2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]

Abstract

Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]CMAJ 2007;176(8 suppl): S1-13 This is a summary of the full document, which consists of this summary as well as 26 chapters on specific aspects of obesity prevention and management.The full document can be found at www.cmaj.ca/cgi/content/full/176/8/S1/DC1.O besity is now reaching epidemic proportions in both developed and developing countries and is affecting not only adults but also children and adolescents. Over the last 20 years, obesity has become the most prevalent nutritional problem in the world, eclipsing undernutrition and infectious disease as the most significant contributor to ill health and mortality. It is a key risk factor for many chronic and noncommunicable diseases.In Canada, the prevalence of overweight and obesity has increased over recent decades among both children and adults in all areas of the country. According to the most recent estimates from the 2004 Canadian Community Health Survey, 1 59% of the adult population is overweight (i.e., body mass index [BMI] ≥ 25 kg/m 2 ) and 1 in 4 (23%) is obese (i.e., BMI ≥ 30 kg/m 2 ). The sheer numbers of people who are overweight and obese highlight a pressing public health problem that shows no signs of improving in the near future. What is more alarming is the problem of obesity among children and adolescents in Canada, which is advancing at an even more rapid pace than obesity among adults. In 2004, 1 in 4 (26%) Canadian children and adolescents aged 2-17 years was overweight. The obesity rate has increased dramatically in the last 15 years: from 2% to 10% among boys and from 2% to 9% among girls.1,2 This increase is cause for concern, since there is a tendency for obese children to remain obese as adults. Moreover, obesity-related health problems are now occurring at a much earlier age and continue to progress into adulthood. Given the recent temporal obesity trends among children and youth, the prevalence of obesity among adults will likely continue to increase as the current generation of children enters adulthood.Obesity should no longer be viewed as a cosmetic or body-image issue. There is compelling evidence that overweight people are at increased risk of a variety of health problems, including type 2 diabetes, hypertension, dyslipidemia, coronary artery disease, stroke, osteoarthritis and certain forms of cancers. It has recently been estimated that about 1 in 10 premature deaths among Canadian adults 20-64 years of age is directly attributable to overweight and obesity. In addition to affecting personal health, the increased health risks translate into an increased burden on the health care system. The cost of obesity in Canada has been conservatively estimated to be $2 billion a year or 2.4% of total health care expenditures in 1997.3 Thus, the continuing epidemic of obesity in Canada is exacting a high toll on the health of the population.The cause of obesity is complex and multifactorial. Within the context of environm...

Is weight loss the optimal target for obesity-related cardiovascular disease risk reduction?

“…Consistent with the argument that weight loss is the primary end point for obesity reduction, leading health authorities suggest that the utility of exercise as a strategy for obesity reduction depends in large measure on body weight reduction (8). Although exercise-induced weight loss is associated with attenuated CVD risk, several lines of evidence suggest that weight loss is not absolutely necessary to observe substantial benefit.…”

Cardiovascular risk factors, diet and lifestyle among European, South Asian and Chinese adolescents in Canada

“…Detecting high-risk ethnic groups and CVD RF in adolescence could help initiate long-term interventions earlier in life; particularly diet, weight control and lifestyle modifications that can halt the progression of future atherogenic CVD (16,17).…”

Physical Activity and Genitourinary Cancer Survivorship

“…Adiposity, frequently measured in terms of BMI, is now convincingly associated with increased breast cancer risk in postmenopausal women, and weight gain and abdominal fatness are probably also causally related (Renehan et al 2008 (Donnelly et al 2009;Lau et al 2007). However, there is only limited evidence supporting the effectiveness of physical activity for abdominal fat loss (Lau et al 2007;Ross and Janssen 1999).…”

“…Adiposity, frequently measured in terms of BMI, is now convincingly associated with increased breast cancer risk in postmenopausal women, and weight gain and abdominal fatness are probably also causally related (Renehan et al 2008 (Donnelly et al 2009;Lau et al 2007). However, there is only limited evidence supporting the effectiveness of physical activity for abdominal fat loss (Lau et al 2007;Ross and Janssen 1999). It remains plausible, however, that postmenopausal women could be amenable to significant abdominal fat loss given the right exercise prescription (e.g., Cuff et al 2003;Giannopoulou et al 2005;Irwin et al 2003).…”