Friday, August 25, 2017

Obesity and your feet.

As we grow older our waistline starts to expand and the need to wear flared trousers upside down becomes esential. According to the Australian Bureau of Statistics’ National Health Survey (2005) 72% of men and 58% of women in the middle years were overweight or obese. However a more recent survey from the Institute of Health and Welfare’s suggests obesity is on the increase with 1 in 3 Australians overweight. More frighteningly almost half of all adults were over weight (7.4 million) and 3 in 10 children were considered obese. Just when you thought it safe to come out of the cookie jar, women in their early thirties gained 12kg as they approach their mid fifties, and men upscaled, 8kg during the same 20 year period.

Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Body mass index (BMI) which is a simple index defined as the weight in kilograms divided by the square of the height in meters (kg/m2) is used as a guide by health experts to measure obesity. The World Health Organization (WHO) defines "overweight" as a BMI equal to or more than 25, and "obesity" as a BMI equal to or more than 30. Increased body mass index (obesity) affects every part of the body, including the feet and now experts are saying obese people are more likely to suffer from chronic health problems like diabetes II, certain cancers, cardiovascular disease and high blood pressure.

Cardiovascular disease (mainly heart disease and stroke) - already the world's number one cause of death each year.
Diabetes – which has rapidly becoming a global epidemic. WHO projects that diabetes deaths will increase by more than 50% worldwide in the next 10 years.
Musculoskeletal disorders – especially osteoarthritis.
Some cancers (endometrial, breast, and colon). Childhood obesity is associated with a higher chance of premature death and disability in adulthood.

In 2009, the standardised death rate for obesity was 0.9 per 100,000 of population, an increase from 0.6 per 100,000 population in 2000. The standardised death rate for males in 2009 was 1.0 per 100,000 males and 0.9 per 100,000 for females. Health problems related to excess weight impose substantial economic burdens on individuals, families and communities. Data from the Australian Diabetes, Obesity and Lifestyle (AusDiab) study indicate that the total direct cost for overweight and obesity in 2005 was $21 billion ($6.5 billion for overweight and $14.5 billion for obesity). The same study estimated indirect costs of $35.6 billion per year, resulting in an overall total annual cost of $56.6 billion (Colagiuri et al. 2010).

Many factors influence our weight but any sustained minor change in energy imbalance between calories (in) consumed and calories (out) expended during exercise can result in weight gain. (sic) All I need to do, is lie on the couch and look at a piece of bread and butter and the pounds pile on. Some people are more likely to gain weight than others because of their genetic and biological makeup. A major disadvantage of obesity is the unwanted pressure on weight bearing joints which can, in some cases adversely effect the function of feet. Being overweight or obese has been reported to increase the risk of orthopedic complaints such as osteoarthritis, tendinosis, bursitis, overuse syndromes and surgical complications. Obesity is considered to be a mechanical risk factor for osteoarthritis with the knee joints especially susceptible. The World Health Organisation (WHO) recommend a reduction in weight of 5Kg will result in pain reduction of 50%. The overload effect on joint cartilage may explain part of the increased risk of osteoarthritis, at least for osteoarthritis of the knee, in overweight people. However recent advances in the physiology of adipose tissue add further insights in understanding the relationship between obesity and osteoarthritis. Research findings suggest joint damage may be caused by systemic factors such as adipokines, which may provide a metabolic link between obesity and osteoarthritis. Further this evidence supports the hypothesis osteoarthritis is a systemic disorder and not just due to body wear and tear.

Very obese people (young and old) walk with a wider base of gait (shuffling) and in some cases place intolerable stress on the architecture of their feet. Continued presence may also accelerate wear and tear in the joints themselves causing traumatic arthritis which further impairs mobility as we age. Research supports a clear relationship between diabetes and obesity and a global shift to diets which contain energy-dense foods (high in fat and sugars but low in vitamins, minerals and other micronutrients) this combined with a sedentary existence where we take less physical activity. The combination is deadly.

Higher sugar intake places increasing demand on natural supply of insulin in the body and as we age sometimes the insulin balance cannot cope either because we produce less quantity or what is available, is ineffectual. Diabetes and its co-moribund partners can lead to damage to blood vessels and nerve supply, reducing the blood flow to the feet and increasing blood pressure. The reduction in the ability of sufferers to feel their feet and increased risk of developing foot ulcers and infection places them at greater risk of ulceration and amputation.

A change in dietary habits helps with a reduction of sugar intake and increase in the consumption of fibre and vitamins. Weight loss by eating sensibly combined with physical exercise is highly recommended. A good way to start is walking and regular 30 minute exercise if recommended. Speak to your doctor if you experience either tingling, numbness or burning sensation in your feet; or leg pain when you walk. See a podiatrist if you experience chronic foot pain such as arch or heel soreness.

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