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:: Alimenta.com.uy :: Sobrepeso y obesidad
 
Sello ganador categoria pericom.uy
Suscripción
Enviar
Recetas

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Sobrepeso y obesidad


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Más de la mitad de la población Uruguaya tiene sobrepeso u obesidad
Sobrepeso y obesidad

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La obesidad es un problema de salud que afecta a los países desarrollados y en desarrollo, lo que ha llevado a la Organización Mundial de la Salud (OMS) a establecer que esta afección constituye un grave problema de salud pública mundial.

En nuestro país, el estudio ENSO 1, hace ya varios años, evidenció que más de la mitad de la población uruguaya (51%) tenían sobrepeso u obesidad, mientras que el 17 % eran obesos y un 5% se encontraba en situación de riesgo.

La obesidad reduce la expectativa de vida, pues quienes son obesos a los 40 años tienen una reducción de alrededor de siete años de su expectativa de vida. Esto se debe a que las personas obesas presentan múltiples problemas de salud: mayor prevalencia de enfermedades cardiovasculares, diabetes, algunos tipos de cáncer, afecciones respiratorias y osteoarticulares, entre otras. La obesidad puede ser además causa de sufrimiento, depresión y de comportamientos de rechazo social que perjudican la calidad de vida de los individuos.



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¿Que es la obesidad?


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La obesidad se define como el incremento de grasa corporal, en relación con la masa magra, que por lo general se acompaña con un aumento de peso (esta condición puede a veces no cumplirse), que pone en riesgo la salud del individuo. Normalmente en un hombre adulto, un 25 % de su peso corporal es graso y en una mujer el 30% de su peso es tejido adiposo.

Actualmente existen varios métodos para medir la grasa corporal, algunos más simples de realizar como la bioimpedancia eléctrica y otros más sofisticados a través de imagenología por rayos X. En la práctica se utilizan en general indicadores más sencillos, el más utilizado es el IMC (Índice de masa Corporal) que se obtiene de una relación entre el peso y la talla (peso/talla2). Según este índice, se define al sobrepeso a aquellas personas que tienen un IMC de 25 o más, y obesos a aquellos con un IMC superior a 30. En la actualidad se sabe que cuanto mayor IMC tiene un individuo mayor probabilidad de desarrollar enfermedades como diabetes, hipertensión arterial, insulino resistencia. Y mas que conocido es que tanto el sobrepeso como la obesidad son uno de los principales enemigos del corazón.


Un aspecto importante a tener en cuenta es que: la distribución de la grasa corporal también modifica el riesgo para la salud del individuo.


¿Querés conocer tu índice de masa coporal? click aquí





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Tipos de obesidad según la distribución del tejido adiposo


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.

Obesidad androide: también conocida como obesidad abdominal. Es la forma mas frecuente en los hombres, aunque también se da en mujeres. La grasa se acumula en la mitad superior del cuerpo (tronco y abdomen), dando lo que se conoce como "forma de manzana". Este tipo de distribución grasa ha sido particularmente asociada a mayor riesgo de padecer diabetes tipo 2, hipertensión arterial o enfermedades cardiovasculares.



Obesidad ginoide: también conocida como obesidad subcutánea o glútea. Se da típicamente en mujeres, aunque también puede aparecer en hombres. La grasa se acumula en la región femoral - glútea y por la forma que adopta el cuerpo se la conoce como "forma de pera".



Distribución generalizada: no sigue ningún patrón determinado




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Causas de la obesidad

Causas de la obesidad

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La obesidad es un disbalance entre la cantidad de energía que ingresa con los alimentos y la cantidad de energía gastada.

Las causas de la obesidad son múltiples; dependen de factores ambientales, genéticos, culturales, metabólicos, endócrinos y psicológicos, entre otros.




Los dos puntos más importantes a tener en cuenta son:

1.- Una ingesta de calorías superior a la necesaria

2.- Una menor actividad física


Por lo tanto en cualquier tratamiento de obesidad la persona debe cambiar sus hábitos alimentarios y el ritmo de vida (realizar actividad física regularmente) para regular el balance entre el gasto energético y el aporte calórico.

La herencia tiene un papel importante, tanto es así que los hijos de padres obesos tienen un riesgo bastante superior a lo normal de sufrir obesidad. Esto se debe en parte a tendencias metabólicas de acumulación de grasa, pero también a hábitos culturales de alimentación y al sedentarismo, que suelen compartir los padres con sus hijos.




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¿Por qué debemos evitar el sobrepeso o la obesidad? ¿Qué consecuencias traen para la salud?


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.

La obesidad se asocia con mayor riesgo de sufrir:


- Hipertensión arterial

- Diabetes

- Patologías cardiovasculares

- Gota

- Cálculos biliares

- Problemas respiratorios

- Deformaciones óseas de miembros inferiores, columna vertebral y articulaciones

- Algunos tipos de cáncer


La obesidad lleva a una disminución de la expectativa de vida de los individuos.




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Tratamiento


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La obesidad es una enfermedad crónica, por lo que su tratamiento supone cambios en los hábitos de vida del individuo obeso.

Los tratamientos para la obesidad deben estar siempre supervisados por el equipo de salud, ya que en general siempre existen riesgos de mayor o menor entidad.



Los objetivos son:

1.- Lograr alcanzar un peso más saludable, una reducción de un 10% del peso inicial se asocia con mejoría de las complicaciones asociadas a la obesidad.

2.- Mantener a largo plazo el peso logrado.



Algunos aspectos importantes a tener en cuenta son:


- El adelgazamiento debe ser un proceso lento, salvo en situaciones especiales donde peligre la vida del paciente.

- La dieta no debe ser excesivamente restrictiva, otro motivo por el cual es ideal que sea recomendada por profesionales.

- La alimentación debe ser variada, es decir que debe contener todos los grupos de alimentos.

- Mantener en lo posible los hábitos alimentarios. Se deben evitar dietas extrañas a los hábitos nutricionales del individuo. Lo recomendable es seguir pautas de alimentación alterando lo menos posible el patrón familiar y/o personal.

- Practicar actividades físicas regularmente. Aún cuando la práctica de actividad física siempre es positiva como complemento de un plan de alimentación, siempre se tendrá en cuenta la edad, la magnitud de la obesidad para programar los ejercicios más adecuados a cada individuo.



No existe un tratamiento único para tratar la obesidad, sino que se debe adaptar a cada paciente; pero en general las acciones terapéuticas son las siguientes:


Plan de alimentación: Es el eje del tratamiento. Una dieta hipocalórica aportará menos calorías que lo que el organismo necesita, lográndose un balance energético negativo, y así una movilización de grasa para compensar ese déficit energético.



Ejercicio físico: El gasto energético por medio de la actividad física junto a la restricción de calorías son fundamentales en el tratamiento del sobrepeso y la obesidad. El mejor ejercicio es el de tipo aeróbico: caminar, nadar, andar en bicicleta, etc. De todas formas se considera útil cualquier tipo de ejercicio, y éste siempre debe adecuarse a las posibilidades de cada paciente.



Fármacos: Cuando el plan de alimentación y el ejercicio físico no tienen resultados satisfactorios, el médico puede sugerir la necesidad de utilizar fármacos. Según el primer Consenso Latinoamericano de Obesidad la medicación antiobesidad está indicada en aquellos individuos con un IMC mayor de 30 o IMC entre 25 y 30 con morbilidades asociadas al exceso de grasa corporal. De todas formas los fármacos nunca sustituye el plan de alimentación, el ejercicio o los cambios en el estilo de vida y debe ser indicado y controlado por un médico.

Solamente existen dos fármacos autorizados que han demostrado eficacia y seguridad en el tratamiento a largo plazo de la obesidad: Orlistat y Sibutramina.



Cirugía bariátrica: está indicada en obesidades severas, ante el fracaso de los tratamientos convencionales. La cirugía permite lograr una disminución de peso mediante la reducción del volumen del estómago o con técnicas de derivación gastrointestinal que reducen la absorción de los alimentos.







Bibliografía consultada

1.- Pisabarro R, Irrazábal E, Recalde A. Primera Encuesta Nacional de Sobrepeso y Obesidad. ENSO 1. Rev Med. Uruguay 2000. Vol: 6; Nº 1; 31-38.

2.- Pisabarro R, Recalde A, Irrazábal E, Chaftare Y ENSO niños 1: Primera encuesta nacional de sobrepeso y obesidad en niños uruguayos. Rev Med. Uruguay 2002. Vol: 18; Nº 3; 244-250.

3.- World Health Organization. Obesity: preventing and managing global epidemic. WHO Technical Report Series Nº 894. Geneva: WHO, 2004.

4.- Halsam D, James P. Obesity. Lancet 2005; 366: 1197-209.

5.- Obesidad en adultos: prevalencia y evolución Rev.Urug.Cardiol. v.22 n.2 Montevideo set. 2007

6.- Bastos, A. A.; González Boto, R.; Molinero González, O. y Salguero del Valle, A. (2005) Obesidad, nutrición y Actividad Física. Revista Internacional de Medicina y Ciencias de la Actividad Física y el Deporte vol. 5 (18) pp. 140-153

7.- Girolami, D, Fundamentos de Valoración Nutricional y Composición Corporal, Ed. Ateneo, Buenos Aires, Argentina, 2003.

Sitios consultados

www.plazadedeportes.com

www.nutrar.com

www.nutriguia.com.uy





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Comentarios

Publicado por Alicia Puglia,
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08-01-2016 | 07:15


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Nosotros solucionamos el problema cambiando de hábitos alimenticios comiendo sano. En comidas como en casa ofrecen muy buenas viandas con calorías controladas. Arman los menues de forma personalizada esta muy bueno, se los recomiendo. Busquen en google viandas saludables personalizadas :)

Publicado por Roberto,
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29-12-2013 | 07:02


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Quisiera saber si me pueden orientar, mi padre de 70 esta pesando unos 140 kilos. Su alimentacion es normal. No tiene colesterol, hipertencion ni problemas cardiacos o diabetes pero me preocupa su peso, camina poco popr dolor en rodillas, que podemos hacer?

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    En esta nota te detallamos cuales son los alimentos libres de gluten y aquellos que pueden contener gluten.

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Miamamma

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i2es
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