Overvægt og fedme er hotte emner i det danske samfund og medier. Det skyldes primært den stigende forekomst af overvægt, vi ser i Danmark, hvor omkring 43 % af befolkningen er overvægtige (BMI >25-30), og 13 % lider af svær ovevægt (BMI>30).
En af konsekvenserne af abdominal overvægt er inflammation i kroppen, som kan føre til metabolisk syndrom – et syndrom, der er ved at vinde frem i Danmark og kendetegnes ved et taljemål på over 80 cm for kvinder og 94 cm for mænd, samt minimum to faktorer i form af forhøjet triglycerid indhold, formindsket HDL indhold, forhøjet plasma glukose, og forhøjet blodtryk.
Af Caroline Alsted
Artiklen blev bragt i magasinet sund-forskning og //mig// – februar 2015
Kriterier for det metaboliske syndrom:
- Taljemål på over 80 cm for kvinder og over 94 cm for mænd
- Samt mindst to af de følgende kriterier:
- Triglycerid indhold over 150 mg/dL (1.7 mmol/L)
- HDL indhold Under 40 mg/dL (1.03 mmmol/) hos mænd og under 50 ml/dL (1.29 mmmol/L) hos kvinder
- Blodtryk: systolisk over 130 mm Hg eller diastolisk over 85 mm Hg
- Plasma glukose over 100 mg/dL (5.6 mmol/L)
Årsager til udvikling af overvægt
Hvis vi skal forebygge og mindske udvikling af overvægt samt reducere forekomsten af det metaboliske syndrom, er det nødvendigt med en bredspektret forståelse og viden om de grundliggende årsager for overvægt.
Grundlæggende samspillende årsager til overvægt:
- Energi ubalance – større energiindtag i forhold til energiforbrug
- Inaktiv livsstil
- Miljø og omgivelser: mangel på fortove, cykelstier og grønne arealer, arbejdstider mm.
- Gener og familie-historik
- Krops- og sundhedstilstand: hormonelle ubalancer
- Medicin: antidepressiv medicin, kortikossteroider mm.
- Graviditet
- Rygestop
- Alder
- Psykologiske faktorer: stress, overspisning mm.
- Søvnmangel
To kategorier af overvægt: hypertrofisk og hyperplastisk overvægt
Overvægt skyldes et samspil mellem de nævnte årsager og kan inddeles i to grupper, afhængigt af om der er tale om forstørrelse af fedtcellerne (hypertrofisk overvægt) eller antallet af fedtceller (hyperplastisk overvægt).
Hyperplastisk fedme og barndommens betydning
Hyperplastisk fedme betegnes af WHO som en kronisk sygdom på grund af de kropslige dysfunktioner og det kronisk forøgede antal fedtceller, som ikke kan reduceres uden medicinsk eller kirurgisk indgreb. Hyperplastisk fedme skyldes primært gener og udvikles i barndommen eller ungdomsårene, hvilket gør det ekstra svært at gøre noget ved i voksenlivet. Hos normalvægtige børn tre-firdobles både størrelsen og antallet af fedtceller fra spæd til 2-års alderen, hvorefter der først sker en forøgelse af fedtceller omkring puberteten igen. Hos småbørn med overvægt sker der fra 2-årsalderen og op til puberteten derimod en fortsat udvikling i både størrelse og antal af fedtceller. Et barn med hyperplastisk overvægt får altså rigtig svært ved at komme ned på sin idealvægt senere i livet, da kroppen har udviklet et kronisk forhøjet antal fedtceller i barndommen. Derfor er det enormt vigtigt at gribe ind overfor overvægt så tidligt i barndommen som muligt. En måde udvikling af hyperplastisk overvægt kan forebygges på, er ved at fokusere på børn, der er disponeret for hyperplastisk overvægt, da de skal bevæge sig betydeligt mere end andre børn og have en varieret kost allerede fra 2-3 års alderen.
Hvem er i risiko for at udvikle hyperplastisk overvægt:
Personer der har:
- Familie-historie med overvægt
- Overvægt i barndommen eller ungdomsårene
- Svært ved at ændre vægt, uanset fysisk aktivitet og kostændringer
- Mislykkede vægttabsforsøg, som ender tilbage på startvægten igen
Hyperplastisk overvægt hos børn kan tjekkes via barnets vægt og familie-historie:
Ved én overvægtig forælder er risikoen nemlig 40 % for at udvikle hyperplastisk overvægt, og ved overvægt hos begge
forældre er risikoen oppe på 80%.
Hypertrofisk overvægt
Hypertrofisk overvægt er primært aldersbetinget og udvikles, i modsætning til hyperplastisk overvægt, oftest i voksen-livet, når vi bliver mere stillesiddende, og hormonerne ændrer sig. En person med hypertrofisk overvægt kan bedre tabe sig ved hjælp af livsstilsændringer, da det her drejer sig om størrelsen på fedtcellerne, som godt kan mindskes. Det er det, viser, når taljen svinder ind ved vægttab.
Genernes betydning for overvægt
Hyperplastisk overvægt er et eksempel på genernes betydning for overvægt og samspillet mellem gener og miljø.
Forskere har fundet hundrede forskellige slags gener, der er indblandet i udvikling af overvægt og fedme. Den stigende viden om genernes betydning for overvægt bidrager til et holistisk syn på overvægt og kan være med til bekæmpelse
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