Overweight (Obesity): Prevention

To prevent obesity (overweight), attention must be paid to reducing individual risk factors. Behavioral risk factors

• Diet
  • Chronic overeating
    • High caloric intake ↑↑
    • High fat diet (1 g of fat provides 9.3 kcal); this results in stimulation of leptin and insulin secretion. This results in initial stimulation of beta receptors, but then down-regulation occurs, so that compensatory activation of the sympathetic nervous system-an energy expenditure-increasing mechanism-is absent
      • High proportion of saturated fatty acids (↑).
      • High proportion of monounsaturated fatty acids (↑)
      • High proportion of polyunsaturated fatty acids ?
    • High sugar consumption, esp. mono- and disaccharides (monosaccharides and polysaccharides), due to excessive consumption of sweets and sweet drinks; with excessive intake of carbohydrates and amino acids, conversion to fatty acids takes place in the liver. The fatty acids offered with high-fat diets, as well as increased self-production of fats, lead to a deposition of triglycerides in the liver cells, which can lead to steatosis hepatis (fatty liver).
    • High consumption of table salt ?
    • High alcohol intake (↑)
  • Too low a proportion of complex carbohydrates
  • Diet low in fiber
  • Constant availability of food
  • Eating behavior (eating too fast; eating until you feel full).
  • Micronutrient deficiency (vital substances) – see prevention with micronutrients.
• Consumption of stimulants
  • Alcohol – Excessive alcohol consumption (weight gain due to alcohol addition; 1 g of alcohol provides 7.1 kcal)
  • Tobacco (smoking) – Smokers who smoke more than 20 cigarettes daily (heavy smokers) have both higher body weight and BMI significantly above the averages for nonsmokers
• Physical activity
  • Lack of exercise (increased sedentary behavior) – it results in a reduced basal metabolic rate With the same eating behavior, there is a positive energy balance (= weight gain), for example, immobilization after surgery, etc..
• Psycho-social situation
  • Mental reasons such as frustration and boredom.
  • Stress – the cerebral cortex sends increased signals to the amygdala and hippocampus under stress. Both areas activate the hypothalamus, which stimulates the increased release of stress hormones such as cortisol. These direct glucose to the brain and glucose uptake in the body is inhibited. When information processing is disturbed, the brain thus permanently demands energy, resulting in an imbalance between energy intake and energy consumption. The result is a positive energy balance and means weight gain. Caution. The increased glucocorticoid release leads primarily to the formation of visceral fat (abdominal fat).
  • In children continued to show excessive television and video games and lack of sleep as additional risk factors
• Sleep duration
  • Sleep duration < 5 hours
  • Sleep deprivation in women: Women with five hours of sleep 1.1 kg and those with six hours 0.7 kg more than the comparison group with seven hours. In this respect, the authors suggest that sleep deprivation lowers the basal metabolic rate by disrupting the day-night rhythm and, consequently, glucose and hormone metabolism.
  • Too little sleep (< 6 hours) impairs not only the metabolism of insulin, but also that of leptin – a satiety hormone – which also increases the risk of overweight or obesity.
• Pregnancy

Environmental pollution – intoxications (poisonings).

• Bisphenol A (BPA) as well as bisphenol S (BPS) and bisphenol F (BPF) are associated with obesity in children
  • Detection of BPF (versus no detection) showed an association with abdominal obesity (OR 1.29) and BMI (BPA is considered an endocrine disruptor and obesogen).
  • Bisphenol A: Mortality risk was about 50% higher in the third with the highest urinary BPA concentrations than in the third with the lowest exposure.
• Phthalates (plasticizers used in the plastics industry), these enter especially in fatty products (cheese, sausage, etc.).Note: Phthalates belong to the endocrine disruptors (synonym: xenohormones), which even in small amounts can harm health by altering the hormonal system.

Other risk factors

• Neuroticism and impulsivity – that is, overweight people are less able to align their actions with long-term consequences. Overweight people are also more extroverted and receptive to rewards than normal weight people.
• Sectio caesarea (cesarean section); Note: The intestine contains less bifidobacteria and more staphylococci.

Prevention factors (protective factors)

• Genetic factors:
  • Genetic risk reduction depending on gene polymorphisms:
    • Genes/SNPs (single nucleotide polymorphism; English : single nucleotide polymorphism):
      • Gene: MC4R
      • SNP: rs2229616 in gene MC4R
        • Allele constellation: AG (0.79 decreased risk; decreased waist circumference (-1.46 cm); decreased BMI)
        • Allele constellation: AA (0.79 decreased risk; decreased waist circumference (-1.46 cm); lower BMI)
      • SNP: rs52820871 in the MC4R gene.
        • Allele constellation: GT (0.5 decreased risk; lower BMI).
        • Allele constellation: GG (0.5 lowered risk; lower BMI).
• Prolonged breastfeeding (> 6 months) is more likely to keep mothers slim for up to ten years afterwards. As part of an observational study (POUCH study), which had searched for causes of premature birth, the participating women were examined again seven to 15 years after delivery. Waist circumference was also measured. Women who had breastfed their children for an average of 3.9 months had a waist circumference of ≥ 88 cm; if they had breastfed for 6.4 months, the waist circumference was smaller, and it was smallest in women who had breastfed for more than six months.