Keterangan
Obesity and malnutrition coexist as global health challenges, affecting individuals across different socioeconomic backgrounds. While obesity results from excessive calorie intake, malnutrition can occur due to nutrient deficiencies, even in overweight individuals. Poor dietary choices, lack of essential micronutrients, and imbalanced meals contribute to both conditions. Addressing these issues requires a holistic approach, including proper nutrition education, lifestyle modifications, and access to healthy food options. Integrating preventive strategies can help combat the paradox of obesity-related malnutrition and promote overall well-being.
Ringkasan
- Obesity, defined by the WHO as abnormal or excessive fat accumulation impairing health, is a global issue affecting over 2.5 billion overweight and 890 million obese individuals, including 37 million children under five. This multifactorial disease stems from a chronic positive energy balance, costing the global economy approximately $2 trillion annually. Projections indicate a concerning rise in obesity rates worldwide.
- Malnutrition extends beyond underweight individuals, encompassing disease-related malnutrition, sarcopenia (muscle loss), and age-related weakness. Sarcopenia, a common age-related decline in muscle mass and strength, is particularly concerning. Malnutrition, including sarcopenia, is often overlooked in obese individuals due to their high BMI but can decrease immunity and affect COVID outcome.
- BMI, calculated as weight by height squared, is a common assessment tool, but does not seek on body composition. Asian cutoffs differ from global standards. Waist circumference, especially important for Asians, is used in conjunction with BMI to assess abdominal obesity and associated health risks. Obese individuals can be malnourished due to increased fat percentage and low muscle mass and have insulin resistance and increased adipose tissues.
- Metabolic syndrome (MS), linked to obesity, involves abdominal obesity, hyperglycemia, high triglycerides, elevated blood pressure, and reduced HDL. Any combination of three or more of these increases the risk of type 2 diabetes and heart disease. Obesity contributes to numerous non-communicable diseases, highlighting the importance of weight management.
- The causes of obesity include consumption of energy dense foods, insufficient physical activity, stress, medications, genetic factors, environmental factors, and medical conditions like PCOS. Weight gain significantly increases the risk of diabetes, particularly among South Asians, due to increased insulin resistance.
- Assessment of malnutrition and muscle loss involves BMI, calf circumference, mid-arm circumference, and nutrition-focused physical examinations, even when body composition techniques are unavailable. Various muscle function tests are important to conduct such as hand grip strength, sit stand test and balance test, but can be limited.
- Management of obese patients begins with lifestyle modifications, including dietary changes and increased physical activity. Dietary approaches include low-calorie, low-fat, and low-carbohydrate diets, with some studies indicating benefits from the Atkins diet. Structured meal plans, including meal replacements, can enhance weight control.
- Very low-calorie diets, like those used in the DIRECT trial, have shown impactful results in weight loss and diabetes remission. Protein intake is crucial for obese patients with sarcopenia, with guidelines recommending up to 2 grams per kg body weight for critically ill patients. The distribution of protein throughout the day and the choice of protein source are critical for maximizing muscle protein synthesis, with whey protein being superior to casein and soy.
Contoh Sertifikat
Tentang Pembicara
Dr. Daphnee D K, Ph.D. RD
Chief Clinical Dietitian, Head, Dept of Dietetics, Apollo Hospitals, Chennai
Pengungkapan Keuangan
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