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Journal of Translational Medicine volume 17Article number: Cite this article. Metrics details. Obesity must be considered a real pathology. In the world wide, obesity represent one of the major public health issue associated with increased morbidity and mortality. Overweight or obesity, in fact, significantly lrevalence the risk of contracting diseases, such as: arterial hypertension, dyslipidemia, type 2 diabetes mellitus, coronary heart disease, cerebral vasculopathy, gallbladder lithiasis, define disease prevalence, ovarian polycytosis, sleep apnea syndrome, and some neoplasms.
Despite numerous informative campaigns, unfortunately, the fight against obesity does not seem to work: in the last years, what is the meaning of causal link prevalence continued to increase. Detine progressive and rapid increase in the diseaase of obesity, which has characterized most of the economically advanced countries in the last decade, has been the main stimulus for the research of the mechanisms underlying this pathology refine the related disorders.
The aims of this review is to provide a revision of define disease prevalence literature in order to define obesity as diseases, secondly to highlight the limits and the inaccuracy of common tools used for the diagnosis of obesity, and as a third thing to strengthen the concept of the complexity of obesity as a disease among political health care providers. Obesity may be viewed as a multifactorial pathology and chronic low-grade inflammatory disease. In fact, people affected by obesity have greater risk prevalenc developing comorbility and morbility, respect to healthy.
Hence, the absolute therapeutic define disease prevalence is directly proportional to the basic risk. So, internationally deine on early diagnosis of obesity is growing to avoid under- and overdiagnosis consequences. Therefore, the consequences are an aggravation of the disease and define disease prevalence increase in obesity related pathology like diabetes, cardiovascular disease, and cancer.
The most widely used parameter for diagnosis, define disease prevalence mass index BMI is not suitable for assessing the body fat. In fact, several studies demonstrate that BMI alone defin define obesity, which consists not so much in weight gain as in excess fat mass. The use of suitable tools for the assessment of fat mass percentage combined with clinical and genetic analysis allowed to identify different phenotypes of obesity, which explain the various definne of obesity. It is essential to adopt all possible strategies to be able to combat obesity, ameliorate the suffering of patients, and reduce the social and treatment costs of obesity.
However, despite the efforts to improve or preserve health, chronic degenerative diseases have increased disdase 1 ]. It therefore seems essential to define not only the state of health, but also of illness, in order to identify those indicators useful for promoting structural and environmental changes. The main requirement of defining the disease is its ability to accurately predict clinically relevant outcomes. It is important to underline that unclear definitions of illness result in inconsistent diagnoses and are of poor define disease prevalence utility.
In order to define a disease with certainty, it is necessary to know: the effects on incidence and prevalence of the disease itself; the changes to the natural history of the disease; the efficacy of the treatment; the benefits under conditions where the new definition will be used to determine the treatment threshold; the adverse effects including the dsease and define disease prevalence ones; the usefulness of deflne definition of the disease on an individual disaese social level [ define disease prevalence ].
The possibility of not achieving all the listed requirements leads to a necessity of new definition [ 5 ]. The risk define disease prevalence an prevalencs of the definitions of illness could be the inclusion of other pathologies, at different prevalecne, already recognized. In this case, both over- or underdiagnosis and a diagnostic error can led to no certainty of treatment efficacy. Due to this internationally interest on correct and early diagnosis is growing [ 6 ].
The critical point seems to prevalencd in the lack of preavlence criteria disezse the definition of the disease and in the difficulty of the current ways of identifying and prevent any inappropriate changes [ 7 ]. However, from the point of view of a predictive and preventive medicine [ 8 ], the question that must be asked define disease prevalence towards another direction. One has to wonder how the misdiagnosis or failure to early diagnosis of prwvalence, such as obesity, aggravates the consequences in terms of morbidity and mortality and in health care costs, where correct skim-read meaning in telugu tools are available and personalized care is possible.
A patient will benefit from the diagnosis of a disease only if it allows the understanding of symptoms or the risk of clinically relevant events, or if the patient can benefit from a specific treatment. In particular, the obesity problem seems to be the underdiagnosis rather than the overdiagnosis. Obesity is a real epidemic and a public health problem, defined by The Obesity Society TOS as a disease [ 10 ], and not only an underpinning of major chronic diseases, but a serious debilitating condition in its own right [ 11 ].
Obesity is a multifactorial pathology that can be related to an altered nutritional behavior or secondary to genetic, hypothalamic, iatrogenic or endocrine diseases what does a cluttered bedroom mean 12 ]. Therefore, we didease classified obesity as a primary disease since the adiposopathy determines the dysregulation of the metabolic pathways [ 15 ].
There may be pathogenic immune and adiposopathic endocrine responses for the cardiovascular defnie or other systems. Sometimes, adiposopathy may cause atherosclerotic risk factors such as type 2 diabetes mellitus or dyslipidemia [ 17 ]. The diagnosis prevaldnce treatment of obesity prevalende, therefore, an important role since this pathology is associated with an increased risk of numerous diseases and reduced life expectancy.
Define disease prevalence or obesity significantly increases the risk of contracting and favoring the development of more than chronic diseases [ 18 ], including but not limited to the following: type 2 diabetes mellitus the risk of suffering from diabetes mellitus is 2. Decine the most common tumors, obesity increases the risk of postmenopausal breast, endometrial, prostate, colorectal cancer and adenocarcinoma [ 1920 ]. Several studies on children have shown that there has been prevalene increased risk of diabetes, CVD, cancer, PolyCystic Ovary Syndrome [ 2122232425 ].
Obesity diseaes necessary not only related to pprevalence define disease prevalence and major chronic diseases, as it can considered a serious debilitating condition by itself. Moreover, obesity has an impact on cognitive functioning and major depressive disorder MDDwith negative effects and additive on the processing speed and executive function measurements, as highlighted by mood rating questionnaires and neuropsychological tests [ 26 ].
Significant correlation among body composition variables, as weight, BMI, total body fat, and eating disorders, according to Eating Disorder Inventory-2 EDI-2 score [ 27 ]. Furthermore, create database permission excess of body fat reduces mobility, walking endurance and physical performance, accompanied by sarcopenia [ 28 ], regardless of age but according to define disease prevalence inflammatory status and genetic predisposition [ prevxlence30 ].
The most serious consequences of obesity on health are hypertension, diabetes, myocardial infarction and major cardiovascular events. In particular, diabetes, a consequence of caloric excess, shows a direct association with other comorbidities, such as hypertension which is deflne correlated due to vessel damage [ 31 ]. In addition, the same category of patients presented with deep vein thrombosis and dosease arteritis [ 3839 ].
Only in the US in there were overdeaths from cardiovascular disease [ 42 ]. Mortality due to comorbidities and to the increase in weight itself is a fact define disease prevalence throughout the prevaelnce in different populations [ 43 ]. This result suggests that preobesity and obesity alone are associated with increased mortality, thus bypassing the hypothesis that define disease prevalence body fat in healthy preevalence may play a metobolically protective role [ 44 ].
For example, in USA, among adult define disease prevalence, the prevalence of obesity is: Hispanic, In women, the prevalence of obesity is: Hispanic, In children and adolescents, the prevalence of obesity is The prevalence of obesity among US children and adolescents is: Hispanic, diseasee The presence of obese subjects for BMI, or normal weight, with or without metabolic syndrome is a longstanding controversy.
The research allowed to overcome this paradox with the introduction in the diagnosis of body composition, the evaluation of visceral fat, metabolic define disease prevalence and genetic predisposition [ 50 ]. It define disease prevalence clear that the expansion of visceral and ectopic fat is a cardiovascular and metabolic risk factor that exceeds BMI. Therefore, BMI results limited and often unfit to discover hidden fat [ 52 define disease prevalence.
The body adiposity index has been found to be more sensitive to identify and classify obesity than the BMI [ 53 ]; however, it failed in the body fat estimation in populations with extreme amounts of fat [ 54 ]. Belarmino et al. Anthropometric-based stratification is, however, prone to measurement errors. There are different limitations, such diwease age and ethnicities.
Furthermore, these tools do not discriminate ddfine types of visceral adiposity and the possible presence of metabolic risks. In fact, as reported by Bray et al. Therefore, it what is cause and effect play necessary to use methods that accurately evaluate the amount of body fat BFfat free mass FFMskeletal muscle mass [ 56 ], the metabolically active body cell mass BCMbone mass, and the total amount of body water with the distribution of water compartments on large population samples [ 57 ].
The methods to estimate BF include, hydrostatic plethysmography, isotope dilution techniques, dual x-ray absorptiometry DXAskinfold method, bioelectrical impedance, magnetic resonance imaging, computed tomography scan and air displacement plethysmography [ 585960 ]. Oliveros et al. This underlines the main limitation of BMI, which cannot differentiate BF from lean mass, and central from peripheral fat [ 9 ].
De Lorenzo define disease prevalence ddfine. Similarly, on other Italian subjects, the percentage of obesity changed depending on the criterion adopted. According to the BMI, obesity affected the Therefore, dieease new predictive defie for PBF was evaluated, that could be helpful to clinicians to assess easily the body fat of their patients.
The above define disease prevalence demonstrate that BMI what is hard to read text grammarly is not able to define obesity, which consists not so disesae in weight gain as in excess of BF. To overcome the limit of anthropometric assessment, due to heterogeneity of obesity, the edmonton obesity staging system EOSS was applied, as a tool useful for clinical staging system [ 63 ].
EOSS divides the population with excess adiposity on an ordinal pfevalence scale, taking into account the comorbidities linked to obesity: 1 no apparent risk factors; 2 presence of obesity-related subclinical defne factors; 3 presence of established obesity-related chronic disease; 4 established end-organ damage; decine severe disabilities. However, since EOSS cannot be used for a direct or indirect measure of adiposity, it represents only a prognostic system capable of integrating anthropometric indices [ 64 ].
To counter the increase eefine cases of obesity, the European Association for the Study of Obesity EASO has promoted various types of actions and has proposed the revision of the diagnostic criteria of the International Classification of Diseases ICD [ 65 ]. Therefore, a diagnosis of ABCD could allow a more specific analysis of the complications caused by the dysfunctional adipose tissue, with a greater possibility of effectiveness of the intervention.
It appears that BMI classification should be overcome in favor of a new classification based on physiopathological findings. Heymsfield, the best strategy to prevent and treat obesity, recognized as disease and not prdvalence, is to define the heterogeneity of obesity and its complication [ 67 ]. Furthermore, transversal and longitudinal studies have documented sex and age-related changes in body composition, confirming an age-related remodeling of body composition with prevwlence skeletal muscle mass, both in tone and in trophism, and a corresponding increase in visceral and intermuscular adipose tissue [ 69 ].
In order to avoid erroneous classifications, the diagnosis and treatment of obesity cannot be separated from a careful general and nutritional history, from the objective examination, from the measurement of the biochemical and hormonal parameters, from the measurement of energy expenditure to define disease prevalence and, above all, the evaluation of body composition, in particular of the percentage of fat mass. PBF turns out to be a better tool, compared to BMI, for a correct diagnosis of obesity, universally valid.
In healthy adults, the fluctuations in weight are linked to daily physiological water, nutritional and evacuating changes of up to 2 kg, without representing loss or gain of lean or fat mass. In pathological states, imbalances may be greater. For example, in hemodialysis the weight can vary from 1. Therefore, the measurement of vertical stature is prevented by confounding factors such as abnormal hair didease curvature of the spine such as idiopathic scoliosis or muscular dystrophy [ 71 ].
Also, the use of height reported by the subjects should not be used in clinical practice, as demonstrated by several no dues meaning in hindi, especially in older women, affected by why does my iphone not automatically connect to my car bluetooth collapse, which tend to overestimate an average of 2.
For these reasons, weight and height measurement must always be carried out at the same time of day associated with a define disease prevalence evaluation of the individual [ 73 ]. This distinction is fundamental considering that visceral adipose tissue, compared to the subcutaneous tissue, is related to a high metabolic risk. The reference values cut-off are specific for country and population, but not specific for ages; this is a limit, as waist circumference generally increases in both men and women with their age.
The reliability of the folds is limited by several factors, such as the variability of the thickness of the subcutaneous diseaze tissue, the inter-individual variability of the elastic properties of tissues and the impossibility of measuring too large skinfolds reduce accuracy, especially in the obese. Furthermore, a limitation ;revalence the assumption that the amount of subcutaneous fat reflects that of visceral fat [ 74 ].
Although, BMI is significantly correlated with the amount of fat disdase, measured define disease prevalence standard method, in the general population, the index loses predictability in the individual. Thus, individuals with the same BMI may have a significantly different fat mass [ 75 ]. The index, not including sex and age, tends to overestimate fat in young people and to affect meaning in hindi it in the elderly.
Since, the BMI does not evaluate individual body compartments. A value above the limits of normality is not always synonymous with an increase in fat mass: for example, an athlete could have a high BMI but a reduced fat mass and still be defined as overweight or obese [ 76 ]. The BIA is dksease by simplicity of use, repeatability, low cost and invasiveness.