medigraphic.com
Colegio de Medicina Interna de México.

2007, Number 5

<< Back Next >>

Med Int Mex 2007; 23 (5)

Abdominal obesity among physicians and their patients

Lara A, Meaney A, Kuri MP, Meaney E, Asbún-Bojalil J, Álvarez LCH, Olivares I, Ceballos G

Language: Spanish
References: 43
Page: 391-397
PDF size: 129.93 Kb.


ABSTRACT

Objective: To estimate the frequency of abdominal obesity among a sample of Mexican patients and their primary care physicians.
Methods: A convenient sample of primary care physicians were randomly selected in six large cities of Mexico. Every physician enrolled an arbitrary number of patients, aged between 18 and 80 years, excluding pregnant women. The following variables were assessed in both patients and physicians: weight, height, body mass index, waist circumference, systolic, diastolic and pulse blood pressures (SBP, DBP, PP) and smoking status.
Results: The data from 7,747 patients provided by 270 physicians were recorded. Overweight was observed in 42.4% of male, and 35.2% of female patients, while 34.9% of male and 36.2% of female patients were obese. Abdominal obesity according to Mexican criteria (80 and 90 cm average, in females and males) was observed in 69% of males and 78.5% of female patients. Among physicians 39% of male and 29% of female suffered overweight, while 38% of male and 30% of female physicians were obese. Abdominal obesity was observed in 73% of male and 63% of female physicians. The proportion of smokers in patients was 42% and 37% in physicians. All blood pressures were significantly higher in physicians than in patients.
Conclusions: Primary care physicians face a similar or higher cardiovascular risk than their patients.


REFERENCES

  1. Cummings D, Schwartz MW. Genetics and pathophysiology of human obesity. Ann Rev Med 2003;54:453-71.

  2. Caterson ID, Hubbard V, Bray GA, Grunstein R, et al. Obesity, a worldwide epidemic related to heart disease and stroke: Group III. Worldwide comorbidities of obesity. Circulation 2004;110:476-86.

  3. Murphy NF, MacIntyre K, Stewart S, Hart CL, et al. Long-term cardiovascular consequences of obesity: 20 year follow-up of more than 15 000 middle-aged men and women (the Renfrew- Paisley Study). Eur Heart J 2006;27:96-106.

  4. Field AE, Coakley EH, Must A, Spadano JL, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 2001;161:1581-6.

  5. Folsom AR, Kushi LH, Anderson KE, Mink PJ, et al. Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women’s Health Study. Arch Intern Med 2000;160:2117-28.

  6. Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease: AHA Nutrition Committee. Circulation 1998;97:2099-100.

  7. Haffner S, Taegtmeyer H. Epidemic obesity and the metabolic syndrome. Circulation 2003;108:154.

  8. World Health Organization. Obesity, preventing and managing the global epidemic–report of a WHO consultation on obesity. Geneva 1997.

  9. Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature 2006;444:881-7.

  10. Reeder BA, Senthiselvan A, Despres JP. The association of cardiovascular disease risk factors with abdominal obesity in Canada. Can Med Assoc J 1997;157:S39-45.

  11. Chen MM, Lear SA, Frohlich JJ, Birmingham CL. Intraobserver and interobserver realiability of waist circumference and the waist-to-hip ratio. Obes Res 2001;9:651.

  12. Pouliot MC, Despres JP, Lemieux S, Moorjani S, et al. Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994;73:460-8.

  13. Secretaría de Salud (México). Norma Oficial Mexicana NOM-043- SSA2-2005, Servicios básicos de salud. Promoción y educación para la salud en materia alimentaria. Criterios para brindar orientación. Diario Oficial de la Federación, 23 de enero del 2006.

  14. Sanchez-Castillo CP, Velazquez-Monroy O, Lara-Esqueda A, Berber A, et al. Diabetes and hypertension increases in a society with abdominal obesity: results of the Mexican National Health Survey 2000. Pub Health Nutr 2004;8:53-60.

  15. González-Barranco J. Obesidad: problema de salud pública en México. Nutrición Clínica 2002;5:213-8.

  16. Arellano-Montaño S, Bastarrachea-Sosa RA, Bourges-Rodríguez H, Calzada-León R, et al. La obesidad en México. Rev End Nut 2004;12:S80-S87.

  17. OECD health data 2007: statistics and indicators for 30 countries. http://www.oecd.org/document/30/0,2340,en_2649_ 37407_12968734_1_1_1_37407,00.html. Accesado el 12 de febrero de 2007.

  18. Hernández y Hernández H, Meaney Mendiolea E, Skromne Kadlubik D. Estudio del hipertenso. III Consenso Nacional de Hipertensión Arterial. Rev Mex Cardiol 2005;16:15-18.

  19. American Heart Association. Recommendations for human blood pressure determination by sphygmomanometers. Report of a special task force appointed by the steering committee. Circulation 1988;77:501B-14B.

  20. Chobanian AV, Bakris GL, Black JR, Cushman WC, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report. JAMA 2003;289:2560-72.

  21. Dirección General de Epidemiología, Secretaría de Salud. Encuesta Nacional de Adicciones, México, 1998.

  22. Reaven GM. The metabolic syndrome: requiescat in pace. Clin Chem 2005;51:931-8.

  23. Grundy SM. Point: the metabolic syndrome still lives. Clin Chem 2005;51:1352-4.

  24. Grundy SM. Metabolic syndrome: connecting and reconciling cardiovascular and diabetes worlds. J Am Coll Cardiol 2006 47:1093-100.

  25. Isomaa B, Almgren P, Tuomi T, Forsblom C, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001;24;683-9.

  26. Alberti KGMM, Zimmet PZ, Shaw JE. The metabolic syndrome: a new world-wide definition from the International Diabetes Federation consensus. Lancet. 2005;366:1059-62.

  27. Worl Health Organization. Obesity and overweight, 2003. http://www.who.imt.dietphysicalactivity/publications/facts/obesity/en/. Accesado el 28 de marzo del 2007.

  28. Secretaría de Salud (México). Causas de mortalidad en México 2000. Estadísticas de Mortalidad. http://www.ssa.gob.mx. Accesado el 28 de marzo del 2007.

  29. Rivera JA, Barquera S, Gozalez-Cossio T, Olaiz G, Sepulveda J. Nutrition transition in Mexico and in other Latin American countries. Nutrition Reviews 2004:62;S149-57.

  30. Sepúlveda-Amor J, Lezama MA, Tapia-Conyer R, Valdespino JL, et al. Estado nutricional de preescolares y mujeres en México: resultados de una encuesta probabilística nacional. Gac Med Mex 1990;126:207-24.

  31. Sepúlveda-Amor J, Rivera-Dommarco J, Arce-Bustamante B, Saavedra N, et al. Encuesta Nacional de Nutrición 1999. Secretaría de Salud, Instituto Nacional de Salud Pública, INEGI.

  32. Olaiz G, Rojas R, Barquera S, Shamah T, et al. Encuesta Nacional de Salud 2000. Tomo II. La salud de los adultos. Instituto Nacional de Salud Pública: Cuernavaca, Morelos, México, 2003.

  33. Meaney E, Lara-Esqueda A, Ceballos-Reyes GM, Asbun J, et al. Cardiovascular risk factors in the urban Mexican population: The FRIMEX study. Pub Health 2007;121:378-84.

  34. Despres JP. Abdominal obesity: the most prevalent cause of the metabolic syndrome and related cardiometabolic risk. Eur Heart J 2006;8(B):B4-B12.

  35. Rexrode KM, Buring JE, Manson JE. Abdominal and total adiposity and risk of coronary heart disease. Int J Obes 2001;25:1047-56.

  36. Wei M,Gaskill SP, Haffner SM, Stern MP. Waist circumference as the best predictor of noninsulin dependent diabetes mellitus (NIDDM) compared to body mass index, waist/hip ratio and other anthropometric measurements in Mexican Americans–a 7-year prospective study. Obes Res 1997;5:16-23.

  37. Dey DK, Rothenberg E, Sundh V, Bosaeus I, Steen B. Waist circumference, body mass index, and risk for stroke in older people: a 15-year longitudinal population study of 70-year-old. Am Geriatr Soc 2002;50:1510-8.

  38. Caprio S, Hyman L, McCarthy S, Lange S, et al. Fat distribution and cardiovascular risk factors in obese adolescent girls: importance of the intraabdominal fat depot. Am J Clin Nutr 1996;64:12-17.

  39. Fogelman Y, Vinker S, Lachetr J, Biderman A, et al. Managing obesity: a survey of attitudes and practices among Israeli primary care physicians. In J Obes 2002;26:1393-7.

  40. Franc E, Rothenberg R, Lewis C, Belodoff BF. Correlates of physicians’ prevention-related practices. Arch Fam Med 2000;9:359-66.

  41. Hash RB, Munna RK, Vogel RL, Bason JJ. Does physician weight affect perception of health advice?. Prev Med 2003;36:41-44.

  42. Franc E, Rothenberg R, Lewis C, Belodoff BF. Correlates of physicians’ prevention-related practices. Arch Fam Med 2000;9:359-66.

  43. Franc E, Wright EH, Serdula MK, Elon LK, Baldwin G. Personal and professional nutrition-related practices of US female physicians. Am J Clin Nutr 2002;75:326-32.




2020     |     www.medigraphic.com