GLOBAL OBESITY

GLOBAL OBESITY

Focus on :

1.      Ask significant questions before reading

2.      Identify and use nouns and noun phrases from information academic texts

3.      Make plausible inferences when reading

4.      Analyze the use of statistics to support statements

5.      Identify audience and purpose in a reading

Nutrition Objectives

1.      Study key terms in nutrition and health-related disiplines

2.      Examine the steps in the scientific method of research in nutrition

3.      Examine your eating habits by using information about nutrition and health

Obesity is spreading across the globe. In fact, the World Health Organization has coined a new word to describe it; globesity. This serious health concern is also a major topic of study in nutrition and other health fields such as dietetics, medicine, nursing, and biology.

What is Nutrition? 1.      The process of nourishing, especially the procces by which a living organism uses food. 2.      The study of food and nourishment 3.      Nourishment; diet.

POWER GRAMMAR Word Families As you learned in chapter 2, english words belong to families. Word “members” of the family perform a variety of functions in sentemces. Common functions are subject, verb, and object. Words can also be identified by the parts of speech noun, verb, adjective, and adverb. When a word’s function changes, its form, or ending, changes.

            Read the following sentences, focusing on the italicized members of the word family of dict. Pay attention to the ending of each italicized word.

Dieters have to watch what they eat. Soe people diet for a few weeks, but then they quite their diets.

Dietetics is the study of nutrition as it relates to health.

                        Dieticians recommend dietary guidlines for maintenance of good health.

            The word family of diet has many members, as the chart below indicates. A word family may consist of more than one part of speech and none of another part. You can study word families by using a dictionary.

Noun	Verb	Adjective	Adverbs
Diet Dietetics Dieter dietician	diet	Dietary dietetic	Dietarily Dietetically

STRATEGY Asking questions before reading Asking questions about the reading topic before you read enables you to focus your reading on finding specific information. Especially in readings from academic textbooks, the textbook titles, headings, and subheadings can provide topics for prereading questions. Then, as you read, try to answer the question.

EXERCISE

Reading selection 1

OBESITY AND BEING OVERWEIGHT

FACTS

·         Globally, there are more than 1 billion overweight adults, at least 300 million of theme obese.

·         Obesity and being overweight pose a major risk for chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer.

·         The key causes are increased consumption of energy-dense foods high in saturated fats and sugars and reduced physical activity.

Obesity has reached epidemic prportions globally, with more than one billion adults overweight-at least 300 million of them clinically obese- and is a major contributor to the global burden of chronic disease and disability. Often, coexisting in developing countries with under-nutrition, obesity is a complex condition, with serious social and psychological dimensions, affecting virtually all ages and socioeconomic groups.

Increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturared facts, combined with reduced physical activity, have led to obesity rates that have risen three fold or more since 1980 in some areas of North America, the United Kingdom, Eastern Europe, the Middle East, the Pacific Island, Australasia and China. The obesity epidemic is not restricted to industrialized societies; this increase is often faster in developing countries than in the developed world.

Obesity and being overweight pose a major risk for serious diet-related chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer. The health consequences range from increased risk of premature death, to serious chronic conditions that reduce the overall quality of life. Of especial concern is the increasing incidence of child obesity.

Why is this happening?

            The rising epidemic reflects the profound changes in society and in behavioural patterns of communities over recent decades. While genes are important in determining a person’s susceptibility to weight gain, energy balance is determined by calorie intake and physical activity. Thus societal changes and worldwide nutrition transition are driving the obesity epidemic. Economic growth, modernization, urbanization and gllobalization of food markets are just some of the forces thought to underlie the epidemic.

            As incomes rise and populations become more urban, diets high in complekx carbohydrates give way to more varied diets with a higher proportion of fats, saturated fats and sugars. At the sae time, large shifts towards less physicallu demanding work have been observed worldwide. Moves toward less physical activity are also found in the increasing use of automated transport, technology in the home, and more passive leisure pursuits.

How do we define obesity and being overweight?

            The prevalance of being overweight and obesity is commonly assessed by using body mass index (BMI) defined as the weight in kilograms divided by the square of the height in meters (kg/m2). A BMI over 25 kg/m2 is defined as overweight, and a BMI of over 30 kg/m2 as obese. These markers provide common benchmarks for assessment, but the risks of disease in all populations can increase progressively from lower BMI levels.

            Adult mean BMI levels of 22-23 kg/m2 are found in Africa and Asia, while levels of 25-27 kg/m2 are prevalent across North America, Europe, and in some Latin American, Nrth African and Pasific Island countries. BMI increases amongst middle aged elderly people, who are at the greatest risk of health complications. In countries undergoing nutrition transition, overnutrition often co-exists with undernutrition. People with a BMI below 18,5 kg/m3 tend to be underweight.

            The distribution of BMI is shifting upwards in many popullations. And recent studies have shown the pople who were undernourished in early life and then become obese in adulthood, tend to develop conditions such as high blood pressure, heart disease and diabetes at an earlier age and in more severe form than tose who were never undernourished.

The extent of the problem

            Currently more than 1 billion adults are overweight-and at least 300 million of them are clinically obese. Current obesity levels range from below 5% in China, Japan and certain African nations, to over 75% in urban Samoa. But even in relatively low prevalence countries like China, rates are almost 20% in some cities.

            Childhood obesity is already epidemic in some areas and on the rise in others. As estimated 17,6 million children under five are estimated to be overweight worldwide. According to the U.S. Surgeon general, in the USA the number of overweight children has dubled and the nimber of overweight adolescents has trebled since 1980. The prevalence of obese children aged 6-11 years has more than doubled since the 1960s. Obesity prevalence in youths aged 12-17 has increased dramatically from 5% to 13% in boys and from 5% to 9% in girls between 1966-70 and 1988-91 in the USA. The problem is global and increasingly extends into the developing world; for example, in Thailand the prevalence of obesity in 5 to 12 year old children rose from 12,2% to 15,6% in just two years.

            Obesity accounts for 2-6% of total health care costs in several developed countries; some estimates put the figure as high as 7%. The true costc are undoubtedly much greater as not all obesity related conditions are included in the calculations.

How does excess body fat impact healt?

            Being overweight and obesity lead to adverse metabolic effects on blood pressure, cholesterol, triglycerides and insulin resistance. Some confusion of the consequences of obesity arise because researchers have used different BMI cut-offs, and because the presence of many medical conditions involved in the development of obesity may confuse the effects of obesity itself.

            The non-fatal, but debilitating health problems associated with obesity include respiratory difficulities, chronic musculoskeletal problems, skin problems and infertility. The more life threatening problems fall into four main areas: cardiovascular disease problems, conditions associated with insulin resistance such as type 2 diabetes; certain types of cancers, especially the hormonally related and large bowel cancers; and gallbladder disease.

            The likelihood of developing type 2 diabetes and hypertension rises steeply with increasing body fatness. Confined to older adults for most of the 20th century, this disease now affects obese children even before puberty. Approximately 80% of people with diabetes are type 2, and of these, 90% are obese or overweight. And this is increasingly a developing world problem. In 1995, the emerging market economics had the highest number of diabetics. If currents trends continue, India and the middle Eastern crescent will have taken over by 2025. Large increases would also be observed in China, Latin America and the Caribbean, and the rest of Asia.

            Raised BMI also increases the risks of cancer of the breast, colon, prostate, endometrium, kidney and gallbladder. Chronic overweight and obesity contribute significantly to osteoarthritis, a major cause of disability in adults. Although obesity should be considered a disease in its own right, it is also one of the key risk factors for other chronic diseases together with smoking, high blood pressure and high blood cholesterol. In the analyses carried out for world health report 2002, approximately 58% of diabetes and 21% of ischaemic heart disease and 8-42% of certain cancers globally were attributable to a BMI above 21 kg/m2.

What can we do about it?

            Effective weight management for individuals and groups at risk of developing obesity involves a range of long term strategies. These include prevention, weight maintenance, management of co-morbidities and weight loss. They should be part of an integrated, multi sectoral, population based approach, which includes environmental support for healthy diets and regular physical activity. Key elements include:

·         Creating supportive population based environments through public policies that promote the availability and accessibility of a variety of low fat, high fiber foods, and that provide opportunities for physical activity.

·         Promoting healty behaviours to encourage, motivate and enable individuals to lose weight by:

Eating more fruit and vegetables, as well as nuts and whole grains:

Engaging in daily moderate physical activity for at least 30 minutes;

Cutting the amount of fatty, sugary foods in the diet;

Moving from saturated animal based fats to unsaturated vegetable oil based fats.

·         Mounting a clinical response to the existing burden of obesity and associated conditions through clinical programs and staff training to ensure effective support for the those affected to lose weight or avoid further weight gain.

EXERCISE

READING ASSIGNMENT 2

NEWS REPORTS FROM TWO COUNTRIES: “MORE MONEY, MORE OBESITY IN CHILDREN” AND “TACKLING ASIA’S GROWING WAISTLINE”

NEWS REPORT 1: MORE MONEY, MORE OBESITY IN CHILDREN

[SUNDAY, MAY 26, 2002] NEW DELHI: Affluence is now taking its toll on children’s health, with a new study in Delhi indicating that every 15^th school-going child in the high- or high-middle income group is obese.

The study conducted in a public school cautions that all these children are prone to hypertension, diabetes, coronary artery disease and overall morbidity and mortality during adult life.

“There is increasing evidence that children and adolescents of affluent families are overweight. It is possibly because of decreased physical activity, sedentary lifestyle, altered eating patterns with more fat content in the diet,” Dr. Umesh Kapil, adjunct professor from the Department of Human Nutrition and Biostatistics at AIIMS, who along with his team conducted the study, said.

“Only 19 percent of the school children were found to be engaged in outdoor activities in our study, while 90 percent of the obese children did not engage in any outdoor activity at all,” Kapil said.

The research, involving 870 children, was carried out in a public school of Delhi catering to the affluent segment of the population. It reported an overall prevalence of obesity as 7,4 percent. An earlier study in 1990 had reported an almost similar prevalence of obesity, according to the paper published in the science journal Indian Pediatrics.

Kapil said prevalence of a disorder above five percent was a public health problem. These children would grow into adults and were likely to contribute to the ever increasing burden of non-communicable diseases, he said.

“Once obese, a child remains so in adulthood and even old age. Obesity also leads to hypertension, cardiovascular diseases, gall stones, osteoarthritis and diabetes,” he said. Kapil said children from affluent sections were frequenting fast-food joints more often, were engaged in indoor activities like watching television and computer games and doing less physical activity. With affluence, there is a tendency to enhance consumption of costly fatty items and oil.

This led to a positive calorific balance with children eating more calories than they are expending. “Forty to fifty years back, children used to engage in more outdoor activities,” he said.

A large number of children in the study had a high calorific intake and visited fast-food joints. Besides, most of the children had to skip their morning breakfast as they had to leave for schools early. In the school, they would consume oily cafeteria stuff. He said 28 percent of the children visited fast-food joints once a week and 18 percent visited twice a week.

Only 19 percent of all of the children were engaged in outdoor activities-38 percent were entertained through TV, 21 percent through computers, 10 percent by music, and eight percent were engaged in reading.

The study also related obesity with nuclear families stating that 65 percent of the children in the study were from nuclear families. Kapil said in nuclear families there is no dearth of funds which might lead to children spending money on fatty food.

The phenomenon is prevalent in other parts of the world as well. During the past 20 years, the prevalence of obesity among children and adolescents has doubled in the U.S., the study said.

According to the statistics available with the U.S. National Center for Health, nearly 15 percent of adolescents are overweight (when ratio of weight and height is between 25 and 30) or obese (when this ratio is more than 30), it said.

The paper said the maximum prevalence of obesity was found during the pubertal period, between 10 and 12 years. This may be associated with the increase in fat tissues and overall weight gain during the pubertal growth spurt.

Kapil explained that one factor for this may be that children at this age start getting independent pocket money, which they might be spending on fatty eatables in school canteens.

He said the problem was that children were unaware of their nutritional needs, adding that adolescent education programs should be introduced in schools.

NEWS REPORT 2: TACKLING ASIA’S GROWING WAISTLINE

From Jaime FlorCruz

CNN Beijing Bureau Chief

            Sunday, November 2, 2003 TIANJIN, China (CNN)- Acupuncture needles get planted on the flabby frame of Cheng Jian, a 20-year-old student undergoing treatment to cure obesity.

            “The discomfort,” he says, “is nothing compared to the pain of being extremely obese.”

            “People talked behind my back because they hadn’t seen a person as fat as I was,” he tells CNN.

            Cheng is one of the many Chinese and foreign patients who have checked into the Aimin Obesity Reduction Hospital to lose weight and gain self-esteem.

            Twenty-five years of China’s economic boom have brought the good life, sedentary lifestyles and fat-laden food-swelling people’s waistlines.

            “The number of obese youths grows 10 percent every year,” says Aimin hospital director Shi Lidong. “It’s partly because they are spoiled by doting parents and grandparents.”

            Aimin’s doctors offer unconventional treatment. “Acupuncture mainly helps reduce appetite and improve metabolism. But our treatment is holistic.”

            In the virtual fat farm, patients are given meals with carefully counted calories. They are also counseled on how to change eating habits.

            In between meals, they do physical exercises, like running and dance aerobics.

            The fat farm’s solution is basic: eat less, and exercise more. Here, the chubby generation learns how to burn calories and melt the fat away.

            But some weight-watchers still get nightmares while trying to curb their cravings.

“A fellow patient dreamt of eating out with her parents, but they refused to give her food,” says a camper, Wang Ping.

“She shouted in her dream, “why not let me eat!” we were all awakened by her screams.”

            Fat farmers get emotional support and inspiration from graduates like Meng Qinggang, Aimin’s most celebrate success story.

            Meng weighed 215 kilograms (473 pounds) when he sought Aimin’s help three years ago.

            “I used to eat five meal a day. I needed help to put on clothes or walk. I was close to drying,” Meng tells CNN.

            Meng then lost 80 kilos (176 pounds) in 100 days, and slimmed down even more. He now weighs 89 kilos (196 pounds).

            “I can now drink beer and even eat fried, high-calorie food. It’s okay as long as the amount is right,” he says. “And I run regularly.”

STRATEGY Use of statistics to support statements Academic reading that report on significant trends, result of conclusion often use statistics as support. Statistics are “numerical data.” Or “the mathematics of the collection, organization, and interpretation of numerical data,” according to the American Heritage College dictionary (2002, p. 1351). Statistics can provide effective supporting evidence to prove that a statement is true or accurate.

            Reading selection 2 uses the pattern of statement + statistical support. Numerical data may be expressed in numbers, percentages, or words that indicate numbers, like double, tripled, and so on. To understand this pattern, study the example sentences from “More Money, More Obesity in children” below.

            Statement

 In the school, they would consume only cafeteria stuff. He said statistic.

28 percent of children visited fast-food joints once a week and statistic.

18 percent visited twice a week.

The first example sentences states that children ate oily food. The second sentence includes statistics that show a significant percentage of the children frequented fast-food restaurants. These numerical data serve as proof that the children consumed food that may not be healthy.

Steps in the Scientific Method

            The reading selection in Chapter 4 report the findings of research related to obesity and being overweight, a subject of study in nutrition and other health-related disciplines. Reading selection 2 illustrates the scientific method, the steps that scientists use to find answers to questions. Scientific research generally includes the following steps.

·      First, scientists make observations. They observe something significant or interesting that occurs around them.

·      Second, they develop a hypothesis to explain the observations.

·      Third, they create a controlled situation in which to test the hypothesis. Then they test the hypothesis to see if it can explain their observations.

·      After thy complete the test, they report the results and make conclusions.

EXERCISE

COMMUNICATING NUTRITION AROUND THE WORLD

1.       What picture comes to mind when you think of healthful diet? The U.S. Departements of Agriculture (USDA) and Health and Human Services hope you their Food Guide Pyramid.

Since 1992, the Pyramid has served as a visual adaptation of rhe U.S. Dietary Guidelines for Americans, the even basic dietary recommendations to promote wellness and prevent chronic disease. Today, the pyramid can be seen not anly in nutrition education materials for children and adults, but also on grocery bags, food packages and in the media.

2.       Food guides, sucah as the USDA’s Food Guide Pyramid, are tools used to communicate complex scientific information in a consumer friendly to communicate dietary guidance messages that provide population-wide reccommendations for eating to promote health.

A Photographic History

3.       Food guides are not new educational tools. The first United States food guide was developed in 1916 by the USDA and consisted of five food groups-milk and meat; cereals; vegetables and fruits; fats and fat foods; nd sugars and sugar foods. By the 1940 the food guide listed ten food groups, including water and eggs. Vegetables and fruits were split into three individual groups leafy green and yellow vegetables; citrus;, tomato and cobbage; and other vegetables and fruits. Teb food groups were difficult for cunsumers to remember, so these groups were trimmed to four food groups by the late 1950s.

4.       Previous versions of the United State food guide were tools used to promote a diet containing essential vitamins and minerals. School children were often the educational target for the simple illustrations used to depict the optimal diet. One of the most familiar food guides of the past is the “ Basic Four “ , containing four food groups-milk, fruit and vegetable, bread and cereal, and meats groups-which was used nearly 25 years. The emphasis pf the “ Basic Four “ food guide was to help American get a foundation diet, meaning, it was intended to meet only a portion of caloric and nutrient needs.

5.       After the publication of the first Dietary Guidelines for American in 1980, work began on a new food guide graphic to reflect the latest science on the diet and health. In addition to a review of existing research, government agencies conducted extensive quantitative and qualitative research with American consumers to ensure the resulting graphic communicated key dietary guideline concepts. The pyramid design proved most useful in graphically communicating the intended messages across various socioeconomic groups.

6.       No single adaptation of the pyramid graphic can depict all of the eating practices of the diverse American populace. However, because of the simplicity and understandability of the pyramid shape, teh U.S. Food Guide Pyramid can be translated to reflect customs of numerous ethnic and cultural groups within the United States. The pyramid concept has also been adapted to Asian, Mexican, vegetarian and Mediterranean diets by various organizations. For instance, to better serve their state population, the Washington State Departement of  Health created materials using the pyramid shape to depict diets for Russians, Southeast Asians and Native Americans.

7.       The pyramid concept has also been adapted to communicate other health-promoting acivities. For example, a physical activity pyramid, developed by a private organization, promotes waysbstay active in everyday life, and a “ life balance “ pyramid by the same groups offers ideas to build and maintain emotional well-being.

Pictures From Around the World

8.       The use of the pyramid has been very successful in the United States. The pyramid shape appears to easily convey the concept of variety and the relative amounts to eat of the various food groups. However, because of cultural differences in communicating symbolism and other cultural norms, the pyramid is not necessarily the graphic of choice for food guides worldwide.

9.       Yet, despite the different pictorial representations, different countries communicate similar themes. Food guide graphics from countries as diverse as Italy and South Africa convey a common message balance, variety and moderation in food choices.

10.   The wheel or dinner plate design is a popular graphic that represents the total diet, with each section depicting a food group and its relative proportion to the total diet. This design is used in the United Kingdom, Germany and Norway, among other countries.

11.   The larger outer arcs of the rainbow are the grain products and fruits and vegetables. According to Canada’s dietary guidelines, these foods should make up a larger part of a healthy eating plan. Similarly, the smaller inner arcs make up the milk products and meat alternatives that should make up a smaller amount of a healthy eating plan.

12.   Many of the food guides around the world emphasize the bread, cereals and grain foods are the largest part of the diet. Israel has one of few food guides that characterize water as a principal part of the diet.

13.   South Africa’s food guide graphic contains the least number of food groups and organizes foods in a unique way according to the food “function” in the body.

A Picture Paints a Thousand Words

14.   Nutrition education has long proven this idiom to ring true through the use of food models and pictures to depict such things as portion sizes. Likewise, symbols such as a heart, checkmark or apple are often used on restaurant menus to denote choices that meet specific nutrition or health guidelines.

15.   The primary role of food guides, whether in the United States or around the world, is to communicate an optimal diet for overall health of the population.

Key concepts for Dietary Patterns:

·         Total diet, rather than nutrients or individual foods should be addressed.

·         Dietary guidelines need to reflect food patterns rather than numeric nutrient goals.

·         Various dietary patterns can be consistent with good health.

Drawing Plausible Inferences from Reading Just as a scientist can make conclusions from research, a careful reader can draw inferences from reading. An inference is a logical conclusion you can make by using information given to you. In reading, a text may not state a conclusion directly, but it provides information that the reader can use to make a plausible, or likely, conclusion.

Plausible inferences:

·         Some Chinese parents and grandparents use food to spoil their children.

·         Therefore, in some Chinese families, food must be a positive thing, a treat, or a reward to children.

·         Also, the standard of living in China is probably high enough for families to provide children with excess food.