Obesity is defined as the excess amount of fat in the body. It occurs because the energy taken in is more than the amount spent. There are approximately 2 billion adults worldwide who are classified as overweight or obese due to genetic factors, nutrition, lifestyle changes and economic well-being. Its incidence is also high in developing countries like ours.
Adipose tissue constitutes 15-18% of adult body mass in men and 20-25% in women. If the fat ratio exceeds 25% of body mass in men and 35% in women, obesity is mentioned. Body mass index (BMI) is used to determine the degree of obesity. Accordingly, there are criteria accepted by the World Health Organization (WHO). Individuals whose BMI result is more than 30 kg/m2 can be called obese/fat. But this process may not be decisive for every individual. For example, although athletes have high muscle mass, their BMI may be high, these individuals are not called obese.
It is not only the amount of fat in the body that determines the risks and diseases associated with obesity, but also the distribution of this fat. Obesity is divided into two types according to the region of fat distribution: central abdominal (android, apple form) and gluteofemoral (gynecoid, pear form) obesity. The distinction between these two is determined by the ratio of waist circumference measurement to hip circumference measurement. If this ratio is less than 0.9in women and 1.0in men, it is called 'gynecoid obesity'; If it is high, it is defined as 'android obesity'.
Health evaluation of waist circumference measurement according to gender in adults risk low risk high
In women < 80 cm > 88 cm
In men < 94 cm > 102 cm
(Report of a WHO Expert Consultation 2008, WHO)
Waist and hip measurements are made as shown in the figure on the side. Measurements are taken at the widest part of the hips and waist, 2 fingers above the belly button.
According to the American Heart Association, beverages with added sugar are the biggest source of calories. Generally, soft drinks contain high amounts of sugar instead of sugar. Additional fructose corn syrup is used and is considered a potential risk for obesity. Attention should be paid to packaged products and ready-made drinks.
WHAT ARE THE DISEASES CAUSED BY ABDOMINAL FAT?
The International Diabetes Foundation also counts abdominal obesity among the risk factors of metabolic syndrome. According to the results of the Turkey Diabetes, Hypertension, Obesity and Endocrinological Diseases Prevalence Study-II (TURDEP-2), abdominal obesity is seen in 32% of people aged 20 and over in our country. Every obese patient should be screened for metabolic syndrome and waist circumference measurement should be used instead of BMI as an indicator of visceral adiposity.
Various studies have shown that obesity, like Metabolic Syndrome, has a risk of causing cardiovascular diseases. According to a study conducted by the Turkish Society of Cardiology, almost 25,000 of the Coronary Heart Disease cases that develop in our population every year can be attributed to abdominal obesity. It is estimated that a 1 cm increase in waist circumference leads to a 6 to 7,000 increase in the number of Coronary Heart Diseases in adults.
Visceral fat is very active metabolically. It can be used in the liver and cause hepatic insulin resistance. Therefore, this situation may pave the way for impaired glucose tolerance or type 2 diabetes. In addition, changes in lipoprotein lipase and hepatic triglyceride lipase levels lead to dyslipidemia, especially hypertriglyceridemia and low HDL cholesterol level.
According to a study published in The American Journal, the relationship between body mass index and central fatness and diabetes was investigated, and as a result, it was concluded that waist/hip ratio and waist size could be associated with diabetes.
WHAT SHOULD WE DO?
• Adequate and balanced calorie intake should be ensured and a healthy diet should be arranged. Dietary models that are limited in saturated fats and cholesterol, rich in complex carbohydrates, consume plenty of fruits and vegetables, and include salt restriction in those with hypertension are recommended. .
• Increasing physical activity and motivating people in this regard. Thus, both the risk of cardiovascular events and the development of metabolic syndrome can be reduced.
• It is known that increasing the consumption of foods such as fish, vegetables and fruits, dried legumes, and unpurified grains rich in omega-3 fatty acids and antioxidants reduces the risk of coronary diseases.
• Slowly digested low glycemic index diets may also have beneficial effects on lipid metabolism.
• According to the American Journal of Nutrition; Green tea helps lose weight along with regular exercise. Researchers have found that the catechins contained in green tea increase calorie burning in the body and reduce fat around the waist. In studies conducted on mice eating blueberries, it was found that the waist area was less fatty.
• When talking about lifestyle changes, the issue of smoking and alcohol should also be emphasized. I recommend reducing the amounts or eliminating it from your life if possible.
In summary;
Eating a balanced and adequate diet and getting more exercise is the best way to reduce waist circumference. A lot of research has been done; Following a balanced diet that meets all nutritional elements with fruits, vegetables, whole grains, low-fat dairy products, legumes, oily seeds, lean meat, fish, eggs and supporting it with 30 to 60 minutes of exercise 3-4 days a week can help keep waist circumference under control. It shows that it can be taken.
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