurate measure of total body fat compared with the assessment of body weight alone. Inexpensive, easily calculated Most practical method of assessing body composition for large epidemiologic studies. Limitations: Overestimates body fat in persons who are very muscular. Can underestimate body fat in persons who have lost muscle mass (example: many elderly)
Most highly correlated with insulin resistance (PMID: 8922352, 7615840, 9313753)
Visceral fat fat deposits in the peritoneal cavity, surrounding internal organs
Excess visceral fat has been associated with insulin resistance, hyperlipidemia, hypertension, cardiovascular disease, and certain forms of cancer.
Waist circumference
Fat in the abdominal region is associated with a greater health risk than peripheral fat (gluteal-femoral region)
Abdominal fat appears to be an independent risk predictor for type 2 diabetes, dyslipidemia, hypertension, and CVD in patients with a BMI of 25 - 34.9 kg/m2.
For individuals with BMI 35, waist circumference adds little to the predictive power of the disease risk classification of BMI.
Dual X-ray Can quantify composition absorptiometry (DEXA) in specific body parts
Portable
Renehan et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 2008;371:569-578. PMID: 18280327
Food, Nutrition, Physical Activity and the Prevention of Cancer: A Global Perspective
Systematic review of the nutrition, physical activity and cancer literature Detailed review of the evidence supporting an association between obesity and cancer risk. Entire document can be downloaded for free: www.dietandcancerreport.org
Maintenance of a health weight throughout life may be one of the most important ways to protect against cancer
Persistent organic pollutants Polychlorinated biphenols (PCB) Dichlorodiphenyltrichloroethane (DDT) Dioxins Heavy metals (mercury, arsenic, cadmium, lead) Vitamin D
Morbidly obese women are significantly less likely to report recent mammography (PMID: 19277790) Obese white women are less likely to report being screened for cervical cancer than their lean counterparts, and this does not hold true for black women
(PMID: 18997682)
Associations between obesity and cancer recurrence Increased risk of complications following surgical resection Unclear how to dose chemotherapy for overweight and obese patients
Relative risk per 5 kg/m2 increase in BMI and prostate-cancer specific mortality. Cao and Ma 2011, PMID: 21233290