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Medicine is to heal from the inside

Childhood obesity as a Risk factor for Cardiovascular disease

How big is the problem?
Obesity itself is a medical condition in which excess body fat accumulated to the extent and it may have effect to the heart. Early obesity alone, is linked to certain abnormalities in the blood that can predispose individuals to developing cardiovascular disease early in adulthood.

Based on US government statistics, almost 32% of US nation's children and adolescents are obese or overweight. Of that 32%, 20% of kids 6- to 11-years-old and 18% of those between 12 and 19 are actually obese.
Or in the other words is the obese children are quite large in numbers.


The upward shifts in population body-fat distributions. Shown, by the increase in obesity has been particularly marked in children. There is strong evidence that adult obesity is a risk factor for atherosclerotic disease, cardiovascular events, and cardiac dysfunction, and partly a consequence of its strong association with the risk of developing type 2 diabetes. Until now, cardiovascular's disease is the leading cause of death in the world, not only death but also cause significant numbers of morbidity.

Raising in childhood obesity, gives a substantial challenges for clinicians and those concerned with public health. It maybe related to widespread decline in physical activity and energy expenditure, without a compensatory decline in dietary energy intake. As an example: the usage of motorized transport has replaced physical modes of transport such walking and cycling. Also, calorie density of many foods and drinks, make calorie intake excess the daily needs. As result, accumulation body fat can't be avoided.
Sedentary lifestyle


Health effects
Obesity is associated with cardiovascular disease and also metabolic syndrome.
Childhood obesity, it will cause a widespread increase in body fat from early life, so it increases the burden of obesity of longer duration, and will lead to certain circumstances such greater risk of cardiovascular disease.

Childhood obesity carries a greatly increased risk of adult obesity, which is likely to be accentuated as adult obesity prevalence increases.
Adult obesity investigations may find out several informations about health behaviors, diet and exercise from childhood period.
Obese children

Childhood obesity has the same effects on the cardiovascular system as adult obesity but the changes occurs earlier., including impaired endothelial function, diminished arterial distensibility, adverse changes in intimamedia thickness and increased risk of atherosclerosis.

From Health Central study, obese children experienced fatty deposits in their arteries earlier by age of 7, and developed stages of arteries hardening in their teens. This may become the first generation of kids whose life expectancy will be shorter than those of their parents.

American Heart Association found in 2008, that obese children and teens or have high cholesterol have the thickness of artery walls as 45-year-olds. The researchers at Nemours Children's Clinic in Jacksonville, Florida also found that obese children are showing higher levels of the clotting factor fibrinogen, as well as ten times higher levels of the inflammation marker C-reactive protein as early as age seven.

In summary, that obese children as young as seven, are at an increased risk of cardiovascular disease, even before others medical condition appears such as metabolic syndrome.

Suggestions
From those findings, we need to do more aggressive interventions for weight control in obese children, even for those who do not have the co-morbidities of the metabolic syndrome.

In the last two decades, we have seen a drop in mortality from cardiovascular disease attributed to better risk factors control. Such as cigarette smoking prohibition, aggressive treatment of high cholesterol and blood pressure and improvements in diagnosis and treatment modalities.
However, that increasing levels of obesity, type 2 diabetes, insulin resistance and metabolic syndrome components will reverse the current favorable mortality trends. Moreover, the current social distribution of obesity, which is more prevalent in lower social groups, suggests that the increasing importance of obesity as a determinant of cardiovascular risk could exacerbate social inequalities in cardiovascular disease in the West.
obese person

American Academy of Pediatrics develops a simple steps known as the 5, 2, 1, 0 plan, in order to prevent childhood obesity and take care of obese children.

• 5: Eat at least five fruits and vegetables a day.

• 2: Limit screen time (TV, video games, computer) to two hours or less a day.

• 1: Get one hour or more of physical activity a day.

• 0: Drink fewer sugar-sweetened beverages.

But, for more complete evaluations and solutions about childhood obesity, you can contact your doctor.
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Adding Fish Oil to Low-Fat/High-Carb Diet May Improve Cholesterol

In this article, i gonna discuss about AHA publication about Fish Oil and its beneficial effects on our health.

Fact or Hoax
Since the first American Heart Association recommend us to add fish oil to our diet cause its possible benefits. In 2002, AHA publish their large scale epidemiological research about fish oil benefits.
It had been said that there are significant effects of omega-3 (or n-3) fatty acids on cardiovascular disease (CVD) in patients with preexisting CVD as well as in
healthy individuals.
Heart Essential of Living

New information about how omega-3 fatty acids affect cardiac function (including antiarrhythmic effects), hemodynamics (cardiac mechanics), and arterial
endothelial function have helped clarify potential mechanisms of action.
food rich of omega-3

Potential Benefits
Many epidemiological were being done to measure potential benefits of omega-3 and determine the optimum dose. Some older results show that a risk reduction in cardiovascular disease such as myocard infarction, sudden death and stroke or inverse association or maybe more easy to say as protective effect.
But few research also show that no significant risk reduction for cardiovascular events compare to people with normal diet.

So, it was planned to do more research about it. And it's done by randomized controlled trial (higher level of evidence in proofing). In aggregate, available RCTs show a beneficial effect of dietary and supplemental omega-3 fatty acids, including both EPA DHA and -linolenic acid, on Cardiovascular Disease.

Possible Mechanisms
- Reduce susceptibility of the heart to ventricular arrhythmia
- Antithrombogenic
- Hypotriglyceridemic (fasting and postprandial)
- Retard growth of atherosclerotic plaque
- Reduce adhesion molecule expression
- Reduce platelet-derived growth factor
- Antiinflammatory
- Promote nitric oxide-induced endothelial relaxation
- Mildly hypotensive
Heart Attack

Side Effects and Safety
Several researchs are done to calculate optimal dose for its benefits.
Up to 1 g/d, there is a proven beneficial effects, and lower complication rates.
Above 3g/d, the complication effects overcome the benefits of the omega-3.

Some species of fish may contain significant levels of environmental contaminants. These substances bioconcentrate in the aquatic food chain such that levels are generally highest in older, larger, predatory fish and marine mammals.
These contaminants is longer half-life in the body and can accumulate in people who consume contaminated fish on a frequent basis and may impact our health.
For this may be, you should contact your dietitian our nutritionist, or is easier for you to choose a supplement.

Summary of Recommendation
Patients without documented CVD, Eat a variety of (preferably oily) fish at least twice a week. Include oils and foods rich in -linolenic acid (flaxseed, canola, and soybean oils; flaxseed and walnuts)

Patients with CVD, Consume up to 1 g of EPA DHA per day, preferably from oily fish. EPADHA supplementscould be considered in consultation with the physician.

Patients needing triglyceride lowering Two to four grams of EPADHA per day provided as capsules under a physician’s care.


Thank you for your appreciation.
Have a nice time


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