By: Jennifer Brierley

A Growing Epidemic

Section One

Developing a Thesis and Finding Data

What is obesity?

What is diabetes?

How are obesity and diabetes related?

Obesity by definition is an increase body weight caused by excessive accumulation of fat.

How do you know if someone is

obese? A person is obese when their Body Mass Index

(BMI) exceeds 30 and a person is considered

overweight when their Body Mass Index is

between 25 and 30.

What is a Body Mass Index?

A Body Mass Index commonly known as your BMI is a common

measure expressing the relationship of weight-to-height.

BMI = mass (kg)

(height (m))2

Quick Data Fact

• The Body Mass Index Formula is a Mathematical Index

• A mathematical index is an arbitrarily defined number that provides a measure of scale.

• It is determined by a mathematical calculation that combines various attributes of each case in order to make comparisons.

• Mathematical Indices are found in Unit 3 (Tools for Analyzing Data)

Jen Brierley’s BMI

Weight = 52 kilograms

Height = 1.57 meters

BMI = mass (kg)

height (m)2

BMI = 52

(1.57)2

BMI =21I am not obese!

There are 3 types of diabetes:

1. Type 1 Diabetes

2. Type 2 Diabetes

3. Gestational Diabetes

Diabetes is a chronic, metabolic condition that results from the body’s inability to

sufficiently produce and/or properly use

insulin

Quick Fact!

Type 2 Diabetes is one of the fastest growing diseases in

Canada with more than 60,000 new cases yearly.

Type 2 Diabetes can be prevented!

I researched the risk factors, health risks, symptoms, and prevention methods for obesity and diabetes.

I then drew a mind map in order to examine how obesity and diabetes are related.

Type 2 Diabetes

Symptoms Health Risks

Causes(risk factors)

Obesity

High risk ethnic groups

South AsianAfrican AsianHispanic Aboriginal

Abdominal obesityNon-abdominal obesity

Being age 40 +

High blood pressure

High Cholesterol/other fats in the body

Genetics

Have had gestational diabetes

Given birth toA baby > 9 lb

Frequent Urination

FatigueUnusual

thirst

Unexplained weight loss

Heart disease

Nerve damage

Reduced blood Supply to limbs

stroke

BlindnessErectile

dysfunction

Causes

Imbalance involvingExcessive calorie

consumption

InadequatePhysicalactivity

InadequateEnergy

expenditure

Factors

Body weight

Behavioral

Environmental

Cultural

Metabolic

Socioeconomic influences

Health Risks

Gallbladder disease

Types of Cancer

Osteoarthritis

Sleeping Problems

Breathing Problems

BMI

Height Prevention

Maintain normalBlood pressure

Keep cholesterolAnd other fats

Within target level

Eat regular,Balanced meals (include

Four food groups)

Limit intake ofFat and sugar

Be physically active

Achieve healthy weightAnd maintain it

Don’t smoke

Hispanic

African

Aboriginal

Asian

South Asian

Age

Date of birthAdult

Child

Sex Male

Female

MIND MAP

After analyzing the connections I was interested in whether or not Canadians could reduce the risk of

diabetes if in fact they started to live a healthy lifestyle.

What effect do Canadian’s knowledge, attitudes and behaviors concerning obesity have on type 2 diabetes?

Thesis Question

•The better Canadian’s knowledge, attitudes and behaviors are concerning obesity, the lower the chance of developing type 2 diabetes will be

•Obesity and diabetes are directly correlated

•As the population as a whole becomes healthier, the prevalence of type 2 diabetes will decrease among Canadians

What do knowledge, attitudes and behavior mean?•Knowledge is if the population knows the facts and the statistics related to the topic

•Attitude is how much the population care about the issue and whether they are willing to engage in the topic.

•Behavior is what the population is doing. Are they dealing with the topic issue? Are they putting their knowledge and attitudes into effect?

•Will examine Canadian’s knowledge, attitudes, and behaviors related to obesity in order to determine what type of intervention would lead to reducing obesity.

•Will examine Canadian’s knowledge concerning the health factors related to obesity and whether or not Canadian’s are aware of the effect obesity has on developing type 2 diabetes.

Objectives:

Using Diagrams to find Connections and Organize Ideas

Section Two

Cause and Effect

.

Does a person have knowledge about diet?

Does the person have poor diet?

No

No

Yes

Does a person have a good

attitude towards their diet?

No

Does a person have good

behaviors towards their diet?

Yes

No

unhealthy

Yes

healthy

Low risk ofdeveloping diabetes

Is the person overweight?No

High risk ofdeveloping diabetes

Diet’s Role in Developing Diabetes

Obesity

Genetics

Had gestational diabetes

Being age 40 +High cholesterol

High blood pressure

High risk ethnic groups

Given birth to a baby >9 lb’s

Network Diagram

Causes of type 2 diabetes that relate

to each other

Obesity Had gestational

diabetes

Gave birth to a baby >

9lb’s

High blood

pressure

High cholesterol

High risk ethnic groups

Genetics Being age 40 +

Obesity ------------ - - + + + + -

Had gestational diabetes

- ------------------ + - - + + +

Gave birth to a baby > 9lb’s

- + --------------- - - - - +

High blood pressure + - - ------------- - + + +

High cholesterol + - - + ------------- + + +

High risk ethnic groups

- - - - - ------------- - -

Genetics - - - - - _ ----------- -

Being age 40 + - - - - - _ - -----------

Table that corresponds with network diagram.

+ represents a relationship

-represents no relationship

------ represents that there is no relationship with itself

Network Diagram

Canada

Male Female

Age

14 and under 15 - 25 26 - 49 50 +

Level of education obtained

Elementary school High school College University Post graduate

Ontario Quebec

Sex

Organization Chart

Diabetes

Type 1 Type 2

Does not apply to project

Causes (risk factors)

Obesity

Abdominal Non abdominal

Does not apply to project

Prevention

Genetics High riskethnic groups

Had gestational

diabetes

Highcholesterol

High blood pressure

Given birth to a baby > 9 lb’s

Being age 40+

Be physically active Achieve healthy weight and maintain it

Don’t smoke Limit intake of fat and

sugar

Maintain normal blood pressure

Eat regular, balanced meals (include 4 food

groups)

Keep cholesterol and other fats

within target level

Tree Diagram

Part One: Obesity in Canada

Part Two: Diabetes in Canada

Part Three: Effects of Obesity on Diabetes (correlation between the two)

Section Three

•The distribution of this graph is left skewed because the greatest frequencies are near the right end of the bar graph, although the 2004 data

could be viewed as a mound shaped distribution.•The greatest obesity rates occur among adults ages 45 to 64.

•This is accurate as the onset of type two diabetes is around age 40

Obesity Rates in 1978/79 and 2004 by Age Group

 Median 1978/79 = 17

 Median 2004 = 30

30 –17 = 13The median and mode also display the increase in obesity rates since 1980. The median increase by 13 % and the

mode by 10%. 

Mode 1978/79 = 20 

Mode 2004 = 30

Mean 1978/79 = 6+9+13+17+20+20+11

7=13.7

 Mean 2004 =

11+21+20+30+30+25+247

= 23.0

23.0 –13.7 = 9.3

This is showing that the average percent of obese people in Canada has risen

about 9% since 1980.

Trends in Obesity Rates

Calculation:

Coefficient of determination (r2 ) =

0.8296

83% of the variation in the percentage of

obese people is due to the variation of the

year.

This graph clearly and effectively shows that Canadians need to pay attention to their weight because since 1991 obesity rates have increased by rapidly compared

to the obesity rates from 1978 to 1991.

Obesity Prevalence in 2000/01 of the population ages 20 to 64(in this graph obesity is measured by someone with a BMI>27)

Prevalence of Obesity in Canada from 1985 to 1998

Percentage distribution of body mass index (BMI) by sex (2004)

This shows that obesity is a rising problem in Canada because in men the percentage of obesity is only 10% below the percentage of the

population with a normal weight and in women it is only 20% below.

Mound Shaped Distribution

Obesity Rates by Fruit

and Vegetable Consumption (2004)

Left Skewed Distribution

MMMMM

Obesity Rates by Physical Activity Level (2004)

Left Skewed Distribution

Obesity Rates by Level of

Education Obtained (2004)

Prevalence Rate of Diagnosed Diabetes by Age and Sex (1998/99)

Prevalence Rate of Diagnosed Diabetes by Age and Sex

0

2

4

6

8

10

12

14

16

18

20 - 39 20 - 59 60 - 74 75 +

Age Group

Per

cen

tag

e (%

)

Percentage(%) Both

Percentage (%) Women

Percentage (%) Men

Trends in the prevalence of diabetes (1994 to 2002)

 Coefficient of

determination (r2) = 0.974

This graph evidently displays the increase in the prevalence of diabetes over the years.

Did you know that diabetes is the 7th leading

cause of death in Canada!!!!

Mortality Rates due to Diabetes

Estimated Future Deaths from Diabetes

(Number of actual and projected deaths due to diabetes by sex,

Canada, 1970 - 2050)

Prevalence of Diabetes by Body Mass Index (BMI) Category

Relative Risk for Comorbidities in Obese Subjects (1997)

Observations and Conclusions based on Secondary Data

•Obesity is an rapidly increasing health risk in Canadian society

•Obesity and diabetes are directly correlated.

•Obesity is a modifiable risk factor of diabetes

•Diet and Physical Exercise prevent both diseases

•Diabetes prevalence in Canada is on the rise. It is already the 7th leading cause of death. If it continues to increase it will produce a major health epidemic in our society.

How can we fix this fast approaching epidemic?

What effect do Canadian’s knowledge, attitudes, and behaviors concerning obesity have on type two

diabetes?

Section Four

Analyzing Primary Source Data

Surveyed 100 people

Objectives:

1. Obtain information to back up secondary sources

2. Explore my thesis and come to some concrete conclusions

Gender Response Frequency

0

10

20

30

40

50

60

Fre

qu

ency

Male Female UnknownGender

Gender Distribution of Survey Respondents

Age Distribution

0

5

10

15

20

25

30

Fre

qu

ency

Under 14 14-25 26-49 50+ Unknow n

Age

Age Dis tribution of Survey Respondents

0

5

10

15

20

25

30

35

Fre

qu

en

cy

Elementary High School College University Postgraduate Unknow n

Level of Education

Education Distribution of Survey Respondents

0

5

10

15

20

25

30

35

40

45

50

Fre

qu

ency

0-19 20-25 26-30 30+

BMI Range

Opinions on Ideal BMI

0

5

10

15

20

25

30

35

40

45

Fre

qu

ency

Very Satisf ied Satisf ied Disastisf ied VeryDisastisf ied

Unknow n

Level of Satis faction

Satisfaction with Diet and Fitness Level

0

5

10

15

20

25

Fre

qu

ency

0-9% 10-19% 20-29% 30-39% 40-49% 50-59% 60% Plus Unknow n

Percent Range

Pecentage of Canadians Believed to be Overweight by Survey Respondents

Survey Respondent's Belief in Obesity as an Increasing Health

Problem

No

Don't Care

Yes

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0 to 3 4 to 6 7 to 9 10 to 12 13 P lus

S ervings

Daily Servings of Fruits and Vegetables Reported by

Respondents

11 to 15 Servings

5 to 10 Servings

1 to 4 Servings

Response to "What is the recommended number of servings per day of f ruit and vegetables based in the Canadian Food Guide?"

1

5

000

4

1

6

10

13

8

3

1

4

7

11

8

6

01

1

2

2

5

0%

20%

40%

60%

80%

100%

Fre

qu

ency

15 min or less 30 min 1 hour More than 1 hour

Average Length of Exercise

Respondents' Exercise Behaviour

5 or More Times PerWeek4 Times Per Week

3 Times Per Week

2 Times Per Week

1 Times Per Week

0 Time Per Week

Response to "On average, how many times per w eek do you exercise?"

Section Five

Conclusion

Data Sources and Limitations

Bias

Conclusion

Obesity rates in Canada are increasing rapidly. Why? Do Canadians not know about how to live a healthy life? Do they not care? Are they just

choosing not to live a healthy life? 23% of the population is obese. Obesity has many serious health consequences, one being diabetes,

which is directly correlated. Diabetes in Canada is on the rise as well. Diabetes is the 7th leading cause of death in Canada at the moment. If obesity leads to the development of type two diabetes then as obesity

continues to rise so will the development of diabetes and ultimately more deaths.

After many hours of research and analysis of graphs I realized that the Canadian’s knowledge about obesity and its consequences is reasonably good and their attitude

towards solving the problem and reducing obesity rates is good. Then why are obesity rates still so high. The reason is behavior. Canadians are not acting upon

their knowledge and attitudes toward obesity. In my survey almost 80% of the people new the correct number of servings of fruit and vegetables you need per day but in the secondary source graph 80% were not eating the correct amount. In order to solve the rising epidemic I believe that the government should develop programs to encourage the behaviors of Canadians towards a healthy living in order to reduce

obesity and thus reduce diabetes.

Obesity is a modifiable risk factor for diabetes and stats show that an intensive healthy lifestyle (physical exercise) can reduce the risk of developing type two

diabetes in an obese person by 58%. A person can reduce symptoms of diabetes through physical activity and proper diet. With obesity being a modifiable risk factor

for diabetes, by improving Canadians behaviors towards obesity we can solve two major health issues as well as other benefits such as health care costs. If Canada could increase the number of physically active Canadians by 1% then the annual saving in the cost of treating type two diabetes would be $877,000. In conclusion obesity is a huge factor in reducing diabetes and in order to accomplish that the behaviors of Canadians need to be addressed because that is what the general population is lacking, not the knowledge, not the attitudes, but the behaviors.

Conclusion Continued

Data Sources and LimitationsData Sources

The majority of my data was found using reputable statistic sources. The main two data sources I used were:

Statistics Canada – I found the majority of my raw data for my secondary sources there.

Health Canada – I found many published and approved reports on obesity, diabetes , and the correlation between the two.

Limitations

For the obesity data there were a few limitations in the secondary sources.

•There was not a lot of available data that included the under 18 age group because the body mass index standards differ for adults and children. This was a limitation because my survey evaluated data from people under 18.

•Data was not collected from the territories.

For the diabetes data there was one big limitation and that was the fact that statistics do not differ from the various types of diabetes. The stats represented all 3 types: type 1, type 2, and gestational. Although it might have skewed the data slightly, type 2 diabetes accounts for 90% of all cases so it wasn’t too much of a problem.

sampling interval =population sizesample size

= 32270500100

= 322705 

I encountered a few bias in my survey. The first was a sampling bias. I sampled 100 people to represent the population of Canada. My sample didn’t accurately

represent the population.

No non-response bias, which was surprising because I thought I would run into that

problem.

 

Household bias occurred in my survey analysis because I did not survey equal amounts of males and females, and my age groups were not equally weighted.

The bias did not affect my overall results.