Nutrition role in diseases
By
Ahmed Ghandour
OBESITY
⚫ Obesity is defined simply as a condition
of abnormal or excessive fat
accumulation in adipose tissue, to the
extent that health may be impaired.
Measurement of obesity:
1.Body mass index [BMI]:
- BMI = weight (kg) / height² (meter²)
- Not suitable for athletes, children
2.Waist circumference:
- Obesity (increased risk of various health complications) if ≥88 cm in
women and ≥102 cm in men.
3.Waist-to-hip ratio [WHR]:
- WHR was determined by dividing waist circumference by hip
circumference.
- Normal values are not exceeding 0.90 and 0.80 for men and women
- Higher ratio indicates an increased risk of various health
complications
⚫ Causes of obesity:
1. Energy imbalance:
A-Increased calorie consumption:
B-Decreased calorie used:
2. Genetic causes:
3.Psychological causes:
4.Diseases:
5. Drugs:
⚫ WHO reported that the key causes of increasing rates of obesity
and overweight are increased consumption of energy-dense food
high in saturated fats and sugars and reduced physical activity.
⚫ Hazards of obesity:
Obesity should be considered as disease in its own right
1. Arthritis:
2. Cancers:
• Obesity is associated with high risk of cancers of breast,
endometrial, esophagus, stomach, colorectal and renal
3. Cardiovascular diseases:
• Obesity is a major risk factor for heart attack.
4. Diabetes [ type 2]:
• As many as 90% of individuals with type 2 diabetes are reported
to be overweight or obese.
• Obesity complicates the management of type 2 diabetes by
increasing insulin resistance which make drug treatment for type
2 diabetes less effective.
5. Gallbladder disease:
• Obesity is an established predictor of gallbladder
disease. Gallstones are common among overweight and
obese persons at a rate of 30% versus 10% in non-
obese.
6. Hypertension
7. Stroke:
8. Gout:
9. Impaired immune response:
10. impaired respiratory function:
11. Pancreatitis:
12. Obstetric and gynecologic complications:
• Women with severe obesity have a menstrual disturbance rate 3 times higher
than that of women with normal weight.
• High pre-pregnancy weight is associated with an increased risk during pregnancy
of hypertension, gestational diabetes, urinary infection, cesarean section and
toxemia.
13. Deep venous thrombosis [DVT].
⚫ Obesity increases the risk of DVT.
14. Infections following wounds:
• Obesity is associated with the increased incidence of wound infection.
Also burn patient with obesity are reported to develop pneumonia and
wound infection with twice the frequency of non-obese.
15. Surgical complication:
16. Lower back pain:
⚫ Obesity and overweight as a global health
problem
• WHO reported that globally, there are more
than 1 billion overweight adults, at least 300
million of them obese. Obesity and
overweight pose a major risk for chronic
diseases, including type 2 diabetes,
cardiovascular disease, hypertension, stroke,
and certain forms of cancer.
⚫ Obesity in Egypt
• According to 100 million health survey (2021),
prevalence of obesity is 40 %.
• WHO 2020 ranks Egypt 18th with the highest
prevalence of obesity worldwide.
• WHO 2016 estimated prevalence of obesity
among children and adolescent (5 – 9 years)
by 17.6 %
⚫ DIET AND DISEASE PREVENTION
CALCIUM AND OSTEOPOROSIS:
• Osteoporosis is a disease in which the calcium content of bones
has been depleted. In this disease, calcium and phosphorus,
which are normally present in the bones, become reabsorbed
back into the body. This process results in brittle, fragile bones
that are easily fractured.
• Adequate calcium intake throughout childhood and puberty is
one key to preventing osteoporosis.
• A low-calcium diet later in life also increases the risk of
osteoporosis.
Fiber and cancer:
• Dietary fiber is found in plant foods, fruits, beans, nuts,
seeds, whole grains where it occurs in two forms:
soluble and insoluble. Soluble fiber attracts water and
turns to gel during digestion. This process slows
digestion and the rate of nutrient absorption from the
stomach and intestine. Insoluble fiber also adds bulk to
the stool.
• A diet high in fiber has been thought to reduce the risk
of cancers of the rectum and colon. [Also can prevent
from many of intestinal problems as constipation,
diverticulosis and IBS]
FRUITS, VEGETABLE AND CANCER:
• Eating more fruits and vegetables helps provide a good
supply of fiber, Vitamin A, Vitamin C, beta carotene,
other carotenoids and vitamins, and other valuable
substances called phytochemicals. Studies have
indicated that a diet high in these nutrients and fiber can
reduce the risk of developing several kinds of cancer,
including stomach, colorectal, esophagus, larynx, and
lung cancer.
• Vitamin C and beta carotene, which forms Vitamin A, are
antioxidants. As such, they protect body cells from
oxidation, a process that can lead to cell damage and
may play a role in cancer.
FAT AND CANCER:
• A diet high in fat has been shown to increase the risk of cancers of the
breast, colon, and prostate. A high-fat diet does not necessarily cause
cancer. Rather, it may promote the development of cancer in people
who are exposed to cancer-causing agents.
SATURATED FAT,CHOLESTEROL AND
CORONARY HEART DISEASE:
• Eating too much saturated fat is one of the major risk factors for heart
disease. Because of its high calorie content and cholesterol.
• Too much dietary fat also increases the risk of heart disease in that it
increases the likelihood that a person will become obese, which is
another risk factor for heart disease.
NITRATES AND CANCER:
• Countries in which people eat a lot of salt-
cured, smoked, and nitrite-cured foods have a
high prevalence of cancer of the stomach and
esophagus. Examples of such foods include
bacon, hot dogs, and salt-cured fish.
• If salted, smoked, and cured foods are part of
the usual diet, they should be restricted to
occasional consumption.
FIBER AND CORONARY HEART DISEASE:
Some fiber, especially soluble fiber, binds to lipids such as
cholesterol. The fiber then carries the lipids out of the body
through the stool. This lowers the concentration of lipids in the
blood and may reduce the risk of coronary heart disease.
SODIUM AND HYPERTENSION:
• Sodium intake may have little effect in persons without high
blood pressure, but it may have a profound effect in sodium-
sensitive individuals and may develop hypertension in these
individuals from excess amount of sodium in diet.
ALCOHOL:
Alcohol use increases the risk of liver cancer. When
combined with smoking, alcohol intake also increases
the risk of cancers of the mouth, throat, larynx, and
esophagus. In addition, alcohol intake is associated with
an increased risk of breast cancer in women.
⚫ Continued and excessive use of alcohol can result in an
increase in blood pressure.
⚫ Chronic heavy drinking also can cause damage to the
heart muscle (cardiomyopathy).
⚫ In addition, stroke is associated with both chronic heavy
drinking.
⚫ Healthy eating
1. Eating bread, grains, pasta, rice or potatoes several
times per day.
2. Eating a variety of vegetables and fruits, preferably
fresh several times per day (at least 400 g per day).
3. Maintain body weight between the recommended limits
(a BMI of 20–25) by taking moderate levels of physical
activity, preferably daily.
4. Control fat intake (not more than 30% of daily energy)
and replace most saturated fats with unsaturated
vegetable oils or soft margarines.
5. Replace fatty meat and meat products with beans,
lentils, lean meat or skinless fish and poultry.
6. Use milk and dairy products (sour milk, yoghurt and
cheese) that are low in both fat and salt.
7. Select foods that are low in sugar, and eat refined sugar
sparingly, limiting the frequency of sugary drinks and
sweets.
8. Choose a low-salt diet. Total salt intake should not be
more than one teaspoon (6 g) per day, including the salt
in bread and processed cured and preserved foods. (Salt
iodization should be universal where iodine deficiency is
endemic.)
9. If alcohol is consumed, limit intake to no more than 2
drinks (each containing 10 g of alcohol) per day.
10. Prepare food in a safe and hygienic way. Steam, bake,
boil or microwave to help reduce the amount of added
fat.
