Professor Donal O'Shea, Consultant Endocrinologist, St Vincent's Hospital, presentation at the launch of safefood's Stop the Spread campaign, May 2011

1. Overweight is associated with
• Diabetes
• Cancer
• Sleep Apnoea
• Osteoarthritis
• Fatty liver disease
• Psoriasis
• Dementia
• High Blood pressure
• Cardiovascular Disease

2. Relationship of BMI to Excess
Mortality
300
Age at Issue
250 20-29
30-39
200
150
100
Low Moderate High
50 Risk Risk Risk
0
15 20 25 30 35 40
Body Mass Index (kg/[m2])
Bray GA. Overweight is risking fate. Definition, classification,
prevalence and risks. Ann NY Acad Sci 1987;499:14-28.

3. META-ANALYSIS OF 1.4 Million people – NEJM Dec 2010

4. Excess weight is a MAJOR risk factor for
diabetes in US adults, 2001 (n=195, 005)
Prevalence of diabetes (%)
30
25.6
20
14.9
10 7.3
4.1
0
Normal Overweight Obese Obese
BMI 25-29.9 BMI 30-39.9 BMI 40
Mokdad et al. JAMA 2003; 289: 76-9

5. Relative Risk of Developing Cancer
in Males
Cancer Type Relative Risk if Relative Risk if
Overweight Obese
Oesophegeal 1.5 2.3
Thyroid 1.3 1.7
Colon 1.2 1.5
Renal 1.2 1.5

6. Normal weight finishes at
Male 12st 2lbs
78Kgs
Female 10st 3lbs
65 kgs

7. Normal Weight
Waist < 32inches Waist < 37inches
Female Male

10. Toxic environment we live in…

11. Unsuspected calories abound

12. Unsuspected Calories

13. Unsuspected Calories

15. Burning a lot less energy (per half
hour)
Calories Burned 2004 Calories Burned 1984
Lift (2 mins) 3 Take Stairs 19
Order take away 1 Cook Meal 70
Load Dishwasher 23 Wash Up 80
Watch TV 35 Play Cards 52
Go to car wash 35 Wash Car 104
Play Video Game 53 Play Basketball 280
Ride Lawn Mower 88 Mow Lawn 193

16. Benefits of weight reduction in
overweight
• 5 to 10% loss from presenting body weight
- 20% reduction in all cause mortality
- 40% reduction in diabetes related mortality
- 37% reduction in cancer deaths
- 10mmHg reduction in systolic BP
- Improved lipid profile

17. Overweight - diet/lifestyle change only required
• Diet – 500 kcalorie deficit/day
healthy eating priciples
• Activity - No consensus
Up to 90 minutes daily
(8 days a week)
• No approach works without this

18. Who would you rather be?
• Man on Left = Driver
• Man on Right = Conductor

19. Physical Activity at Work
• Prof. Jerry Morris,
– Physical Activity Epidemiology
– Lancet 1953
• 31,000 London Transport Workers
– Drivers and Conductors
– London Double Decker Bus
• Drivers had higher rates of Coronary Occlusion
(heart attacks) and higher early mortality than
conductors

20. Results
Coronary Artery Disease of 31,000
London Transport Workers
1.6
1.4 Drivers
Rate per 1000
1.2 Conductors
1
0.8
0.6
0.4
0.2
0
Coronary Occulsion Early Mortality
(MI) (within 3 days of MI)
Morris JN et al., Lancet 1953

21. Results
Coronary Artery Disease of 31,000
London Transport Workers
1.6
1.4 Drivers
Rate per 1000
1.2 Conductors
1
0.8
0.6
0.4
0.2
0
Coronary Occulsion Early Mortality
(MI) (within 3 days of MI)
Morris JN et al., Lancet 1953

22. Normal Weight
Waist < 32inches Waist < 37inches
Female Male

23. 2010 – 25,650 papers on
overweight
• 4 Key points for weight management

24. 2010 – 25,650 papers on
overweight
• 4 Key points for weight management
- Never miss breakfast

25. 2010 – 25,650 papers on
overweight
• 4 Key points for weight management
- Never miss breakfast
- Weigh yourself once a week

26. 2010 – 25,650 papers on
overweight
• 4 Key points for weight management
- Never miss breakfast
- Weigh yourself once a week
- Build activity up to 90 minutes daily

27. 2010 – 25,650 papers on
overweight
• 4 Key points for weight management
- Never miss breakfast
- Weigh yourself once a week
- Build activity up to 90 minutes daily
- Watch the calories