Friday, August 26, 2011

A good reason to eat 6 small-portioned, low glycemic index meals per day that feature high-fiber and low fat:


 

Half of Americans Projected to Be Obese in 2030

By John Gever, Senior Editor, MedPage Today
Published: August 25, 2011
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.
If the current "obesity epidemic" continues unchecked, 50% of the U.S. adult population will be obese -- with body mass index values of 30 or higher -- by 2030, researchers said.

Drawing on data from the National Health and Nutrition Examination Survey (NHANES) series from 1988 to 2008, Y. Claire Wang, MD, of Columbia University's Mailman School of Public Health, and colleagues projected that, compared with 2010, there will be "as many as 65 million more obese adults" in the U.S. by that year.

Obesity prevalence in both men and women in their 40s and 50s would approach 60%, the researchers indicated in the Aug. 27 issue of The Lancet, part of a series of papers on the growing worldwide burden of obesity.


Wang and colleagues also projected that, as a result of the burgeoning obese population, the U.S. will see the following health impacts:
  • 6 to 8.5 million more people with diabetes
  • 5.7 to 7.3 million more cases of heart disease and stroke
  • 490,000 to 670,000 additional cancers
  • 26 to 55 million quality-adjusted life-years lost
The economic burden of these increasing morbidities will be substantial, the researchers indicated -- medical expenditures alone will be higher by $48 to $66 billion annually by 2030, without taking into account lost productivity and other indirect costs associated with a generally sicker population.

Reduced productivity would add another $390 to $580 billion to the annual tab, the researchers said, based on a 2009 study linking obesity to lost work time.
Another country with an aging population and a growing problem with obesity is Great Britain. Wang and colleagues analyzed NHANES-like health data collected in England from 1993 to 2008, finding slightly lower prevalences of obesity relative to the U.S., but similar rates of increase.

If the current trends in England continue, they would project to obesity prevalences in 2030 of about 40% in men and 35% in women.

Both NHANES and the Health Survey for England (HSE) involve interviews and physical exams in more than 10,000 people per iteration. The HSE is repeated annually, while NHANES is conducted over two-year periods. In both programs, the individual participants change from one survey to the next, but they are selected to be sociodemographically representative of the national populations.

Wang and colleagues used epidemiological and outcomes data in the literature to estimate the disease burdens that would result from the growing prevalence of obesity.

They also calculated what would happen if everyone's BMI was 1% lower -- approximately 1 kg (2 lb) in an average adult.

"This change might sound small, but such a scenario would have a substantial effect on consequent health burdens," the researchers wrote.

In the U.S. more than 2 million cases of diabetes, roughly 1.5 million cardiovascular disease diagnoses, and about 100,000 cancers would be avoided, their models showed.
Wang and colleagues acknowledged that their calculations were "mere extrapolations from available data" and that current trends may very well not continue.

"Past trends do not always predict the future," they wrote.

An important finding was the rising burden of obesity among people 60 and older, the researchers emphasized. Of the 65 million additional obese people projected in the U.S. in 2030, 24 million would be in this age range.

This population -- already the sickest and most expensive in terms of medical costs -- is the fastest-growing in the U.S. and Britain. Therefore, the overall disease burden and economic effects of obesity may be magnified.

In addition to their caveat about extrapolating trends into the future, Wang and colleagues cited other limitations to the study: methodological issues related to the NHANES and HSE surveys; uncertainties in the relationships between obesity, other diseases, and economic impacts; and the study's 20-year timeframe, which may underestimate future impacts of pediatric obesity.
The study was supported by the National Collaborative on Childhood Obesity Research, which coordinates childhood obesity research across the National Institutes of Health, the CDC, the Department of Agriculture, and the Robert Wood Johnson Foundation.
Study authors declared they had no relevant financial interests

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