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GIZI LEBIH dan OBESITAS

definisiDefinisi TradisionalObese: Lemak tubuh yang melebihi (diatas) ketentuan normalOverweight: Berat tubuh yang melebihi (diatas) ketentuan normal

Definisi Terkini (WHO)Bentuk abnormalitas atau akumulasi lemak yang berlebihan yang dapat mempengaruhi kesehatanBerdasarkan pengukuran BMI (Body Mass Index) : BB(kg) TB(m)

2Risk of Co-morbiditiesBMIcategory< 18.5UnderweightAverage18.5 24.9NormalIncreased25.0 29.9OverweightModerate30.0 34.9Obese ISevere35.0 39.9Obese IIVery severe 40Obese IIISource: Behavioral Risk Factor Surveillance System, CDC.199619912003Obesity Trends* Among U.S. AdultsBRFSS, 1991, 1996, 2003No Data 140 ordiastolic BP > 9013

BMI and Prevalence of HypertensionObesity and CancerPositive association with:Breast Cancer (post menopause)Colon CancerProstate CancerEndometrial CancerEssentially all except lung cancer15The Cost of ObesityHealth Affairs, Aug 2006Year% of Medicare Patients with obesity% of Medicare spending on obese patients198711.7%9.4%200222.5%24.8%$336 billion 2005 total Medicare expensesheart diseasetype 2 diabeteshypertensionhigher incidence of joint and mobility problemssome types of cancerMorbidity Associated with Obesity17What concerns us about overweight and obesity is that we find increased levels of certain diseases among those who are overweight or obese.These include heart disease, type 2 diabetes, hypertension, elevated incidence of joint and mobility problems, and some types of cancer, : endometrial (cancer of the lining of the uterus), colon, gall bladder, prostate, kidney, and postmenopausal breast cancer.

Obesity-associated MorbiditiesType 2 diabetesHeart diseaseHypertensionStrokeCancerSleep apneaAsthmaUrinary incontinenceGallbladder disease Nonalcoholic FLDOsteoarthritisPsychological disorders

Body Mass Index: Are You at a Healthy Weight?

Waist Circumference and Ratio MeasurementsWaist circumference should be less than:Men: 40 inchesWomen: 35 inchesWaist-to-hip ratio should be less than:Men: 1.0Women: 0.8Factors Contributing to Obesity HeredityBody type and genesTwin studiesObserve twins separated at birth and raised in different environmentsSpecific obesity genesOb genePhysiological and Hormonal FactorsBasal metabolic rate (BMR)Set-point theoryHunger hormonesSatiety HungerAppetiteFat cellsHyperplasia is an excessive number of fat cells.Hypertrophy is the ability of existing fat cells to swell and shrink.Activity Break: Environmental FactorsList environmental factors that can directly or indirectly contribute to obesity.1 to 2 minutesWe will compile a list.Environmental FactorsBombardment with advertising (high-calorie foods, super-sized portions, etc.)Changes in the number of working womenBottle feeding of infantsMisleading food labelsIncreased opportunities for eatingSoda20 Years AgoToday 85 Calories 6 ouncesCalorie Difference: 165 calories How many calories are in this soda? 250 calories 20 ounces *Based on 160 pound person

How long would you haveto garden to burn 165 calories?.How to burn* 165 calories:Garden for 35 Minutes26Turkey Sandwich20 Years AgoToday 320 calories Calorie Difference: 500 caloriesHow many calories are in this turkey sandwich? 820 calories

*Based on 130 pound person

How long would you have to biketo burn up 500 calories?How to burn 500 calories:Bike for 1 hour and 25 minutes27French Fries 20 Years AgoToday210 Calories2.4 ounces How many calories are in these fries?610 calories6.9 ouncesCalorie Difference: 400 calories *Based on 160 pound person

How long will you have to walk to burn* 400 calories?

How to burn* 400 calories:Walk leisurely for 1 hr 10 Minutes28The Obesity EnvironmentConsumption of energy encouraged!Wide variety, low cost, good taste, high fat/energy dense foods available everywhere Large portionsExpenditure of energy discouraged!Reduction of jobs requiring physical laborReduction of PE at schoolsIncreased time spent watching TV, web, video gamesUrban sprawl29When you look at the environment and energy intake..Consumption of excess energy is encouraged!Wide variety, low cost, good taste, high fat/energy dense foods available everywhere Large portions

On the energy output side of the scale.Expenditure of energy discouraged!Reduction of jobs requiring physical laborReduction of PE at schoolsIncreased time spent watching TV, web, video gamesUrban sprawlno sidewalks, long commutes, no neighborhoods with places to walk to.

Courtesy of Dr. Kelly Brownell30The option of extra value meals is in most fast food outlets. These options are great money makers for the fast food establishments costing them pennies, while offering consumers more calories than can be expended. Psychosocial FactorsBig contributorsPhysical activitySmokingAdditional factorsFood used as a rewardComfort foodsSocial ritualClock as a guide for time to eatGender DifferencesMenIdeal is a total body fat of 11 to 15 percentWomenIdeal is a total body fat of 18 to 22 percentRisk Factors for ObesityHigher in minorities, especially womenEnvironmental factorsAdvertisingFast foodBottle feeding infantsMisleading food labelsSedentary lifestylesAutomated equipmentComputer and TV useDecline in physical education requirements in schoolsManaging Your WeightKeep weight control in perspective.Understand calories.Include exercise.Improve eating habits.Select a nutritional plan.Therapeutic ApproachesBehavioraldietary changesincrease activity decrease inactivityPharmacologicSurgical

Weight Loss DietIndividually planned caloric deficit dietGenerally 500-1000 Kcal/day deficit