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Obesity in rwanda

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By Christian Mazimpaka …

By Christian Mazimpaka
NUR/RWANDA/FACULTY OF MEDICINE

Published in: Health & Medicine, Business

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  • Benefits of regular physical activity in obese persons Regular physical activity is an important component of any weight loss program because it is associated with long-term weight maintenance and has beneficial health effects, such as decreasing coronary heart disease and diabetes, that are independent of weight loss itself. The important physiological and clinical issues regarding the use of physical activity as part of obesity therapy will be reviewed in this section.
  • Physical activity helps preserve fat-free mass during weight loss Approximately 75% of weight that is lost by dieting is composed of fat and 25% is fat-free mass (FFM) [1]. Adding a physical activity program to dietary therapy can affect the composition of weight loss. Two meta-analyses that pooled data from 46 [1] and 28 [2] published trials found that exercise can attenuate the loss of FFM. In subjects with a mean weight loss of 10 kg, regular exercise decreased the percentage of weight lost as FFM by half, from approximately 28% to 13% in men and from 24% to 11% in women ( P <0.05). However, this large difference in percentage of weight lost as FFM represented only a small (approximately 1 kg) difference in the absolute amount of FFM lost between groups. Moreover, conservation of FFM does not necessarily represent conservation of muscle protein; the greater retention of FFM associated with exercise may be related to increased retention of body water and muscle glycogen. It is not known whether performing resistance exercise while dieting leads to greater conservation of FFM than performing endurance exercise because of limited and conflicting data [3,4]. Ballor DL, Poehlman ET. Exercise-training enhances fat-free mass preservation during diet-induced weight loss: a meta-analytical finding. Int J Obes Relat Metab Disord 1994;18:35-40. Garrow JS, Summerbell CD. Meta-analysis: effect of exercise, with or without dieting, on the body composition of overweight subjects. Eur J Clin Nutr 1995;49:1-10. Wadden TA, Vogt RA, Anderson RE, et al. Exercise in the treatment of obesity: effects of four interventions on body composition, resting energy expenditure, appetite and mood. J Consult Clin Psychol 1997;65:269-277. Geliebter A, Maher MM, Gerace L, et al. Effects of strength or aerobic training on body composition, resting metabolic rate, and peak oxygen consumption in obese dieting subjects. Am J Clin Nutr 1997;66:557-563.
  • Five steps to facilitate behavior change Five steps that clinical practitioners can take to facilitate behavior changes in their patients are: 1. Identify the specific behavior change that is desired. 2. Review when, where, and how the new behaviors will be performed. 3. Instruct the patient to keep a record of the behavior change. 4. Review the patient’s progress at each treatment visit. 5. Congratulate the patient on successes that have been achieved, but do not criticize failures. Criticism may cause embarrassment and a loss of self-esteem, which may make it uncomfortable for the patient to continue treatment. Wadden TA, Foster GD. Behavioral treatment of obesity. Med Clin North Am 2000;84:441-461.
  • Five steps to facilitate behavior change Five steps that clinical practitioners can take to facilitate behavior changes in their patients are: 1. Identify the specific behavior change that is desired. 2. Review when, where, and how the new behaviors will be performed. 3. Instruct the patient to keep a record of the behavior change. 4. Review the patient’s progress at each treatment visit. 5. Congratulate the patient on successes that have been achieved, but do not criticize failures. Criticism may cause embarrassment and a loss of self-esteem, which may make it uncomfortable for the patient to continue treatment. Wadden TA, Foster GD. Behavioral treatment of obesity. Med Clin North Am 2000;84:441-461.
  • Transcript

    • 1. OBESITY IN RWANDA 1
    • 2. Case presentation Sara ,32 years old Rwandan female Divorced with 2 children Works as a general secretary in a district hospital
    • 3. Measurements Height:1,72 meters Weight:110kgs BMI:37 Initial BP:146/94
    • 4. Laboratory Glucose: 130mg/dl(fasting) LDL:130 HDL:36 TG:198 Total cholesterol:149
    • 5. Clinical course Physician educated her about basic nutrition, exercise tips and diabetes Patient motivated to decrease weight when she understood that all of her medical problems could possible be resolved by weight loss.
    • 6. Monthly summary progress Month weight BP Notes 1 110 146/94 2 100 138/90 Feeling motivated, taking stairs at work, feels healthier and report having more energy 3 91 125/80 Patient continues to be motivated, do well 4 85 128/80 Patients blood sugar improving.
    • 7. DISCUSSION
    • 8. OBESITY
    • 9. Obesity is defined as excess of adipose tissue that impartsHealth risk ,It means too much of body fat.
    • 10. BMIMost widely used method to evaluate obesity is BMI.Which is equal to weight in kg by height in square meter i.e., wt/(ht)2.For a healthy individual BMI value ranges from 18- 25.
    • 11. BMI Classification  Normal 18.5 - 24.9  Overweight 25.0 - 29.9  Obesity  I 30.0 - 34.9  II 35.0 - 39.9  III > 40.0
    • 12. Global Health burden of obesity The latest WHO projections indicate that at least one in three of the worlds adult population is overweight and almost one in 10 is obese. Additionally there are over 20 million children under age five who are overweight.
    • 13. Global Health burden of obesity Overweight and obesity are important clinical and public health burdens worldwide. WHO recommends that national programs for prevention and treatment of overweight, obesity and related comorbidities and mortalities should be a public health priority
    • 14. What are Health consequences ofObesity?
    • 15. Obesity Virtually Guarantees BadHealthDiseases Tied to Obesity Hypertension  Some cancers Type 2 diabetes  Osteoarthritis High lipids  Stroke Cardiovascular disease  Respiratory disease Gallbladder disease etc..
    • 16. The good news is that overweight and obesityare largely preventable.What Are the secrets?
    • 17. Regular Physical Activity is the key. Improves maintenance of weight loss Improves cardiovascular and other health risks
    • 18.  When one walks on the streets of Kigali, you see an increased number of obese people. The thought that first comes to your mind is “These people should start exercising.” But then, after seeing people exercise and stay the same, the question comes whether exercise alone really helps in losing the extra and unwanted kilos.
    • 19. Exercises alone do not help much. 35 Men 30Loss of Fat-Free Mass(% Total Weight Loss) Women 25 20 15 10 5 0 Exercises Exercises plus Diet
    • 20.  To be clear! Regular physical activity is very good to keep healthy. But when it comes to weight loss, exercise alone won’t help. It will be effective if coupled with a sensible diet.
    • 21. What is the situation in ourcountry? A survey done in Rwanda and published in 2005 by the WHO showed that among women 15 to 49 years old who had given birth, 12.5% were overweight (with a body mass index of 25kg/m2 and be-yond), with 1.3% being obese (with a body mass index of 30kg/m2 and beyond).
    • 22. Survey Year(s): 2000.Survey Population: national, both urban and rural women who havegiven birth from 2000 to 2005
    • 23. Growing tendency of obesity inRwanda Many people especially in Africa are found of being fat. In Rwanda, fatness is associated with financial ability and as it is a country which is rapidly developing ,obesity tend also to increase. However, being obese is a risk to health!
    • 24. Causes of obesity in Rwanda Increase of beverages and food from industries in public service venues Fear of loosing weight Insufficient physical education in school Genetic factors Lack of education
    • 25. Challenges and barriers faced in Rwandaregarding obesity Lifestyle changes Cultural behaviours Poverty Urbanization
    • 26. What measures can the governement take to reduce obesity?1 The government Should Increase and improve Availability of Healthier Food in Public Service Venues. The government Should Increase Opportunities for 2 Extracurricular Physical Activity. The government Should Increase Physical 3 Education in Schools.
    • 27. Our Responsibility  Educate ourselves on available options for obese clients.  Make sure patients are aware of the risks involved.
    • 28. What can our community and individuals do to reduce obesity? Discourage consumption of sugar1 sweetened beverages Increase support for breast feeding 2 Participate in community coalitions or partnership to3 address obesity 4 Enhance walking for short distance
    • 29. Summary Obesity in itself is preventable but it cannot be managed solely at the individual level.Communities,governments and medical proffessionals need to work together to modify the environment so that it is less conductive to weight gain.
    • 30. Remember!Exercises Healthier diet
    • 31. References http://www.who.int/topics/obesity/en/ http://health.einnews.com/news/rwanda-dieting-obesity-weight-co http://www.globalhealthfacts.org/data/topic/map.aspx?ind=50 http://ubuzimabwacu.com/tag/rwanda-obesity/ www.afro.who.int/index.php?option country-bmi.findthedata.org/d/g/
    • 32. THANK YOU VERY MUCH!MURAKOZE CANE!
    • 33. QUESTIONS? 33

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