Obesity is a risk factor

Are you overweight?

First of all, you need to decide whether your weight is normal or overweight. To do this, you need to calculate your Body mass index , abbreviated as BMI.

It's very easy to do it yourself:

1. Measure and record your weight in kilograms

2. Measure and record your height in meters

3. Divide the indicator of your body weight in kilograms by the indicator of your height in meters squared.

In this way,

BMI \u003d weight (kg) / [height (m)] 2

For instance,

Your weight is -102 kg,

Height -1.68 m (168 cm),

hence,

Your BMI \u003d 102: (1.68 x 1.68) \u003d 36

Waist circumference If calculating body mass index seemed difficult to you, then you can use a simpler indicator - Waist Circumference (OT). It is measured under the lower edge of the ribs above the navel. Women with OT less than 88 cm and men with OT less than 102 cm have nothing to worry about. Higher rates are a serious reason to think about your health.

In accordance with the obtained BMI, it is possible to assess the degree of risk of developing concomitant diseases (diabetes mellitus, atherosclerosis, arterial hypertension and a number of other, equally serious diseases) according to the following table:

Classification	BMI	Health risk	What to do
Underweight	Less than 18.5	Absent
Norm	18.5 - 24.9	Absent
Overweight	25.0 - 29.9	Elevated	weight loss
Obesity	30.0 - 34.9	Tall	weight loss
	35.0 - 39.9	Very tall
Pronounced obesity	Over 40	Extremely high	It is necessary immediate decline body weight

Please note: BMI\u003e 30 indicates obesity, which is a serious health threat. In this case, you should immediately consult a doctor in order to develop an individual weight loss program.

Obesity-related diseases and risk factors

Many obese individuals have impaired insulin function and carbohydrate metabolismas well as the exchange of cholesterol and triglycerides. All of these concomitant conditions are risk factors for cardiovascular disease, and their severity increases with an increase in BMI (see table).

The relative risk of diseases often associated with obesity

Dramatically increased (relative risk\u003e 3)	Moderately increased (relative risk 2-3)	Slightly increased (relative risk 1-2)
Type 2 diabetes mellitus	Coronary heart disease	Cancer (breast in postmenopausal women, endometrium, colon)
Gallbladder disease	Arterial hypertension	Hormonal reproductive disorders
Hyperlipidemia	Osteoarthritis (knee joints)	Polycystic ovary syndrome
Insulin resistance	Hyperuricemia / gout	Infertility
Dyspnea		Low back pain caused by obesity
Sleep apnea syndrome		Increased anesthetic risk
		Fetal pathology due to maternal obesity

For example, in obese individuals, the relative risk diabetes mellitus Type 2 triples compared to the risk in the general population. Likewise, obese individuals have a double or triple risk of coronary heart disease.

Obesity is often accompanied by the development of:

? type 2 diabetes mellitus

? impaired glucose tolerance

? elevated insulin and cholesterol levels

? arterial hypertension

Obesity is an independent risk factor for cardiovascular disease. Body weight is a better predictor of coronary heart disease than blood pressure, smoking, or high blood sugar. Moreover, obesity increases the risk of other forms of pathology, including some types of cancer, diseases digestive system, respiratory organs and joints.

Obesity significantly impairs the quality of life. Many obese patients suffer from pain, limited mobility, low self-esteem, depression, emotional distress and other psychological problems due to prejudice, discrimination and isolation in society.

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

Most doctors agree that being overweight accelerates the aging process. The accumulation of excess fat can occur as a result of catabolic processes, but at the same time it speeds up the processes aging... There are many factors for the accumulation of excess fat.

Obesity types

The constitutional obesity develops in people hereditarily predisposed to overweight. In such people, the breakdown of fats is extremely slow, and at the same time, carbohydrates and proteins are quite intensively converted into fats.

Common obesity develops against the background of physical inactivity, accompanied by an unbalanced and immoderate diet. With this lifestyle, excess fat is formed from nutrients that are not used in energy production. And physical inactivity reduces the need for energy to a minimum, contributing to the preservation and increase of body fat.

Obesity reasons

One of the factors of age-related accumulation of fat mass is hyperadaptosis. IN nervous system the supply of neurotransmitters is depleted, and mainly those that cause excitation of cells. This leads to an excess of the concentration of glucocorticosteroids in the blood plasma.

Glucocorticosteroids contribute to the predominance of catabolism over anabolism. In this case, catabolic processes occur both in the muscles and in the adipose tissue. However, the breakdown of protein structures is more intense. The body responds to this process by dramatically throwing it into the blood a large number of hormone insulin. Insulin inhibits the destructive effect of glucocorticosteroids on protein structures, enhancing anabolic processes. However, insulin contributes to an even more intense anabolism of fats, which leads to obesity.

A decrease in the amount of sex hormones in the blood, as well as a loss of cell receptor sensitivity to them, also contributes to obesity. This is because sex hormones are able to function like neurotransmitters, stimulating the process of breaking down fats, and their absence leads to the opposite consequences.

Pathology endocrine system, regardless of their origin, lead to excess fat accumulation. The following deviations lead to the accumulation of excess fat: a lack of growth hormone in the blood, a decrease in the secretion of insulin-like growth factor (observed in liver diseases), hypothyroidism, adrenal hyperactivity, non-insulin dependent diabetes.

Why does excess body fat accelerate the aging process?

Adipose tissue is not just a static storage of fat. Adipose tissue cells are completely self-sufficient, and they live according to the same laws as cells of other tissues. They require a fairly large amount of nutrients - proteins, carbohydrates, vitamins and amino acids. Adipose tissue is self-sufficient, and in some ways even more independent and self-sustaining. Its independence is manifested in the fact that it absorbs a considerable amount of thyroid and sex hormones, and at the same time enhances the process of releasing the hormone insulin and glucocorticosteroids into the blood plasma. Thus, rather difficult situation: the more metabolic processes are disturbed in the body, the more intensively fat stores grow, and the more fat, the more metabolic processes are disturbed.

A process called lipolysis takes place in the human body. Lipolysis is the continuous breakdown of fat into glycerol and fatty acids, which enter the bloodstream. It follows from this that the more fat reserves the body has, the higher the concentration of fatty acids in the blood.

In the process of "lipid peroxidation" (LPO), when fatty acids are oxidized by oxygen-containing free radicals, they break down into extremely poisonous substances, much more dangerous than oxygen-containing free radicals. Products of "lipid peroxidation" are extremely poisonous. They react with DNA to induce mutagenesis, which shortens the life of the DNA. By ruptured cell membranes, lipid peroxidation products damage mitochondria - energy producers. Damaged mitochondria cannot break down fatty acids, which makes the process of lipid peroxidation even more intense.

Weighing the cons of obesity, one gets the impression that there is no such disease that is not aggravated in its course due to the accumulation of excess body fat.

A person often falls into vicious circles. For example: the amount of insulin released into the blood depends on the amount of food consumed. Insulin is secreted by the pancreas and enters the bloodstream even after the absorption of nutrients. It provokes a decrease in the concentration of glucose in the blood. It creates an appetite. A vicious dependence looms here: the more a person has, the more he wants to eat. Getting out of these vicious circles can be challenging.

How to slow down the aging process?

Modern medicine states that life expectancy depends on a combination of hereditary factors and human interaction with the environment throughout life. The hereditary factor cannot be corrected today. However, our way of life is completely in our hands.

In order to minimize the aging process, many scientists and nutritionists, in addition to healthy way life is advised to use the following antioxidants every day (including with the use of dietary supplements Tiens):
vitamin E - 400 IU (contained in Weikan preparation);
β-carotene - 250,000 IU (contained in the Weikan preparation);
zinc - 15 mg (contained in the Biozinc preparation);
selenium - 0.1 mg (contained in the Spirulina preparation);
magnesium - 0.25 g (contained in the Spirulina preparation);

This course of antioxidants:
halves the likelihood of sudden death;
reduces the likelihood of death from a malignant tumor by 14%;
halves the likelihood of heart failure and cerebral infarction;
reduces the likelihood of developing cataracts - by 35-40%.

Scientific studies on volunteers conducted in the PRC have shown that the daily intake of 20-30 mg of β-carotene, together with tocopherol and selenium, reduces the likelihood of developing malignant tumors in tobacco smokers.

Obesity, i.e. excess fat in adipose tissue is the most common pathology in humans.

Adipose tissue in women is 15 - 18% of the total body weight, in men 8 - 12%. It plays a very important role, being a storehouse of fatty acids, which are present in it in the neutral fat - triglycerides. In adipose tissue there are 120,000 - 150,000 kcal, while in protein - 24,000, and in carbohydrate - 1,000 kcal. The human body is able to store energy in the form of fat, which is essential to sustain life. If the regulation of maintaining a normal amount of fat in adipose tissue is disturbed, obesity develops.

In adipose tissue, metabolic processes are constantly occurring - lipolysis and lipogenesis. Lipolysis - the release of fatty acids from neutral fat in adipose tissue, accompanied by a decrease in its amount, occurs when food does not enter the body. Fatty acids enter the bloodstream and are delivered by the blood to peripheral tissues, mainly muscles and myocardium, as a source of energy. Lipogenesis is the opposite of lipolysis, that is, the synthesis of new fat. Its normal amount maintains a balance between lipolysis and lipogenesis. It is a complex system of neurohormonal and humoral factors. It involves the central nervous system, counter-regulating hormones, cholecystokinin, adipose tissue hormones - adipsin and leptin, neurotransmitters in the central nervous system - norepinephrine, serotonin, opioids, dopamine.

Risk factors are:

• external factors: overeating, low physical activity, stressful situations;
• internal factors: disturbances in the centers of appetite, decreased adaptive thermogenesis, impaired tissue adipostat, age;
• hormonal factors: hyperinsulinemia, excess cortisol, deficiency.
• hereditary factor: predisposition to obesity.

There are two types of obesity: primary and secondary.

The primary is not a consequence of any disease. Secondary occurs with various endocrine diseases (insulinoma, central nervous system diseases) and genetic syndromes.

By the nature of the distribution of fat, two types of obesity are distinguished: trunk and peripheral. Trunk fat is characterized by an uneven distribution of fat with excess fat deposition in the upper half of the body, on the abdomen, and on the face. There is little fat on the limbs, hips, buttocks. Typically, this type develops in adulthood. With trunk obesity, the amount of fat cells in the adipose tissue is within normal limits, but the amount of fat in them is increased.

The trunk type is characterized by the presence of insulin resistance and hyperinsulinemia. This is due to the fact that the synthesis of fat in adipose tissue is carried out with the participation of insulin. As the amount of fat in the fat cell increases, more insulin is required, and with normal amounts of insulin, its effect is insufficient and insulin sensitivity decreases. In response, compensatory hyperinsulinemia develops.

Peripheral is characterized by an even distribution of fat and its deposition in the hips and buttocks. This type occurs in childhood and most often due to overfeeding of the child.

The main treatments for obesity:

• low calorie diet;
• physical activity;
• drug therapy (anorexigenic drugs);
• surgery.

1

1 GBOU VPO "Moscow State University of Medicine and Dentistry named after A.I. Evdokimov "Ministry of Health of the Russian Federation

2 FSBI "Central Research Institute for Organization and Informatization of Health Care" of the Ministry of Health of the Russian Federation

In the modern world, the percentage of obese people is increasing from year to year. The main reasons for the increase in the number of people with impaired body weight are inappropriate nutrition and decreased physical activity. Obesity is currently an undeniable risk factor for the development of many chronic noncommunicable diseases. The most common of these are diseases of the cardiovascular system, such as arterial hypertension (AH) and coronary heart disease (CHD). Cardiovascular disease is the cause of the majority of deaths worldwide. They kill 17.5 million people annually. They are followed by cancer (8.2 million), respiratory diseases (4 million) and diabetes (1.5 million). A number of researchers note the connection between professional activity and the development of body weight disorders. Particularly noteworthy are those in dangerous professions such as firefighters and rescuers. The totality of unfavorable factors of the conditions of professional work of such people requires special control and monitoring of their health. Many firefighters are diagnosed with hypertension, hyperlipidemia and obesity. Weight loss in such persons can lead not only to the occurrence of chronic non-infectious diseases, but also to professional unfitness. However, the existing methods for assessing the state of health do not allow determining the relationship between the anthropometric indicators of the body and the risk of developing chronic non-infectious diseases among people of hazardous professions.

chronic noncommunicable diseases

dangerous professions

risk factors

obesity

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Low physical activity and unbalanced diet lead to the development of overweight, and subsequently to obesity. Weight loss is a huge global problem. Its frequency is so high that it has acquired the character of a non-infectious epidemic. According to the World Health Organization (WHO, WHO), the number of overweight people is approaching 2 billion. According to UN statistics, Russia entered the twenty most "complete" countries in the world. Every fourth Russian is overweight.

The origins of obesity lie in childhood and adolescence, when the main food addictions, habits, lifestyle are formed and metabolic processes in the body are developing. The prevalence of obesity in the child population is growing catastrophically both in Russia and abroad, and varies from 4.5 to 38%.

The most common and likely causes of obesity in children are usually overeating and lack of exercise. This is often associated with an improper diet, with eating habits that adults instill. Nutritionists say adolescent obesity often occurs in families where one or both parents are overweight. If there is one overweight parent, the risk of developing the disease in children is 30%, and if both mother and father suffer from this, then the risk is already more than 80%. Childhood obesity is a contributing factor to the higher likelihood of obesity, premature death and disability in adulthood.

In both childhood and adulthood, excess body weight is not only a personal problem of a person, significantly reducing his quality of life. Obesity is currently an undeniable risk factor and predictor of many chronic diseases. This marked an increase in the medical, economic and social significance of the obesity problem. So, about 70% of patients with arterial hypertension and 90% of patients with type 2 diabetes mellitus are overweight or obese.

Among chronic non-communicable diseases, type 2 diabetes mellitus (DM 2), atherosclerosis, and coronary heart disease (CHD) occupy a special place. In the United States, coronary heart disease is the leading cause of death, according to the National Institutes of Health. A similar picture is typical for all developed countries.

Arterial hypertension (AH) is the greatest pandemic, determining the structure of cardiovascular morbidity and mortality. The prevalence of hypertension in the world among the adult population ranges from 450 to 900 million (30-40%), and in Russia - more than 40 million people (39% of men and 41% of women). Hypertension is often combined with obesity, especially its abdominal type (AO).

The problem of hypertension combined with obesity is in the focus of modern medicine due to the increased risk of cardiovascular complications and premature mortality compared to the general population. In obese patients, hypertension occurs up to 6 times more often than in persons with normal body weight, and the presence of obesity at a young age is a risk factor for its subsequent development. The combination of obesity with hypertension increases the risk of coronary artery disease by 2-3 times, and cerebral strokes by 7 times.

In overweight people, the level of systolic and diastolic blood pressure in the daytime is higher than in people with normal body weight, and in the structure of the daily profile, an insufficient decrease in blood pressure at night prevails. Even with the use of antihypertensive therapy in such people, these figures are higher. normal valuesespecially in obese individuals.

The main reason for the increase in the number of persons with body weight disorders is the development of civilization. Progress has led to a decrease in the need for manual labor, reduced the need for active movement. According to the WHO, every third adult in the world is not active enough. This is connected both with the person's lifestyle and with his professional activities. A number of researchers note the connection between professional activity and the development of body weight disorders.

Special attention should be paid to persons of dangerous professions, because, on the one hand, they are constantly exposed to stress, and on the other, they have an irregular work schedule, night shifts. Decision-making and the activities of rescuers themselves require an accurate analysis of the situation, the most effective actions in a limited time and in extreme conditions, which makes special requirements for professional selection and psychological state that determines professional performance.

The totality of unfavorable factors of the conditions of professional work of such people requires special control and monitoring of their health. Many firefighters are diagnosed and under-treated for hypertension, hyperlipidemia and obesity, as well as poor dietary habits and extreme exercise.

According to the National Fire Protection Association (USA), 65-70% of firefighters' morbidity is due to cardiovascular diseases, which is possibly due to the high intensity of their work.

In foreign literature, there are few studies of certain categories of persons in hazardous professions, such as firefighters and rescuers. According to some foreign researchers, firefighters and police are one of the prevailing groups in the development of obesity. For example, in North America 80% of firefighters are overweight or obese. Due to high rates of obesity and cardiovascular events, cardiovascular disease is the leading cause of death on duty among firefighters.

In Russia, depending on the length of service, up to 80% of rescuers have various pathologies internal organs... This indicator reaches its maximum values \u200b\u200bwith a work experience of up to 3 years and more than 6 years as a professional rescuer. This is due to the violation of adaptive mechanisms during these periods. Diseases of the digestive system, blood circulation, respiratory, endocrine and musculoskeletal systems are predominant.

During the medical examination of professional rescuers of the Ministry of Emergency Situations of Russia from the North-West region, a relationship was revealed between the incidence and functional state of the rescuers with the age and length of service in the specialty. However, there are no data on the analysis of the prevalence of overweight and obesity among this group of people.

In the domestic literature, there are data on the assessment of the violation of the relationship of mental, psychophysiological and physiological functions of the body among themselves among persons of dangerous professions. It allows you to determine the nature and level of changes in professional health and choose methods of its correction, aimed at normalizing intersystem interactions. However, these methods do not allow assessing the relationship between the anthropometric parameters of the body and the risk of developing chronic non-infectious diseases among people of hazardous professions.

Conclusion

The development of cardiovascular diseases - hypertension, ischemic heart disease, myocardial infarction and cerebral stroke, as well as heart failure, in turn, leads to early disability and premature death. Meanwhile, a comparative study of the prevalence of body weight disorders in persons of hazardous occupations, depending on the type of professional activity, and a detailed description of the nature of changes in the health status of this professional group in the available literature is practically absent.

However, it should be remembered that a violation of body weight in persons of hazardous professions can lead not only to the occurrence of chronic non-communicable diseases, but also to professional unsuitability, which is disadvantageous for the country's economy, since can lead to the loss of highly qualified personnel.

The loss of skilled workers directly affects the quality and efficiency of the work performed, which in an emergency situation can lead to untimely assistance, and, consequently, to unjustified casualties among the population.

The work was carried out within the framework of the grant of the President of the Russian Federation MK-5330.2015.7

Reviewers:

Lakshin A.M., Doctor of Medical Sciences, Professor of the Department of General Hygiene of the State Budgetary educational institution higher professional education "Moscow State University of Medicine and Dentistry named after A.I. Evdokimova ", Moscow;

Yarygin N.V., Doctor of Medical Sciences, Associate Professor of the Department of Disaster Medicine and Life Safety of the State Budgetary Educational Institution of Higher Professional Education “Moscow State University of Medicine and Dentistry named after A.I. Evdokimov "of the Ministry of Health of the Russian Federation.

Bibliographic reference

Arkhangelskaya A.N., Burdyukova E.V., Ivkina M.V., Lastovetskiy A.G., Kudentsova S.N., Stulina D.D., Gurevich K.G. OBESITY AS A RISK FACTOR FOR THE DEVELOPMENT OF CHRONIC NON-COMMUNICABLE DISEASES IN PERSONS OF DANGEROUS PROFESSIONS // Contemporary problems science and education. - 2015. - No. 5 .;
URL: http: // site / ru / article / view? Id \u003d 22107 (date accessed: 01/30/2020).

We bring to your attention the journals published by the "Academy of Natural Sciences"

How many people are overweight in the world?

In the modern world, obesity can be classified as one of the most common chronic diseases. According to the World Health Organization (WHO), up to 30% of the world's inhabitants are overweight or obese. In our country, overweight is observed in more than 40% of the population, while in 26% of them excess weight can be regarded as obesity. According to the results of the clinical examination of certain groups of the adult population that took place in the Volgograd region for 9 months of 2015, the number of overweight people is 47%.

Both in Russia and in the world, the number of obese people is steadily increasing every year, so experts predict that it is obesity that can become an epidemic of the XXI century.

Especially alarming is the fact that every year obesity is getting younger, becoming a problem not only for adults, but also for children. Taking into account the fact that, according to WHO, it is obesity that is the second leading cause of morbidity and mortality that can be eliminated, more and more attention is paid to this problem in modern medicine.

Why are there so many obese people?

The reason for the widespread prevalence of excess weight in modern society is the changes in our way of life that have occurred in recent decades: thanks to technological progress, the level of physical activity modern man significantly decreased, lifestyles became sedentary, while the dietary intake of high-calorie, high-fat, low-fiber foods increased significantly. A significant "contribution" to such a wide spread of obesity was made by fast food, which, in conditions of constant lack of time, has become a familiar product in the diet of the modern working person.

There is such an expression: "Fertility is a sign of health" ...

For a long time in our country, the attitude towards the problem of overweight was ambiguous: on the one hand, obesity was perceived as a punishment for overeating, and on the other hand, stoutness, especially in children, was considered an indicator of good health. but modern medicine, including the domestic one, rejects the concept of "healthy obesity", which is based on the assertion that an overweight person can remain healthy: it has been proven that obesity is a risk factor for the development of cardiovascular diseases, diabetes mellitus, atherosclerosis, while the risk of developing these diseases increases with increasing body weight.

How to tell if a person is overweight?

For a rough estimate, the calculation of the so-called Body Mass Index (or Quetelet Index) has proven itself best. This indicator is calculated as follows: weight (in kilograms) divided by height (in meters), squared.

With normal weight, the Body Mass Index is 18.5-24.9. A body mass index ranging from 25.0 to 29.9 indicates overweight. The value of the indicator from 30.0 to 34.9 corresponds to the first degree of obesity, from 35.0 to 39.9 - to the second degree, more than 40.0 - to the third. It should be remembered that the Body Mass Index indicator cannot be used for children, pregnant women, people over 65 and professional athletes, as it is not reliable for them.

Is the risk of developing cardiovascular disease the same in obese and slender people, or is it higher in obese people?

Obesity is a risk factor for a number of diseases, but, first of all, pathology of the cardiovascular system. High mortality rates and the incidence of cardiac complications in obese people are mainly a consequence of vascular lesions.The fact is that obesity is a factor that predisposes: to the development of dyslipidemia - deviations from the norm in cholesterol metabolism (up to 30% of obese people have hyperlipidemia), sugar type 2 diabetes (up to 80% of patients with type 2 diabetes are overweight or obese), arterial hypertension (about half of obese individuals have arterial hypertension), that is, those diseases in which the vessels are affected. In addition, obesity causes fatty infiltration of the myocardium, which, together with an increase in the body's oxygen demand as a result of a significant increase in body weight, leads to an increase in the load on the heart. A complication of prolonged overload of the heart is myocardial dystrophy.

How can a person assess the likelihood of developing heart disease?

To assess the risk of developing CVD, not only the degree of obesity, but also the nature of the distribution of subcutaneous fat is of great importance. The relationship between obesity and CVD is more common in the so-called. central or visceral obesity (which is more pronounced in the abdomen and chest) than in general obesity (which affects the lower half of the body). That is why the popular expression "The narrower the waist, the longer the life" has real scientific confirmation.

The clinical diagnosis of central obesity is based on changes in waist and hip circumferences. A waist circumference of more than 100 cm at the age of 40 and over 90 cm at the age of 40-60 (for both men and women) is an indicator of visceral obesity. If the ratio of the waist circumference to the hip circumference in men exceeds 0.95, and in women 0.85, then we can talk about pathological fat deposition in the abdominal region.

So obesity is a disease and needs to be treated?

Yes, indeed, obesity is a serious disease and it can and should be treated. However, overweight people often choose the wrong weapon to combat this problem. This is due to the fact that in the pursuit of profit, the media are actively disseminating various theories weight loss, often without any evidence base. Such methods are either not beneficial, causing disappointment in their own strengths, or they are harmful to health. Therefore, the treatment of obesity should be under the guidance of specialists.

Overweight is treated by doctors of three directions - nutritionists, endocrinologists and surgeons. The modern approach to the problem of obesity implies the use of complex methods of treatment, such as diet therapy, psychotherapy, drug therapy, physiotherapy exercises, massage, physiotherapy.

Kramar V.O.

candidate of Medical Sciences, Head department

integrated programs

prevention of non-communicable diseases

adult population and interagency relations

GKUZ "VOCMP"

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