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1
PROJECT REPORT
SURVEY OF DIFFERENT FACTORS CAUSING OBESITY &
PREVALENCE OF DIFFERENT RELATED DISEASES IN
OBESE PEOPLE
DE...
2
Abstract
Obesity is the medical condition in which excess of body fats are accumulated. An obese person
has the increase...
3
Most common cause of obesity is excessive intake of food or consuming too many calories.
People eat too much than they u...
4
As already mentioned, obesity is defined by BMI, according to the definitions established by
WHO in 1997 and published i...
5
Table 1: Number of affected individuals with respect to different age groups and gender
Fig 1: Percentage of obese peopl...
6
iv) A compete diet plan of subjects was asked to check the impact of different food stuff
on weight gain of that subject...
7
Fig 2: Number of obese individuals with respect to different casts.
Following are the results with respect to different ...
8
Following are the results on the basis of fluctuation in weight.
Sr.
no.
Fluctuation in
weight
No. of
subjects
Percentag...
9
Fig 5: Factors causing the obesity
Following are the results of no of obese due to the interaction between genetic and
e...
10
Fig 6: Genetic & Environmental factors causing obesity
Following are the results of no of obese due to the environmenta...
11
Fig 7: Environmental factors causing obesity
Following are the results showing prevalence of different obesity related ...
12
12 Headache 31 63.26% 21 42.85%
13 Dyspnea 24 48.97% 25 51.02%
14
Stress urinary
incontinence
11 22.44% 38 77.55%
15 Os...
13
Since obesity is a multifactorial disorder, main focus of survey was to interpret the factors
causing obesity in a part...
14
samosas, French fries also reported to be taken by some people. Some used to take sweets once
in a week. Among salty sn...
15
References
1. World Health Organization. The world health report 2000: health systems: improving
performance. World Hea...
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Survey of Different Factors Causing Obesity & Prevalence of Different Related Diseases in Obese People

Survey of Different Factors Causing Obesity & Prevalence of Different Related Diseases in Obese People

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Survey of Different Factors Causing Obesity & Prevalence of Different Related Diseases in Obese People

  1. 1. 1 PROJECT REPORT SURVEY OF DIFFERENT FACTORS CAUSING OBESITY & PREVALENCE OF DIFFERENT RELATED DISEASES IN OBESE PEOPLE DEPARTMENT OF MICROBIOLOGY AND MOLECULAR GENETICS
  2. 2. 2 Abstract Obesity is the medical condition in which excess of body fats are accumulated. An obese person has the increased chances of reduced life expectancy and several other health problems. Obesity is a multifactorial disorder and besides genetic factors, other factors that cause obesity are environmental factors. Environmental factors that cause obesity are Dietary habits, sedentary life style, sleeping habits, Lack of physical activities, medication and psychiatric illness. In this study, a brief survey was conducted to understand different factors causing obesity and prevalence of different diseases associated among 49 obese population of Punjab, Pakistan. In majority of cases (57.14%), obesity was due to the interaction between genetic and environmental factors. Large proportion of people (42.86%) was obese due to environmental factors only. However, none of the cases were observed where only genetic factors were causing obesity alone. Introduction Obesity refers to medical disorder in which excess of body fats are accumulated. The extra body fats are responsible for serious health problems. An obese person has reduced life expectancy and several other problems. A person may be considered obese if he/she has body weight 20% more than normal or if his/her BMI (body mass index), which is obtained by dividing his/her weight in kilogram by square of height in meters [1] BMI = mass (kg) (Height in m) 2 Obesity turns out to be major health issue during 21st century, with increasing prevalence in children and adults. According to WHO ( World Health Organization) , in 2005 about 1.6 billion adults over 15+ age were obese and at least 20 million children under 5 years were overweight. Obesity is responsible for increased risks of many diseases among which most common are Coronary heart diseases, type II diabetes, cancers, hypertension or High blood pressure. It may also result in high blood cholesterol levels, sleep apnea, osteoarthritis etc. such diseases remarkably decrease life expectancy in obese people. [2]
  3. 3. 3 Most common cause of obesity is excessive intake of food or consuming too many calories. People eat too much than they used to and this trend is spreading worldwide. According to the obesity society, in 1980, 14% of adult population in USA was obese and by 2000, figure reached 31%. Most of this extra food energy comes from increased consumption of carbohydrates [3] such as sweetened beverages and potato chips [4] . Sweetened beverages consumption is the leading cause of obesity among adults. Increased Fast food consumption has also been associated with increase in obesity. Lack of physical activities and leading sedentary life styles is also a major cause of obesity. With increasing facilities of modern convenience devices like washing machines, dishwashers, automobiles as well as Television and computers, majority of people have a sedentary life style. As a result of limited movements and activities, fewer calories burn and it also affects activity of certain enzymes dealing with food. For instance, physical activities keep level of insulin balanced in the body. With lack of physical activities, unstable levels of insulin result in weight gain. Very few cases are caused by genes, medications and psychiatric illness. A little evidence supports the cases where some obese people eat very little but due to slow metabolism, they gain weight. Some cases of obesity may result from interplay between genes and environmental factors. Different genes are involved in controlling the appetite and metabolism in body. Polymorphisms in such genes result in predisposition to obesity when there is sufficient intake of food energy as well. People carrying two copies of FTO gene (Fat mass and obesity associated gene) have increased risk of obesity. [5] Obesity may also be aggravated by insufficient sleep and several medications specially antipsychotics. The risk of obesity is greater in patients with psychiatric illness. Insufficient sleep results in hormonal changes that increase appetite. Also it is associated with leptin deficiency in body. Smoking also has a major role in weight gain. Since smoking suppresses appetite, decreased smoking rate increases risk of obesity. Men who quit smoking gain weight of about 4.4 kg while women gain weight of about 5 kg [6] . However, little effect has been reported by changing rates of smoking on obesity.
  4. 4. 4 As already mentioned, obesity is defined by BMI, according to the definitions established by WHO in 1997 and published in 2000, the values are listed in table below [1] . BMI (kg/m2 ) Classification <18 underweight 18.5-24.9 Normal weight 25-29.9 Over weight 30-34.9 Class I obesity 35-39.9 Class II obesity >40 Class III obesity Abnormally high body weight and excess of fats is associated with life threatening diseases. Obesity is responsible for increased mortality rates. On average obesity has been found to reduce life expectancy by 6-7 years. BMI (body mass index) of about 30-35 kg/m2 reduces by 2-4 years whereas severe obesity (BMI >40 kg/m2 ) has reduced life expectancy by at least ten years. [7] Obesity associated morbidity is also of major concern. This includes combination of medical disorders including Hypertension, diabetes mellitus type 2 and high cholesterol levels [8] . Such disorders may be directly caused by obesity or otherwise result from related common cause such as poor diet and lack of physical activities. The strongest link of obesity is with type 2 diabetes. Increase in body fats result in insulin resistance, hence body does not response normally to insulin. Materials The survey included 49 human subjects as sample having BMI greater than 30 kg/m2 and data was kept confidential. Out of these 49 subjects, 14 were males and 35 were females.
  5. 5. 5 Table 1: Number of affected individuals with respect to different age groups and gender Fig 1: Percentage of obese people with respect to different age groups Methods i) The questionnaire made for this activity contains basic information of subjects like age, height, weight, sex, cast, occupation, marital status and smoking habits etc. ii) After that the complete medical history including surgery of every subject was taken in order to estimate risks of different diseases to occur in obese population. iii) The next major concern was to know about the family history of the subjects to evaluate the genetic pattern of obesity. Age group Males females Total <10 years 1 - 1 11-20 years 3 3 6 21-30 years 6 13 19 31-40 years 1 6 7 41-50 years 2 6 8 >50 years 1 7 8 14 35 49 2% 12% 39% 14% 17% 16% Percentage of obese people with respect to different age groups <10 years age 11-20 21-30 31-40 41-50 >50
  6. 6. 6 iv) A compete diet plan of subjects was asked to check the impact of different food stuff on weight gain of that subject. v) Then psychiatric history was taken which includes questions about bulimia, anorexia, depression and schizophrenia etc. vi) The exercise also plays important role for obtaining healthy weight, so exercise history was taken too. vii) Sedentary life style and sleeping habits of subject were asked at last. viii) The results were concluded by considering all these areas, percentages were calculated to make tables and graphical representation. Results Following results were concluded by considering all these areas, percentages were calculated and graphs were plotted. Following are the results on the basis of different casts. Table 2: Number of obese individuals with respect to different casts Cast No. of subjects Rajput 5 Awaan 1 Abbassi 2 Jutt 4 Syed 3 Malik 4 Butt 4 Sheikh 5 Arain 11 Qureshi 6 Mughal 4
  7. 7. 7 Fig 2: Number of obese individuals with respect to different casts. Following are the results with respect to different BMI ranges. Sr.No Class BMI Range (Kg/m2 ) No. of subjects Percentage of subjects 1 Class - I 30 – 34.9 34 69.38% 2 Class - II 35 – 39.9 14 28.57% 3 Class - III >40 1 2.04% Table 3: BMI ranges in obese people Fig3: BMI ranges in obese people 10% 2% 4% 8% 6% 10% 23% 8% 8% 13% 8% Percentage of obesity in different casts rajput awaan abbassi jutt syed sheikh arain butt malik qureshi mughal BMI Range 30 - 34.9 (69.38%) 35 - 39.9 (28.57%) >40 (2.04%)
  8. 8. 8 Following are the results on the basis of fluctuation in weight. Sr. no. Fluctuation in weight No. of subjects Percentage of subjects 1 Yes 18 36.73% 2 No 31 63.26% Table 4: Fluctuation of weight in obese people Fig 4: Fluctuation of weight in obese people. Following are the results on the basis of factors causing obesity. Sr. no. Factors causing obesity No. of subjects Percentage of subjects 1 Genetic & environmental 28 57.14% 2 Environmental only 21 42.86% 3 Genetic only 0 0% Table 5: Factors causing the obesity Fluctuation in weight Samples showing fluctuation (36.73%) Samples not showing fluctuation (63.26%)
  9. 9. 9 Fig 5: Factors causing the obesity Following are the results of no of obese due to the interaction between genetic and environmental factors. Sr. no Genetic & Environmental Factors No. of subjects Percentage of subjects 1 Genetic + sedentary 5 17.85% 2 Genetic + dietary 7 25% 3 Genetic + surgical 2 7.14% 4 Genetic + dietary + sedentary 13 46.44% 5 Genetic + sedentary + surgical 1 3.57% Table 6: Genetic & Environmental factors causing obesity Causative Factors of Obesity Genetic + Environmental Factors (57.14%) Environmental Factors only (42.86%) Genetic Factors only (0.00 %)
  10. 10. 10 Fig 6: Genetic & Environmental factors causing obesity Following are the results of no of obese due to the environmental factors alone. Sr. no Environmental Factors No. of obese Percentage of obese 1 Sedentary 2 9.5% 2 Dietary 2 9.5% 3 Post-pregnancy 2 9.5% 4 Sedentary + Dietary 11 52.33% 5 Sedentary + Surgical 4 19.04% Total 21 Table 7: Environmental factors causing obesity Genetic and Environmental Factors Causing Obesity Genetic + Sedentary (17.85%) Genetic+dietary (25%) Genetic+surgical (7.14%) Genetic+sedentary+dietary (46.44%) Genetic+sedentary+surgery (3.57%)
  11. 11. 11 Fig 7: Environmental factors causing obesity Following are the results showing prevalence of different obesity related diseases in obese. Sr.No Diseases No. of obese carrying associated diseases Percentage of obese carrying associated diseases No. of obese without associated diseases Percentage of obese without associated diseases 1 Hypertension 19 38.77% 30 61.22% 2 Diabetes mellitus 6 12.24% 43 87.75% 3 Obstructive sleep apnea 6 12.24% 43 87.75% 4 Heart disease 1 2.04% 48 97.95% 5 Reflux 24 48.97% 25 51.02% 6 High cholesterol 38 77.55% 11 22.44% 7 Snoring 28 57.14% 21 42.85% 8 Arthralgia other than knee 13 26.53% 36 73.46% 9 Back pain 25 51.02% 24 48.97% 10 Swelling of feet 15 30.61% 34 69.38% 11 Knee pain 16 32.65% 33 67.34% Environmental factors Sedentary (9.5%) Dietry (9.5%) Post-Pregnancy (9.5%) Sedentary + Dietry (52.33%) Sedentary + Surgical (19.04%)
  12. 12. 12 12 Headache 31 63.26% 21 42.85% 13 Dyspnea 24 48.97% 25 51.02% 14 Stress urinary incontinence 11 22.44% 38 77.55% 15 Osteoarthritis 5 10.20% 44 89.59% 16 Irregular menstrual cycle 13 26.53% 22 44.89% Table 8: Diseases related to obesity and their prevalence in obese people Fig 8: Diseases related to obesity and their prevalence in obese people Discussion A brief survey was conducted on different factors causing obesity and prevalence of different diseases associated among obese population of Punjab, Pakistan. As the data was collected from people of different age groups, casts and locality, variety of results were obtained. These results were analyzed and graphs were plotted. 0 10 20 30 40 50 60 70 80 90 Percentage of diseases among obese Percentages
  13. 13. 13 Since obesity is a multifactorial disorder, main focus of survey was to interpret the factors causing obesity in a particular patient. When collective results of 49 people were analyzed, in majority of cases, factors causing obesity were genetic and environmental. Out of 49, 28 people or 57.14% people came out to be obese due to interaction between genetic and environmental factors. Their family history helped to conclude whether the problem was due to genes and it ran along the family or not. Environmental factors that seemed to be interplaying with genetic factors were sedentary life styles, diet and surgical history. 46.44% (out of 57.14%) of people were due to genetic causes, their dietary habits and sedentary life styles. Hence, supporting the idea that genetic factors can influence the risk of obesity among people having inappropriate diet and sedentary life styles. People with only genetic and dietary factors were lesser in number, about 25% (out of 57.14%). Large proportion of people about 21 out of 49 or 42.86% was obese due to environmental factors only and no problem could be observed with genes. Their family history showed none of other family member being obese making it clear that people were obese due to environmental factors only. Environmental factors included variety of factors such as diet, sedentary life style, pregnancies and surgeries. Of the 21 people, 52.33% were suffering due to diet and sedentary life style. 9.5% people had normal diet but sedentary life style while 9.5% were obese due to diet only. 9.5% were women suffering from obesity after births of their babies. Yet another majority of about 19.04% suffered due to both surgeries and sedentary life styles. However, none of the cases were observed where only genetic factors were causing obesity alone. Hence, supporting the idea that genes can mostly show their effects when favorable environment is present. The dietary history of most of people showed that they often do over eating. A few had serious eating disorder. Majority eat four times per day i.e., breakfast, lunch, snacks and supper. Most of people used to eat on dining table and couch with support. And also most of them reported to take water during and after meal. Large number of people reported to take soft drinks on daily basis. Coke was the majority’s choice. A few used to take milk shakes. Some reported to eat bakery items, mostly cakes and biscuits. Increased fast food consumption was also reported and famous brands like KFC, Fri chicks and MacDonald’s was top of the list. Fried food like
  14. 14. 14 samosas, French fries also reported to be taken by some people. Some used to take sweets once in a week. Among salty snacks, most of the people used to eat Lays chips. The psychiatric history of most people was clear except a few ones who were suffering from depression and schizophrenia. Only few people reported to do exercise, majority was unable to do exercise due to lack of time and laziness. In sedentary life styles, most of people used to watch Television for at least 2-3 hours and spent 5-6 hours on internet. Mostly buses and cars were used as means of transport. And almost all people reported to spend their free times watching TV or reading books. Most people used to take normal sleep; very few had insufficient sleep during night. And majority did not take nap during day hours. Fluctuations in weight of obese people were also studies and analysis showed that 18 out of 49 (36.73%) patients had fluctuations in their body weights. These people reported that they tried to control their weights but observing diets and exercising whereas, 31 out of 49 did not have any fluctuations in weight. According to values provided by WHO (World Health Organization), obese people were classified into three classes. 69.38% patients lied in obesity class I with BMI range of about 30- 34.9 kg/m2 . 28.57% were in class II with BMI range about 35-39.9 kg/m2 and 2.05% were in class III with BMI > 40 kg/m2 . Hence, majority of obese patients were lying in class I obesity and very few were lying in severe obesity. Several other disorders were associated with obesity in many people. Highest percentage of obese people was those having high blood cholesterol level i.e, 77.55%. Snoring was the major problem with most people (57.14%) but none of them took medication to avoid it. Reflux or heart burn was also reported in 48.97% people. It mostly occurred after taking meal. Hypertension appeared to be most severe problem with 38.77% people. And unexpectedly diabetes type 2 was less common. It was reported only in 12.24 % people. Heart disease was very less common, because majority of the patients were less than 40 years in age. Obstructive sleep apnea was also reported in 12.24% people.
  15. 15. 15 References 1. World Health Organization. The world health report 2000: health systems: improving performance. World Health Organization, 2000. 2. Haslam. D. W., James. W. P. (2005)., Obesity. Lancet 366 (9492): 1197–209. 3. Wright. J. D., Kennedy-Stephenson. J., Wang. C.Y., McDowell. M. A. and Johnson. C. L. 2004. Trends in intake of energy and macronutrients—United States, 1971–2000. MMWR Morb Mortal Wkly Rep 53 (4): 80–2. 4. Mazaffarian. D., Hao. T, Rimm. E. B., Willett. W. C. and Hu. F. B. 2011. Changes in Diet and Lifestyle and Long-term Weight Gain in Women and Men. The New England Journal of Medicine. 364 (25): 2392-404. 5. Loos. R. J. and Bouchard. C. 2008. FTO: the first gene contributing to common forms of human obesity. Obes Rev 9 (3): 246-50. 6. Flegal. K. M., Troiano. R. P. Pamuk. E. R., Kuczmarski. R. J. and Campbell. S. M., 1995. The influence of smoking cessation on the prevalence of overweight in the United States., N. Engl. J Med. 333 (18): 1165-70. 7. Whitlock. G., Lewington. S. and Sherliker. P. 2009. Body-mass index and cause specific mortality in 900 000 adults: collaborative analysis of 57 prospective studies. Lancet. 373 (9669): 1083-96. 8. Grundy. S. M. 2004. Obesity, metabolic syndrome and cardiovascular disease. J. Clin. Endocrinol. Metab. 89 (6): 2595-600.

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