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השמנת יתר

השמנת יתר. חמד"ע. פרופ' ארדון רובינשטין. 26.1.06. BMI-Associated Disease Risk. Additional risks: Large waist circumference (men>40 in; women >35 in) 5 kg or more weight gain since age 18-20 y Poor aerobic fitness Specific races and ethnic groups.

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השמנת יתר

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  1. השמנת יתר חמד"ע פרופ' ארדון רובינשטין 26.1.06

  2. BMI-Associated Disease Risk • Additional risks: • Large waist circumference (men>40 in; women >35 in) • 5 kg or more weight gain since age 18-20 y • Poor aerobic fitness • Specific races and ethnic groups

  3. Relationship Between BMI and Percent Body Fat in Men and Women Women Men Body Fat (%) Body Mass Index (kg/m2)

  4. Medical Complications of Obesity Idiopathic intracranial hypertension Pulmonary disease abnormal function obstructive sleep apnea hypoventilation syndrome Stroke Cataracts Nonalcoholic fatty liver disease steatosis steatohepatitis cirrhosis Coronary heart disease Diabetes Dyslipidemia Hypertension Severe pancreatitis Gall bladder disease Cancer breast, uterus, cervix colon, esophagus, pancreas kidney, prostate Gynecologic abnormalities abnormal menses infertility polycystic ovarian syndrome Osteoarthritis Phlebitis venous stasis Skin Gout

  5. Age-Adjusted Prevalence ofOverweight and Obesity in Men Percent _

  6. Age-Adjusted Prevalence of Overweight and Obesity in Women Percent _

  7. (*BMI > 30, or ~ 30 lbs overweight for 5’4” woman) Obesity Trends* Among U.S. Adults: BRFSS, 1988

  8. (*BMI > 30, or ~ 30 lbs overweight for 5’4” woman) Obesity Trends* Among U.S. Adults: BRFSS, 1994

  9. Obesity Trends Among* U.S. Adults: BRFSS, 2000

  10. % Distribution of BMI >30 kg/m2by Age in 695 Men & 1020 Women in Israel, 2000 25-3435-44 45-5455-65 years

  11. Obesity BMI>30 in Israel, 2000 : comparison with countries: WHO Monica 1987-92, Obes Res 1999 % Prevalence

  12. Obesity (BMI>30) among females by ethnicity & years of education (%)First National Health & Nutrition Survey (MABAT) 1999-2000

  13. Diabetes (%) among Jews & Arabs aged 25-64 by sex & years of education males Jews females Arabs First National Health & Nutrition Survey (MABAT),1999-2000

  14. NHANES III Prevalence of Hypertension* According to BMI Percent

  15. Prevalence of Hypertension* According to BMI by Sex Percent _ BMI Levels

  16. Obesity and Diabetes Risk Incidence of New Cases per 1,000 Person-Years BMI Levels

  17. <22 <23 23 - 23.9 24 - 24.9 25 - 26.9 27 - 28.9 29 - 30.9 31 - 32.9 33 - 34.9 35+ Relationship Between BMI and Risk of Type 2 Diabetes 93.2 Men Women 54.0 Age-Adjusted Relative Risk 42.1 40.3 27.6 21.3 15.8 8.1 5.0 11.6 4.3 2.9 2.2 6.7 4.4 1.5 1.0 1.0 1.0 Body Mass index (kg/m2)

  18. Metabolic Syndrome • Abdominal obesity • Hyperinsulinemia • High fasting plasma glucose • Impaired glucose tolerance • Hypertriglyceridemia • Low HDL-cholesterol • Hypertension

  19. Clinical Identification of the Metabolic Syndrome*: NCEP-ATP III *Diagnosis is established when >3 of these risk factors are present ** 2003 New ADA IFG criteria (Diabetes Care)

  20. Metabolic Syndrome: Impact on Mortality Without metabolic syndrome With metabolic syndrome Mortality Rate (%) *P < 0.001.

  21. Metabolic Syndrome: Impact on Cardiovascular Health Without metabolic syndrome With metabolic syndrome Prevalence (%) *P < 0.001.

  22. 26 -Year Incidence of Coronary Heart Disease in Men Incidence/1,000 BMI Levels

  23. Relationship Between BMI and Cardiovascular Disease Mortality Men Women Relative Risk of Death Lean Overweight Obese <18.5 18.5–20.4 20.5–21.9 22.0– 23.4 23.5– 24.9 25.0– 26.4 26.5–27.9 28.0– 29.9 30.0– 31.9 32.0–34.9 35.0– 39.9 >40.0 Body Mass index

  24. 300 Age at Issue 20-29 250 30-39 200 150 100 High Moderate Low Risk Risk 50 Risk 0 15 20 25 30 35 40 Relationship of BMI to Excess Mortality Mortality Ratio Body Mass Index (kg/[m2])

  25. Direct Cost * of Chronic Diseases in the United States $53.2 $51.6 $38.7 Direct Cost ($ Billions) $18.4 $18.1 Type 2Diabetes Obesity CoronaryHeart Disease Hyper-tension Stroke *Adjusted to 1995 dollars.

  26. Effect of Obesity on Expected Lifetime Medical Care Costs* in Men Age (y) Costs ($)* 55-64 45-54 35-44 37.5 32.5 27.5 22.5 Body Mass Index (kg/m2) *Total cost of CHD, type 2 DM, hypertension, hypercholesterolemia, stroke

  27. Economic Effect of Obesity to Business: 3-Year Costs to First Chicago NBD Obese* Lean $1,546 $6,822 $4,496 $683 Healthcare Absenteeism *BMI >27.8 kg/m2 in men; >27.3 kg/m2 in women.

  28. תודה רבה

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