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Obesity Health Conditions Do Now Answer the following questions on your note page. Does America have an obesity problem? Is it an epidemic? What percentage US adults do you think are overweight, obese or severely obese? Obesity Facts - What is your reaction? Obesity is the 2nd leading cause of preventable death after smoking About 69% of adults in the US are overweight or obese(2012) About 35.1% are obese (2012) About 18.4% of adolescents are obese (2010) Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Obesity Trends* Among U.S. Adults BRFSS, 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Obesity Trends* Among U.S. Adults BRFSS, 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Obesity Trends* Among U.S. Adults BRFSS, 1988 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Obesity Trends* Among U.S. Adults BRFSS, 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% Obesity Trends* Among U.S. Adults BRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20% Obesity Trends* Among U.S. Adults BRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults BRFSS, 2002 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults BRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. Adults BRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. Adults BRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. Adults BRFSS, 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. Adults BRFSS, 2010 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2011 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. WA MT OR ME ND ID MN VT SD WI IA NE NV PA IL UT CO KS CA AZ OK NM TX OH IN WV MO KY VA NC TN AR SC MS AK NY MI WY NH MA RI CT NJ DE MD DC AL GA LA FL HI GUAM 15%–<20% 20%–<25% 25%–<30% PR 30%–<35% ≥35% Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2012 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. WA MT OR ME ND ID MN VT SD WI IA NE NV PA IL UT CO KS CA AZ OK NM TX OH IN WV MO KY VA NC TN AR SC MS AK NY MI WY NH MA RI CT NJ DE MD DC AL GA LA FL HI GUAM 15%–<20% 20%–<25% 25%–<30% PR 30%–<35% ≥35% Prevalence* of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2013 *Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011. WA MT OR ME ND ID MN VT SD WI IA NE NV PA IL UT CO KS CA AZ OK NM TX OH IN WV MO KY VA NC TN AR SC MS AK NY MI WY NH MA RI CT NJ DE MD DC AL GA LA FL HI GUAM 15%–<20% 20%–<25% 25%–<30% PR 30%–<35% ≥35% Overweight? Obese? Morbidly Obese? Defined simply as too much body fat Simply classified using BMI Why BMI? Using BMI Body Mass Index= (Weight in pounds/Height in inches2) x 703 Quick assessment of a person’s weight relative to their height Can be misleading for some… Used to determine if a person is overweight, obese or severely (morbidly) obese Overweight, Obesity, Severe Obesity Defined simply as too much body fat For Adults (19+): Overweight= BMI 25 to 29.9 Obesity Class 1= BMI 30 to 34.9 Obesity Class 2= BMI 35 to 39.9 Severe Obesity Class 3= BMI 40+ Overweight, Obesity, Severe Obesity For children and adolescents: The American Obesity Association uses percentiles of BMI to determine classification 85th percentile of BMI for overweight and the 95th percentile for obesity. Obesity problems are likely to persist into adulthood Causes of Obesity What are some causes of obesity? Modifiable causes: Environment Behavior Non-Changeable cause: Genetics Effects of Obesity Both Body and Mind are affected At higher BMIs, there is found to be greater risk for: Hypertension Heart Disease Type 2 Diabetes Cancer Breast Esophagus Colorectal Effects of Obesity Arthritis Breathing Problems Asthma Sleep Apnea Problems in pregnancy *Psychosocial Effects & Stigma Relationship Between Media & Weight Issues Over half of Americans are overweight. Media encourages what? What is the real healthy option? Messages in the Media Do Now Page 3 of Notes Make a list of weight loss/ management recommendations. Separate the ones you believe to be healthy recommendations. Calorie Facts 1 pound= 3500 calories Whopper= 670 calories in An Orange= 60 calories in 140 lbs person running 6mph for 30 minutes= 319 calories out Calories in + Calories out= Net calories -500 net calories/day = -1 lb/week Shouldn’t lose more than 2 lbs/week Healthy Weight Management Recommendations… Overall Recognize your unique body. Have realistic, healthy expectations Make health a lifestyle. Healthy Weight Management Recommendations… Healthy Eating Identify the problem in your eating habits. High-calorie snacking, mood-related eating, weekend lapses Start a food diary. Eliminate temptation. Eat breakfast and don’t skip meals. Healthy Weight Management Recommendations… Healthy Eating Eat small portions more often rather than few big meals. Eat slowly. Eat a well balanced diet. Drink lots of water. Healthy Weight Management Recommendations… Exercise Make exercise a priority. Be consistent with exercise. 30 minutes most days of the week 60 minutes most days for weight loss Determine what exercise you like. Healthy Weight Management Recommendations… Exercise Keep things interesting and challenge yourself. Be accountable. Get a partner Let people know Combine Cardio and Strength Training Listen to your body. Healthy Weight Management Recommendations Have a healthy outlook. Showing up and/or starting Law of attraction The Other Extreme Anorexia Nervosa Characterized by low body weight and distorted self image Bulimia Nervosa Characterized by periods of splurging and then purging Coming Up Quiz on Obesity and Weight Control begin Cardiovascular Disease Cardiovascular Disease Health Conditions Cardiovascular Disease A class of diseases that involve the heart and/or blood vessels Usually refers to atherosclerosis or coronary artery disease Atherosclerosis- disease affecting arterial blood vessels. Hardening of arteries caused by formation of plaques within arteries Terminology Angina- chest pain due to ischemia Ischemia- lack of blood flow and therefore oxygen supply Myocardium- muscle tissue of the heart Myocardial Infarction- heart attack Risk Factors Family History Age- men 45+, women 55+ Gender- men at greater risk Smoking- current or quit w/in 6 months Hypertension - High Blood Pressure Hypercholesterolemia - High Cholesterol Diabetes or High Blood Sugar Sedentary Lifestyle Modifiable? Put an X next to the risk factors that can be modified in order to prevent cardiovascular disease What is cholesterol? Cholesterol is a soft waxy substance made naturally in our bodies. We need cholesterol because it helps to form or repair cell membranes, some hormones, vitamin D and other tissues. Where does it come from? The two sources of cholesterol are the 1. Liver 2. Food The body produces 80% of the cholesterol it needs. The cholesterol in our blood is manufactured by the liver in our bodies. The remaining 20% comes from the food we eat. Diet Lowers blood cholesterol levels Raises blood cholesterol levels Heart Attack Questions What is the main function of the heart? Increased amounts of cholesterol lead to fat-filled growths called _________________. What causes the natural, regular beating of the human heart? What forms around the ruptured membranes of plaques during a heart attack? During a heart attack, heart cells stop beating and eventually die due to a lack of ________________. How soon after a heart attack must victims be treated? What is the main function of the heart? Increased amounts of cholesterol lead to fat-filled growths called _________________. Pump oxygenated blood around the body delivering it to tissues Plaques What causes the natural, regular beating of the human heart? Electrical wave What forms around the ruptured membranes of plaques during a heart attack? During a heart attack, heart cells stop beating and eventually die due to a lack of ________________. Blood clots oxygen How soon after a heart attack must victims be treated? As quickly as possible, within 20 mins. Coming Up Quiz next class none Next Class Heart Attack Review Heart Attack Symptoms Heart Attack Immediate Care and Treatment Heart Attack Symptoms Onset is usually gradual, over several minutes Chest pain Pain radiating to the left arm Pain in lower jaw, neck, back, abdomen Shortness of breath Sweating, weakness, nausea *1/3 of heart attacks are silent w/ no symptoms Immediate Care Call for help Open window and loosen collar to help breathing Take an aspirin- prevents blood clot Follow general first aid principles- monitor pulse, breathing, consciousness Prepare for CPR and AED Treatment Preventative Lifestyle Changes Smoking Cessation Cardiovascular Exercise Healthy Diet- low in fats and cholesterol Medications Blood Pressure Reducing Meds Aspirin to prevent blood clotting Cholesterol lowering drugs Treatment Surgery Coronary Artery Bypass Surgery Arteries or veins are grafted from the aorta to the coronary arteries to bypass atherosclerotic narrowings to supply blood to the heart muscle http://www.webmd.com/heart/video/coronary-bypass Angioplasty A wire with a balloon catheter is passed from the femoral artery in the leg to the coronary artery of concern. When the balloon is inflated, it compresses plaque and stretches the artery wall to expand it. http://www.mayoclinic.com/health/coronary-angioplasty/MM00048 The Facts In the US, diseases of the heart are the leading cause of death 1,200,000 people suffer from a coronary attack every year. 40% of them will die as a result. About every 65 seconds, an American dies of a coronary event. Coming Up Quiz next class Know how much of your cholesterol needs that your body makes 2 risk factors you can modify, 2 you can’t modify Know Heart attack video questions 2 warning signs of a heart attack 2 multiple choice questions on surgeries Next Class Diabetes Diabetes Health Conditions Diabetes A metabolic disorder characterized by hyperglycemia or high blood sugar There are 23.6 million people in the United States, or 8% of the population, who have diabetes. -ADA One in every three children born in the year 2000 will develop diabetes in their lifetime.- JAMA Insulin Importance Glucose is the basic fuel for the cells in the body, and insulin takes the sugar from the blood into the cells When glucose builds up in the blood instead of going into cells, it can cause two problems: Right away, your cells may be starved for energy. Over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart. Three types Type 1 Type 2 Gestational Diabetes Similar signs, symptoms, and consequences Different causes and population distributions Type 1 The body destroys the pancreatic beta cells that produce insulin No cure, but treatable- take insulin and monitor Gestational Diabetes involves insulin resistance Hormones of pregnancy cause insulin resistance in some Resolves with delivery Type 2 Also called non-insulin dependent diabetes, adult-onset diabetes, or obesity related diabetes Most common form Tissue-wide insulin resistance Sometimes progresses to loss of beta cell function and not enough insulin produced No cure, but treatable Type 2 Diabetes Type 2 Risk Factors Genetic Factors More common in: African Americans Latinos Native Americans Asian Americans Obesity Sedentary Lifestyle Age High BP High Cholesterol Signs and Symptoms Frequent urination Increased thirst Increased appetite Blurred vision Fatigue Slow healing infections Signs/ Tests Fasting Blood Glucose Level Higher than 126 mg/dL on 2 occasions Non-fasting Glucose Level Over 200 mg/dL and symptoms Treatment No Cure 2 Main Treatment Goals Reduction of mortality Preservation of quality of life Adjust diet and exercise Oral anti-diabetic drugs Treatment Must Learn How to test and record blood glucose What to eat and when How to take medications How to recognize and treat low or high blood sugar How to handle sick days Where to get supplies and how to store them Watch Out For Eye problems Kidney Failure Nerve damage Heart Disease Stroke Foot Problems Must check feet regularly In people with diabetes, prolonged high blood sugar levels are linked with damage to the nerves in the feet. Nerve damage can cause loss of sensation as well as deformities of the feet. Poor blood flow to the feet is also common in people with diabetes, and this slows the wound healing process and increases the risk of infection and amputation. Diabetic Foot Ulcer Wounds Coming Up Quiz next class What diabetes is What 3 types do and do not have in common 2 Signs and symptoms 2 ways of treating or managing diabetes 3 long term issues/ possible problems Next Class Start Sex Ed