The wide ranging negative impacts of obesity in women have been well documented. Compared with women whose Body Mass Index falls within the accepted parameters, those whose waistlines exceed the accepted BMI are at specific risk, especially, during pregnancy. Also, of concern are risks faced by women in midlife which include diabetes, disrupting the hormone reproductive system and cancer. As the numbers of women who fall victim to these diseases continue to rise, health officials are now taking a serious look at the root causes and how these deadly non communicable diseases in women can be reduced. Studies have revealed, often the key lies in following simple rules, such as, daily exercises, healthy diets and abstaining from leading sedentary lifestyles.
The Sunday Observer spoke to Family Physician, Ministry of Health, Dr Ramya L.Premaratne to find some answers and learn about the latest interventions by the Health Ministry to promote healthy lifestyle in women.
Q. Globally, nearly 300 million are said to be obese. Medically speaking what does obesity signify?
A. Obesity is a medical condition where a person has accumulated so much body fat that it might have a negative effect on their health.
It is a leading, preventable cause of death, worldwide. Authorities view it as one of the most serious public health problems of the 21st century.
Q. What causes obesity? Are the causes the same for men and women?
A. Obesity is commonly caused by a combination of excessive food intake, lack of physical activity, and genetic susceptibility, endocrine disorders, medications, or mental disorders. The causes are the same for both men and women.
Q. In the US 2 out of 3 women are said to be obese. What is the prevailing figure among Lankan women?
A. About 46 percent of women are obese in Sri Lanka.
Q. What are the negative impacts of obesity on one’s health?
A. Some of the co-morbidities related to overweight and obesity include Type 2 diabetes, hypertension, stroke, coronary artery disease, congestive heart failure, asthma, chronic back pain, osteoarthritis, cancers (cancers of breast, endometrial, ovarian, colorectal, esophageal, kidney, pancreatic, prostate), pulmonary embolism, gallbladder disease, and also an increased risk of disability. All this leads to more than three million deaths worldwide, annually.
Q. Is there a link of obesity to non-communicable diseases?
A. Yes, obesity, is characterized by having a body-mass index above 30 kg.m2, and described as a Non-Communicable Disease risk factor.
Among various risk factors responsible for the development of NCDs, obesity related Non-communicable diseases (NCDs) lead to millions of deaths all around the world.
Q. What about thyroid problems? Is there a connection?
A. The thyroid gland produces three hormones: Thyroxine (T4), Triiodothyronine (T3) and Calcitonin. These hormones play a significant role in your metabolism and in energy regulation in the body.
Q. A lot of junk food is now being consumed along with sweetened drinks. How closely associated is poor diet to obesity, especially, when they are pregnant.
A. Eating a high fat and high sugar diet when pregnant leads to metabolic impairments in both, the mother and her unborn child.
Metabolic dysfunction in the mother compromises the flow of nutrients to the foetus, altering its growth and metabolism during its development.
It explains why babies of mothers who are obese or eat fatty foods and high sugar diets during pregnancy have a tendency to develop conditions such as obesity, hypertension and type 2 diabetes as adults.
Excessive consumption of sugar and fat compromised the mother’s glucose tolerance and her sensitivity to insulin – the hormone that controls blood sugar levels. By contrast, the sensitivity of the maternal liver to insulin was increased, which reduces glucose production during pregnancy.
As a result, the mother was unable adequately to control glucose levels or produce enough glucose to support the pregnancy. Also, children born to mothers who ate fatty food during pregnancy suffer from more immune diseases and allergies. A high-fat diet damages cells in the foetal liver, which can affect the child’s immune system in later life.
Q. Obese mothers also put their babies at risk. I read that babes born to obese mothers have a higher risk of developing asthma and around 30% are likely to have chest associated problems.
Do you agree?
A. Yes, maternal obesity entails risk factors for early childhood asthma. Obesity is common among women of childbearing age. Intrauterine exposure to maternal obesity or gestational weight gain may influence the development of asthma in early childhood.
Q. A new study has emerged that obese mothers also put their babies at risk of developing Autism, true or false?
A. Yes, it is true.Women who are overweight when pregnant increase their risk of having a child who is later diagnosed with Autism.
Q. How do you know if you are obese? Is there an ideal weight like a measurement chart?
A. Yes, people are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight by the square of the person’s height, is over 30 kg/m2, with the range 25–30 kg/m2 defined as overweight.
Q. A study from the University of Manchester has said that there is evidence, that obese mothers are more likely to have babies with larger thigh and arm bones and bigger head circumferences. What is the Sri Lankan evidence on this?
A. A case study in Sri Lanka, found that obese mothers tend to have babies with larger thighs and arm bones and bigger head circumference.The children born to obese mothers had a higher risk of being overweight /obese at preschool age even after controlling other factors.
Q. When do you think a woman should start learning about the adverse effects of obesity?
A. Women, who are in child bearing age, themselves must make their health a top priority and take steps towards eating a well-balanced nutritious diet, getting regular physical activity as well as routine checkups and screening exams.
Q. What are the interventions to prevent obesity in women by the Health Ministry?
A. Health Ministry has conducted studies aimed at assessing the association between high carbohydrate diet, physical inactivity and central obesity among premenopausal housewives in Sri Lanka and revealed that high carbohydrate diet and physical inactivity are possible explanations for the high prevalence of central obesity.
This study was conducted as a cross-sectional study. A sample of 100 premenopausal women with home duties, aged between 20 to 45 were selected randomly from two Divisional Secretariats (DS), representing urban and rural sectors in Sri Lanka. Data on basic characteristics, anthropometric measurements, dietary assessment and physical activity were collected.
The Ministry of Health has implemented effective specific public health interventions at household level to reverse this trend among housewives in Sri Lanka.
Q. What are the gaps you see in the system?
A. It is widely accepted that the obesity epidemic in Sri Lanka is partly due to unhealthy dietary habits. The Sri Lankan population mainly depends on cereal-based diets that lack dietary diversity. Based on recent research findings, the average daily serving size of starch consumption among Sri Lankan women exceeded the recommended level.
Q. Your word of advice to women on how to prevent obesity.
A. Eat five to six servings of fruits and vegetables daily. Choose whole grain foods such as, brown rice and whole wheat bread. Avoid highly processed foods made with refined white sugar, flour and saturated fat.
Weigh and measure food to gain an understanding of portion sizes. (Eating more calories than you burn for energy will lead to weight gain.) Weigh yourself regularly. Avoid foods that are high in “energy density” or that with a lot of calories.
Involve in at least 30 - 45 minutes moderate-intensive activity or walk, or weeding the garden, sweeping, preferably, all days of the week. Make opportunities during the day for even 10 or 15 minutes of some calorie-burning activity, such as, walking around the block or up and down a few stairs at work.