Day 7 - Health

Obesity

Obesity contributes to numerous and varied comorbid conditions. Complications can occur in many organ systems, ranging from cardiovascular to respiratory to orthopedic and even ophthalmologic. Overweight and obesity are known risk factors for heart disease, diabetes, hypertension, gallbladder disease, osteoarthritis, sleep apnea and other breathing problems, and some cancers (uterine, breast, colorectal, kidney, and gallbladder). In addition, obesity is associated with pregnancy complications, high blood cholesterol, menstrual irregularities, psychological disorders, and increased surgical risk. Social discrimination against obese persons has a strong negative effect on their quality of life.








Visceral Fat




Visceral fat, or abdominal fat, is a type of body fat that exists in the abdomen and surrounds the internal organs. Everyone has some, especially those who are sedentary, chronically stressed, or maintain unhealthy diets. A different type of fat — subcutaneous fat — which builds up under the skin, has less of a negative impact on health and is easier to lose than visceral fat. In fact, excessive deposits of visceral fat are associated with many serious health problems including cardiovascular disease, types 2 diabetes, and increased blood pressure. Though it is possible to lose, it requires a larger commitment than spot exercises, like sit ups or crunches; a combination of cardiovascular activity and a lean diet is typically required.







Causes of Development


People gain abdominal fat for a variety of reasons, including eating lots of high fat or high sugar foods, and maintaining an inactive lifestyle. Not exercising for long periods of time often leads to a cumulative effect in which people gain more abdominal fat quicker over time, but a little exercise can greatly inhibit its development. Lifestyle factors, like not getting enough sleep or being stressed also increase the chances of developing this type of fat. Some studies show that people who routinely experience discrimination or harassment are prone to develop deposits of this fat.





Diabetes



What is It?


Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel.

With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level.




Nerve Damage


Diabetic neuropathy is a nerve disorder caused by diabetes. Symptoms of neuropathy include numbness and sometimes pain in the hands, feet, or legs. Nerve damage caused by diabetes can also lead to problems with internal organs such as the digestive tract, heart, and sexual organs, causing indigestion, diarrhea or constipation, dizziness, bladder infections, and impotence. In some cases, neuropathy can flare up suddenly, causing weakness and weight loss. Depression may follow. While some treatments are available, a great deal of research is still needed to understand how diabetes affects the nerves and to find more effective treatments for this complication.










Kidney Failure



Obesity contributes to numerous and varied comorbid conditions. Complications can occur in many organ systems, ranging from cardiovascular to respiratory to orthopedic and even ophthalmologic. Overweight and obesity are known risk factors for heart disease, diabetes, hypertension, gallbladder disease, osteoarthritis, sleep apnea and other breathing problems, and some cancers (uterine, breast, colorectal, kidney, and gallbladder). In addition, obesity is associated with pregnancy complications, high blood cholesterol, menstrual irregularities, psychological disorders, and increased surgical risk. Social discrimination against obese persons has a strong negative effect on their quality of life.








What Is Diabetic Nephropathy?


Diabetic nephropathy -- kidney disease that results from diabetes -- is the number one cause of kidney failure. Almost a third of people with diabetes develop diabetic nephropathy.


People with diabetes and kidney disease do worse overall than people with kidney disease alone. This is because people with diabetes tend to have other long-standing medical conditions, like high blood pressure, high cholesterol, and blood vessel disease (atherosclerosis). People with diabetes also are more likely to have other kidney-related problems, such as bladder infections and nerve damage to the bladder.


Kidney disease in type 1 diabetes is slightly different than in type 2 diabetes. In type 1 diabetes, kidney disease rarely begins in the first 10 years after diagnosis of diabetes. In type 2 diabetes, some patients already have kidney disease by the time they are diagnosed with diabetes.


What Are the Symptoms of Diabetic Nephropathy?


There are often no symptoms with early diabetic nephropathy. As the kidney function worsens, symptoms may include:
Swelling of the hands, feet, and face
Trouble sleeping or concentrating
Poor appetite
Nausea
Weakness
Itching (end-stage kidney disease) and extremely dry skin
Drowsiness (end-stage kidney disease)
Abnormalities in the hearts' regular rhythm, because of increased potassium in the blood
Muscle twitching


As kidney damage progresses, your kidneys cannot remove the waste from your blood. The waste then builds up in your body and can reach poisonous levels, a condition known as uremia. People with uremia are often confused or comatose.


How Is Diabetic Nephropathy Diagnosed?


Kidney damage can be detected early by finding protein in the urine. Treatments are available that can help slow progression to kidney failure. That's why you should have your urine tested every year if you have diabetes.


How Is Diabetic Nephropathy Treated?


Lowering blood pressure and maintaining blood sugar control are absolutely necessary to slow the progression of diabetic nephropathy. Some medicines called angiotensin converting enzyme (ACE) inhibitors can help slow down the progression of kidney damage. Although ACE inhibitors -- including ramipril (Altace), quinapril (Accupril) , and lisinopril (Prinivil, Zestril) -- are usually used to treat high blood pressure and other medical problems, they are often given to people with diabetes to prevent complications, even if their blood pressure is normal.


If a person has side effects from taking ACE inhibitors, another class of drugs called angiotensin receptor blockers (ARBs) can often be given instead.


If not treated, the kidneys will continue to fail and larger amounts of proteins can be detected in the urine. Advanced kidney failure requires treatment with dialysis or a kidney transplant.




Sleep Apnea



Why does sleep apnea happen? Much of the reason is a structural problem. In many instances, the soft tissues of the lower throat and neck are being pulled by gravity while the patient is laying flat. As the tissues are pulled down, the airway gets smaller. They may snore or they may be very restless during sleep. Their partner may notice that breathing stops during sleep, and their body jerks them awake.


Sleep apnea is actually linked to several chronic diseases [Source: Goldman]. An obvious problem that comes from poor sleep is fatigue. This can become dangerous in situations such as driving. Unfortunately, sleep medicines don't offer a cure. Many people with resistant high blood pressure suffer from sleep apnea. Some might try three to four medicines before diagnosing sleep apnea as the problem. This condition is also related to other heart conditions such as coronary artery disease, irregular heartbeats and even stroke [Source: Connolly]. Sleep apnea may also play a significant role in mood and anxiety. Poor sleep will really effect every aspect of life, including one’s vitality and general outlook. It's also easy to see how patients can become anxious since the body is constantly trying to keep the body breathing; a process that should not require much effort. Even loss of sex drive may be linked to sleep apnea.


Another major issue with sleep apnea is weight gain, and the near inability to lose weight. Patients often have very little energy to actually go exercise. This becomes a vicious cycle leading to more fatigue, greater weight gain and worsening sleep apnea. Being overweight may predispose a patient to sleep apnea. Large, thick necks may aggravate the problem, as can extra weight around the mid section of the body.


Sleep apnea is diagnosed by the patient’s symptoms (or by the symptoms described by the partner) and by a sleep study test. A sleep study is done in a hospital setting using monitors that can detect the number of apneic episodes that occur. The sleep study can also follow the depth of the patient’s sleep and can determine possible treatments that might be helpful.









Arteries


Arteries are blood vessels that carry blood rich in oxygen throughout your body. They go to your brain as well as to the tips of your toes. Healthy arteries have smooth inner walls and blood flows through them easily. Some people, however, develop clogged arteries. Clogged arteries result from a buildup of a substance called plaque on the inner walls of the arteries. Arterial plaque can reduce blood flow or, in some instances, block it altogether.


Clogged arteries greatly increase the likelihood of heart attack, stroke, and even death. Because of these dangers, it is important to be aware, no matter how old you are, of the causes of artery plaque and treatment strategies to prevent serious consequences.


What causes arterial plaque?


Plaque that accumulates on the inner walls of your arteries is made from various substances that circulate in your blood. These include calcium, fat, cholesterol, cellular waste, and fibrin, a material involved in blood clotting. In response to plaque buildup, cells in your artery walls multiply and secrete additional substances that can worsen the state of clogged arteries.


As plaque deposits grow, a condition called atherosclerosis results. This condition causes the arteries to narrow and harden.


Although experts don’t know for sure what starts atherosclerosis, the process seems to stem from damage to the arterial wall. This damage, which enables the deposition of plaque, may result from:
High ''bad'' cholesterol and low ''good'' cholesterol. High levels of ''bad'' cholesterol, or low-density lipoprotein (LDL), are major contributors to arterial plaque formation. But that doesn’t tell the whole story. Everyone also has ''good'' cholesterol, or high-density lipoprotein (HDL), circulating in the blood. HDL is believed to remove some of the bad cholesterol from plaque in clogged arteries and transport it back to the liver, where it is eliminated.
High blood pressure . Having high blood pressure increases the rate at which arterial plaque builds up. It also hastens the hardening of clogged arteries.
Cigarette smoke. Cigarette smoke seems to increase the rate of atherosclerosis in the arteries of the heart, legs, and the aorta -- the largest artery in the body.
Diabetes, or elevated circulating blood sugaris also a major culprit. Even people who have elevated sugars not yet at the level of diabetes, such as seen in the metabolic syndrome, also have increased risk of plaque formation.







Plaque often starts to develop during the childhood or teenage years. Then clogged arteries develop in middle age or later.