Relationship between Obesity and Cardiovascular Diseases.

Nature & scope of proposed project:

Overweight or obesity, according to the CDC, is more significant than what is considered healthy for a given height. The Body Mass Index (BMI) is a technique for determining whether someone is overweight or obese. Although BMI does not accurately measure excess weight, it is somewhat associated with more direct fat mass measurements from skinfold thickness measurements, bioelectrical impedance, submarine weighing, dual-energy x-ray absorptiometry (DXA), and other factors techniques. Moreover, even with these additional immediate actions of body fatness, BMI seems to be highly linked with various adverse health outcomes (CDC, 2021).

Obesity is a common, life-threatening, and expensive disease. In 2017–2018, the obesity speed in the U.S was 42.4 percent. Between 1999 and 2018, most overweight and obesity in the U.S rose from 30.5 percent to 42.4 percent (CDC, 2021). During the exact duration, the plurality of extreme obesity grew from 4.7 percent to 9.2 percent. Heart illness, stroke, type 2 diabetes, and cancer are all related to obesity. Pursuing is some of the most typical reasons for death globally. In 2008, the yearly medical cost of the obesity external symbol in the U. S. was projected to be $147 billion. Obesity-related medical expenses stood at $1,429 more than healthy size (CDC, 2021).

   From a population standpoint, treating obesity entails reversing this trend by declining the implied BMI and diminishing the rate of obesity, during which people reach the upper end of the BMI range. (Kumanyika,2010). The first sign of success would be a stability of the BMI dispersion or an increase in the number of unique individuals reaching the appropriate BMI point (30 kg/m2 for adults or the 95th sex–age percentile of the BMI reference for children), followed by a decrease in these indicators. To accomplish it within the community, healthy adults (not too thin, fat, or obese) must keep their weight and prevent the shared aging wonder of excessive significance increase (Kumanyika,2010).

     Management for kids is keeping a healthy weight trajectory and avoiding excessive weight gain as they grow, and mature (Kumanyika,2010). Attempting to prevent or delay the development of obesity-related health conditions in people who are otherwise healthy looking or obese can be described as sidestepping progress to a more powerful obesity story and stopping or slowing the beginning of adiposity illnesses in people who are already plump or obese.

      Considering rising overall importance rates and obesity prevalence, a 1995 IOM statement on standards for the importance of assessing weight-loss initiatives was highlighted the significance of assigning increased focus to obesity precluding (IOM, 1995) (Kumanyika,2010). Even though the report’s primary goal is on establishing criteria for each concentrating consequence control schedule, the group that created it set the foundation for considering preventive classes from a folk viewpoint. Rather than using the primary, secondary, and tertiary prevention diction, which is typically used in connection to chronic illnesses and is predicated on a continuum of disease development, the section identifies preventative categories in the duration of inhabitant’s elements. As a result, the 1995 board shifted its prevention strategy to a broader risk mitigation strategy.

       In addition, a combination of techniques is required. Individual-oriented techniques are essential, but they should be utilized with caution when dealing with problems that affect entire communities because they are often among the most resource-intensive ways (Kumanyika,2010). Such mentioned preventative techniques are therapy tactics aimed at adults and children who are overweight or obese to prevent them from progressing to adulthood obesity. Case diagnosis and intense, long-term counseling are required for these tactics (Kumanyika,2010).

   Some other aim is to focus very little on individual-oriented overweight standard precautions, which is what creates psychosocial protection. Obesity diagnosis and management are both predicated on the same energy density theory, but the issues are distinctive (Kumanyika,2010). Effective procedure on the creation of lousy energy rebalancing thru the considerable reduction in calorie consumption and rises in physical exercise to generate a noticeable decrease in body weight. Caloric compensation or caloric input that helps optimal development practices in children is the goal of prevention, as is avoiding a chronic, minor positive vibes imbalance that leads to excess weight gain over time (Kumanyika,2010).

      Consequently, quantifying the precluding outcomes is challenging since the products are slightly noticeable no difference in poundage or health effects, in contrast to the poundage failure and reduction in danger elements associated with therapy (Kumanyika,2010). Likewise, it is challenging to evaluate or, from someone’s view, be assured that they are creating tiny modifications in caloric consumption and biological action that could help them avoid gaining too much weight (Kumanyika,2010). As a result, global preventative measures that encourage collective behaviors across boundaries that reduce the chance of chronic extra caloric consumption concerning cost are critical.

      Such strategies primarily concentrate on changing social norms and structures via shifts in policy or the deployment of extensive initiatives that limit population-wide direction to obesity-promoting states (Kumanyika,2010). The same can be said for tailored preventative methods targeting specific subpopulations, kids, and adolescents, or racial or socioeconomic class companies with a higher-than-average obesity majority. It could be necessary to concentrate on distinct residents to confirm that interventions handle inequities in environmental and social situations associated with eating or biological activity, access to food or accessibility, or physical activity options. Individuals may be addressed as part of a broader preventive strategy, but not one-on-one (Kumanyika,2010). Mass education or social marketing initiatives are personal knowledge and skills connected to weight change and positively responsive to environmental or legislative changes.

   Obesity has been related to a wide range of cardiovascular disorders (CVD), including coronary heart disease, heart failure, hypertension, stroke, atrial fibrillation, and sudden cardiac arrest. In the United States, heart disease is the top cause of mortality for men, women, and people of most racial and ethnic groups (CDC,2022). In the United States, one person dies from cardiovascular disease every 36 seconds. Cardiovascular disease claims the lives of around 659,000 people in the United States each year, accounting for one out of every four deaths. Between 2016 and 2017, the United States spent $363 billion on heart disease. (CDC,2022) That covers the number of medical services, medications, and lost productivity due to mortality.

Obesity can both intrinsically and extrinsically increase CVD morbidity and mortality. (Koliaki et al., 2019). Adiposity structural and functional modifications of the cardiovascular system to accept extra body fat and adipokine effects on inflammation and vascular homeostasis indirectly. Insulin resistance, hyperglycemia, hypertension, and dyslipidemia are examples of CVD risk factors with indirect implications (Koliaki et al., 2019). For cardiovascular risk, the structure and function of adipose tissue (AT) are more significant than the absolute number.

The impact of physical movement, dietary intervention, obesity, and cigarette smoking on cardiovascular health and CVD deterrence is the subject of this review (Buttar et al.,2005). Everyone’s life includes some form of physical activity or exercise. However, the level of physical exertion varies from person to person. Several evidence-based analyses have invariably seen a connection between physical exercise and good health. Nonetheless, when assessing how well-controlled investigations have been conducted, various aspects of physical activity must be considered. Physical activity definitions vary widely, making the findings of different studies incomparable.

Fortunately, three focus areas in determining biological action remain consistent: intensity, duration, and frequency. (Buttar et al.,2005). The degree or extent of exertion is referred to as intensity, and it is frequently expressed as a rate of target heart rate or lung volume (oxygen consumption). Duration guides how extended an action survives, whereas commonness directs the number of periods performed. Numerous analyses have shown a connection between physical training and overall well-being. It has been frequently demonstrated that there is an inverse association between biological activity and the event of CVDs (with improved physical activity, the comparative threat of producing CVD is reduced) (Buttar et al.,2005).

 Clinical and laboratory investigations have demonstrated the advantages of bodily exercise involving distinct surrogate features and physical aspects linked to CVD hazard characteristics (high blood pressure and improved cholesterol and triglyceride attention). These quantitative dimensions were taken out to define the impact of training on blood clotting and fibrinolysis, vascular remodeling, blood pressure, and blood lipid profiles. Besides, these analyses have cleared light on the possible adverse outcomes of practice, especially when negotiating with patients with chronic heart failure, and the protection that should be taken to avoid these health risks (Buttar et al.,2005).

Obesity is identified as a heterogeneous disease in which individuals with comparable BMIs can hold very different metabolic and CVD threat statuses. Therefore, sensitivity to obesity-related cardiovascular health issues is judged primarily by regional body lubricant dispersal contrasts, negatively impacting cardiac form and process (Powell-Wiley et al., 2021). With the increasing preponderance of obesity in residents with more extended life spans, there is a need for future research to assess tools underlying obesity-related cardiac dysfunction and to enhance the control of patients with obesity and CVD. Also, the substantial growth in the ratio of youthful people with symptomatic obesity underscores the demand for better upstream interventions for primary deterrence and more suitable therapy of obesity as a chronic illness (Powell-Wiley et al., 2021).

This APE project aims to examine the interaction between environmental stress and cardiovascular health which was affected by metabolic illness like obesity and identify molecular determinants aligned with behavioral approaches that may help limit and prevent the development of cardiovascular diseases.

Objectives:

1)     By March 3, 2022, examine the effect of obesity on the risk of cardiovascular disorder research with at least ten evidence-based literature citations.

2)     By March 15, 2022, define connectivity between behavioral and social factors that attribute to dysfunction of cardiovascular and its health implications reviewing ten evidence-based research articles.

3)     By April 15 2022, explore molecular determinants between environmental factors and behavioral (or social) factors that contribute to disease transformation from obesity to cardiovascular by reviewing ten evidence-based research articles.

4)     By May 6, 2022, explore environmental factors that cause cardiovascular impairment associated with metabolic syndrome like obesity ​by developing a 25- PowerPoint slide format for the purpose of public awareness.

Strategies to be used:

Performance of a thorough literature review to recognize the interaction between obesity and cardiovascular risk factors, prevention, hazardous effects, and the magnitude of the problem. Through journal articles peer-reviewed via PubMed, Google Scholar, and other web reliable sources. Also, we will collect information from the World Health Organization (WHO), National Institutes of Health (NIH), and the Centers for Disease Control and Prevention (CDC).

Site resources to be used:

            Site resources to be used (if special permission is needed to gain access to data, records, etc. how it will be arranged) after permission to use. All literature review materials will be provided search engine from PubMed, CDC, WHO, the CounterACT Centre of Excellence at Rutgers University, Piscataway NJ. Any other materials and resources required to conduct the study will also be used within core/satellite-facility.

Identify which competencies you will be developing during your APE:

• FC 2: Select quantitative and qualitative data collection methods appropriate for a given public health Context.
• FC 7: Assess population needs, assets and capacities that affect communities’ health.
• FC 19: Communicate audience-appropriate public health content, both in writing and through oral presentation.
• HBCH 1: Identify and describe the major behavioral and social sources of morbidity and mortality.
• HBCH 5: Identify the role that social, environmental, and personal stressors play in the health of individuals and communities.

Final products: (Each student must include two products. Students must match their identified competencies to their products. A specific deliverable can cover more than one competency):

• Literature review
• APE report
• APE poster
• APE PowerPoint handout

Practice-based products that demonstrate MPH competency achievement
Specific products in portfolio that demonstrate application or practice	List competency name and number as defined in the APE Guidelines (Appendix A, Appendix B)
Literature review	FC 2, FC 7, FC 19, HBCH 1, HBCH 5
APE report	FC 2, FC 7, FC 19, HBCH 1, HBCH 5
APE poster	FC 2, FC 7, FC 19, HBCH 1, HBCH 5
APE PowerPoint handout	FC 2, FC 7, FC 19, HBCH 1, HBCH 5

References:

Buttar, H. S., Li, T., & Ravi, N. (2005). Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation. Experimental and clinical cardiology, 10(4), 229–249.

Centers for Disease Control and Prevention (2021, June 7). Defining Adult Overweight and Obesity. https://www.cdc.gov/obesity/adult/defining.html

Centers for Disease Control and Prevention. (2021, November 12). Obesity is a Common, Serious, and Costly Disease. https://www.cdc.gov/obesity/data/adult.html

Centers for Disease Control and Prevention. (2022, February 7). Heart Disease Facts | cdc.gov. https://www.cdc.gov/heartdisease/facts.htm

Kumanyika, S. K. (2010). Bridging the Evidence Gap in Obesity Prevention: A Framework to Inform Decision Making (1st ed.). National Academies Press.

Koliaki, C., Liatis, S., & Kokkinos, A. (2019). Obesity and cardiovascular disease: revisiting an old relationship. Metabolism, 92, 98–107. https://doi.org/10.1016/j.metabol.2018.10.011

Powell-Wiley, T. M., Poirier, P., Burke, L. E., Després, J. P., Gordon-Larsen, P., Lavie, C. J., Lear, S. A., Ndumele, C. E., Neeland, I. J., Sanders, P., & St-Onge, M. P. (2021). Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation, 143(21). https://doi.org/10.1161/cir.0000000000000973