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Obesity and Life expectancy

Obesity and Life expectancy. January 2003 Life Table analysis of Framingham Data Obese at 40 live 6 to 7 years less than normal Overweight at 40 live 3 years less than normal Obese smoker live 14 years less than normal. Obesity Accounts for. 5% of heart attacks and strokes

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Obesity and Life expectancy

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  1. Obesity and Life expectancy • January 2003 Life Table analysis of Framingham Data • Obese at 40 live 6 to 7 years less than normal • Overweight at 40 live 3 years less than normalObese smoker live 14 years less than normal

  2. Obesity Accounts for • 5% of heart attacks and strokes • 10% cases of osteoarthritis • 20% cases of hypertenstion • 40% of cancers • 80% cases of Type 2 diabetes. • There is limited data on the cost of obesity but evidence suggests that the direct cost accounts for 5 to 7% of total health care expenditure (WHO,1998).

  3. What is Obesity? • Defined by World Health Organisation using body mass index (BMI) (Weight in Kg divided by height in meters squared) • 5’4” Normal 65kgs (10 stone 3 lbs) Obese 78kgs (12 stone 2 lbs) • 5’10” Normal 78kgs (12 stone 2 lbs) Obese 94kgs (14 stone 10 lbs)

  4. Bray GA. Overweight is risking fate. Definition, classification, prevalence and risks. Ann NY Acad Sci 1987;499:14-28. Relationship of BMI to Excess Mortality 300 Age at Issue 20-29 250 30-39 200 150 Mortality Ratio 100 High Moderate Low Risk Risk Risk 50 0 15 20 25 30 35 40 Body Mass Index (kg/[m2])

  5. Current Prevalence data in Ireland • Female: 33% Overweight 26% Obese (13% self report) • Male: 45% Overweight 24% Obese (16% self report) • Children: 20% Overweight or obese(5-12 yo)Slan 2007 Independently Measured

  6. Grades of BMI Kg/M2 • BMI 19-25 -Normal • BMI 25-30 -OverweightObesity • BMI 30-35 -Grade 1 • BMI 35-40 -Grade 2 BMI >40 -Grade 3(Morbid) Overweight or obese USA 71%, UK 65% USA 5% have BMI > 40 Ireland 2% have BMI > 40

  7. Grades of BMI Kg/M2 • BMI 19-25 -Normal • BMI 25-30 -OverweightObesity • BMI 30-35 -Grade 1 • BMI 35-40 -Grade 2 BMI >40 -Grade 3(Morbid) Overweight or obese USA 71%, UK 65% USA 5% have BMI > 40 Ireland 2% have BMI > 40

  8. BMI and weight

  9. Normal weight finishes at • BMI 25 Male 12st 2lbs 78Kgs Female 10st 3lbs 65 kgs

  10. BMI ranges BMI 1 BMI 2

  11. BMI range <20 to 25 BMI 19 BMI 25

  12. BMI range <20 to 25 BMI 19 Guess 20 BMI 25 Guess 23

  13. BMI 4 BMI 3

  14. BMI range 40 to 45 BMI 44 BMI 40

  15. BMI range 40 to 45 BMI 44 Guess 35 BMI 40 Guess 32

  16. BMI 5 BMI 6

  17. BMI range 50 to 55 BMI 51 BMI 52

  18. BMI range 50 to 55 BMI 51 Guess 43 BMI 52 Guess 42

  19. BMI 7 BMI 8

  20. BMI range 70 to >75 BMI 72 BMI 76

  21. BMI range 70 to >75 BMI 72 Guess 50 BMI 76

  22. Severe (Grade 3) Obesity • BMI 40 --- Male 20st 128kgsFemale 16st 10lbs 108kgs

  23. Current Prevalence data (Adult) • Female: 33% Overweight 26% Obese (13% self report) • Male: 45% Overweight 24% Obese (16% self report)Slan 2007 Independently Measured

  24. Obesity is associated with • Diabetes • Cancer • Sleep Apnoea • Osteoarthritis • Fatty liver disease • Psoriasis • Dementia • Cardiovascular Disease • Death from H1N1 (Swine Flu)

  25. Excess weight is a MAJOR risk factor for diabetes in US adults, 2001 (n=195, 005) Prevalence of diabetes (%) 30 25.6 20 14.9 10 7.3 4.1 0 Normal OverweightBMI 25-29.9 ObeseBMI 30-39.9 ObeseBMI 40 Mokdad et al. JAMA 2003; 289: 76-9

  26. Figure 3: Summary risk estimates by cancer sites in men

  27. Figure 4: Summary risk estimates by cancer sites in women

  28. Relative Risk of Developing Cancer in Males

  29. Obesity also reduces survival in certain cancers • Colon • Breast • Endometrium • Prostate • Ovary

  30. Increased risk of dementia • BMI and increased risk of dementia – analysis of prospective cohort study (Whitmer et al. 2005) • Increased risk of dimentia in later years for those overweight / obese in mid-life • Increased risk for • Males • Females

  31. Relative Risk of Developing Dementia

  32. Obese patient with Acute abdomen • 30% chance of atelecasis/pneumonia • 2.8 times more likely than non obese

  33. Overweight and obesity following Road Accidents • Study of 1,615 CrashesCrash factor adjusted odds for dying 2.08 for overweight 3.17 for obese Injury severity adjusted odds for dying 1.87 for overweight 3.89 for obese Ryb J.Trauma 2008(64)406-411 CIREN study

  34. Role of weight and seatbelts • Seatbelts decrease risk of death and intraabdominal injury in obese and non obeseLack of seatbelt increases risk of death 9.7 fold in obese 5.2 fold in non obese Zarzaur & Marshall J Trauma 2008(64)412-417

  35. Crash Dummy Research

  36. Equipment Needs

  37. A lot of equipment • Has upper weight limit of ~ 150kgsTrolleysBedsTheatre TablesRadiology – equipment and quality

  38. Radiology Equipment in Ireland • Audit of 40 hospitals • CT, MRI, Fluoroscopy • Weight Limit • Aperture Diameter

  39. Toxic environment we live in…

  40. Unsuspected calories abound

  41. Unsuspected Calories

  42. Unsuspected Calories

  43. Bagel Cheeseburger 20 Years Ago Today 20 Years Ago Today Chips 20 Years Ago Today 350 calories 333 calories 590 calories 140 calories 210 calories 610 calories

  44. Burning a lot less energy (per half hour)

  45. What about children?

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