Wen Jie Zhang MD PhD Professor of Pathology School of Medicine Health Sciences and Engineering Susquehanna Township High School Lecture Series Week 1 August 2014 Clinical Relevance of This Weeks Topic ID: 655799
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Slide1
Obesity and Your Daily Life
Wen Jie Zhang, MD, PhDProfessor of Pathology
School of Medicine, Health Sciences and Engineering
Susquehanna Township High School
Lecture Series
Week 1, August
2014
Clinical Relevance of This Week’s Topic Slide2
Screening for Cervical Cancer in ChinaSlide3Slide4Slide5Slide6Slide7Slide8Slide9Slide10Slide11
Teaching and Learning Strategy
Scientific Research Reports/ArticlesIntroduction/Background
Identifying a disease to study
Diagnosis, Treatment, Prevention, etc.
Materials and Methods
Mice/Patients, Reagents/Device/Tests
Results
Measurements obtained and analyzed
Discussion (and Conclusion)
The results’ meaning, significance, and conclusion(s)
References/Further ReadingsSlide12
Learning Objectives
What is obesityConsequences of obesityHow to measure obesityHow to classify obesity
Obesity control and preventionSlide13
Session 1
IntroductionSlide14
Obesity – An Individual’s Challenge
Daily news in public mediaIntense scientific reportsCommercial Ads on fat reductionAn Individual’s questions:
Am I overweight or obese?
What to eat/drink and what not to?
Should I be on diet?
How should I exercise to reduce weight?
Should I consult a doctor for advice?Slide15
Which one is your favorite?Slide16
More, please!Slide17
Should I do it ?Slide18
The World’s Largest McDonald’s
Built on April 23, 1992 Beijing China (~Tiananmen Sq)
29 cash registers
700 seats
40,000 customers/1st
Buz
daySlide19
Buddy, Do I have a piece?Slide20Slide21Slide22
Definition of Obesity
A medical condition in which excess body fat has
accumulated to the extent that it may have an adverse effect on health, leading to
reduced
life expectancy
and/or
increased
health risks
.
Body Mass Index (BMI)
is a simple index of weight-for-height that is commonly used to measure/classify underweight, overweight and obesity in adults.Slide23
Body Mass Index (BMI)
BMI is defined as the weight in kilograms divided by the square of the height in meters (unit=kg/m2).
Formula:
BMI
= mass (kg) ÷ height (m)
2
= kg/m
2
Example:
BMI
= 68.2 kg ÷
(1.7m)
2
=
68.2÷ 2.89 = 23.6
kg/m
2Slide24
Table 1: The International Classification of adult underweight, overweight and obesity according to BMI
Classification
BMI (
kg/m
2
)
Principal cut-off points
Additional cut-off points
Underweight
<18.50
<18.50
Severe thinness
<16.00
<16.00
Moderate thinness
16.00 - 16.99
16.00 - 16.99
Mild thinness
17.00 - 18.49
17.00 - 18.49
Normal range
18.50 - 24.99
18.50 - 22.99
23.00 - 24.99
Overweight
≥25.00
≥25.00
Pre-obese
25.00 - 29.99
25.00 - 27.49
27.50 - 29.99
Obese
≥30.00
≥30.00
Obese class I
30.00 - 34.99
30.00 - 32.49
32.50 - 34.99
Obese class II
35.00 - 39.99
35.00 - 37.49
37.50 - 39.99
Obese class III
≥40.00
≥40.00
Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004
.Slide25
“Globesity
” – Obesity, A Global Issue
On a worldwide scale
Nutrition improvements and
e
xcessive high
e
nergy
f
ood
Lifestyle shift (less active)
Global pandemic trends
Source: WHO, Global Database on Body Mass Index Slide26
Characteristics of BMI
Age-independentSame for both sexes (females may have 1.0 kg/m2 higher than females)Population differences
May not correspond to the same degree of fatness
BMI-associated health risks may differ
Caucasians vs. Blacks vs. AsiansSlide27
Obesity Pandemic Around the Globe 1
Source: WHO, Global Database on Body Mass Index
Percent of Adults with BMI 18.5-24.99Slide28
Obesity Pandemic Around the Globe 2
Source: WHO, Global Database on Body Mass Index
Percent of Adults with BMI ≥30 Slide29Slide30
Super Obesity
A "super obese" male with a BMI of 47 kg/m2:
weight
146 kg (322 lb), height 177 cm (5 ft 10 in)Slide31
Super ObesitySlide32
Hands-on Laboratory Work
Session 2Materials/Subjects and Methods
Session 3
Results/ObservationsSlide33
Results – Observed
BMI = 18.5-24.99 xx persons, %BMI = 25-29.99
xx
persons, %
BMI ≥ 30
xx
persons, %Slide34
Session 4
Discussion/Conclusion(s)Slide35
Correlation between BMI and Body Fat
% Body Fat
BMISlide36
3 Major Risk Factors of Obesity
Excessive food energy intakeLack of physical activityGenetic susceptibility
58 genetic loci associated with obesity traits identified
>18 BMI-associated loci shared by European and East Asian ancestry populations
FTO
(Fat Mass and Obesity Associated) gene
Leptin
(
adipo
-
cytokine) geneSlide37
Consequences of Obesity
Increased mortalityIncreased health risksHypertension, coronary heart disease, strokeType 2 diabetes
Dyslipidemia
Sleep apnea and
respiratory problems
Gallbladder disease
Osteoarthritis
Cancers
(10 common cancers including colon
, breast, endometrial)
(2014 “Lancet” journal report)Slide38
Treatment of Obesity
Bariatric (fat reduction) surgeryMost effectiveLong-term weight loss
Decreased
overall mortality
Medications
M
odest
w
eight loss (
2.9 kg
[6.4
lb]) in
1 to 4
years
Side effects concerns
Gene therapy?Slide39
Prevention of Obesity
Dietary changeLower food energy diet (long-term or permanent)
Limit weight gain more than weight loss
Physical exercise
Long-term or permanent
Limit weight gain more than weight lossSlide40
Session 5
References/Literature(Further Readings)Slide41
References/Further Readings
The Obesity Societyhttp://www.obesity.org/World Health organization (WHO)
Global Database on Body Mass
Index
http://apps.who.int/bmi/index.jsp
The Scientific American (journal)
Popkin
BM.
Sci
Am, 2007 Sep;297(3):88-95Slide42
Key Words Learned
ObesityBody Mass Index (BMI)Epidemic / PandemicGenetic susceptibility
Life expectancy
Bariatric surgery
Dietary change
Physical activitySlide43
Your Private Project
Based on what you have learned, figure out your daily food consumption and make yourself a plan for healthy diet and physical activities.Measure your BMI on a fortnightly or monthly basis to monitor your body weight
.
Serve as a “physician” for your family members and monitor their BMI monthlySlide44
The End