Evaluación y comportamiento del sobrepeso y la obesidad en una población de las islas baleares

Resum

In the 21st century, the global obesity pandemic has become unstoppable. According to figures from the World Health Organization, it is expected that by 2025 there will be around 2.7 billion overweight individuals and by 2030 it is estimated that 1 billion human beings will suffer from obesity. The Spanish Society for the Study of Obesity (SEEDO) has openly declared war on obesity and proposes that it should be considered as responsible for practically all diseases, since it is difficult to find any pathology that is not more prevalent in the subject with obesity, or pathology whose condition does not worsen with the appearance of obesity. Currently, Spain is considered one of the European Union countries with the highest rate of obesity, both in the adult population and in children. The Body Mass Index (BMI) is currently the reference index in all clinical studies and in daily medical practice, but its disadvantage is that it reflect neither the degree of adiposity nor the cardiometabolic risk to which subjects suffering from obesity are exposed. The SEEDO considers that only by ensuring that each and every one of the people with obesity is correctly diagnosed, evaluated, advised and treated, will the Health System be maintained in the place of excellence that it deserves. The objective of this Doctoral Thesis was to evaluate the behavior of overweight and obesity in terms of diagnosis, associated comorbidities, impact on metabolic health, alterations in body composition and nutritional status of vitamin D in a population cohort of the Balearic Islands. Observational and crosssectional study in witch 1997 participants of both sexes voluntarily attended a clinic to lose weight under control and became part of a population cohort. A clinical history was made that included a dietary survey, toxic habits and lifestyle, anthropometric measurements, blood pressure recording, body composition analysis by electrical bioimpedance, blood analysis to determine metabolic parameters. The subjects with morbid obesity and extreme obesity (BMI ≥ 40 kg/m2 and ≥ 50 kg/m2, respectively) were assigned a personalized dietary treatment. The final cohort was made up of 1826 subjects (171 were excluded because they were under 16 years of age, BMI < 18.5 kg/m2, and had spent less than 1 month in the study), 85.2% women and 14.8% men. According to the classification by the BMI, 38.6% presented obesity and within this percentage, 13% presented morbid and extreme obesity, 38.1% overweight and 23.3% normal weight. 35.7% of the women studied were menopausal. The results showed unhealthy dietary habits and little or no physical activity in overweight and obese subjects. There was a high prevalence of abdominal obesity and Metabolic Syndrome in the cohort and a high vitamin D deficiency. The menopausal women studied showed unhealthy dietary habits, sedentary lifestyle and a high prevalence of Obesity and Metabolic Syndrome. Their main components were the abdominal obesity, hypertension and/or under treatment and hyperglycemia and/or under treatment. The High Protein Diet studied in subjects with morbid and extreme obesity had a positive impact on weight loss and on the metabolic parameters evaluated; significantly improved body composition with decreased fat mass and visceral fat index, minimal loss of muscle mass and increased seric levels of vitamin D. The nutritional treatment designed in the dietary intervention performed was safe and effective.