obesitas modul 3.2 2015 (salinan berkonflik home-pc 2015-11-22)

8/15/2019 Obesitas Modul 3.2 2015 (Salinan Berkonflik Home-PC 2015-11-22)

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OBESITY

BAGIAN GIZI FK UNDIP


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OBESITY:

DEFINITION & EPIDEMIOLOGY


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Who is too fatAncestors were not over fatExcess body fat is a by-product ofurbanization, ec!anization, asedentary "ifesty"e and abundant !i#!-ca"orie foodsBein# fat is beautifu" in so e societiesBein# fat represents a !i#! socio-econo ic c"assBeautifu" $ Barbie do""


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Obesity De!"itio"

A condition of abnor a" or excessivefat accu u"ation in adipose tissue tot!e extent t!at !ea"t! ay be

i paired%easurin# body fat is di&cu"tsurro#ate easures suc! as B%I andwaist circu ference are co on"yused


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Obesity De!"itio"

%etabo"ic disorder resu"tin# froc!ronic i ba"ance between ener#yupta'e and expenditure

(!ronic) "ife"on# treat ent re*uiredTreat ent contro"s do not curedisease

+o s!ort-ter so"utionsisease recurs after treat ent is

wit!drawn


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OBESITY : T E.AT O/E+ESIS


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01 /enetic factors in !u anobesity

Obesity te"#s to $%" i"fa i'ies( b%t #oes "ot )$o*ethe $o'e +e"eti, fa,to$s i" the#e*e'o) e"t of obesity-o.e*e$( so e )eo)'e a$e+e"eti,a''y o$e s%s,e)tib'eto e"*i$o" e"ta' fa,to$s.hi,h )$e#is)ose to obesity

St%#y i" $ats obesity is a$es%'t of a #efe,t i" a +e"e.hi,h sho%'# )$o#%,e 'e)ti"(b%t the $o'e of 'e)ti" $e ai"s%",'ea$


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/Is it +e"eti,01

o b +e"e 2e+%'ates )$o#%,tio" of leptin Leptin is secreted by fat cells and has dual

activity of decreasing food intake andincreasing metabolic rate

Mi,e bo$" .itho%t the abi'ity to a3e 'e)ti"4ob5ob i,e6 eat .itho%t $est$ai"t


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ob5ob o%se"o$ a' i,e


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ob5ob o%se


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ob5ob o%se

ob5ob o%i"7e,te# .i'e)ti"


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So, 2ust #ive obese!u ans "eptin333

I" fa,t( this .o$3s i" 'e)ti"8#e!,ie"t h% a"s( b%t9

::;::< of obese h% a"s ha*e-IG- 'e*e's of 'e)ti"( b%t ha*ebe,o e i"se"siti*e to it;


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-e$e#ita$y fa,to$s

The genetic contribution to body

weight is esti ate# to be bet.ee"

=> a"# ?> )e$,e"t 4.ith so e $a$e

,ases of se*e$e obesity 'i"3e# tos)e,i!, +e"e e$$o$s6


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The e)i+e"eti,s of i",$easi"+ .ei+ht th$o%+h

the +e"e$atio"s 4/O"e hy)othesis is that

ate$"a' obesity befo$e a"# #%$i"+)$e+"a",y a e,ts the estab'ish e"t of bo#y

.ei+ht $e+%'ato$y e,ha"is s i" he$ baby;

Mate$"a' obesity ,o%'# )$o ote obesity i"the "e t +e"e$atio";C 4Wate$'a"#( >> 6


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41 .!ysica" inactivity

• Data o" the ,o"t$ib%tio" of i"a,ti*ityto the ,%$$e"t e)i#e i, of obesity is'i ite#

• E*i#e",e – Peo)'e eat o$e tha" they #i# i" the

)ast – E"e$+y e )e"#it%$e i" a"%a' 'abo%$ o$

*i+o$o%s 'eis%$e a,ti*ity has #e,'i"e#.ith the i",$ease of T *ie.i"+ a"#'abo%$ sa*i"+ a))'ia",es


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45 Years A#o Today

465 ca"ories 7 cups

.O.(O8+

0655ca"ories

40 cupsbuttered


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Obese )eo)'e ha*e e"#o,$i"eab"o$ a'itiesPo'y,ysti, o*a$y sy"#$o e 4P OS6 isasso,iate# .ith obesity a"# o*a$ia"f%",tio" i )$o*es .ith .ei+ht 'ossLa,3 of e*i#e",e fo$ )$i a$ye"#o,$i"e #efe,t as the ,a%se ofobesity

91 Endocrine


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E"#o,$i"e ha"+es

2009

There are various endocrine changes associated withoverweight.Changes in the reproductive system are among the most

common.Irregular menses and frequent anovular cycles arecommon.

Rates of fertility may also be reduced.

Endocrinol Metab Clin N Am. 2003; 32: 761-786


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E"#o,$i"e ha"+esAsso,iate# .ith Obesity

2009

Increased cortisol productionInsulin resistanceDecreased sex hormone-binding globulin in women

Decreased progesterone levels in womenDecreased testosterone levels in menDecreased growth hormone production

Common hormonal abnormalities associated with obesity



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Psy,ho'o+i,a' Diso$#e$sAsso,iatio"s .ith Obesity

2009

besity is associated with an impaired quality of life.!igher "#I values are associated with greater

adverse effects.$hen compared to obese men% obese women appearto be at a greater ris& for psychological dysfunction.This may be due to the societal pressure on women to

be thin.


J La tate Med oc .'(()* +), + / 01'-12.


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Obesity is a $es%'t of e ,ess oftota' e"e$+y i"ta3e $e'ati*e toe"e$+y e )e"#it%$e $athe$ tha" a,e$tai" a,$o"%t$ie"t

71 %acronutrientba"ance


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Ne%$o)e)ti#es a"# Le)ti" i" Foo#I"ta3e a"# Obesity

BW ho eostasis is ai"tai"e# *ia a se$ies of,o )'e i"te$a,tio"s of hy)otha'a %s a"# the)e$i)he$y *ia 'e)ti"

Le)ti" is sy"thesise# i" a"# se,$ete# f$oa#i)ose tiss%e( i"hibits o$e i+e"i, "e%$o)e)ti#esa"# th%s( #e,$easi"+ foo# i"ta3e a"# bo#y.ei+ht( i",$easi"+ fat o i#atio" a"# e"e$+y

e )e"#it%$e


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O$e i+e"i, "e%$o)e)ti#es

Ne%$o)e)ti#es YMe'a"i" ,o",e"t$ati"+ ho$ o"O$e i" A a"# BO)ioi#s


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A"o$e i+e"i, )e)ti#es

o,ai"e8 a"# A )heta i"e82e+%'ate# T$a"s,$i)t 4 A2T6

o$ti,ot$o)i"8$e'easi"+ -o$ o"e4 2-6H8Me'a"o,yte8sti %'ati"+ ho$ o"e

4H8MS-6


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or a yei#!t, ;at istribution, and

Activity

2009

The following factors have been shown to increasemortality in individuals/

3xcess body weight Regional fat distribution $eight gain patterns 0edentary 4ifestyle



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%orta"ity8e#iona" ;at istribution

2009

Regional fat distribution can contribute to mortality.

This was first noted in the beginning of the '(th

century.bese individuals with an android or apple distribution of

body fat are at a !reater ri"# for diabetes and heart diseasethan were those with a gynoid distribution pear .

Android $%noid



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(entra"isation of Body ;at

Fat a,,% %'ates )$e#o i"a"t'y i",e"t$a' #e)osit

Se$*es as a" easi'y a*ai'ab'es%bst$ate fo$ i )o$ta"t 'i*e$ a"#)e$i)he$y f%",tio"s2ese$*e #e)ot fo$ )e$io#s .he" thes%$$o%"#i"+ i'ie% is th$eate"i"+


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5ndroid fat distribution results inhigher free fatty acid levels%

higher glucose and insulin levels and reduced !D4levels.higher blood pressure and inflammatory mar&ers.


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Mortality and Morbidity Associated wit! Obesity

2009

The effects of excess weight on mortality andmorbidity have been recogni6ed for more than '%(((years.It was !ippocrates who recogni6ed that 7suddendeath is more common in those who are naturally fatthan in the lean.8



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%orta"ityei#!t /ain

2009

In addition to overweight and centralfatness% the amount of weight gain afterages +9 to '( also predicts mortality.

The :urses; !ealth 0tudy and the !ealth


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%orbidityAssociated wit! Obesity

bstructive sleep apneasteoarthritis

Cardiovascular disorders>astrointestinal disorders#etabolic disorders

3ndometrial% prostateand breast

cancersComplications of pregnancy#enstrual irregularities


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a$#io*as,%'a$ Diso$#e$sAsso,iate# .ith Obesity

2009

!ypertension0tro&e

Coronary 5rtery Disease

bese individuals are at a greater ris& of developing thesecardiovascular disorders/


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-y)e$te"sio"

2009

"lood pressure is often increased in overweight individuals.3stimates suggest that control of overweight would eliminate19? of the hypertension in Caucasians and '9? in5frican 5mericans.

verweight and hypertension interact with cardiacfunction% leading to thic&ening of the ventricular

wall and larger heart volume% and thus to agreater li&elihood of cardiac failure.

J La tate Med oc .'(()* +), + / 01'-12.


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(o"on (ancer;indin#s 8e"atin# to Obesity

2009

Colon cancer has been shown to occur morefrequently in people who are obese than in people who are of a healthy weight.

5n increased ris& of colon cancer has beenconsistently reported for men with high "#Is.

$omen with high "#I are not at increased ris& ofcolon cancer.

There is evidence that abdominal obesity may beimportant in colon cancer risk.

:CI


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/a""stones;indin#s 8e"ated to Obesity

2009

Obesity appears to be associated with the development of gallstones.More cholesterol is produced at higher body fat levels.Approximately 20 mg of additional cholesterol is synthesi ed for eachkg of extra body fat.!igh cholesterol concentrations relative to bile acids andphospholipids in bile increase the likelihood of precipitation ofcholesterol gallstones in the gallbladder.



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/a""stones;indin#s 8e"ated to Obesity

2009

In the :urses; !ealth 0tudy% when compared to those having a "#I of '1 orless% $omen with a "#I @ A( &gBm' had a '-fold increased ris& for

symptomatic gallstones. $omen with a "#I @ 1) &gBm' had a ,-fold increased ris& for

symptomatic gallstones.

The relative increased ris& of symptomatic gallstone development withincreasing "#I appears to be less for men than for women.

J La tate Med oc .'(()* +), + / 01'-12.


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(ancer;indin#s 8e"atin# to Obesity

2009

verweight and obesity are associated with anincreased ris& of/

esophageal% gallbladder% pancreatic% cervical%breast% uterine% renal% and prostate cancers.

besity and physical inactivity may account for 2&to 30 percent of several ma or cancers% including---colon% breast postmenopausal % endometrial%&idney% and cancer of the esophagus.

J La tate Med oc .'(()* +), + / 01'-12.


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obesitas modul 3.2 2015 (salinan berkonflik home-pc 2015-11-22)

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