Obesity Prevention and Control
- Being obese increases the risk of chronic diseases like cardiovascular diseases (CVD), diabetes, a variety of cancers and death and it is closely related to the BMI (body mass index) status. Weight loss has shown to decrease these health risks associated with obesity. Even a modest amount of weight loss has beneficial effects on hypertension and diabetes.1
- Obesity prevention should not only focus on eating healthy, but also eating less food.
- Prevention of obesity requires discipline in food choices and portion size to avoid caloric excess.
- Caloric restriction (>500 calories/day) can be achieved by any reasonable diet plan to initiate weight reduction.
- Added sugar is a major contributor to obesity pandemic leading to chronic diseases. The American Heart Association (AHA) recently released a scientific statement recommending reductions in added-sugar intake to no more than 100 to 150 kcal/d for most Americans.
- Physical activity added to dietary measures results in incremental weight loss and regular physical activity is crucial to maintenance of weight loss.
- Physical activity provides substantial benefits even in the absence of weight loss. It is better to be fit and fat rather than unfit and of normal weight.2
- Large dose of physical activity (300 minutes/week) is needed for substantial weight loss. Weight maintenance is even more challenging and requires much more discipline and support.
- Weight loss as little as 5-10% reduces insulin resistance, improves glucose control, reduces blood pressure and increases HDL-C in the short-term and probably reduces mortality in the long-term. This is because most of the weight loss occurs in the dangerous visceral fat mass resulting in reduction of waist circumference as well as hepatic steatosis.3-6
- Current obesity treatment guidelines have stressed lifestyle modification and control of other associated risk factors to decrease obesity-related morbidity and mortality. Practice guidelines have established optimal targets for blood pressure and lipid parameters.7
- Following any named diet other than prudent diet is waste of time and money. Both very low carbohydrate diet and very low fat diet have been shown to produce weight loss in the short-term but impossible to maintain in the long-term resulting in net weight gain after several years.8
Sources
1. Elmer PJ, Obarzanek E, Vollmer WM, et al. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial. Annals of internal medicine. Apr 4 2006;144(7):485-495.
2. Weaver NF, Hayes L, Unwin NC, Murtagh MJ. “Obesity” and “Clinical Obesity” Men’s understandings of obesity and its relation to the risk of diabetes: a qualitative study. BMC Public Health. 2008;8:311.
3. Goodpaster BH, Delany JP, Otto AD, et al. Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial. JAMA. Oct 27 2010;304(16):1795-1802.
4. Goodpaster BH, Krishnaswami S, Harris TB, et al. Obesity, regional body fat distribution, and the metabolic syndrome in older men and women. Arch Intern Med. Apr 11 2005;165(7):777-783.
5. Katsuki A, Sumida Y, Urakawa H, et al. Increased visceral fat and serum levels of triglyceride are associated with insulin resistance in Japanese metabolically obese, normal weight subjects with normal glucose tolerance. Diabetes Care. Aug 2003;26(8):2341-2344.
6. Miyazaki Y, Glass L, Triplitt C, Wajcberg E, Mandarino LJ, DeFronzo RA. Abdominal fat distribution and peripheral and hepatic insulin resistance in type 2 diabetes mellitus. Am J Physiol Endocrinol Metab. Dec 2002;283(6):E1135-1143.
7. Bhan V, Yan RT, Leiter LA, et al. Relation between obesity and the attainment of optimal blood pressure and lipid targets in high vascular risk outpatients. Am J Cardiol. Nov 1 2010;106(9):1270-1276.
8. Enas EA, Senthilkumar A, Chennikkara H, Bjurlin MA. Prudent diet and preventive nutrition from pediatrics to geriatrics: current knowledge and practical recommendations. Indian heart journal. Jul-Aug 2003;55(4):310-338.