So pervasive is the obesity theme these days -- and the accompanying claims of "epidemic" and "crisis" -- that the venerable American Heart Association has dedicated an entire issue of its respected weekly journal, Circulation, to the topic with enough numbers and statistics to keep any stat-junkie happy for a very long time.
In nearly 160 pages, the AHA published editorials, letters and results from several studies that only further underscored that overweight contributes to higher risk of diseases such as heart disease and diabetes as well as a higher risk of death. The editors put a particular emphasis on the dangers to children who are growing up fatter and less active than any previous generation, partly because it is so difficult to make healthier choices since they are as not as easily available. But the society has begun to make steps, the April 19 journal stated in its opening editorial:
"How can this epidemic be stopped? Society as a whole has begun to exert some small pressure. Healthier options are appearing in restaurants, and even the Sunday comics exhort children to shop around the perimeters of supermarkets, where the fresh food is located."
Still, it may take some time to turn the depressing tide found in studies and information presented in the journal.
>> In one study -- "Excess Deaths Associated with Underweight, Overweight and Obesity" -- researchers calculated the number of excess deaths associated with a range of individual body mass index (BMI) scores. The estimated numbers came from the follow-up studies by the National Health and Nutrition Examination surveys (NHANES I --1971-1975; II -- 1976-1980; III -- 1988-1994) and the data on prevalence of BMI levels in NHANES 1999-2002. The study found that obesity as a risk factor contributed to 111,909 excess deaths in 2000, although the relative risks of mortality associated with obesity were lower in NHANES II and NHANES III than in NHANES I. Â
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The study also noted that although the rates of high blood pressure hypertension have declined substantially for all the groups since the 1960s, the rates for those with BMIs of 30 or higher (considered "obese") and the adult population in general from the NHANES 1999-2000 survey are higher than those from the NHANES III (1988-1994).
>> Another study -- "Secular Trends in Cardiovascular Disease Risk Factors According to Body Mass Index in U.S. Adults" -- was designed to measure 40-year trends in cardiovascularÂ risk factors in U.S. adults aged 20 to 74 years. That study found that except for diabetes, rates of cardiovascular risk factors (such as high cholesterol, high blood pressure and smoking) have declined considerably over the past 40 years in all BMI groups.
"Obesity and related consequences remain a top priority for the American Heart Association and should be a high priority for the public as well, said Robert Eckel, M.D., president-elect of the AHA. "We may be doing a better job at treating some of the risk factors, but the toll that obesity is taking includes a reduced quality of life."Â
New wave of obesity
Eckel said he believes many of the overweight or obese patients in the studies may have had heart attacks or strokes, but are living longer due to new treatments. He's also concerned that the data may not reveal the overall impact of the new wave of obesity.Â
"Obesity prevalence is increasing in adults and in the young, and we may not see that impact on cardiovascular disease and death until the next three to four decades. Other risk factors for heart disease and stroke are being treated more aggressively, but now we need to prevent and treat obesity more effectively."Â
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Despite efforts, more is needed across and by different segments of society, the editors wrote.
"Essential to our success in helping the public with this difficult task is our role in advocating for a healthier environment. We will continue to educate policymakers about the important role that physical activity and better nutrition should play in our schools. We will continue to communicate with the Food and Drug Administration and the Federal Trade Commission about the role of food labeling and the importance of giving the public the information it needs to make reasonable choices about calories, serving size, and components they want to limit or avoid for heart health, such as saturated fats and trans fats.
"To create a healthier America, we need to engage a broad range of individuals, from basic and clinical scientists to parents to politicians to healthcare providers."
The April 19 issue of Circulation: Journal of the American Heart Association (Circulation, Issue 111, 2005) is a special obesity-themed issue containing original research papers on obesity. Articles include an American Heart Association scientific statement on childhood obesity; research linking body fatness and increased cardiovascular risk factors in aerobically fit men; a study indicating women with large waistlines and elevated trigylcerides face a dramatic increase in the risk of death from heart disease and stroke; a report that teens who have insulin resistance combined with obesity are more likely to have cardiovascular risk factors; and a "Cardiology Patient Page" offering guidance on weight loss, nutrition and physical activity. To check out the "Fattening of America" special issue, go to www.americanheart.org.
For more information on obesity-related research, terminology and diseases in layman's terms:
>> click here to read the association's scientific position paper on obesity and overweight.
>> click here to read the association's position on overweight in children.
>> click here to read about the definitions and validity of body composition tests and BMI.
>> click here to read about risk factors for coronary heart disease.