Advanced nutrition and dietetics in obesity

371 Pages·2018·4.358 MB·English

by  Hankey, Catherine

Advanced Nutrition
and Dietetics in Obesity
Advanced Nutrition
and Dietetics in Obesity
Edited by
Catherine Hankey
PhD RD
Series Editor
Kevin Whelan
PhD RD FBDA
This edition first published 2018 © 2018 by John Wiley & Sons Ltd
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ADVANCED NUTRITION AND DIETETICS BOOK SERIES
Dietary recommendations need to be based on solid evidence, but where can you find this information?
The British Dietetic Association and the publishers of the Manual of Dietetic Practice present an essential
and authoritative reference series on the evidence base relating to advanced aspects of nutrition and dietetics
in selected clinical specialties. Each book provides a comprehensive and critical review of key literature in
the area. Each covers established areas of understanding, current controversies and areas of future develop-
ment and investigation, and is oriented around six key themes:
• Disease processes, including metabolism, physiology and genetics
• Disease consequences, including morbidity, mortality and patient perspectives
• Clinical investigation and management
• Nutritional consequences of disease
• Nutritional assessment, including anthropometric, biochemical, clinical, dietary, economic and social
approaches
• Nutritional and dietary management of disease
Trustworthy, international in scope, and accessible, Advanced Nutrition and Dietetics is a vital resource for
a range of practitioners, researchers and educators in nutrition and dietetics, including dietitians, nutritionists,
doctors and specialist nurses.
Contents
Preface ix
Foreword xi
Editor biographies xiii
Contributors xv
Abbreviations xix
SECTION 1 Introduction 1
1.1 Definition, prevalence and historical perspectives of obesity in adults 3
1.2 Definition, prevalence and historical perspectives of obesity in children 11
1.3 Development of overweight and obesity across the life course 18
1.4 Diagnostic criteria and assessment of obesity in adults 24
1.5 Diagnostic criteria and assessment of obesity in children 31
SECTION 2 Consequences and comorbidities associated with obesity 39
2.1 Obesity in the development of type 2 diabetes 41
2.2 Obesity in the development of cardiovascular disease 49
2.3 Obesity as a risk factor in the development of cancer 56
2.4 Obesity as a risk factor in osteoarthritis and pulmonary disease 64
2.5 Psychology and mental health issues in obesity 71
2.6 Binge eating and obesity 78
SECTION 3 Aetiology of obesity in adults 85
3.1 Genetics and epigenetics in the aetiology of obesity 87
3.2 Food intake and appetite in the aetiology of obesity 97
3.3 Physiological control of appetite and food intake 106
3.4 Obesogenic medication in the aetiology of obesity 113
3.5 Gut microbiome in obesity 118
3.6 Physical activity and physical inactivity in the aetiology of obesity 126
3.7 Obesogenic environment and obesogenic behaviours 132
viii Contents
SECTION 4 Weight management in adults 139
4.1 Macronutrient composition for weight loss in obesity 141
4.2 Meal replacements for weight loss in obesity 150
4.3 Formula diets for weight loss in obesity 157
4.4 Group‐based interventions for weight loss in obesity 164
4.5 Commercial weight management organisations for weight loss in obesity 169
4.6 Fad diets and fasting for weight loss in obesity 177
4.7 Pharmacological management of weight loss in obesity 183
4.8 Diet to support pharmacological management of weight loss 188
4.9 Surgical management of weight loss in obesity 193
4.10 Diet to support surgical management of weight loss 203
4.11 Physical activity for weight loss in obesity 212
4.12 Psychological interventions for weight loss in obesity 221
4.13 Weight loss interventions in specific groups: overweight and obese men 228
4.14 Weight loss interventions in specific groups: Adults with intellectual
disabilities and obesity 235
4.15 Weight maintenance following weight loss in obesity 242
4.16 Economic cost of obesity and the cost‐effectiveness of weight management 252
SECTION 5 Aetiology of obesity in children 261
5.1 Genetics, epigenetics and obesity: focus on studies in children 263
5.2 Food intake, eating behaviour and obesity in children 271
5.3 Physical activity and inactivity in the aetiology of obesity in children 277
SECTION 6 Weight management in children 287
6.1 Diet in the management of weight loss in childhood obesity 289
6.2 Physical activity in the management of weight loss in childhood obesity 295
6.3 Psychological and behavioural interventions in childhood obesity 301
6.4 Residential programmes and weight loss camps in childhood obesity 309
6.5 Pharmacological management of weight loss in childhood obesity 315
6.6 Surgical management of weight loss in childhood obesity 320
SECTION 7 Public health and the prevention of obesity 329
7.1 National campaigns to modify eating behaviour in the
prevention of obesity 331
7.2 Increasing physical activity to prevent childhood obesity 339
7.3 Designing public health initiatives for the prevention of obesity 349
Index 355
Preface
Obesity, which is often described using terms such intractable and persistent condition and a time‐
as fat, stout or corpulent, is in fact derived from the consuming issue that they were unable to treat
Latin word obesus. Obesity is a disease, and as such effectively. Any treatments they considered were
has had an International Classification of Disease long term, resource intensive and only poorly effec-
code since just after World War II. Despite having tive. Sadly, these data from the 1990s have been
the status and recognition as a disease, obesity replicated many times.
treatment has often been overlooked as a regular Advanced Nutrition and Dietetics in Obesity
component of medical management. Comorbidities takes on the huge task of describing the aetiology
associated with obesity, such as type 2 diabetes, of obesity across the life course. There are large
hypertension and hyperlipidaemia, have themselves sections devoted to the disease in children and in
been treated, while interventions that aim to reduce adults. Treatments including surgical, pharmaco-
body weight are less rigorously and consistently logical and lifestyle interventions are considered.
employed. Prevention of weight gain and obesity, the role of
The first clinical guidelines for obesity were pub- the environment, new town design and transport
lished in 1996, advocating roles and responsibilities policy too are discussed. The occurrence of obesity
for a range of health professionals – including has reached epidemic proportions worldwide, and
doctors (general practitioners/family physicians), this text aims to provide the reader with a broad
nurses and dietitians – to manage obesity. In the understanding of the multifactorial causes of exces-
light of these clinical guidelines, researchers sought sive and unwanted weight gain. After reading this
the views of health professionals whose practice book, I hope the reader will feel that obesity is not a
was either in the community (primary care) or in a simple problem, but a global phenomenon that is
speciality based in a hospital (secondary care). multifactorial in nature, requiring a multidisciplinary
Hospital consultants across all specialities agreed approach for management and prevention. Much
that effective weight management could, without effort, commitment and research are still required to
exception, improve treatment outcomes. However, challenge this chronic and persistent disease.
none had a treatment protocol in place, suggesting This book is aimed at all those whose work
that obesity management was ad hoc. A majority embraces any aspect of obesity. This includes clini-
felt unable to resource weight management, sug- cians, researchers, public health experts, educators
gesting that community (primary care) and general and health economics specialists. Those undertak-
practice were more suitable as locations for treat- ing further studies in health and disease too may
ment. General practice staff, general practitioners find this a useful reference and resource.
and practice nurses also felt that reduction in body
weight would improve the health of many adults Catherine Hankey PhD RD
who consulted them. Once more, they themselves Senior Lecturer in Human Nutrition
felt unable, for the same reasons, to address the University of Glasgow, UK
need for weight loss as part of their care. Many Editor
considered obesity an inevitable result of aging, an Advanced Nutrition and Dietetics in Obesity
x P reface
This book is the third title in a series (Advanced Obesity. We hope that it will impact on health
Nutrition and Dietetics Book Series) commissioned professionals’ understanding and application of nutri-
as part of a major initiative between the British tion and dietetics in the management and prevention
Dietetic Association and Wiley. Each book in the of obesity. Effective weight management improves
series provides a comprehensive and critical review of the health of both adults and children. Prevention of
the key literature in a clinical area. Each book is the chronic weight gain of adulthood in many parts
edited by one or more experts who have themselves of the world are essential, and approaches to address
undertaken extensive research and published widely this issue so far are discussed.
in the relevant topic area. Each book chapter is written
by experts drawn from an international audience Kevin Whelan PhD RD FBDA
and from a variety of disciplines as required of the Professor of Dietetics
relevant chapter (e.g. dietetics, medicine, public health, King’s College London, UK
psychology, biomedical sciences). A future title in Series Editor
this series will cover nutritional support. Advanced Nutrition and Dietetics Book Series
The editor and I are proud to present the third title
in the series, Advanced Nutrition and Dietetics in
Foreword
This book is a very timely synthesis of the dimen- only an understanding of the underlying features
sions of the problems of obesity and how to manage of appetite control but also the need for routine
them in what is rapidly now becoming the most physical activity incorporated into most individuals’
intractable issue in both clinical management and normal habits. There are very authoritative accounts
public health across the globe. This book, written of the genetic, endocrinological and clinical aspects
by contributors from the UK, Europe and throughout of the epidemic in adults as well as in children, in
the world, comes at a time when it looks as though whom obesity only emerged in the last 20 years as a
politicians are finally waking up to the fact that major burden in paediatric practice. Although the
health services are already overwhelmed by the childhood obesity epidemic seems to be slowing in
numbers of people with multiple obesity‐related many European countries, the overall prevalence of
conditions. As healthcare professionals become childhood overweight and obesity are still horrifying.
ever more sophisticated at coping with the immedi- Hence, we can expect to see vicious combinations
ate risk factors of type 2 diabetes and cardiovascular of genetic and epigenetic influences as these
disease, we still see most clinical teams neglecting children and the next generation enter adulthood,
obesity as the underlying driver, with all its proxi- with their clinical care becoming ever more diffi-
mal causes. Given the magnitude of the currently cult. Thus, young overweight women now entering
escalating health burden, it is timely that this book, pregnancy seem unaware of the challenges that new
essentially geared to the clinical teams involved in research suggests lies in wait for their families and
obesity prevention and treatment, is now published. family practitioners. With rapidly rising rates of
The descriptions cover the full range of new ideas gestational diabetes, especially in Europe’s ethnic
and evidence of both the underlying pressures on minorities, we are already witnessing far earlier
the majority of our population and how to begin onsets of adult abdominal obesity and type 2 diabe-
to effectively manage such a challenging organisa- tes, with its sustained challenges for maintaining
tional and multidimensional problem. medical care of chronically sick patients. The
Many of these expert contributors have decades of chapters on the co‐morbidities should therefore
experience in trying to establish effective approaches help to amplify a broader approach to the manage-
to the management and prevention of obesity. The ment of an array of risk factors, and this book
historical account emphasises the struggle that benefits from adding musculoskeletal and psycho-
has gone on for decades, with the first semi‐official logical comorbidities to the traditional cardiovascular
reports on appropriate clinical schemes for manag- foci of concern.
ing the problem only emerging 20 years ago in both There are very appropriate chapters first on the
Scotland and the USA. Much of the drive, as is diagnostic criteria that should be used in both
usual in medical management, has come with the screening and monitoring clinical progress in children
search for suitable pharmacological strategies; and adults, followed by a comprehensive descrip-
nevertheless, as other chapters emphasise, the neglect tion and analysis of dietary approaches that have
of the transformation of both the dietary modifica- been tried and progressively evaluated. Then come
tion and physical activity required necessitates not assessments of the value of pharmacological and
xii Foreword
surgical management, as well as interventions to integrated contributions could have been produced
improve physical activity levels. a decade ago, but then we would not have benefitted
Fitting all this together with the issues of obe- from so much of the new research and analyses
sity prevention and how this can link into clinical that are presented here.
practice is a real challenge. This book therefore W. Philip T. James
gives us both an overview and the detail that is so Professor, London School of Hygiene and
necessary if we are to engineer a revolution in Tropical Medicine
clinical practice. One just wishes that the many Past president of the World Obesity Federation