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Book ChapterDOI

The Definition and Prevalence of Obesity and Metabolic Syndrome.

Atilla Engin1
01 Jan 2017-Advances in Experimental Medicine and Biology (Springer, Cham)-Vol. 960, pp 1-17
TL;DR: Obesity is associated with a large decrease in life expectancy, but up to 30% of obese patients are metabolically healthy with insulin sensitivity similar to healthy normal weight individuals, lower visceral fat content, and lower intima media thickness of the carotid artery than the majority of metabolically "unhealthy" obese patients.
Abstract: Increase in prevalence of obesity has become a worldwide major health problem in adults, as well as among children and adolescents. Furthermore, total adiposity and truncal subcutaneous fat accumulation during adolescence are positively and independently associated with atherosclerosis at adult ages. Centrally accumulation of body fat is associated with insulin resistance, whereas distribution of body fat in a peripheral pattern is metabolically less important. Obesity is associated with a large decrease in life expectancy. The effect of extreme obesity on mortality is greater among younger than older adults. In this respect, obesity is also associated with increased risk of several cancer types. However, up to 30% of obese patients are metabolically healthy with insulin sensitivity similar to healthy normal weight individuals, lower visceral fat content, and lower intima media thickness of the carotid artery than the majority of metabolically “unhealthy” obese patients.
Citations
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Journal ArticleDOI
TL;DR: Progress has been made in identifying patients with a considerable risk of stroke occurrence, such as those with patent foramen ovale, and future prevention studies might result in a decrease in the incidence of stroke and its sequelae in young adults.
Abstract: Epidemiological evidence suggests that the incidence of ischaemic stroke in young adults (18-50 years) has increased substantially. These patients have a long life expectancy after stroke, and the costs of long-term care pose huge challenges to health-care systems. Although the current recommendations for treatment of young and old (>50 years) patients with stroke are similar, the optimal management of young adult patients with stroke is unknown. They are usually not included in trials, and specific subanalyses limited to young adult patients with stroke are usually not done, owing to lower incidence of stroke and lower prevalence of vascular risk factors in young adults. Progress has been made in identifying patients with a considerable risk of stroke occurrence, such as those with patent foramen ovale. Future prevention studies might result in a decrease in the incidence of stroke and its sequelae in young adults. The development of guidelines specifically devoted to the management of stroke in young adults will be an important step in achieving this aim.

212 citations

Journal ArticleDOI
TL;DR: Multimorbidity is common and has been increasing over the last 25 years, which has implications for public health policy and anticipated health costs for the coming years.
Abstract: Importance: The simultaneous presence of multiple conditions in one patient (multi-morbidity) is a key challenge facing primary care. Objective: The purpose of this study was to determine the prevalence of multi-morbidity and to document changes in prevalence during the last 25 years. Design/Setting: Cross-sectional study using multiple years (1988–2014) of the National Health and Nutrition Examination Survey (NHANES) were analyzed. Setting: Multiple years (1988 to 2014) of the National Health and Nutrition Examination Survey (NHANES) from the United States were analyzed. Participants: Noninstitutionalized adults. Main Outcomes and Measures: Number of chronic conditions per individual analyzed by age, race, gender, and socioeconomic factors. Results: A total of 57,303 individuals were surveyed regarding the presence of multi-morbidity in separate surveys spanning 1988–2014. The overall current prevalence in 2013–2014 of >2 morbidities was 59.6% (95% CI 58.1%–61.1%), 38.5% had 3 or more, and 22.7% had 4 or more morbidities, which was significantly higher than in 1988 (45.7%, 95% CI 43.5%–47.8%, with >2 morbidities). Among individuals with 2 or more morbidities, 54.1% have obesity compared to 41.9% in 1988. Among adults age >65, prevalence was 91.8% for 2 or more morbidities. Whites and Blacks had significantly higher prevalence (59.2% and 60.1%) than Hispanic or “other” race (45.0%, P 2) than men (55.9%, P = .01). Conclusions and Relevance: Multimorbidity is common and has been increasing over the last 25 years. This finding has implications for public health policy and anticipated health costs for the coming years.

148 citations

Journal ArticleDOI
TL;DR: Although, there are numerous studies defines the effective role of PPs against MD via altering the GM, a significant research effort is still needed to consider PPs as promising nutraceuticals against MD.
Abstract: Background Metabolic syndrome (MetS) is defined as the cluster of metabolic disorders that consist of insulin resistance, hyperglycemia, dyslipidemia, central adiposity, and hypertension, which is associated with metabolic diseases (MD). Gut microbiota (GM) has a profound effect on human metabolism. The composition and function of GM play a critical role in MD, but the mechanisms have not been fully understood yet. Microorganisms that colonize the human gut play a pivotal role in the digestion and absorption of dietary polyphenols (PPs). GM is capable of metabolizing high-molecular-weight PPs into more biologically active metabolites. As a result, phenolic metabolites can modulate the growth of GM. PPs are naturally occurring compounds that are available in food, such as fruits and vegetables. PPs intake is inversely associated with metabolic syndrome (MetS) via modulating GM. Scope and approach In this review, we present an overview of the evidence supporting the GM dysbiosis during MD. In addition, health-beneficial effect of PPs against MD via modulating the GM is discussed. Key findings and conclusions Literature evidence supports PPs as novel and strategic molecules in the prevention and treatment of MD. This is explained not only by their anti-obesity, anti-oxidative, anti-inflammatory, anti-diabetes, and anti-hypercholesterolemic effects but also by their ability to improve and inhibit the growth of beneficial and pathogenic bacteria. Although, there are numerous studies defines the effective role of PPs against MD via altering the GM, a significant research effort on GM is still needed to consider PPs as promising nutraceuticals against MD.

143 citations

Journal ArticleDOI
TL;DR: In this article, the structural changes that occur after metabolic reactions in polyphenols (curcumin, quercetin, and catechins) and their effect on GM composition were investigated.
Abstract: Polyphenols (PPs) are the naturally occurring bioactive components in fruits and vegetables, and they are the most abundant antioxidant in the human diet. Studies are suggesting that ingestion of PPs might be helpful to ameliorate metabolic syndromes that may contribute in the prevention of several chronic disorders like diabetes, obesity, hypertension, and colon cancer. PPs have structural diversity which impacts their bioavailability as they accumulate in the large intestine and are extensively metabolized through gut microbiota (GM). Intestinal microbiota transforms PPs into their metabolites to make them bioactive. Interestingly, not only GM act on PPs to metabolize them but PPs also modulate the composition of GM. Thus, change in GM from pathogenic to beneficial ones may be helpful to ameliorate gut health and associated diseases. However, to overcome the low bioavailability of PPs, various approaches have been developed to improve their solubility and transportation through the gut. In this review, we present evidence supporting the structural changes that occur after metabolic reactions in PPs (curcumin, quercetin, and catechins) and their effect on GM composition that leads to improving overall gut health and helping to ameliorate metabolic disorders.

118 citations

Journal ArticleDOI
TL;DR: An in-depth look in preclinical, in vitro and in vivo, and clinical studies indicates the preventive effects of anthocyanins on cardioprotection, neuroprotection, antiobesity as well as their antidiabetes and anticancer effects.
Abstract: Anthocyanins are natural phenolic pigments with biological activity. They are well-known to have potent antioxidant and antiinflammatory activity, which explains the various biological effects reported for these substances suggesting their antidiabetic and anticancer activities, and their role in cardiovascular and neuroprotective prevention. This review aims to comprehensively analyze different studies performed on this class of compounds, their bioavailability and their therapeutic potential. An in-depth look in preclinical, in vitro and in vivo, and clinical studies indicates the preventive effects of anthocyanins on cardioprotection, neuroprotection, antiobesity as well as their antidiabetes and anticancer effects.

117 citations


Cites background from "The Definition and Prevalence of Ob..."

  • ...…is crucially important: intraabdominal fat is mainly responsible for the development of the metabolic syndrome (MS), which is defined as the combination of impaired glucose tolerance or diabetes mellitus, insulin resistance, high blood pressure, atherogenic dyslipidemia, and obesity (Engin, 2017)....

    [...]

  • ...org 9 The localization of the accumulated fat is crucially important: intraabdominal fat is mainly responsible for the development of the metabolic syndrome (MS), which is defined as the combination of impaired glucose tolerance or diabetes mellitus, insulin resistance, high blood pressure, atherogenic dyslipidemia, and obesity (Engin, 2017)....

    [...]

References
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Journal ArticleDOI
16 Jun 1993-JAMA
TL;DR: Dairy therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD, and the fundamental approach to treatment is comparable.
Abstract: THE SECOND report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II, or ATP II) presents the National Cholesterol Education Program's updated recommendations for cholesterol management. It is similar to the first in general outline, and the fundamental approach to treatment of high blood cholesterol is comparable. This report continues to identify low-density lipoproteins (LDL) as the primary target of cholesterol-lowering therapy. As in the first report, the second report emphasizes the role of the clinical approach in primary prevention of coronary heart disease (CHD). Dietary therapy remains the first line of treatment of high blood cholesterol, and drug therapy is reserved for patients who are considered to be at high risk for CHD. However, the second report contains new features that distinguish it from the first. These include the following: Increased emphasis on See also pp 3002 and 3009.

28,495 citations

Journal ArticleDOI
TL;DR: A WHO Consultation has taken place in parallel with a report by an American Diabetes Association Expert Committee to re‐examine diagnostic criteria and classification of diabetes mellitus and is hoped that the new classification will allow better classification of individuals and lead to fewer therapeutic misjudgements.
Abstract: The classification of diabetes mellitus and the tests used for its diagnosis were brought into order by the National Diabetes Data Group of the USA and the second World Health Organization Expert Committee on Diabetes Mellitus in 1979 and 1980. Apart from minor modifications by WHO in 1985, little has been changed since that time. There is however considerable new knowledge regarding the aetiology of different forms of diabetes as well as more information on the predictive value of different blood glucose values for the complications of diabetes. A WHO Consultation has therefore taken place in parallel with a report by an American Diabetes Association Expert Committee to re-examine diagnostic criteria and classification. The present document includes the conclusions of the former and is intended for wide distribution and discussion before final proposals are submitted to WHO for approval. The main changes proposed are as follows. The diagnostic fasting plasma (blood) glucose value has been lowered to > or =7.0 mmol l(-1) (6.1 mmol l(-1)). Impaired Glucose Tolerance (IGT) is changed to allow for the new fasting level. A new category of Impaired Fasting Glycaemia (IFG) is proposed to encompass values which are above normal but below the diagnostic cut-off for diabetes (plasma > or =6.1 to or =5.6 to <6.1 mmol l(-1)). Gestational Diabetes Mellitus (GDM) now includes gestational impaired glucose tolerance as well as the previous GDM. The classification defines both process and stage of the disease. The processes include Type 1, autoimmune and non-autoimmune, with beta-cell destruction; Type 2 with varying degrees of insulin resistance and insulin hyposecretion; Gestational Diabetes Mellitus; and Other Types where the cause is known (e.g. MODY, endocrinopathies). It is anticipated that this group will expand as causes of Type 2 become known. Stages range from normoglycaemia to insulin required for survival. It is hoped that the new classification will allow better classification of individuals and lead to fewer therapeutic misjudgements.

15,167 citations

Journal ArticleDOI
TL;DR: This statement from the American Heart Association and the National Heart, Lung, and Blood Institute is intended to provide up-to-date guidance for professionals on the diagnosis and management of the metabolic syndrome in adults.
Abstract: The metabolic syndrome has received increased attention in the past few years. This statement from the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) is intended to provide up-to-date guidance for professionals on the diagnosis and management of the metabolic syndrome in adults. The metabolic syndrome is a constellation of interrelated risk factors of metabolic origin— metabolic risk factors —that appear to directly promote the development of atherosclerotic cardiovascular disease (ASCVD).1 Patients with the metabolic syndrome also are at increased risk for developing type 2 diabetes mellitus. Another set of conditions, the underlying risk factors , give rise to the metabolic risk factors. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria to be used in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general they include a combination of both underlying and metabolic risk factors. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics commonly manifest a prothrombotic state and a pro-inflammatory state as well. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB), increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C). The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it truly is a syndrome, ie, a grouping of ASCVD risk factors, but one that probably has more than one cause. Regardless of cause, the syndrome identifies individuals at an elevated risk for ASCVD. The magnitude of the increased risk can vary according to which components of the syndrome are …

9,982 citations

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Trending Questions (1)
Obesity definition, prevalence, associated health risks in elders?

Obesity is a major health problem worldwide, affecting adults, children, and adolescents. It is associated with decreased life expectancy and increased risk of certain cancers.