-by Andres Acosta, MD, PhD.

In the United States, obesity is this century’s epidemic; 64 percent of adults are overweight or obese.  Obesity is a silent disease that impacts your health, your cost of living and the quality of your life. Making the right healthy choices and using the right supplements can determine how you can live healthy. 

Obesity is strongly associated with cardiovascular disease (heart attacks and strokes), type 2 diabetes, high blood pressure, high cholesterol, high triglycerides, cancer, sleep apnea, osteoarthritis and many other conditions. This alarming obesity epidemic poses a heavy burden to the U.S. economy, costing more than $150 billion every year—10 percent of the total health budget—according to the Centers for Disease Control and Prevention (CDC). 

The burden to the economy also weighs heavily on your personal budget. In 2009, the U.S. Agency for Healthcare Research and Quality reported that overweight and obese people spend 43 percent more each year in medical expenses than those who have normal weight. The Agency also found that obese workers are paid less than their coworkers who are normal weight. Moreover, the costs associated with obesity are greater—higher insurance costs and higher indirect costs associated with disability, absenteeism, and loss of productivity. 

The impact of obesity on your health and budget should be motivation enough to lose weight. Unfortunately, losing weight is not easy, and it’s a special challenge for those who have lower incomes. 

In his article, “Poverty and Obesity in the USA,” published in diabetes, the journal of the American Diabetes Association, Dr. J.A. Levine reported that people are prone to becoming obese because of 1) lack of access to healthy food, 2) difficult or minimal access to parks and facilities where they can be physically active and 3) less access to health providers and weight loss programs. These three main factors have risen as people’s incomes have declined in this difficult economy. With less money to spend on healthy foods, more people are consuming inexpensive foods that are low in quality and are  unhealthy.

Overweight and obese people need more information about healthy living and the negative effects of obesity on their health and living expenses. People need to make smart decisions about the many different ways to lose weight.  It is our role as health care providers to promote the smart choices and educate patients so they are not choosing yo-yo diets or consuming products that claim to help them lose weight without clear scientific evidence.

To make smart choices, people need to understand how obesity affects their bodies. 

Obesity is defined as an excess of adipose (fat) tissue. When you are obese, you accumulate adipose tissue around the internal abdominal organs, producing “Abdominal Obesity,” which is a waist circumference larger than 102 cm in men and 88 cm in women.  Abdominal Obesity has a harmful effect known as ”Metabolic Syndrome,” which includes insulin resistance, elevated glucose, high blood pressure, high triglycerides and low HDL “good” cholesterol. The American Heart Association describes Abdominal Obesity and Metabolic Syndrome as one of the most important risk factors for heart attacks and stroke.

There are multiple theories on how Abdominal Obesity contributes to Metabolic Syndrome. One of the most accepted theories is explained by “lipotoxicity,” which is explained as an increase in stress and fatty acids, fat hormones, and pro-inflammatory markers secreted directly into the liver. This excess of adiposity produces liver toxicity. The liver toxicity produces insulin resistance and elevated glucose, bad cholesterol and inflammation. 

Therefore, it is essential to stop Metabolic Syndrome by reducing Abdominal Obesity, also known as “belly fat.” 

Diet and exercise are essential for weight loss. The current guidelines recommend losing 7 – 10 percent of your body weight by following a low-caloric diet and increasing your physical activity to at least 170 minutes per week. It’s hard to tell which diet or exercise program is better for you.

When my patients ask me, I always tell them to choose the one they like the most and can follow for a long time. Most studies have shown that long-term compliance with a healthy diet and exercise program has the best outcome.  

Despite diet and exercise, it is not easy to lose weight and abdominal fat is the most difficult one to lose.  Recently, a double blind controlled study at Ohio State University found that high-linoleic safflower oil reduced abdominal obesity by an average of 6.3 percent in post-menopausal women when combined with diet and exercise. Additionally, these women had a 20 percent increase of 20 percent in adiponectin, a “good” adipose hormone that promotes weight loss and improves liver metabolism.  

High-linoleic safflower oil has been shown to have an added benefit when combined with diet and exercise. Currently, high-linoleic safflower oil can be found as a nutritional supplement and is a smart choice when combined with a low-calorie diet and exercise. Choosing the right safflower oil can be difficult. 

In conclusion, losing abdominal fat is essential to staying healthy, decreasing the risk of Metabolic Syndrome and the associated risks of heart attack and diabetes.

 When combined with diet and exercise, high-linoleic safflower oil can reduce abdominal fat. 

 In these hard times, particularly if you are on a tight budget, it is important to stay healthy with a smart diet, exercise program, and nutritional supplements such as high-linoleic safflower oil. 

 References:

• Levine J.A, Poverty and Obesity in the U.S. Diabetes, November 2011 60:2667-2668
• Flegal, K.M., Carroll, M.D., Ogden, C.L. & Curtin, L.R. Prevalence and trends in obesity among US adults, 1999-2008. JAMA 303, 235-241. 2010 
• Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003b2006. National health statistics reports; no 13. Hyattsville, MD: National Center for Health Statistics. 2009.
• Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults JAMA. 2001;285(19):2486-2497.
• Tsai, A. G., Williamson, D. F., Glick, H. A. Direct medical cost of overweight and obesity in the USA: a quantitative systematic review. Obesity Reviews, 12 – 1,50-61, 2011
• Joint Scientific Statement: Harmonizing the Metabolic Syndrome: A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity K.G.M.M. Alberti, Robert H. Eckel, Scott M. Grundy, Paul Z. Zimmet, James I. Cleeman, Karen A. Donato, Jean-Charles Fruchart, W. Philip T. James, Catherine M. Loria, and Sidney C. Smith, Jr. Circulation. 2009;120:1640-1645.
   
  Andres Acosta, M.D, Ph.D. 

  Obtained his medical degree at Universidad San Francisco de Quito, Ecuador in 2006 and his doctoral degree at University of Florida in 2009. His Ph.D thesis on Physiology and Pharmacology was focused on the “role of satiation gut hormones in food intake and aggression.” His research focuses on a new pathway which connects the satiation gut hormones with taste and taste perception. His novel findings have opened a new pathway for potential treatments of obesity. 

  During his short career as physician scientist, he has published multiple peer-reviewed articles and he is frequently invited to national and international scientific meetings. He is a member of the Early Career Committee of The Obesity Society and the Alpha Omega Alpha Medical Honor Society.

  Currently, he is specializing in Internal Medicine at Shands Hospital at the University of Florida, where he continues doing research related to satiation gut hormones, obesity and diabetes. His is co-principal investigator in multiple studies related with obesity, diabetes, and it’s interaction with inflammation and metabolic syndrome. He has also organized a multidisciplinary curriculum to teach Internal Medicine Residents about Obesity Medicine and Nutrition.

   

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