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Sanofi Aventis fast facts-obesity, diabetes and heart disease
Article Type: Food facts From: Nutrition
Obesity is a complex, chronic condition that can only be managed effectively through lifelong care. It must be recognised as a chronic condition requiring long-term management including pharmacologic intervention where appropriate. Like any chronic condition, such as diabetes or hypertension, obesity worsens when medications are withdrawn. If it is not treated for the duration of the patient's life, obesity re-emerges as a potent comorbid risk factor for disability or premature death.
Obesity is a major contributor to heart disease affecting more than one in five adults in the UK, 3 this equates to over 12 million people. 4 Almost two in five adults in the UK are overweight. Globally, more than 1 billion adults are overweight, and at least 300 million of these are clinically obese. Obesity in England has more than trebled in the last two decades. The total economic cost of obesity and overweight has been estimated at up to £7.4 billion per year. The cost to the NHS of treating diseases attributable to obesity and overweight is estimated at £3.2 billion per year. Throughout the UK, there is a trend towards increased prevalence of obesity with increasing deprivation.
In recent years, it has become increasingly clear that the distribution of fat is important when considering the risks of obesity. Obesity is typically measured by body mass index (BMI); however, recent findings have shown that abdominal obesity is a much better predictor of heart attack than weight or BMI. Among people who are overweight or obese, it is those with excess fat around their abdomen who are at the greatest risk of developing type 2 diabetes and heart disease. Nearly a quarter of abdominally obese patients have at least two additional risk factors. This excess high risk fat produces chemicals that can cause an imbalance of substances that regulate the breakdown of fats (lipids) and sugar (glucose). This imbalance is thought to increase the risk of developing significant health problems such as insulin resistance, high blood pressure, high blood sugar, cholesterol imbalance and high levels of triglycerides, and thereby potentially placing them at an even higher risk of developing type 2 diabetes and heart disease.
The key indicator of abdominal obesity is a waist circumference of more than 35 inches (88cm) in women and 40 inches (102cm) in men. A waist circumference of more than 35 inches (88cm) in women and 40 inches (102cm) in men indicates the greatest risk for developing cardiovascular disease (CVD) and type 2 diabetes. A waist circumference of 31.5 inches (80cm) in women and of 37 inches (94cm) in men indicates an increased risk. Abdominal obesity is a major contributory factor for some of the commonest causes of death and disability in developed economies, most notably higher rates of type 2 diabetes and accelerated onset of CVD. Abdominal obesity is more prevalent in men and women in manual work compared with those in managerial and professional employment. South Asian ethnic groups are more likely to be abdominal obese and have associated health problems such as heart disease and diabetes, compared with Europeans. In the UK, 29 per cent of men and 26 per cent of women are abdominally obese.
More than two million people in the UK have diagnosed diabetes and it is suspected that a further 750,000 people are unaware that they have diabetes.
Type 2 diabetes is the most common of the two main types of diabetes and accounts for between 85 and 95 per cent of all people with the condition. The risk of developing type 2 diabetes increases linearly with increasing waist Circumference. Being abdominally obese doubles the risk of developing type 2 diabetes. Type 2 diabetes usually appears in people over the age of 40, though in South Asian and African-Caribbean people it often appears after the age of 25.The cost to the NHS of treating diabetes is £700 million, with £530 million of that directly attributable to obesity. Forty seven per cent of type 2 diabetes cases in England can be directly attributed to obesity.
The National Service Framework for diabetes, published in 2003, outlines clinical targets for reducing the impact of diabetes, including improving blood glucose control and reducing cholesterol levels in people with diabetes.
Heart and circulatory disease is the UK's biggest killer. In 2004, CVD caused 37 per cent of deaths in the UK, and killed just over 216,000 people. Only one in four women recognise that coronary heart disease (CHD) is the single biggest threat to their life expectancy. In 2001 CHD claimed the lives of over 50,000 women in the UK more than four times that of breast cancer. In 1998, approximately 28,000 people in England suffered a heart attack that was directly attributable to obesity. The cost to the NHS of treating heart disease (hypertension, myocardial infarction and angina pectoris) attributable to obesity, has been estimated at £261.7 million. The Government is committed to reducing the death rate of CHD and related diseases in people under 75 by at least 40 per cent by 2010.
The National Service Framework for CHD, published in 2000, set out a strategy to modernise CHD services over 10 years. It details 12 standards for improved prevention, diagnosis, treatment, rehabilitation and goals to secure fair access to high quality service.