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Introduction: All over the world, the problem of excess body weight is being raised more and more frequently. In 2021. the number of obese people has tripled compared to 1975. Due to the constantly growing number of people meeting the criteria for overweight and obesity, it is becoming extremely important to implement preventive measures. Cardiovascular Diseases Prevention Program implemented in Poland as part of the National Health Fund program is a good opportunity to identify patients with abnormal body weight and to correct behavior and health education.
Material: A retrospective analysis of data obtained by the National Health Fund as part of the implementation of 86,485 preventive cards of the Cardiovascular Diseases Prevention Program in the Lubelskie Voivodeship in 2008-2018 was carried out. The analyzes were performed using the IBM SPSS Statistics for Windows, version 25 program. The chi-square test and the Pearson linear correlation between the quantitative features were used to test the relationship between the two qualitative features. Significant predictors of a risk factor for cardiovascular disease were determined using multivariate logistic regression. The significance level was assumed to be α = 0.05 for two-tailed tests.
Results: The average BMI value was 26.12 kg / m2. 1st degree obesity was diagnosed in 14.3% of patients, 2nd degree - 2.9%, 3rd degree - 0.7%. Excess body weight was significantly more often observed among men. With the increase in the number of years in the study population, the occurrence of overweight and obesity was significantly higher. One unit increase in BMI was associated with a 13% increase in the risk of high blood pressure and a 12% increase in the risk of serum glucose ≥126 mg/dl. It also increased the risk of hypercholesterolaemia by 4.2% and of elevated LDL levels by 5.5%.
Conclusions: The prevalence of obesity is extremely worrying. Excessive body weight undeniably translates into worse health of the population. The Cardiovascular Diseases Prevention Program at Primary Healthcare Clinics is a convenient opportunity to identify the factors leading to the development of obesity and to promote health-promoting behaviors.
Bibliografia
Araiza, A.M., Wellman, J.D. (2017). Weight stigma predicts inhibitory control and food selection in response to the salience of weight discrimination. Appetite, 114, 382–390. https://doi.org/10.1016/j.appet.2017.04.009
Foreman, K.J., Marquez, N., Dolgert, A., Fukutaki, K., Fullman, N., McGaughey, M., Pletcher, M.A., Smith, A.E., Tang, K., Yuan, C.W., Brown, J.C., Friedman, J., He, J., Heuton, K.R., Holmberg, M., Patel, D.J., Reidy, P., Carter, A., Cercy, K., Chapin, A., Murray, C. (2018). Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet (London, England), 392(10159), 2052–2090. https://doi.org/10.1016/S0140-6736(18)31694-5
Gallus, S., Lugo, A., Murisic, B., Bosetti, C., Boffetta, P., La Vecchia, C. (2015). Overweight and obesity in 16 European countries. European Journal of Nutrition, 54(5), 679–689. https://doi.org/10.1007/s00394-014-0746-4
GUS, (2015). Zdrowie i zachowanie zdrowotne mieszkańców Polski w świetle Europejskiego Ankietowego Badania Zdrowia (EHIS) 2014 r. https://stat.gov.pl/obszary-tematyczne/zdrowie/zdrowie/zdrowie-i-zachowania-zdrowotne-mieszkancow-polski-w-swietle-badania-ehis-2014,10,1.html (access: 01.07.2022).
GUS, (2018). Ambulatoryjna opieka zdrowotna w 2017 r. Urząd Statystyczny w Krakowie, Ośrodek Statystyki Zdrowia i Ochrony Zdrowia, https://stat.gov.pl/obszary-tematyczne/zdrowie/zdrowie/ambulatoryjna-opieka-zdrowotna-w-2017-roku,13,2.html (access: 02.07.2022).
GUS, (2019). Ambulatoryjna opieka zdrowotna w 2018 r. Urząd Statystyczny w Krakowie, Ośrodek Statystyki Zdrowia i Ochrony Zdrowia, https://stat.gov.pl/obszary-tematyczne/zdrowie/zdrowie/ambulatoryjna-opieka-zdrowotna-w-2018-roku,13,3.html (access: 02.07.2022).
Hunger, J.M., Major, B., Blodorn, A., Miller, C.T. (2015). Weighed down by stigma: How weight-based social identity threat contributes to weight gain and poor health. Social and Personality Psychology Compass, 9, 255–268. http://dx.doi.org/10.1111/spc3.12172
Jackson, S. E., Steptoe, A. (2017). Association between perceived weight discrimination and physical activity: a population-based study among English middle-aged and older adults. BMJ Open, 7(3), e014592. https://doi.org/10.1136/bmjopen-2016-014592
Kitahara, C.M., Flint, A. J., Berrington de Gonzalez, A., Bernstein, L., Brotzman, M., MacInnis, R.J., Moore, S.C., Robien, K., Rosenberg, P.S., Singh, P.N., Weiderpass, E., Adami, H.O., Anton-Culver, H., Ballard-Barbash, R., Buring, J.E., Freedman, D.M., Fraser, G.E., Beane Freeman, L.E., Gapstur, S.M., Gaziano, J.M., Hartge, P. (2014). Association between class III obesity (BMI of 40-59 kg/m2) and mortality: a pooled analysis of 20 prospective studies. PLoS Medicine, 11(7), e1001673. https://doi.org/10.1371/journal.pmed.1001673
Kolegium Lekarzy Rodzinnych w Polsce, Polskie Towarzystwo Medycyny Rodzinnej, Polskie Towarzystwo Badań Nad Otyłością (2017). Zasady postępowania w nadwadze i otyłości w praktyce lekarza rodzinnego. Lekarz Rodzinny, Wydanie specjalne, 3, 1-56.
Minister Zdrowia (2019) Obwieszczenie Ministra Zdrowia z dnia 21 marca 2019r. w sprawie ogłoszenia jednolitego tekstu rozporządzenia Ministra Zdrowia w sprawie świadczeń gwarantowanych z zakresu podstawowej opieki zdrowotnej. Dziennik Ustaw Rzeczypospolitej Polskiej http://prawo.sejm.gov.pl/isap.nsf/download.xsp/WDU20190000736/O/D20190736.pdf (access: 15.06.2022).
NCD Risk Factor Collaboration (NCD-RisC) (2017). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet (London, England), 390(10113), 2627–2642. https://doi.org/10.1016/S0140-6736(17)32129-3
Obesity Rates Across Europe – World Atlas (2019) https://www.worldatlas.com/articles/the-fattest-countries-in-europe.html#:~:text=The%20average%20obesity%20rate,in%20Europe%20is%2023.3%25 (access: 05.07.2022).
Ocena rozpowszechnienia i kontroli czynników ryzyka chorób serca i naczyń w Polsce – badania NATPOL 1997, 2002, 2011. (2015). In: G. Kopeć, P. Jankowski, A. Pająk, W. Drygas (eds.) Epidemiologia i prewencja chorób układu krążenia, 57–64, Kraków: Medycyna Praktyczna.
OECD (2017). Obesity update. https://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf (access: 04.07.2022).
Pearl, R.L., Walton, K., Allison, K.C., Tronieri, J.S., Wadden, T.A. (2018). Preference for People-First Language Among Patients Seeking Bariatric Surgery. JAMA Surgery, 153(12), 1160–1162. https://doi.org/10.1001/jamasurg.2018.2702
Pischon, T., Boeing, H., Hoffmann, K., Bergmann, M., Schulze, M.B., Overvad, K., van der Schouw, Y.T., Spencer, E., Moons, K.G., Tjønneland, A., Halkjaer, J., Jensen, M.K., Stegger, J., Clavel-Chapelon, F., Boutron-Ruault, M.C., Chajes, V., Linseisen, J., Kaaks, R., Trichopoulou, A., Trichopoulos, D., Riboli, E. (2008). General and abdominal adiposity and risk of death in Europe. The New England Journal of Medicine, 359(20), 2105–2120. https://doi.org/10.1056/NEJMoa0801891
Seacat, J.D., Dougal, S.C., Roy, D. (2016). A daily diary assessment of female weight stigmatization. Journal of Health Psychology, 21(2), 228–240. https://doi.org/10.1177/1359105314525067
Sideli, L., Lo Coco, G., Bonfanti, R.C., Borsarini, B., Fortunato, L., Sechi, C., Micali, N. (2021). Effects of COVID-19 lockdown on eating disorders and obesity: A systematic review and meta-analysis. European eating disorders review: the journal of the Eating Disorders Association, 29(6), 826–841. https://doi.org/10.1002/erv.2861
Simone, M., Lockhart, G. (2016). Two distinct mediated pathways to disordered eating in response to weight stigmatization and their application to prevention programs. Journal of American College Health, 64(7), 520–526. https://doi.org/10.1080/07448481.2016.1188106
Stepaniak, U., Micek, A., Waśkiewicz, A., Bielecki, W., Drygas, W., Janion, M., Kozakiewicz, K., Niklas, A., Puch-Walczak, A., Pająk, A. (2016). Prevalence of general and abdominal obesity and overweight among adults in Poland. Results of the WOBASZ II study (2013-2014) and comparison with the WOBASZ study (2003-2005). Polskie Archiwum Medycyny Wewnetrznej, 126(9), 662–671. https://doi.org/10.20452/pamw.3499
Sypniewska, G. (2007). Pro-Inflammatory and Prothrombotic Factors and Metabolic Syndrome. Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine, 18(1), 39–46.
Weinberger, N.A., Kersting, A., Riedel-Heller, S.G., Luck-Sikorski, C. (2016). Body Dissatisfaction in Individuals with Obesity Compared to Normal-Weight Individuals: A Systematic Review and Meta-Analysis. Obesity Facts, 9(6), 424–441. https://doi.org/10.1159/000454837
Wendelboe, A.M., Hegmann, K.T., Biggs, J.J., Cox, C.M., Portmann, A.J., Gildea, J.H., Gren, L.H., Lyon, J.L. (2003). Relationships between body mass indices and surgical replacements of knee and hip joints. American Journal of Preventive Medicine, 25(4), 290–295. https://doi.org/10.1016/s0749-3797(03)00218-6
WHO, (2010). Obesity: preventing and managing the globalepidemic. Report of a WHO Consultation. WHO Technical Report Series 894. Geneva: World Health Organization.
WHO, (2021). FactSheets.Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (access: 01.07.2022).
Windak, A., Niżankowski, R., Lukas, W., Tomasik, T., Panasiuk, L., Florek-Łuszczki, M., Paprzycki, P., Jankowska-Zduńczyk, A., Jakubiak, A., Łuczak, J., Lutomski, P., Golema, K., Kijowska, M., Barańska, I., Chmura, R. (2019). Raport „Podstawowa opieka zdrowotna w Polsce – diagnoza i projekty zmian”. http://www.zdrowie.gov.pl/epublikacje/Pobierz/id/57.html (access: 29.06.2022).
Zdrojewski, T., Rutkowski, M., Bandosz, P., Gaciong, Z., Solnica, B., Drygas, W., Wojtyniak, B., Stokwiszewski, J., Pencina, M., Wołkiewicz, E., Piwonski, J., Jędrzejczyk, T., Grodzicki, T., Wyrzykowski, B. (2015). Ocena rozpowszechnienia i kontroli czynników ryzyka chorób serca i naczyń w Polsce – badania NATPOL 1997, 2002, 2011. In: G. Kopeć, P. Jankowski, A. Pająk, W. Drygas (eds.) Epidemiologia i prewencja chorób układu krążenia, 57–64, Kraków: Medycyna Praktyczna.