Παρουσίαση με θέμα: "Τμήμα Επιστήμης Φυσικής Αγωγής και Αθλητισμού"— Μεταγράφημα παρουσίασης:
1Τμήμα Επιστήμης Φυσικής Αγωγής και Αθλητισμού ΠΑΝΕΠΙΣΤΗΜΙΟ ΘΕΣΣΑΛΙΑΣΆσκηση και ΠαχυσαρκίαΗ παχυσαρκία ως επιβαρυντικός παράγοντας στην υγεία – Συνοδές ασθένειεςΣακκάς Γεώργιος PhDΤμήμα Επιστήμης Φυσικής Αγωγής και Αθλητισμού
2Άδειες ΧρήσηςΤο παρόν εκπαιδευτικό υλικό υπόκειται σε άδειες χρήσης Creative Commons.Για εκπαιδευτικό υλικό, όπως εικόνες, που υπόκειται σε άλλου τύπου άδειας χρήσης, η άδεια χρήσης αναφέρεται ρητώς.
3ΧρηματοδότησηΤο παρόν εκπαιδευτικό υλικό έχει αναπτυχθεί στα πλαίσια του εκπαιδευτικού έργου του διδάσκοντα.Το έργο «Ανοικτά Ακαδημαϊκά Μαθήματα Πανεπιστημίου Θεσσαλίας» έχει χρηματοδοτήσει μόνο τη αναδιαμόρφωση του εκπαιδευτικού υλικού.Το έργο υλοποιείται στο πλαίσιο του Επιχειρησιακού Προγράμματος «Εκπαίδευση και Δια Βίου Μάθηση» και συγχρηματοδοτείται από την Ευρωπαϊκή Ένωση (Ευρωπαϊκό Κοινωνικό Ταμείο) και από εθνικούς πόρους.
4Σκοποί ενότηταςΗ απόκτηση γνώση για τις σχετιζόμενες με την παχυσαρκία συνοδές ασθένειες και πως αυτές επηρεάζουν το προσδόκιμο ζωής των ατόμων αυτών.
6What is Obesity – What is the risk Overweight is BMI of 25 to 29.9 Kg/m2 Obesity is BMI anything above 30 Kg/m2
7Obesity - Metabolic Syndrome (MetS) MetS composed of:Insulin resistanceAbnormal fasting glucose levelsIncreased cholesterol (total, LDL) and TGIncreased blood pressureIncreased WHR or central adiposity (visceral fat)MetS is associated withObesity & DiabetesCardioVascular Disease (CVD)Optimal BMI for a healthy life from age 18 to 85 is the 23 to 25 ( African American)
8Obesity - Metabolic Syndrome (MetS) The life-shortening effect of obesity rises if (obese) young people stay obese until the middle and older ages compared to if they become obese into an older age.
10Obesity and Cardiovascular Disease Studies have shown thatadolescence obesity predicts mortality (θνησιμότητα) rates by 80% in male and 100% in female patientsthe risk of death is independent of adult BMI but dependent of “since when” the adult was obeseObesity is associated with reduced life expectancy (προσδόκιμο ζωής)!
11Cardiovascular Impact of Increased Fat Mass Adipose Tissue Circulation Increased Adipose tissue leads to edemaAdipose tissue has an extensive capillary networkResting blood flow is 2-3ml/min/100g fatIncreased after meal to 20ml/min/100g fatIn obesity, perfusion is reduced in 1.5ml/min/100g fat meaning that the water between the fat cells (interstitial space) is not accessible leading to increased edemaIn addition, 30% of the circulated IL6 (Interleukin-6) comes from the adipose tissueIL6 modulates CRP – marker of chronic inflammation – that can trigger acute coronary syndrome
12Left Ventricular Hypertrophy (υπερτροφία της αριστερής κοιλίας) At any given level of activity, the cardiac workload and peripheral resistance are greater for obese subjectsDue to increased left ventricular filling pressure and volume – chamber dilation – there is a high risk for Left Ventricular Hypertrophy (LVH)In weight reduction a decrease in central blood volume gives relief from edema and dyspnea
13Lipid Deposition in Organs Lipid deposition can impair tissue or organ function in three ways:Fat around organs can modify function due toincreased pressure (compression)periorgan fat cells secreting various acting moleculesLipids accumulation may lead to cell dysfunction or cell death – known as LipotoxicityFat deposition in cardiac muscle (epicardial fat) could lead to cardiomyopathy
14Vascular Disease in Obesity Venous Stasis (φλεβική στάση), lower leg edema and cellulitis (κυτταρίτιδα) due to venous valvular incompetenceVenous thrombosis and pulmonary embolism – 2.5 times more risk with waist circumference >100 cmAbnormal endothelial function due to decrease NO (nitric oxide) meaning increased oxidative stressDecrease in NO function leads to increased vasoconstriction and increased vascular resistance
15What is Hypertension?Hypertension or high blood pressure is a condition in which the blood pressure in the arteries is chronically elevated. Blood pressure is the force of blood that is pushing up against the walls of the blood vessels. If the pressure is too high, the heart has to work harder to pump, and this could lead to organ damage and several illnesses such as heart attack, stroke, heart failure, aneurysm, or renal failure.
17Hypertension in Obesity (υπέρταση) The majority of hypertensive patients are overweightHypertension is 6 times more frequent in obese than in lean subjectsWeight gain in a previously lean subject is a potent risk for developing hypertension
18Hypertension in Obesity A 10 kg increase in body weight is associated with 3 mmHg higher systolic and 2.3mmHg higher diastolic blood pressureThis is translated into 12% risk for Coronary Heart Disease (CHD) and 24% for strokeBlood Pressure = Cardiac Output * Systemic Vascular ResistanceC.O. is increased due to oxygen demand from the excess fat tissue, SVR is increased due to endothelial dysfunction (NO etc)
19Obesity is considered a “low-grade systemic inflammation” Peripheral Vascular Resistance in Obesity (περιφερεική αγγειακή αντίσταση)Obesity is associated with inflammationStrong correlation between IL6, CRP and obesityIL6 stimulates CRP from the liverIncreased IL6 is correlated with systolic and diastolic blood pressureObesity is considered a“low-grade systemic inflammation”
20Respiratory Complications in Obesity (αναπνευστικές διαταραχές) Obese subjects haveIncrease demand for ventilationIncreased breathing workloadRespiratory muscle inefficiencyDecreased functional reserve capacity and expiratory reserve volumeClosure of peripheral lung unitsVentilation-Perfusion mismatch (supine position)Obesity is a classic cause of alveolar hypoventilation (κυψελιδικός υποαερισμός)
21Apnea in Obesity (υπνική άπνοια) Obesity is by far the most important risk factor for sleep disordersSleep Apnea – repeated episodes of obstructive apnea and hypopnea during sleep, together with daytime sleepiness or altered cardiopulmonary functionHypertension rises with sleep disordersSleep apnea is associated with increased levels of CRPSleep Apnea – Hypertension – Atherosclerosis
22Pulmonary Hypertension in Obesity (πνευμονική υπέρταση) 15-20% of Sleep Apnea patients suffer from Pulmonary HypertensionMetS is associated with Pulmonary HypertensionMechanism: Obesity relates to sleep apnea – relates to alveolar hypoventilation – relates to alveolar hypoxia = pulmonary vasoconstriction
23Stroke & Obesity (εγκεφαλικό επεισόδιο) Many studies have shown association between BMI – WHR – StrokeObesity is a potential risk factor for stroke independently from cholesterol levels, hypertension & diabetesOverweighted men (25 – 29.9 BMI) had 1.32 times higher risk for Total Stroke, 1.25 for Hemorrhagic Stroke and 1.35 for Ischemic StrokeIf your BMI increases by 1 unit your risk increases by4% for Ischemic Stroke6% for Hemorrhagic Stroke
24Coronary Artery Disease in Obesity (στεφανιαία νόσο) Obesity is associated with advanced atherosclerosis in the Right Coronary Artery & Abdominal Aorta
25Coronary Artery Disease in Obesity Central adiposity is more important for atherosclerosis than total body fatThe levels of HDL , LDL, hypertension, diabetes, smoking and glycohemoglobin accounted for the 15% of atherosclerosis found in obese patients…the rest is explained by central fat (visceral fat)
26Arrhythmias in Obesity (αρρυθμίες) “Sudden death is more common in those who are naturally fat than in the lean” HippocratesObese subjects have an increased risk of arrhythmias and sudden death even in the absence of cardiac dysfunctionAbnormal prolonged QT interval found in obese patientsQT abnormalities are associated with central adiposity or insulin resistance
27Autonomic Nervous System & Obesity (αυτόνομο νευρικό σύστημα) ANS regulates cardiovascular system and energy expenditure10% increase in body weight = decline in parasympathetic tone = increase in resting heart rateIncrease of resting HR is associated with high mortality rates10% reduction in body weight in severely obese subject resulted improvement in cardiac function
28Diabetes in Obesity (διαβήτης) More than 95% type 2 diabetes is attributed to obesityThe risk of type 2 diabetes increases with weight gainWith weight loss, type 2 diabetes and insulin resistance is improved, diabetes medication is reduced
29Dyslipidemia in Obesity (δυσλιπιδαιμία) Obesity is associated with increased total cholesterol, increased LDL, decrease HDL and increased TG levelsWith weight loss, lipidemia is improved by 40% and stays there until weight is regained
30Gastroesophageal Reflux in Obesity (γαστρο-οισοφαγική παλινδρόμηση) Obesity is a major risk factor for gastrointestinal reflux disease (γαστρο- οισοφαγική παλινδρόμηση)Improvement of these symptoms have been found in the majority of the patients who lost weight
31Degenerative Joint Disease in Obesity (ασθένειες του κολλαγόνου) Obesity is clearly a cause of large joint degeneration (ασθένειες του κολλαγόνου) and arthritisWith weight loss, obese patients have found relief from pain in hips, knees, feet and lower backArthroplasty is safe when the patients are within the normal weight range
32Urinary Incontinence in Obesity (ακράτεια ούρων) Obesity appears to be an important etiologic factor in stress urinary incontinence (ακράτεια ούρων), probably through the mechanism of increased abdominal pressureWith weight loss, studies have shown decrease in intra-abdominal pressure, decrease in sagittal abdominal diameter and decrease in stress urinary incontinence
33Non-alcoholic Steatohepatitis in Obesity (μη αλκοολική στεατοηπατίτιδα) Nonalcoholic Liver Disease and Nonalcoholic SteatoHepatitis are strongly associated with obesity and type 2 diabetesNASH may result in cases of cirrhosis and liver failureDeposition of fat in the liver is the primary suspect but the pathophysiology is unknown
34Psychiatric and Social Disorders in Obesity (ψυχιατρικές διαταραχές) The morbidly obese frequently suffer from poor self-image and social stigmatizationThey are at special risk for affective disorders, anxiety and substance abuse (drugs)Repeated diets could lead to depression, anxiety and food preoccupationAfter weight loss, patients have been shown to have better mood, self-esteem and to become more socially active
35Summary Obesity is always followed by something else… From metabolic syndrome and urinary incontinence to psychiatric disordersThe years that somebody has been obese, highly related to the risk of deathReduction of body mass (kg) results in a significant improvement in total healthThe combination of exercise and diet is the optimal way to loose weight and keep it away