Is Obesity Now Considered A Disease?

Depending on where you look, the definition of a ‘disease’ includes such phrases as a change from the normal state, a state of disorder, an abnormal or pathologic condition of the body, and being in dis-ease.  A disease can be brought about by personal factors, genetics, environmental influences, and lifestyle habits.  Common diseases include autoimmune conditions, hypertension, high cholesterol, diabetes, thyroid problems, cancer, endometriosis, ulcers, acne or more.  As of June 2013, the American Medical Association (AMA) has recognized obesity as a disease which could change the way insurance companies reimburse on prevention and treatment options for weight loss however those that oppose the AMA feel that obesity requires some personal responsibility as well.

According to the Centers for Disease Control and Prevention (CDC), almost 36% of Americans are in the obese category.  The classifications for ‘overweight’ and ‘obese’ are not perfect however the Body Mass Index (BMI) chart is most commonly used as it takes into account height and weight but not bone structure or lean muscle ratio.  A BMI between 18.5 and 24.9 is considered a normal, healthy weight.  Between 25 and 29.9 is in the overweight category and above 30 is officially classified as obese.  To give you an example, a 5’6” woman who weighs roughly between 160 and 185 pounds is considered overweight however if she weighs above 185 pounds then she is obese.  Another example would be a 5’4” woman who weighs between 145 and 175 pounds is considered overweight and if she were over 175 pounds she is considered obese. 

As many in the health field feel that abdominal obesity is more concerning as it means there is increased fat around the key abdominal organs, the waist circumference is gaining popularity when determining overweight, obesity and health risks.  Measure around your abdomen just above your hip bones (not necessarily your narrowest section) and women should be under 35 inches and men under 40 inches.  Higher numbers equals an increased girth which increases the risk for high blood sugar/pre-diabetes/diabetes, high cholesterol, high blood pressure and overall increased risk for cardiovascular disease. 

The overall concern is that excess weight can lead to long term consequences that could be preventable and there is an ongoing national push to get America healthier, reduce the number of obese and overweight adults and children, educate on proper nutrition, eliminate high sugar foods and drinks and encourage regular exercise.  Obesity is costing Americans millions of dollars as it can also cause an increased risk of cancer, joint pain, sleep problems, lethargy and more.  Please do not be a statistic – educate yourself and your family and start making healthy changes today!

References:

1.       Frellick, M.  AMA Considers Obesity A Disease.  Web.  23 June, 2013.

http://www.medscape.com/viewarticle/806566

2.        Centers for Disease Control and Prevention (CDC).  Adult Obesity Facts.  Web.  23 June, 2013.

http://www.cdc.gov/obesity/data/adult.html

3.       Centers for Disease Control and Prevention (CDC).  Defining Overweight and Obese.  Web.  23 June, 2013.

http://www.cdc.gov/obesity/adult/defining.html

4.       National Heart, Lung and Blood Institute.  According to Waist Circumference.  Web.  23 June, 2013. 

http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/txgd/4142.htm

What Causes Osteoarthritis?

Many women experience joint pain whether it’s in their knees, hips, fingers or shoulders.  The pain might come and go, be worse in the morning, or feel aching and stiff most of the day.  The diagnosis is typically done with symptoms and possibly an x-ray that shows joint changes.  Arthritis can start as early as the late teenage years/early twenties however more than 50% of people over 65 years old exhibit symptoms of arthritis.  What causes the joints to begin to deteriorate and create arthritis?

1.       Joint injury – Research shows that those who sustained a joint early at a young age are more apt to develop arthritis in that joint at a later age.  As an example, 51% of women developed knee arthritis 12 years after tearing their anterior cruciate ligament (ACL) in soccer.  Many can point back to a car accident, sports injury, broken bone or other trauma when discussing their problem area(s). 

2.       Obesity – Extra weight on the body coupled with daily activities and gravity means more load on the hips, knees, ankles and feet causing those joints to become more strained and inflamed over time plus it increases the wear and tear on the cartilage that leads to osteoarthritis. 

3.       Age – Sorry ladies, aging does take its toll on the joints considering more than 50% of people over 65 have arthritis symptoms (as stated above).  Many women will say “I didn’t have these problems in my 20’s or 30’s!” but over time joint injuries happen, diet/lifestyle choices take effect, genetics kick in, hormones change, weight fluctuates…and suddenly one day women find themselves waking up more stiff and aching.  Those of you who can still go from sitting cross-legged on the floor to a standing position without (much) assistance count yourselves lucky. It will probably change.

4.       Congenital abnormalities – If someone were born with joint problems or cartilage issues, then over time the stress on the joints will cause arthritic changes.  For example, scoliosis in the spine, or one leg shorter than the other will shift the way the body carries itself causing joint problems. 

5.       Endocrine disorders – Diabetics and those with low thyroid hormone are at risk for more joint and cartilage problems that can lead to arthritis.  Women heading into menopause often complain of more joint pain because their estrogen levels are gradually (or suddenly) decreasing. 

What does all this mean?  It means, take good care of yourself!  This is your one body.  Eat healthy, stay hydrated, maintain a healthy body weight, limit sugars and processed foods, and stretch regularly.  Thankfully there are articles here for tips to reduce the symptoms of arthritis if your joints are causing you pain on a regular basis.  Lastly, talk with your health care provider about appropriate work-up and treatment suggestions. 

References:

1.       Sofat, N., Ejindu, V., Kiely, P.  What Makes Osteoarthritis Painful?  Rheumatology. 2011;50(12):2157-2165.

2.       Roos, E.  Joint Injury Causes Knee Osteoarthritis in Young Adults.  Curr Opin Rheumatol. 2005;17(2):195-200.

3.       Kramer, P.  Prevalence and Distribution of Spinal Osteoarthritis in Women.  Spine. 2006;31(24):2843-2848.

What is the Mediterranean Diet?

The mere mention of the word ‘Mediterranean’ conjures up colorful images of crystal blue seas, white wash buildings and islands such as Crete, Malta and Cyprus often visited by cruises.  Besides its beauty, the Mediterranean area is also well known for its cuisine that has a number of health benefits.  Health care providers and well known books on wellness commonly recommend this particular diet therefore it is important to understand exactly what to eat.

The basics of the diet break down as follows; people should choose a fresh and vast array of vegetables.  Branch out from the typical peas and carrots and choose leafy greens (lots of them), zucchini, mushrooms, sun dried tomatoes, artichokes and artichoke hearts, cucumbers, onions, garlic, bell peppers, squash, sweet potatoes and more.  Rotate your vegetables and aim for a serving (or more!) at every meal.  Next, add in some fruit as a snack or dessert.  Use fresh or frozen berries when the sweet tooth monster strikes.  Slice up an apple with some almonds.  Blend half of a banana with your greens and protein powder for your morning smoothie.  Be careful not to eat more fruit than vegetables – it is about balance.

Learn to eat healthy oils.  The Mediterranean diet focuses on olive oil, olives, avocado and healthy nuts and seeds such as almonds, walnuts, pecans, pumpkin and sesame seeds.  Peanuts are not really a nut and therefore should be limited.   Fresh cheeses and unsweetened yogurts are a primary dairy/protein choice but only for those who can tolerate dairy.  Be careful of how over-processed dairy products are as that is not beneficial for health.  Choose organic/free-range fish, chicken and eggs to be consumed a through the week but go light on the red meat.  Add in lentils to round out the protein mixture.  Because of the location of the Mediterranean Sea so near to Italy, wine is often encouraged however please drink with moderation as the alcohol has a lot of sugar, may do damage to the liver and is not good for the hormone estrogen.

Benefits of the diet are a focus more on fruits, vegetables, good fats and lean proteins as opposed to heavy, processed carbohydrates or calorie empty foods.  This diet has been associated with benefiting cardiovascular disease, high insulin, diabetes and weight loss in research which is why several in the medical field tend to recommend it.  If you are considering switching your diet to a more Mediterranean style, talk with your health care provider otherwise follow these suggestions to get started on overhauling your health today.

Read more about this article at empowher!

References:

1.       Wood, S. Mediterranean Diet Beats Low Fat for CVD Prevention.  Web.  10 March, 2013.

http://www.medscape.com/viewarticle/779831

2.       Tucker, M. Insulin Sensitivity Improved with Mediterranean-Style Diet. Web. 10 March, 2013.

http://www.medscape.com/viewarticle/776109

3.       Reuters Health. Mediterranean Diet May Be Best for Diabetes.  Web. 10 March, 2013.

http://www.medscape.com/viewarticle/778917

What Is Gestational Diabetes?

The saying goes that a woman is ‘eating for two’ when she is pregnant however what she chooses to eat has a drastic impact on her risk of gestational diabetes.  There are the common cravings such as ice cream and pickles but many find themselves also reaching more for bread, crackers or comfort food and avoiding their normally healthy choices out of convenience, nausea or sudden aversion to foods they once loved.  These high carbohydrates, high sugar foods cause a considerable amount of weight gain and fill the system with glucose leading to hyperglycemia and insulin resistance.

It is well known that everything changes with pregnancy.  Anatomically, the body shifts completely to accommodate a growing fetus.  Hormones sky rocket and the brain seems to turn to mush (commonly called, mommy brain).  A pregnant woman’s endocrine system also changes as the body has to adapt to all of the shifts however if the output of insulin by the pancreas cannot keep up with the increase in carbohydrate/sugar heavy foods, she becomes diabetic.  Having gestational diabetes also increases a women’s risk for type 2 diabetes later in life and therefore should be monitored carefully both from a screening glucose/insulin  test and a lifestyle stand point.  It is also important to note that given the current increasing trend in overweight and obesity in the United States, research shows that 50-60% of women go into their pregnancy already carrying too many extra pounds on their frame further increasing the risk.

There is not one set standard for diagnosing gestational diabetes however a woman is more at risk if she has a body mass index (BMI) of 30 or more going into the pregnancy, has had gestational diabetes in a prior pregnancy, or has a strong family history of diabetes.  The most common test is the Oral Glucose Tolerance Test (OGTT) where a pregnant woman drinks a very sweet drink then waits an hour and has her glucose tested.  A normal result (depending on the lab) is under 130-140 mg/dL.  The drink is very syrupy and often can cause vomiting, in which case the test must be repeated at a later date.  Follow up testing can include the 3 hour Oral Glucose Tolerance Test where the same test is repeated however glucose levels are drawn every hour for 3 hours.  If 2 out of the 3 hours have abnormally high levels of glucose, gestational diabetes is diagnosed.

As there are considerable risks for the growing baby (heavy birth weight babies, early delivery, and shoulder dystocia) it is important that gestational diabetes be taken seriously.  Pregnancy is not the time to lose weight or go on a diet however routine glucose monitoring, changes in diet and proper exercise can make a huge difference and possibly avert the use of insulin in order to control glucose levels.  Make sure to eat a variety of vegetables, lean protein, good fats and fiber rich foods for the health of everyone involved!

To learn more, read about the women's health website, Empowher, here!

References:

11) Mild Gestational Diabetes.  Web.  20 January, 2013.

http://www.medscape.com/viewarticle/775396

22)  Gestational Diabetes. Web.  20 January, 2013.

http://www.mayoclinic.com/health/gestational-diabetes/DS00316

33) The Relative Contribution of Prepregnancy Overweight and Obesity, Gestational Weight Gain, and IADPSG-Defined Gestational Diabetes Mellitus to Fetal Overgrowth.  Web.  20 January, 2013.

http://www.medscape.com/viewarticle/777162