Abdominal obesity , also known as central obesity , occurs when excess abdominal fat around the abdomen and stomach has awakened to the extent that it is likely to have a negative impact on health.. There is a strong correlation between central obesity and cardiovascular disease. Abdominal obesity is not confined to the elderly and obese. Abdominal obesity has been linked to Alzheimer's disease as well as other metabolic and vascular diseases.
Abdominal fat and abdominal and central abdominal rays exhibit a strong association with type 2 diabetes.
Visceral fat, also known as organ fat or intra-abdominal fat, is located inside the peritoneal cavity, packed between the internal organs and the body, compared with subcutaneous fat, found under the skin, and fat intramuscular, which is found interspersed with skeletal muscle. Visceral fat consists of several adipose depots including mesenteric, epididymal white adipose tissue (EWAT) and perirenal fat. Excess visceral fat is known as central obesity, the effect of "distended stomach" or "beer belly", in which the abdomen protrudes excessively. This body type is also known as "apple-shaped", as opposed to "shaped pear", in which fat is stored in the hips and buttocks.
Researchers first began to focus on abdominal obesity in the 1980s when they realized it had important associations with cardiovascular disease, diabetes, and dyslipidemia. Abdominal obesity is more closely related to metabolic dysfunction associated with cardiovascular disease than is common obesity. In the late 1980s and early 1990s powerful and powerful insight imaging techniques were discovered which would further help advance understanding of the health risks associated with body fat accumulation. Techniques such as computed tomography and magnetic resonance imaging make it possible to categorize the mass of adipose tissue located at the stomach level into the intra-abdominal fat and subcutaneous fat.
Video Abdominal obesity
Health risks
Central obesity is associated with a higher risk of heart disease, hypertension, insulin resistance, and Diabetes Mellitus Type 2 (see below). With an increase in waist to hip ratio and overall waist the risk of death also increases. Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance, full diabetes, and an increased risk of developing cardiovascular disease. It is now generally believed that intra-abdominal fat is the depot that carries the greatest health risk.
Central obesity may be a feature of lipodystrophy, a group of inherited diseases, or secondary causes (often protease inhibitors, a group of drugs against AIDS). Central obesity is a symptom of Cushing's syndrome and is also common in patients with polycystic ovary syndrome (PCOS). Central obesity is associated with glucose intolerance and dyslipidemia. Once dyslipidemia becomes a severe problem, one's abdominal cavity will produce a high free fatty acid flux to the liver. The effects of abdominal adiposity occur not only in those who are obese, but also affect those who are not obese and also contribute to insulin sensitivity.
Recent validation has concluded that total and regional total body volume estimates are positively and significantly correlated with cardiovascular risk biomarkers and BVI calculations are significantly correlated with all cardio-vascular risk biomarkers.
Ghroubi et al. (2007) examined whether abdominal circumference was a more reliable indicator than BMI from the presence of knee osteoarthritis in obese patients. They found that it actually appears to be a factor associated with the presence of knee pain as well as osteoarthritis in the subjects of obesity research. Ghroubi et al. (2007) concluded that high abdominal circumference was associated with a large functional impact.
Diabetes
There are many theories about the exact causes and mechanisms in Type 2 Diabetes. Central obesity is known to affect individuals for insulin resistance. Abdominal fat is mainly hormone active, secrete a group of hormones called adipokines that can impair glucose tolerance. But adiponectin found in low concentrations in obese and diabetic patients has been shown to be useful and protective in type 2 diabetes mellitus.
Insulin resistance is a major feature of Type 2 Diabetes Mellitus (T2DM), and central obesity is correlated with insulin resistance and T2DM itself. Increased adiposity (obesity) increases serum levels of resistin, which in turn directly correlates with insulin resistance. The study also confirmed a direct correlation between resistance levels and T2DM. And it is the waist adipose tissue (central obesity) that appears to be the main type of fatty deposits that contribute to elevated serum levels of resistin. In contrast, serum levels of resistin have been found to decrease with decreased adipocytes after medical treatment.
Asthma
Developing asthma due to abdominal obesity is also a major concern. As a result of breathing at low lung volumes, the muscles are tighter and the airway narrower. It is generally seen that obese people breathe rapidly and frequently, while inhaling a small volume of air. People with obesity are also more likely to be hospitalized because of asthma. A study has found that 75% of patients treated for asthma in the emergency room are overweight or obese.
Alzheimer's Disease
Based on research, it is evident that obesity has a strong relationship with vascular and metabolic diseases potentially linked to Alzheimer's disease. Recent studies also show a link between obesity and dementia in middle age, but the relationship between obesity and dementia later on is less clear. A study by Debette et al. (2010) examined over 700 adults found evidence that showed a high volume of visceral fat, regardless of overall weight, was associated with smaller brain volume and increased risk of dementia. Alzheimer's disease and abdominal obesity have a strong correlation and with added metabolic factors, the risk of developing Alzheimer's disease is even higher. Based on logistic regression analysis, it was found that obesity was associated with nearly 10-fold increased risk of Alzheimer's disease.
Maps Abdominal obesity
Cause
The current belief is that the direct cause of obesity is a clean energy imbalance - organisms consume more usable calories than are thrown away, disposed of, or thrown away through elimination. Several studies have shown that visceral adiposity, along with lipid dysregulation and decreased insulin sensitivity, are associated with excessive fructose consumption. Larger meat consumption is also positively associated with greater weight gain, and especially obesity of the stomach, even when counting calories. Other environmental factors, such as maternal smoking, estrogenic compounds in the diet, and endocrine disruptive chemicals may also be important. Obesity plays an important role in the disruption of lipid metabolism and carbohydrates shown in high carbohydrate diets. It has also been shown that quality protein intake over a 24-hour period and the amount of thresholds of essential amino acids of about 10 g have been achieved inversely proportional to the percentage of belly fat centers. The quality of protein absorption is defined as the ratio of essential amino acids to daily dietary protein.
Visceral fat cells will release their metabolic byproducts in the portal circulation, where blood leads directly to the liver. Thus, the excess triglycerides and fatty acids made by visceral fat cells will enter the liver and accumulate there. At heart, most will be stored as fat. This concept is known as 'lipotoxicity'.
Hypercortisolism, as in Cushing's syndrome, also causes central obesity. Many prescribed drugs, such as dexamethasone and other steroids, can also have side effects that lead to central obesity, especially in the presence of increased insulin levels.
The prevalence of abdominal obesity is increasing in the western population, perhaps due to a combination of low physical activity and high calorie diet, as well as in developing countries, where it is linked to urbanization of the population.
Waist measurements (eg for BFP standards) are more prone to error than measuring height and weight (eg for BMI standards). It is advisable to use both standards. BMI will illustrate the best estimates of your total body fatness, while waist measurements provide visceral fat estimates and the risk of obesity-related illnesses.
Alcohol consumption
A study has shown that alcohol consumption is directly related to waist circumference and with a higher risk of abdominal obesity in men, but not in women. Not including the energy of the under-reporter slightly attenuated this association. After controlling the energy under reporting, it was observed that increased alcohol consumption significantly increased the risk of surplus recommended energy intake in male participants - but not in small numbers of female participants (2.13%) with increased alcohol consumption, even after setting the amount lower drinks per day to characterize women because they consume high amounts of alcohol. Further research is needed to determine whether a significant association between alcohol consumption and abdominal obesity exists among women who consume higher amounts of alcohol.
Diagnosis
There are various ways of measuring abdominal obesity including:
- Absolute waist circumference (& gt; 102Ã, cm (40Ã, di) in men and & gt; 88Ã,® (35Ã, in) in women)
- Waist-hip ratio (waist circumference divided by hip waist & gt; 0.9 for men and & gt; 0.85 for women)
- High waist to ratio
- Abdominal Sagittal Diameter
In those with a BMI under 35, intra-abdominal body fat is associated with negative health outcomes independent of total body fat. Intra-abdominal or visceral fat has a very strong correlation with cardiovascular disease.
BMI and waist measurement is a well-known way to mark obesity. However, waist measurement is not as accurate as BMI measurement. For this reason, it is recommended to use both measurement methods.
While central obesity can be evident only by looking at the naked body (see figure), the severity of central obesity is determined by taking the waist and hip. The absolute waist circumference is 102 cm (40 inches) in men and 88 centimeters (35 inches) in women) and the waist-to-hip ratio (& gt; 0.9 for men and & gt; 0.85 for women) are both used as a measure of obesity central. The differential diagnosis includes distinguishing central obesity from ascites and intestinal bloating. In a cohort of 15,000 people participating in the National Health and Nutrition Examination Survey (NHANES III), the waist circumference describes obesity-related health risks better than body mass index (or BMI) when the metabolic syndrome is taken as a measure of outcomes and this difference is statistically significant. In other words, excessive waist circumference seems to be more of a risk factor for metabolic syndrome than BMI. Another measure of central obesity that has shown superiority to BMI in predicting cardiovascular disease risk is the Middle Obesity Index (waist to high ratio - WHtR), where the ratio of & gt; = 0.5 (ie waist circumference at least half of the individual height) is a predicted increase in risk. Another obesity diagnosis is the analysis of intra-abdominal fat that is most at risk to one's personal health. Increasing the amount of fat in this region is associated with higher levels of lipid plasma and lipoproteins as mentioned by Eric Poehlman (1998). The increased acceptance of the importance of central obesity in the medical profession as an indicator of health risk has led to new developments in the diagnosis of obesity such as the Body Volume Index, which measures central obesity by measuring one's body shape and weight distribution. The effects of abdominal adiposity occur not only in those who are obese, but also affect those who are not obese and also contribute to insulin sensitivity.
Central obesity index
Index of Central Obesity (ICO) is the ratio of waist circumference and height that was first proposed by Parikh et al. in 2007 as a better substitute for waist circumference that is widely used in defining the metabolic syndrome. The National Cholesterol Education Program of Adult Treatment Panel III suggests cutting 102Ã,® cm (40Ã,Â) and 88Ã,® cm (35Ã,Â) for men and women as a marker of central obesity. The same is used in defining the metabolic syndrome. Misra et al. suggest that these cutoffs are not applicable among Indians and cutoffs are lowered to 90 cm (35 inches) and 80 cm (31 inches) for men and women. Racially specific pieces are suggested by different groups. The International Diabetes Federation defines central obesity based on these specific racial and gender differences. Another limitation of waist circumference is that it can not be applied to children.
Parikh et al. looked at the average height of various races and suggested that by using ICO various races and gender specific gaps waist circumference can be discarded. Cutoff ICO 0.5 is recommended as a criterion for determining central obesity. Parikh et al. subsequently tested the definition of modified metabolic syndrome in which the waist circumference was replaced by ICO in the National Health and Nutrition Examination Survey (NHANES) database and found the modified definition to be more specific and sensitive..
This parameter has been used in the study of metabolic syndrome and cardiovascular disease.
Gender differences
50% of men and 70% of women in the United States between the ages of 50 and 79 are now exceeding the waist circumference for central obesity.
When comparing male and female body fat it is seen that men have nearly twice as much visceral fat as pre-menopausal women.
Central obesity is positively related to the risk of coronary heart disease in women and men. It has been hypothesized that gender differences in the distribution of fats can explain the sex differences in the risk of coronary heart disease.
There is a sex dependent difference in regional fat distribution. In women, estrogen is believed to cause fat to be stored in the buttocks, thighs and hips. When women reach menopause and estrogen produced by the ovaries decreases, fat migrates from the buttocks, hips, and thighs to their stomachs.
Men are more susceptible to upper body fat accumulation, most likely in the stomach, due to differences in sex hormones. Abdominal obesity in men correlates with relatively low testosterone levels. Testosterone significantly increases the thigh muscle area, reducing subcutaneous fat accumulation at all measured levels, but slightly increasing the visceral fat area.
Even with the difference, at any rate of central obesity measured as waist or waist circumference to hip ratio, the level of coronary artery disease is identical in both men and women.
Prevention and care
Permanent exercise routines, healthy eating, and, during overweight periods, consuming the same amount or fewer calories than used will prevent and help fight obesity. One pound of fat produces about 3500 calories of energy (32,000 kJ of energy per kilogram of fat), and weight loss is achieved by reducing energy intake, or increasing energy expenditure, thus achieving a negative balance. Adjuvant therapy that may be prescribed by doctors is orlistat or sibutramine, although the latter has been associated with increased cardiovascular events and stroke and has been withdrawn from markets in the United States, Britain, the European Union, Australia, Canada, Hong Kong, Thailand, Egypt and Mexico.
A 2006 study published in the International Journal of Sport Nutrition and Exercise Metabolism showed that combining cardiovascular exercise (aerobics) with resistance training was more effective than cardiovascular training alone in removing belly fat. An additional benefit to exercise is to reduce stress levels and insulin, which reduces the presence of cortisol, a hormone that leads to more abdominal fat deposits.
Self-motivation by understanding the risks associated with abdominal obesity is widely regarded as far more important than concerns about cosmetics. In addition, understanding the health problems associated with abdominal obesity may help in the process of self-motivation losing belly fat. As mentioned above, belly fat is linked to cardiovascular disease, diabetes, and cancer. Especially the deepest abdominal fat layer (fat that you can not see or take) that pose health risks, because these "visceral" fat cells produce hormones that can affect health (eg increased insulin resistance and/or breast cancer risk). The risk increases with the fact that they are near or between organs in the abdominal cavity. For example, fat next to the liver flows into it, causing fatty liver, which is a risk factor for insulin resistance, staging settings for Type 2 diabetes.
In the presence of type 2 diabetes mellitus, doctors may prescribe metformin and thiazolidinediones (rosiglitazone or pioglitazone) as an antidiabetic drug rather than a sulfonylurea derivative. Thiazolidinediones can cause a slight increase in weight but reduce "pathological" abdominal fat (visceral fat), and therefore can be prescribed for diabetics with central obesity. Thiazolidinedione has been associated with heart failure and increased cardiovascular risk; so it has been withdrawn from the market in Europe by EMA in 2010.
A low-fat diet may not be an effective long-term intervention for obesity: as Bacon and Aphramor write, "The majority of individuals regain almost all the weight lost during treatment." The Women's Health Initiative ("the largest and longest randomized controlled randomized controlled intervention trial") found that long-term dietary interventions increased waist circumference from both intervention and control groups, albeit a smaller increase for the intervention group. The conclusion is that the mean body weight decreased significantly in the intervention group from baseline to year 1 of 2.2 kg (P & l: 0.001) and 2.2 kg less than the control group change from the baseline in year 1. This difference of the baseline between control and intervention groups decreased over time, but significant weight differences were maintained until year 9, the end of the study.
Society and culture
Myth
There is a common misconception that on-site exercises (ie, exercising a particular muscle or body location) most effectively burn fat in the desired location, but this is not the case. Spot sports are beneficial for building certain muscles, but have little effect, if any, on the fat in that area of ​​the body, or on the distribution of body fat. The same logic applies to crunches and belly fat. Sit-ups, crunches and other abdominal exercises are useful in building abdominal muscles, but they have little effect, if any, on the adipose tissue located there.
Colloquialisms
Some of the everyday terms used to refer to central obesity, and to those who have it, refer to drinking beer. However, there is little scientific evidence that beer drinkers are more susceptible to central obesity, although known as "beer belly", "beer belly", or "beer pot". One of the few studies conducted on the subject did not find that beer drinkers were more susceptible to central obesity than drinkers or drinkers of palm or liquor. Chronic alcoholism can cause cirrhosis, symptoms including gynecomastia (enlarged breasts) and ascites (stomach fluids). These symptoms may indicate the emergence of central obesity.
The savings of fat over the person's side are usually referred to as "love grip".
Economy
Researchers in Copenhagen examined the relationship between waist circumference and cost among 31,840 subjects aged 50-64 years with different waist circumferences. Their study showed that an increase of just an extra centimeter above the normal waist led to an increase of 1.25% and 2.08% in health care costs in women and men respectively. To put this in perspective, a woman with a waist of 95 cm. (about 37.4 in) and without health problems or comorbidities can result in an economic cost of 22%, or 397 USD, higher per year than women with normal waist circumference.
See also
- Bariatrics, a branch of medicine that deals with the causes, prevention, and treatment of obesity
- Lipoatrophy, a term that describes the loss of localized fat tissue
- Lipodystrophy, a medical condition characterized by abnormal or degenerative conditions of the body's adipose tissue.
- Panniculus, hanging belly fat
- Sagittal Abdominal Diameter (SAD), visceral obesity size
- Steatosis, also called fatty change , fatty degeneration or adipose degeneration
References
Further reading
- Griesemer, Rebecca Lynn (July 25, 2008). Central Obesity Index as a Parameter for Evaluating Metabolic Syndrome for Young Adults, Blacks and Hispanics in the United States (Master's thesis) . Georgia State University. < span>
- Lee, Kayoung; Song, Yun-Mi; Sung, Joohon (2008). "Which Obesity Indicator Is Better Predicts Metabolic Risk ?: Healthy Twin Study". Obesity . 16 (4): 834-40. doi: 10.1038/oby.2007.109. PMID 18239595.
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Shao, J.; Yu, L.; Shen, X.; Li, D.; Wang, K. (2010). "A waist-to-high ratio, the optimal predictor for obesity and metabolic syndrome in Chinese adults". The Journal of Nutrition, Health & amp; Aged . 14 (9): 782-5. doi: 10.1007/s12603-010-0106-x. PMID: 21085910.
External links
Source of the article : Wikipedia
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