Epidemics of the 21st century
The currently growing epidemic of obesity is threatening with health-damaging complications. They are called - the metabolic syndrome (MS). This dry medical term means that every obese person is more threatening than other dangerous health conditions: diabetes, atherosclerosis, venous thrombosis and their complications. An untreated metabolic syndrome causes a growing risk of disability or even junk due to such complications as: retinopathy (threatened by blindness), nephropathy (threatens kidney failure) neuropathy and diabetic foot (threatens foot amputation). Untreated atherosclerosis - threatens coronary heart disease and myocardial infarction and stroke.
We recognize MS when three health disorders occur simultaneously:
- glucose tolerance disorder, which means pre-diabetes
- increased level of fat in blood - so-called triglycerides
- too low level of "good cholesterol" HDL
- high blood pressure
- obesity
Detailed criteria for the diagnosis of a person with metabolic syndrome:
(Criteria according to the International Diabetes Association (IDF) from 2005)
Waist circumference in a woman - equal to or greater than 88 cm; in a man equal to or greater than 102 cm, and in addition when there is at least two of the following adverse health conditions:
- triglyceride level in blood equal to or higher than 150 mg dl (or treatment of dyslipidemia)
- concentration of the so-called good cholesterol (HDL) in the blood - in women lower than 50 mg dl, while in men lower than 40 mg dl
- arterial pressure equal to or higher than 130 85 mm Hg (or treatment of hypertension)
- fasting blood glucose level equal to or higher than 100 mg dl (or treatment of type 2 diabetes)
OBESITY - THE MAIN CAUSE OF A METABOLIC TEAM
The amount of fat in the human body changes with age.
For example, high variability in adipose tissue fatation in children, adolescents and adults has been established. The newborn usually has about 12% of adipose tissue, and six-month-old babies are already around 25%. Later, at the age of 9-12, the amount of body fat should decrease to about 15-17%. After the age of 12, the percentage of adipose tissue increases again. For example, up to 20-25% in girls during puberty (10). It is widely recognized that body weight in early childhood well predicts body weight in adolescence and adulthood. [2]
We like to eat - excess calories are turned into obesity
Obesity is against the common opinion of the pathological state of the organism, which results in the above-mentioned dangerous diseases: diabetes, atherosclerosis, venous thrombosis and their complications. This disease results from the absolute principles of energy balance. Simply excess absorbed calories from food is not balanced by the energy expenditure of physical exercise - and the excess "fuel" which is glucose must be processed and stored in the form of adipose tissue. In a word, the excess of tasty dishes - white bread, cakes, sweets, tasty fatty meats and offals, with a lack of exercise and physical effort - this is the main reason for obesity.
Why do we eat too much?
For wealthy communities in Europe, America and Asia - hearty meals are one of the popular cult pleasures. A tasty and usually caloric snack is more and more often treated as a substitute for relaxation and a measure to combat stress. It is not without significance that the modern gourmet gets a number of hidden stimuli stimulating the appetite. These are, for example, media advertising of foods that stimulate stimuli that can stimulate the hunger-satiety system in the brain.Other typical causes of overeating are: the habit of eating at the same time, religious and personal holidays with their culinary tradition, symbolic snacks for some occasion, chemical stimuli (eg smells of food, alcohol), etc.
Food obesity
Food obesity, also called "simple" obesity - as its name suggests is caused above all by excess of calories in the diet. In addition, the reason is the already mentioned dietary mistakes "too young", compensation for stress with continuous snacking, the relaxation of a gay man, or a taste for sweets, etc. Family and genetic determinants are also important, for example low birth weight is a known risk factor for obesity and metabolic syndrome in young people already.These habit and food conditions are leading in the pathogenesis of obesity. Their influence is estimated at 20-70 %.
Early eating habits and obesity:
1. Already in fetal life, the disorder of natural proportions between fat and lean body mass, which may affect the position of homeostats, the activity of the brain centers that control appetite, modify the structure and function of the pancreas.
2. Artificial feeding during infancy, too sweetening of meals, which may result in addiction to sweets
3 Poor environmental and family eating habits in the form of so-called Overfocations mean that already at the age of 3-4 years there are well-anchored predispositions to obesity.
Girls' puberty favors obesity?
The future sexual maturation of the future woman is the time of accumulating energy in the form of adipose tissue as the preparation for reproduction created by the original forces of evolution. This is facilitated by the activation of the hypothalamo-pituitary-gonadal system and changes in hormones responsible for the process of sexual growth and puberty. Z. cause changes in the activity of centers responsible for the energy balance of the body. Emotional changes occurring in the girl's psyche may disturb the balance of hunger and satiety centers and cause an increase in appetite and so-called excessive appetite. After some time, the consequence is the increase in body fat. In addition, the increase in weight is fostered by the growing tendency in youth to avoid sports, a sedentary lifestyle, fashion for sweets and treating snacks as a spontaneous pleasure.
Overweight due to pregnancy
Stress in many young women who are overweight - more often than their lean peers - induce a decreased secretion of pituitary gonadotropin hormones. This results in reduced estrogen secretion and a further sequence of disorders, which, however, the most troublesome consequences are menstrual disorders and ... an increase in appetite. And the latter causes gluttony and frequent snacking, and consequently uncontrolled weight gain leading to obesity. And so the pathophysiological vicious circle closes. Similarly, pregnancy is one of the so-called natural causes of weight gain.
OBESITY ARISES DIABETES? AND HER RISKS
Obesity leads directly to insulin resistance!
Overeating and low physical activity are recognized causes of obesity. Less popular is the fact that obesity caused by the causes often leads to insulin resistance, i.e. the inability of the cell to absorb the basic "fuel" for our life functions, which is sugar glucose necessary to drive the physiological functions of cells, tissues and organs And that means the beginning of diabetes Type 2. It is worth noting that type 2 diabetes has been seen so far in its advanced age - after the age of 50 or 60. That's why it's often called old-age diabetes. However, the current epidemic of obesity among children and adolescents accelerates the "age" pathology of insulin resistance, which is why type 2 diabetes is increasingly affecting young people. In some countries, pediatricians report a real epidemic of type 2 diabetes in children and adolescents.
What is insulin resistance - the most dangerous harbinger of the metabolic syndrome?
Insulin resistance is a condition in which the pancreas still produces an adequate amount of insulin hormone, but the body does not "notice!" And reacts as if the hormone in the body was missing. The body needs more and more insulin to overcome insulin resistance until the secretory reserves of the pancreas become exhausted. As a result, the level of glucose in the blood is getting higher and its useless, because it is not burned in cells. As a consequence, the body can not obtain from it energy necessary for life.There are symptoms of energy deficiency - despite the excess of sugar in the blood. Advanced diabetes develops and its chronic life-threatening complications. (About this below) This is especially true for people who are environmentally and genetically predisposed to developing type 2 diabetes.
A particular risk is excess abdominal fat
It shows the obesity of the "apple" type. Recall the simplest indicators of abdominal obesity - in a woman the waist circumference above is 88 cm and more; and in a man a circumference equal to or larger than 102 cm. Among other causes that may cause deterioration of insulin tissue sensitivity - the following are mentioned: increased blood levels of free fatty acids, tumor necrosis factor (TNF-alpha) and excess of leptin. It can be added that chronic obesity such as "apple" leads to a disorder characterized by excess insulin in the blood (the so-called hyperinsulinemia).
In fact-based medicine, the influence of obesity on the development of type 2 diabetes is well documented
According to eidemiological data, approximately 90-95% of cases of type 2 diabetes concern people with overweight and obesity. Only 5% -10% is LADA (Late Autoimmune Diabetes in Adults) diabetes and other forms of it, associated with the presence of antibodies against pancreatic antigens or disease caused by genetic determinants. Many doctors claim that type 2 diabetes is not a separate disease, but requires specific treatment for the complication of obesity.
Complication of chronic diabetes - neuropathy
In type 2 diabetes (i.e., not requiring insulin injections) - a chronic excess in the blood of "unburned" glucose sugar has a pathogenic effect on the nervous system - after prolonged exposure it causes a weakening of the rate of the stimuli leading through the nervous system. The release of stimulus guidance is progressive. Initially, it is manifested by disturbances in the conduction of stimuli, and subsequently damage to the peripheral nerves, that is, those that innervate the muscle tissue and skin. A characteristic symptom of disease management may be so-called sensory neuropathy. Patients with it have sensory disturbances, e.g. in feet, so-called "Sock tingling" and gloved hands. Further development of the disease causes long-term pain in the muscles of the legs and hands, sometimes short-term acute, pain. Nerve damage acting independently of our will is called autonomic neuropathy. Damage to peripheral nerves is usually a set of many ailments and symptoms. Sensory neuropathy is the most common form of neuropathy.
Complication of diabetes - diabetic eye retinopathy
Retinopathy - a disease of the eye caused by long-lasting diabetes, initially threatening the loss of visual acuity, and later a complete loss of vision. The direct cause of eye pathology is high blood glucose (hyperglycemia!) That damages the retinal blood vessels. This threat applies to almost every diabetic
Complication of diabetes - neuropathy
Blood in the kidneys flows through a very large number of microscopic filtering units - called nephrons. Nephron is a place where unnecessary metabolic products are separated from it and excreted as urine. Useful products - including eg protein - are "drained" and recycled for use in the body. Small blood vessels found in the nephron, so-called kidney glomeruli, can be damaged by long-lasting excess sugar in the blood (hyperglycaemia). Damage to the small vessels of the kidney glomeruli causes changes in the kidneys, the most serious and the most dangerous are called diabetic nephropathy. The first visible sign of the disease is the increase in the amount of protein in the urine, up to a small barrier exceeding 100 mg of protein per day - recognized as a level harmful to health and a symptom of disease - called as proteinuria.
Failure to diagnose diabetes or ineffective treatment leads to high proteinuria (exceeding 300 mg per day). Exceeding this barrier results from damage to the nephrons and causes the patient to feel symptoms such as loss of appetite, hypertension and edema. The consolidation of proteinuria induces growing symptoms such as swelling of the ankles, hands and face and other parts of the body; skin irritation caused by the build-up of metabolic products; difficulties in achieving correct blood glucose values (ie, blood sugar levels consistent with the physiological standard), despite the use of appropriate doses of insulin or other medicines.
