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Trim Baby Boomers are Not Safe from Obesity as
Senior Years Approach
Vast majority of adults are at risk of becoming
obese, says new study
Oct. 4, 2005 - Making it to middle age without
extra pounds is no guarantee for staying at a healthy weight - even in
the short term. About one in five women and one in four men, who were at
a healthy Body Mass Index (BMI) at a routine study examination, became
overweight after four years. Among those who were overweight, 16 to 23
percent of women and 12 to 13 percent of men became obese within four
years.
A large, community-based study — considered the
first study to assess the long-term risk of developing overweight and
obesity in adults — found that over 30 years, nine out of 10 men and
seven out of 10 women were overweight or became overweight. In addition,
more than one in three were obese or became obese. The study was
supported by the National Heart, Lung, and Blood Institute (NHLBI), one
of the National Institutes of Health (NIH).
Researchers analyzed the short-term and long-term
chances of developing overweight and obesity among more than 4,000 white
adults enrolled in the offspring cohort of NHLBI's landmark Framingham
Heart Study, an ongoing longitudinal study in Framingham, Massachusetts.
Participants ages 30 to 59 were followed for 30
years, from 1971 to 2001. The results appear in the October 4, 2005,
issue of the Annals of Internal Medicine.
“National surveys and other studies have told us
that the United States has a major weight problem, but this study
suggests that we could have an even more serious degree of overweight
and obesity over the next few decades,” said NHLBI Director Elizabeth G.
Nabel, M.D., who also co-chairs the NIH Obesity Research Task Force. “In
addition, these results may underestimate the risk for some ethnic
groups.”
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Who is at Risk?
All overweight and obese adults (age 18 years of age or older)
with a BMI of >=25 are considered at risk. Individuals with a
BMI of 25 to 29.9 are considered overweight, while individuals
with a BMI >=30 are considered obese.
Treatment of
overweight is recommended only when patients have two or more
risk factors or a high waist circumference. It should focus on
altering dietary and physical activity patterns to prevent
development of obesity and to produce moderate weight loss.
Treatment of obesity should focus on producing substantial
weight loss over a prolonged period.
Why Treat Overweight and
Obesity?
Obesity is clearly associated with increased morbidity and
mortality. There is strong evidence that weight loss in
overweight and obese individuals reduces risk factors for
diabetes and cardiovascular disease (CVD). Strong evidence
exists that weight loss reduces blood pressure in both
overweight hypertensive and nonhypertensive individuals; reduces
serum triglycerides and increases high-density lipoprotein (HDL)-cholesterol;
and generally produces some reduction in total serum cholesterol
and low-density lipoprotein (LDL)-cholesterol.
Weight loss
reduces blood glucose levels in overweight and obese persons
with and without diabetes; and weight loss also reduces blood
glucose levels and HbAlc in some patients with type 2 diabetes.
Although there have been no prospective trials to show changes
in mortality with weight loss in obese patients, reductions in
risk factors would suggest that development of type 2 diabetes
and CVD would be reduced with weight loss.
What Treatments Are Effective?
A variety of effective options exist for the management of
overweight and obese patients, including dietary therapy
approaches such as low-calorie diets and lower-fat diets;
altering physical activity patterns; behavior therapy
techniques; pharmacotherapy*; surgery; and combinations of these
techniques.
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Framingham participants were white, and other
studies have shown, for example, that Hispanic and black individuals,
especially women, have a greater prevalence of excess weight compared to
their white counterparts.
According to the National Center for Health
Statistics, part of the Centers for Disease Control and Prevention, 65
percent of U.S. adults aged 20 years and older are either overweight or
obese, and approximately 30 percent of adults are obese. These estimates
are from the 1999-2002 National Health and Nutrition Examination Survey,
a population-based survey.
Framingham researchers assessed the participants’
body mass index (BMI) — a standard measure of weight relative to height,
which is an indicator of total body fat. A BMI of 18.5 to 24.9 kg/m2 is
considered a normal, or healthy, weight for adults. Overweight is a BMI
of 25 to 29.9 kg/m2, and obesity is a BMI of 30 kg/m2 or higher.
Making it to middle age without extra pounds was no
guarantee for staying at a healthy weight — even in the short term.
About one in five women and one in four men who were at a healthy BMI at
a routine Framingham study examination became overweight after four
years. Among those who were overweight, 16 to 23 percent of women and 12
to 13 percent of men became obese within four years.
“Our results, although not surprising, are
worrisome,” comments Ramachandran Vasan, M.D., Associate Professor of
Medicine at Boston University School of Medicine and lead author of the
study. “If the trend continues, our country will continue to face
substantial health problems related to excess weight.”
“Overweight and obesity increase the risk of poor
health. We hope these results will serve as a wake-up call to Americans
of all ages,” adds Nabel. “Even those who are now at a healthy weight
need to be careful about maintaining energy balance to avoid gaining
weight. Taking simple steps to make sure that the overall the number of
calories you consume do not exceed the amount you burn can play a major
role in lowering your risk for many chronic conditions.”
Overweight increases the likelihood of developing
diabetes, high blood pressure and heart disease, stroke, breathing
problems such as asthma and sleep apnea, some cancers, osteoarthritis,
and gall bladder disease. Obesity is associated with these conditions as
well as with early death. Research has shown that even a small weight
loss (just 10 percent of body weight) can help people who are overweight
or obese lower their risk of developing many of these conditions.
The Clinical Guidelines on the Identification,
Evaluation, and Treatment of Overweight and Obesity in Adults recommend
that both people who are overweight as well as those who are at a
healthy weight prevent weight gain. The guidelines are available online
at
http://www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm.
Strategies that promote a healthy weight beginning
in childhood are critical. For information on We Can!, NIH’s national
education program to enhance children’s activity and nutrition to
prevent childhood obesity, visit the website at
http://wecan.nhlbi.nih.gov or call toll-free 866-35-WECAN.
For help assessing obesity risk and advice on how
to lose weight, consult your healthcare professional.
Resources:
Body Mass Index Calculator:
http://www.nhlbisupport.com/bmi/bmicalc.htm
Aim for a Healthy Weight:
http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/patmats.htm
Portion Distortion:
http://hin.nhlbi.nih.gov/portion
We Can! Families Finding the Balance — A Parent
Handbook (in English or Spanish):
http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan_mats/parent_hb_en.htm
Dietary Guidelines for Americans 2005:
http://www.usda.gov/cnpp/dietary_guidelines.html
About source:
NHLBI is part of the National
Institutes of Health (NIH), the Federal Government’s primary agency for
biomedical and behavioral research. NIH is a component of the U.S.
Department of Health and Human Services. NHLBI press releases and other
materials including information about obesity prevention and weight loss
are available online at
www.nhlbi.nih.gov.
The National Institutes of Health (NIH)
— The Nation's Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U. S. Department of Health and Human
Services. It is the primary Federal agency for conducting and supporting
basic, clinical, and translational medical research, and it investigates
the causes, treatments, and cures for both common and rare diseases. For
more information about NIH and its programs, visit
http://www.nih.gov.
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