Pacific Cohort Studies Collaboration: The burden of overweight and obesity in the Asia-Pacific region
ABSTRACT The rise in the prevalence of overweight and obesity (body mass index ≥25 kg m−2) is, in part, a negative consequence of the increasing economic developments of many lower- and middle-income countries in the Asia–Pacific region. To date, there has been no systematic quantification of the scale of the problem in countries of this region. From the most recent nationally representative estimates for the prevalence of overweight and obesity in 14 countries of the region, it is apparent that overweight and obesity is endemic in much of the region, prevalence ranging from less than 5% in India to 60% in Australia. Moreover, although the prevalence in China is a third of that in Australia, the increase in prevalence in China over the last 20 years was 400% compared with 20% in Australia. In addition, across various countries in the region, the population attributable fractions because of overweight and obesity ranged from 0.8% to 9.2% for coronary heart disease mortality, 0.2% to 2.9% for haemorrhagic stroke mortality, and 0.9% to 10.2% for ischaemic stroke mortality. These results indicate that consequences of overweight and obesity for health and the economy of many of these countries are likely to increase in coming years.
- SourceAvailable from: Aoife M Ryan
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- "Of fourteen countries studied by the Asian Pacific Cohort Studies Collaboration (APCSC), Australia presented the highest prevalence of overweight (39%) and obesity (21%) . Over the last twenty years, the prevalence of overweight and obesity in China increased by almost 400% . Obesity is diagnosed using body mass index (BMI): weight in kilograms divided by height in meters squared. "
ABSTRACT: Rates of distal and junctional adenocarcinomas are increasing in Western countries. Systematic review of epidemiological evidence linking obesity to esophageal adenocarcinoma (EA) was performed for studies published from 2005 to 2010. The current understanding of obesity's role in the etiology and potential dysplastic progression of Barrett's esophagus (BE) to EA is reviewed. Accumulating epidemiological studies provide evidence of obesity's role as a driving force behind the increasing rates of EA. The simplest construct is that obesity promotes reflux, causing chronic inflammation and BE, predisposing to adenocarcinoma. However, as obesity is positively associated with the prevalence of many cancers, other mechanisms are important. A link may exist between fat distribution patterns and the risk of BE and EA. Altered metabolic profiles in the metabolic syndrome (MetS) may be a key factor in cell cycle/genetic abnormalities that mark the progression of BE towards cancer. Research highlighting a unique role of MetS in the length of BE, and its association with systemic inflammation and insulin resistance is discussed, as well as adipokine receptor expression in both BE and esophageal epithelium, and how MetS and the systemic response impacts on key regulators of inflammation and tumorigenesis. CONCLUSIONS/IMPACT: Obesity is positively associated with EA. The systemic inflammatory state consequent on the altered metabolism of obese patients, and the associated impact of adipocytokines and pro-coagulant factors released by adipocytes in central fat, may underlie obesity's relationship to this cancer. Novel therapeutic agents that may antagonize adipo-cytokines and potentially offer a promising role in cancer therapy are discussed.04/2011; 35(4):309-19. DOI:10.1016/j.canep.2011.03.001
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ABSTRACT: There has been an increase in the concern about preventing type 2 diabetes mellitus (T2DM), a disease with great and increasing prevalence. The prevalence of obesity, physical inactivity, Western processed diet, important risk factors for the development of T2DM, are also rising. Free fatty acids are increased in obesity and reduce insulin clearance and increase hepatic glucose production. Implementation of a healthy lifestyle has been show to slow the progression of impaired glucose tolerance to T2DM. Orlistat is an inhibitor of lipase activity, with proved efficacy in body weight reduction and long-term management of obesity and more favorable effects on carbohydrate metabolism and it was prospectively shown in XENDOS study that orlistat promoted long-term weight loss and prevented T2DM onset in obese individuals with normal and impaired glucose tolerance at baseline over four years. This benefit could be associated to the weight loss itself, to the limited absorption of lipids and reduction of plasma free fatty acids, to increased production of incretins or to modulation of secretion of cytokines by adipocytes, all effects secondary to orlistat treatment. A proposed strategy is to identify subjects at highest risk to receive a drug intervention, using lifestyle interventions alone at the community level.Vascular Health and Risk Management 02/2008; 4(2):325-36.
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ABSTRACT: Polycystic ovary syndrome (PCOS) is a complex, multifaceted, heterogeneous disorder that affects approximately 5 to 10% of women of reproductive age. It is characterized by hyperandrogenism, polycystic ovaries, and chronic anovulation along with insulin resistance, hyperinsulinemia, abdominal obesity, hypertension, and dyslipidemia as frequent metabolic traits (metabolic syndrome) that culminate in serious long-term consequences such as type 2 diabetes mellitus, endometrial hyperplasia, and coronary artery disease. It is one of the most common causes of anovulatory infertility. However, the heterogeneous clinical features of PCOS may change throughout the life span, starting from adolescence to postmenopausal age, largely influenced by obesity and metabolic alterations, and the phenotype of women with PCOS is variable, depending on the ethnic background. The etiology of PCOS is yet to be elucidated; however, it is believed that in utero fetal programming may have a significant role in the development of PCOS phenotype in adult life. Though a woman may be genetically predisposed to developing PCOS, it is only the interaction of environmental factors (obesity) with the genetic factors that results in the characteristic metabolic and menstrual disturbances and the final expression of the PCOS phenotype. Irrespective of geographic locations, a rapidly increasing prevalence of polycystic ovarian insulin resistance syndrome, excess body fat, adverse body fat patterning, hypertriglyceridemia, and obesity-related disease, such as diabetes and cardiovascular disease, have been reported in Asian Indians, suggesting that primary prevention strategies should be initiated early in this ethnic group. In lieu of the epidemic increase in the prevalence of obesity and diabetes mellitus in most industrialized countries including China and India owing to Westernization, urbanization, and mechanization, and evidence suggesting a pathogenetic role of obesity in the development of PCOS and related infertility, active intervention to combat the malice of these disorders is warranted. Pharmacologic therapy is a critical step in the management of patients with metabolic syndrome when lifestyle modifications fail to achieve the therapeutic goals, and studies in China and India have proved to be effective.Seminars in Reproductive Medicine 02/2008; 26(1):22-34. DOI:10.1055/s-2007-992921 · 3.00 Impact Factor