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Weight and Physical Health - Is Obesity A Disease?, The Genetics Of Body Weight And Obesity, Health Risks And Consequences Of Overweight And Obesity

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If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.

—Hippocrates c. 460–377 B.C.

During the twentieth century, advances in public health and medical care helped Americans to lead longer, healthier lives. Two important measures of the health of the population are infant mortality (death) rates and life expectancy at birth rates. Infant mortality rates significantly decreased and life expectancy increased by thirty years. Table 2.1 shows the decline in infant mortality between 1983 and 2001. Table 2.2 shows the long-term upward trend in life expectancy as well as recent gains—in 2001 life expectancy at birth for the total population reached a record high of 77.2 years, up from 75.4 years in 1990.

As deaths from infectious diseases declined, mortality from chronic diseases, such as heart disease and cancer, increased. Table 2.3 displays the ten leading causes of death in the United States in 1980 and 2001. Overweight and obesity are considered contributing factors to at least four of the ten leading causes of death in 2001—diseases of the heart, malignant neoplasms (tumors), cerebrovascular diseases (diseases affecting the supply of blood to the brain), and diabetes mellitus. (Obesity also may be implicated in some deaths attributable to another leading cause of death—kidney disease or chronic renal failure, which are called nephritis, nephrotic syndrome, and nephrosis in Table 2.3.) Table 2.3 also reveals the rise of diabetes as a cause of death. In 1980 it was the seventh leading cause of death, claiming nearly 35,000 lives. By 2001 it rose to the sixth leading cause of death overall, the fifth leading cause of death among women, and the sixth leading cause of death among men. It was the underlying cause of over 70,000 deaths and was mentioned on the death certificates of more than twice as many additional deaths. Epidemiologists (scientists who study the occurrence and distribution of diseases and the factors that govern their spread) and medical researchers believe that the increasing prevalence of diabetes in the U.S. population and the resultant rise in deaths attributable to diabetes are direct consequences of the obesity epidemic in America.

Figure 2.1 reveals little change in the prevalence of overweight and obesity between the 1960s and 1980, and increasing prevalence of overweight and obesity in the two FIGURE 2.1
Overweight and obesity by age, 1960–2000
TABLE 2.1
Infant, neonatal, and postnatal mortality rates, according to detailed race and Hispanic origin of mother, selected years 1983–2001
[Data are based on linked birth and death certificates for infants]

Race and Hispanic origin of mother 19831 19851 19901 19952 19982 19992 20002 20012
Infant3deaths per 1,000 live births
All mothers 10.9 10.4 8.9 7.6 7.2 7.0 6.9 6.8
White 9.3 8.9 7.3 6.3 6.0 5.8 5.7 5.7
Black or African American 19.2 18.6 16.9 14.6 13.8 14.0 13.5 13.3
American Indian or Alaska Native 15.2 13.1 13.1 9.0 9.3 9.3 8.3 9.7
Asian or Pacific Islander 8.3 7.8 6.6 5.3 5.5 4.8 4.9 4.7
Chinese 9.5 5.8 4.3 3.8 4.0 2.9 3.5 3.2
Japanese *5.6 *6.0 *5.5 *5.3 *3.4 *3.5 *4.5 *4.0
Filipino 8.4 7.7 6.0 5.6 6.2 5.8 5.7 5.5
Hawaiian 11.2 *9.9 *8.0 *6.5 9.9 *7.0 9.0 *7.3
Other Asian or Pacific Islander 8.1 8.5 7.4 5.5 5.7 5.1 4.8 4.8
Hispanic or Latino4,5 9.5 8.8 7.5 6.3 5.8 5.7 5.6 5.4
Mexican 9.1 8.5 7.2 6.0 5.6 5.5 5.4 5.2
Puerto Rican 12.9 11.2 9.9 8.9 7.8 8.3 8.2 8.5
Cuban 7.5 8.5 7.2 5.3 *3.7 4.6 4.6 4.2
Central and South American 8.5 8.0 6.8 5.5 5.3 4.7 4.6 5.0
Other and unknown Hispanic or Latino 10.6 9.5 8.0 7.4 6.5 7.2 6.9 6.0
Not Hispanic or Latino:
White5 9.2 8.6 7.2 6.3 6.0 5.8 5.7 5.7
Black or African American5 19.1 18.3 16.9 14.7 13.9 14.1 13.6 13.5
Neonatal3 deaths per 1,000 live births
All mothers 7.1 6.8 5.7 4.9 4.8 4.7 4.6 4.5
White 6.1 5.8 4.6 4.1 4.0 3.9 3.8 3.8
Black or African American 12.5 12.3 11.1 9.6 9.4 9.5 9.1 8.9
American Indian or Alaska Native 7.5 6.1 6.1 4.0 5.0 5.0 4.4 4.2
Asian or Pacific Islander 5.2 4.8 3.9 3.4 3.9 3.2 3.4 3.1
Chinese 5.5 3.3 2.3 2.3 2.7 1.8 2.5 1.9
Japanese *3.7 *3.1 *3.5 *3.3 *2.5 *2.8 *2.6 *2.5
Filipino 5.6 5.1 3.5 3.4 4.6 3.9 4.1 4.0
Hawaiian *7.0 *5.7 *4.3 *4.0 *7.2 *4.9 *6.2 *3.6
Other Asian or Pacific Islander 5.0 5.4 4.4 3.7 3.9 3.3 3.4 3.2
Hispanic or Latino4,5 6.2 5.7 4.8 4.1 3.9 3.9 3.8 3.6
Mexican 5.9 5.4 4.5 3.9 3.7 3.7 3.6 3.5
Puerto Rican 8.7 7.6 6.9 6.1 5.2 5.9 5.8 6.0
Cuban *5.0 6.2 5.3 *3.6 *2.7 *3.5 *3.2 *2.5
Central and South American 5.8 5.6 4.4 3.7 3.6 3.3 3.3 3.4
Other and unknown Hispanic or Latino 6.4 5.6 5.0 4.8 4.5 4.8 4.6 3.9
Not Hispanic or Latino:
White5 5.9 5.6 4.5 4.0 3.9 3.8 3.8 3.8
Black or African American5 12.0 11.9 11.0 9.6 9.4 9.6 9.2 9.0
Postnatal3 deaths per 1,000 live births
All mothers 3.8 3.6 3.2 2.6 2.4 2.3 2.3 2.3
White 3.2 3.1 2.7 2.2 2.0 1.9 1.9 1.9
Black or African American 6.7 6.3 5.9 5.0 4.4 4.5 4.3 4.4
American Indian or Alaska Native 7.7 7.0 7.0 5.1 4.4 4.3 3.9 5.4
Asian or Pacific Islander 3.1 2.9 2.7 1.9 1.7 1.7 1.4 1.6
Chinese 4.0 *2.5 *2.0 *1.5 *1.3 *1.2 *1.0 *1.3
Japanese * *2.9 * * * * * *
Filipino *2.8 2.7 2.5 2.2 1.6 1.9 1.6 *1.5
Hawaiian *4.2 *4.3 *3.8 * * * * *3.7
Other Asian or Pacific Islander 3.0 3.0 3.0 1.9 1.8 1.8 1.4 1.6
Hispanic or Latino4,5 3.3 3.2 2.7 2.1 1.9 1.8 1.8 1.8
Mexican 3.2 3.2 2.7 2.1 1.9 1.8 1.8 1.7
Puerto Rican 4.2 3.5 3.0 2.8 2.6 2.4 2.4 2.5
Cuban *2.5 *2.3 *1.9 *1.7 * * * *1.7
Central and South American 2.6 2.4 2.4 1.9 1.7 1.4 1.4 1.6
Other and unknown Hispanic or Latino 4.2 3.9 3.0 2.6 2.0 2.5 2.3 2.1
Not Hispanic or Latino:
White5 3.2 3.0 2.7 2.2 2.0 1.9 1.9 1.9
Black or African American5 7.0 6.4 5.9 5.0 4.5 4.6 4.4 4.5

decades between 1980 and 2000. The prevalence of obesity varies by gender, race, and ethnicity. In 1999–2000 slightly more women (34 percent) than men (28 percent), and one-half of non-Hispanic black women, were obese.

Overweight and obesity not only increase the risk of morbidity (disease) and mortality (death) but also the severity of diseases such as hypertension (high blood pressure), arthritis, and other musculoskeletal problems. TABLE 2.1
Infant, neonatal, and postnatal mortality rates, according to detailed race and Hispanic origin of mother, selected years 1983–2001
[Data are based on linked birth and death certificates for infants]

Race and Hispanic origin of mother 1983–851,6 1988–881,6 1989–911,6 1996–982,6 1999–20012,6
Infant3 deaths per 1,000 live births
All mothers 10.6 9.8 9.0 7.2 6.9
White 9.0 8.2 7.4 6.0 5.7
Black or African American 18.7 17.9 17.1 13.9 13.6
American Indian or Alaska Native 13.9 13.2 12.6 9.3 9.1
Asian or Pacific Islander 8.3 7.3 6.6 5.2 4.8
Chinese 7.4 5.8 5.1 3.4 3.2
Japanese 6.0 6.9 5.3 4.3 4.0
Filipino 8.2 6.9 6.4 5.9 5.7
Hawaiian 11.3 11.1 9.0 8.2 7.8
Other Asian or Pacific Islander 8.6 7.6 7.0 5.5 4.9
Hispanic or Latino4,5 9.2 8.3 7.5 5.9 5.6
Mexican 8.8 7.9 7.2 5.8 5.4
PuertoRican 12.3 11.1 10.4 8.1 8.4
Cuban 8.0 7.3 6.2 4.7 4.5
Central and South American 8.2 7.5 6.6 5.2 4.8
Other and unknown Hispanic or Latino 9.8 9.0 8.2 6.8 6.7
Not Hispanic or Latino:
White5 8.8 8.1 7.3 6.0 5.7
Black or African American5 18.5 17.9 17.2 13.9 13.7
Neonatal3 deaths per 1,000 live births
All mothers 6.9 6.3 5.7 4.8 4.6
White 5.9 5.2 4.7 4.0 3.8
Black or African American 12.2 11.7 11.1 9.3 9.2
American Indian or Alaska Native 6.7 5.9 5.9 4.7 4.5
Asian or Pacific Islander 5.2 4.5 3.9 3.5 3.2
Chinese 4.3 3.3 2.7 2.3 2.1
Japanese 3.4 4.4 3.0 2.6 2.6
Filipino 5.3 4.5 4.0 4.1 4.0
Hawaiian 7.4 7.1 4.8 5.6 4.9
Other Asian or Pacific Islander 5.5 4.7 4.2 3.6 3.3
Hispanic or Latino4,5 6.0 5.3 4.8 3.9 3.8
Mexican 5.7 5.0 4.5 3.8 3.6
Puerto Rican 8.3 7.2 7.0 5.4 5.9
Cuban 5.9 5.3 4.6 3.5 3.1
Central and South American 5.7 4.9 4.4 3.6 3.3
Other and unknown Hispanic or Latino 6.1 5.8 5.2 4.5 4.4
Not Hispanic or Latino:
White5 5.7 5.1 4.6 3.9 3.8
Black or African American5 11.8 11.4 11.1 9.3 9.2

Table 2.4 lists many of the health consequences that may result from overweight and obesity.

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