Obesity and Vitamin D levels in Women

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Obesity is often defined as excessive accumulation of fat in the body that has adverse effects on the health of the individual. It is usually defined by the Body Mass Index and further analysis includes determining the waist-hip ratio. Additionally, the risk of cardiovascular diseases is often an indicator of obesity. Individuals with a BMI of 24.5 to 29.5 are considered overweight while those who have a BMI of over 30 are considered obese. BMI is a close relation in deciphering the total percentage of fat in the body and is calculated by dividing the height of the individual by the product of their height in metres. Obesity is further classified into class I, II and III again, all determined by BMI. However, it is important to note that the BMI is adjusted especially for countries in East Asia and Africa as their total body percentage is not part of the normative curve. For instance, Africans have greater body mass and denser bones. Class III obesity is further broken down in categories. Individuals with a BMI of >35 or 40 kg/m2 are considered severely obesity while those with a BMI between 40-44 kg/m2 are considered morbidly obese. A BMI of more than 45 proceeding to 50 kg/m2 is considered super obesity.

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There are numerous causes of obesity of which the most likely is the proportions of food ingested by an individual. Excessive consumption of food beyond what the body needs often triggers insulin to convert the excessive glucose to fat. The fat is deposited in various parts of the body of which the most prominent are the buttocks, hips, breasts and face for both men and women. The imbalance of the food intake and output over a given period of time often leads to obesity. This coupled with a sedentary life is confirmation for bad health. A sedentary lifestyle refers to that which has little to no physical activity. The individual is often seated and their movements are limited to very short distances or none at all. The sedentary life is often facilitated by factors such as having white collar jobs that necessitate one to be at the office desk for up to 9 hours a day. Furthermore, the increased reliance on automated cars and mechanized manufacturing means that many individuals are not exerting themselves physically. Furthermore, the insurgence of reliable fast food outlets has significantly contributed to the obesity malady. Many individuals especially in the United States find it more convenient of have fast food and this often facilitated by the fact that fast food is way cheaper than organic food.

Further review supports the notion that there are 10 other possible causes of obesity other than diet, mostly these factors contributes to the risk of obesity. Lack of adequate sleep has been related to obesity, individuals who sleep late or not at all are at risk of developing obesity as it has been determined that often tend to snack a lot on unhealthy foods at these hours. Secondly, endocrine disruptors could also lead to obesity. This means that interference or alteration of hormones could significantly alter the fat composition of an individual. A good example is women who are often on oral contraceptive especially if it is not compatible with their bodies. Thirdly, decreased rates of smoking, smoking tends to suppress an individuals appetite and therefore if they are doing less of it then chances are that the risk of obesity increases. Use of medication that causes gradual and uncontrolled weight gain is another contributor to weight gain, for example, medication use to treat psychosis or as mentioned before, oral contraceptives. Additionally, ethnic differences tend to determine higher ratios of obesity for example; Caucasians are less likely to be obese as compared to Asians or Africans. This is because the latter tend to have more fat distribution and denser bones compared to the former. Pregnancy in older women contributes to development of obesity as women get older, the metabolism slows down and so it becomes more difficult to shed off the weight after child birth. Other reasons include natural selection, assortative mating and epigenetic risk factors that are transferred from one generation to the next. Genetics also play a role in determining whether an individual will become obese or not. This in association with environmental factors leads to change in composition of various genes that regulate appetite and metabolism. The Fat Mass and obesity gene (FTO) is found to be double in individuals with obesity. Several syndromes have also played a role in development of obesity such as Prader-Willi and the Cohen syndrome.

It is paramount to also analyse the actors that contribute to obesity other than those discussed above. For instance, gender plays a major role in that women tend to have higher rates of obesity compared to men especially over the age of 50. This can also be attributed to the fact that women tend to have more fat cells than men. Secondly, levels of education determine how individuals take in food. Although not concrete, an individual who is aware of the various food groups and the importance of partaking in a balanced diet are less likely to indulge in poor diet habits. This is also because a number of well-educated individuals have a steady source of income and therefore have more access to a varied source of foods while those of low socio-economic status have limited options are more likely to resort to cheaper foods which are not necessarily nutritious. Parity increases the likelihood of obesity in women because with each child a woman gains more or less 1kg.

Measurement of obesity is done in various ways namely: use of the body mass index, anthropometry and bioelectric impedance. Under anthropometry, there has been extensive use of skin fold thickness to determine body fat distribution. Subcutaneous fat is measured using a set of callipers and therefore its thickness is thought to be representative of the total body fat. About four parts of the body are measured and include the triceps, biceps, subscapular and suprailiac. There is a correlation between these sites and the amount of skinfold thickness as well as gender-specific density.

Bioelectrical impedance works under the presumption that fat is a poor conductor of fat whereas as free tissue is a good conductor. A current is usually passed through the body to determine the impedance which is proportional to the conducting volume. Therefore, impedance is the sum total of resistive and reactive components of the body.

Vitamin D is one of the most important vitamins in the body as it serves many purposes namely: development of strong bones and teeth as well as activating the bodys autoimmune system. Obesity in the United States over the last decades has been attributed to lifestyle changes as more people have access to cheap and convenient fast foods as opposed to wholesome foods. Studies have been conducted to determine the relation between vitamin D deficiency and adiposity in individuals especially in developed nations and it has been confirmed that indeed there is a strong correlation. It is now clear that levels of vitamin D are lower in individuals who are obese but the reasons as to why this is still remain unclear.

Vitamin comes in various forms and it has been established that active vitamin D (1, 25-dihydroxyvitamin D) may influence how fatty acids in the body are mobilised in the adipose tissue. Various experiments were conducted on rats (in vitro) also showed that large amounts of vitamin D2 lead to increments of the amount of energy expended in the body due to uncoupling of oxidative phosphorylation in adipose tissues. However, randomized controlled trials (RCTs) testing the effect of vitamin D supplementation on weight loss in obese or overweight individuals have not provided sufficient and conclusive findings furthermore, it is assumed that winter conditions contribute to the levels of vitamin D in the body as during this time, there is limited exposure to the sun which then means that the adipose tissue blocks synthesis of the vitamin. Therefore, there are increased amounts of overall distribution of fat mass. However, vitamin D is stored in the adipose tissue and, hence, perhaps the most likely explanation for the association is that the larger storage capacity for vitamin D in obese individuals leads to lower circulating 25-hydroxyvitamin D [25(OH)D] concentrations, a marker for nutritional status.

A 12-week double-blind randomized clinical trial of vitamin D3 was done on overweight and obese women to determine its supplementation on body fat mass supplementation.

Figure SEQ Figure \* ARABIC 1: Obesity according to Age CITATION Sta14 \l 2057 (State of Obesity, 2014)

Figure SEQ Figure \* ARABIC 2: Obesity prevalence according to states CITATION The14 \l 2057 (The State of Obesity, 2014)According to studies conducted by the State of Obesity, obesity rates among adults increased and had the highest prevalence among certain states namely: Texas, Kansas and Ohio. Three states also stood out for having obesity rates that were above 35% and were Arkansas, West Virginia and Mississippi. This is solely pinned on the behavioural tendencies of Americans as they consume more calories than required. As discussed earlier, this can be attributed to the availability of cheap foods. These cheap foods tend to be high in calories, namely fat and sugar. Also, low-income households tend to have more cases of obesity as they do not have access to organic and wholesome foods. Furthermore, low-income neighbourhoods tend to be unsafe and therefore adults are less likely to go outside or engage in physical activities. This promotes a culture of a sedentary lifestyle. Greater advertising by food franchises has increased the appeal of many consumers who now resort to regular consumption of fast foods.

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