Public Heath Enemy Number 1: Obesity

A few years ago, I wrote about a study done in Great Britain that had determined that being overweight and a smoker was a greater risk to your health than living downwind of the Chernobyl nuclear power plant meltdown. Based on the latest reported studies, if you're overweight, smoking may be the least of your problems.

According to the results of a study reported in the January, 2010, issue of BJU (British Journal of Urology) International, obesity is associated with an increased risk for a specific type of kidney cancer known as clear-cell renal cell carcinoma (RCC).

The study, from Memorial Sloan-Kettering Cancer Center (MSKCC) of New York, NY, evaluated the association between body mass index (BMI) and histologic features of clear cell RCC in a group of 1640 patients with renal cortical tumors that had been surgically removed between January 2000 and December 2007. Of these tumors, 12% were benign and 88% were malignant; of these, 61% were clear-cell RCCs.

The body mass index, or BMI, is calculated by dividing the subject's weight (in kilograms) by the square of the subject's height in meters. A BMI of greater than 30 is considered as obese, with a BMI of 25-30 taken as overweight, and a BMI of 18.5 to 25 being considered as normal.

According to the study data, each unit of BMI greater than 25 resulted in a 4% increased chance that a renal mass would be malignant. Overall, the study found that an obese patient was 1.48 times more likely to have a malignant tumor than a non-obese patient.

Another study, published in the January 21, 2010 issue of the journal Stroke has found that the size of your waistline is directly related to your chances of suffering a stroke.

This study evaluated three measurements that indicate obesity (waist circumference, body mass index (BMI), and the waist / thigh ratio) in a group that included 13,549 participants (5930 men and 7619 women; 3694 blacks and 9855 whites) aged 46 to 64 years who were enrolled in the Atherosclerosis Risk in Communities(ARIC) study and were then followed from 1987 to 2005.

During the follow-up period, there were 598 ischemic strokes that were confirmed through hospital-discharge records and imaging studies. Blacks had a two to three time higher incidence of stroke than whites in each obesity group. The waist circumference was found to be the best predictor of stroke per 1000 person-years and ranged from 1.2 for white women in the lowest category to 8.0 for black men in the highest category.

Finally, yet another study has demonstrated that childhood obesity is directly associated with an increased risk of premature death as an adult.

This study, published in today's New England Journal of Medicine, assessed the extent to which obesity, hypertension, and elevated lipid and cholesterol levels in childrenwithout diabetes predicted premature death (defined as deathbefore 55 years of age) in American Indians from Arizona.

During the study period, 559 of the 4857 participants (11.5%)died before they reached 55 years of age. 188 deathswere from cardiovascular causes: 59 were attributed to alcoholicliver disease, 21 to infections,12 to cancer, 10 to diabetes or diabetic nephropathy, 9 to acutealcoholic poisoning or drug overdose, and 33 to other cause

Of the three parameters evaluated obesity, as determined by a BMI of 30 or greater, was positively associated with the risk of premature death witheach unit of BMI over 30 being associated with a 19% increased risk of death before the age of 55.

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These three studies, taken together, more than adequately demonstrate the danger of obesity to an individual's health. In fact, when these numbers are extrapolated to the public as a whole they indicate that obesity will, as the number of smokers declines, is now the greatest issue in public health.

Do you need any more encouragement to get rid of that excess weight?