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The Problem with Calorie Restrictive Diets Essay

Table of Contents Summary Introduction What happens during a diet? Catabolism and Anabolism Importance of maintaining Muscle Mass Conclusion Works Cited Summary This article focuses on the current trend in calorie restrictive diets wherein people think that the weight they lose when dieting is fat when in reality it is mostly muscle and water weight. The type of myth I chose to utilize this article is that dieting (i.e. drastic calorie deficiency) helps in long term weight loss goals. Introduction What most people fail to realize is that there is a massive difference between weight loss and fat loss. In the case of fad diets, people seem to think that when they see their weight going down it is an indicator that they are losing fat. A more likely scenario is that they are losing muscle mass and water weight since fat is the last thing the body catabolizes which is the worst outcome that could occur (Rubin, 41). What happens during a diet? You see when you go on a calorie restrictive diet; your body automatically shifts into what is known as “famine mode” wherein it tries to store as much fat as possible. This is an evolutionary response during times when food was scarce and the body needed to store as many calories as possible to survive (Fusco and Pani, 3157-3170). The inherent problem though is that at the present, people continue to be more physically active despite subsisting on fewer calories due to the need to go to work or go to school etc. As a result, your body will catabolize your muscles in order to “make up” the difference in caloric intake so that it can continue to function (Fusco and Pani, 3157-3170). Catabolism and Anabolism When you exercise you are making your body enter into a catabolic state wherein it breaks down the muscle in order to perform particular exercises. After that comes an anabolic state where your body uses the food you eat to build back the muscles stronger than before. Basically: a.) catabolism = destroying the muscles Get your 100% original paper on any topic done in as little as 3 hours Learn More b.) anabolism = growth and making the body stronger In cases where a person goes into a long term calorie restrictive diet, they are making their body enter into a long term catabolic state which can be considered as a form of long term destruction. The reason behind this is that they are simply not eating enough to sustain the muscles. As a result, the muscles get smaller and smaller. Importance of maintaining Muscle Mass Our muscles burn calories on a daily basis, the more muscle you have the more calories you burn while the less muscle you have the fewer calories you burn. So, if you enter into a calorie restrictive diet and you keep on losing muscle sure you are losing weight but you are not losing fat, rather, you are losing muscle mass instead and that is a bad thing (Rubin, 41). The fact is that it is a lot harder to gain muscle than fat. In order to gain muscle a person would need to perform various types of resistance training exercises. However, since they are on a calorie restrictive diet, it is unlikely that they would have the energy to do so. It will come to a point that the fat will come back with a vengeance and they will not be able to lose it as easily since they do not have enough muscle mass (Rubin, 41). Conclusion Based on what has been presented so far, it can be seen that in the case of drastic calorie restrictive diets, the weight loss is temporary since when a person bounces back from the diet and there is lesser muscle mass to burn the fat, they will become fatter and it will be harder to lose weight. The end result is that the person dieting will go back to the calorie restriction resulting in them entering a vicious cycle. Works Cited Fusco, Salvatore, and Giovambattista Pani. “Brain Response To Calorie Restriction.” Cellular
LING 123 Mission College Mating Calls In Both Frogs And Song Birds Essay.

Topic: Compare and contrast the mating signals of two very different vertebrate orders: anurans (frogs and toads) and passerines (songbirds). What features do the anuran and passerine mating vocalizations share in common? What features are different? Discuss the mating signals themselves (acoustic structure, including elements and complexity), as well as how (anatomy and physiology) and why (sociology) those particular vocalizations are produced (by speaker) and preferred (by listener). This discussion should include comparison of the physical and social environments in which frogs and songbirds live and what kinds of socio-ecological problems each is required to solve. Your analysis should address at least two of Tinbergen’s four perspectives on animal behavior: adaptation, mechanism, ontogeny, and phylogeny.Guidelines: Essays are assessed not only for content, but also for grammar, clarity, conciseness, and coherence. Strive to make your essays accurate, relevant, and organized, and use academic English. Your writing should demonstrate an understanding of key scientific terms related to sound and communication, with accurate use of technical terms such as amplitude, spectrum, conspecific, heterospecific, etc. You might think of this as writing a short article directed towards an educated layperson, and it should read as a prose essay, not a lab report outlining observations. The purpose is to assess your writing skills in addition to your understanding of the material presented in the course modules.For source material, you may draw on a mix of course lectures, videos and assigned readings, but to earn full credit, you must include material from (and cite) at least two articles from the relevant course readings. No further outside sources are required, though you are certainly welcome to draw on other research materials if you like. There is no need to provide citations for material you draw from lectures, unless the material originated from one of the readings or videos. Properly cite these and any other data drawn from course readings and videos. (You may use the formal citation style of your choice – APA or MLA, so long as you are consistent and the source and page number of the material is made clear. If you do use additional sources, be sure to cite them and provide full bibliographical entries.) Otherwise, as with any academic writing, your work must be your own and in your own words.Formatting and SubmissionProvide your own original, descriptive title for your essay. (Do not simply copy and paste “Frogs and Birds”.)Your essay must be a minimum of 1200 words long, but no longer than 1500 words. Include the word count in your document.Document formatting should use a 12-point font, double-spaced, have 1-inch margins on all sides, and be saved in either doc/.docx or .pdf format only. Documents in shared drives will not be accepted.Your document should include your last name, first name, course name and section at the top of the document.The essay must be uploaded to Turnitin.
LING 123 Mission College Mating Calls In Both Frogs And Song Birds Essay

Automobiles E. Bugatti was a French car manufacturer founded in 1909 in Molsheim, Alsace, as a manufacturer of high-performance automobiles by Italian-born Ettore Bugatti. Well known for the beauty of their design, the Bugattis were also famous for winning a large number of races. Ettore Bugatti belonged to a family of artists and considered himself as an artist and a constructor. His death in 1947 proved to be the conclusion for the Bugatti marquee, and the death of his son Jean before him in 1939 left no one as a successor to run the factory. Approximately 8000 cars were made and the company struggled financially. It released one last model in the 1950s before it was ultimately purchased for its airplane parts business in the 1960s. Today the company is owned by the Volkswagen group, who have revived it as a maker of limited production exclusive super cars. Bugattis latest and highly successful new model introduced in the year 2005 is the Bugatti Veyron EB 16.4, a mid-engined grand touring car, developed by German manufacturer Volkswagen Group, and produced by French marque Bugatti. The Super Sport version of the Veyron is the fastest road-legal production car in the world, with a top speed of 431 km/h (268 mph). The original version has a top speed of 408.47 km/h (253.81 mph). It was named Car of the Decade (2000-2009) by the BBC television programme Top Gear. Based on the Bentley Hunaudières concept and built at Bugatti’s HQ (Château Saint Jean in Molsheim, Alsace, France), the Veyron’s chief designer was Hartmut Warkuss, and the exterior was designed by Jozef Kabaň of Volkswagen, with much of the engineering work being conducted under the guidance of engineering chief Wolfgang Schreiber. Although specially made by Volkswagen, the Veyron is sold only through the Bugatti manufacturer channels and cannot be found at any Volkswagen dealer. The name got its origin after French racing driver Pierre Veyron, who won the 24 hours of Le Mans in 1939 while racing for the original Bugatti Company. The 16.4 refers to 16 cylinders and 4 turbochargers the car has and the engine produces more than a 1000bhp. On BBC’s Top Gear the Veyron won the award for ‘Car of the Year’ in the 2010 end award show. Jeremy Clarkson said “It was a car that just rewrote the rule book really, an amazing piece of engineering, and a genuine Concorde moment”. When tested on the Top Gear test track the standard version was not able to reach the top of the lap time leader board which was speculated as being due to the cars substantial weight. The super sport version on the other hand was able to achieve the fastest time ever on the track and was taken to an average top speed of 431.072 km/h (267.856 mph) by Raphanel on the program, therefore taking its position as the fastest production car in the world. In 2011, Bugatti Veyron: A Quest for Perfection – The Story of the Greatest Car in the World was published, taking the stance that the car had now become so popular that it was effectively a bona fide ‘celebrity’. The book is based on its author Martin Roach as he attempts to track down and drive the car, along the way interviewing chief designers, test drivers, and the president of Bugatti. (, 2012) Bugatti Veyron has become an icon and a legend when it comes to super cars. Probably the most famous car and verified the fastest road legal car in the world today. When it comes to expensive cars, its more or less like expensive watches or any other luxury brands, it’s about the prestige and high status value that a brand promises. But of course at a hiking $1.4 million, this exquisite car is not in the range for the common men of the society and that’s what these expensive brands are all about. These brands are created to match the image of the owner and to give him that extra appeal in comparison to his personality, status in a society and of course the socio-economic class group he belongs to because of the money. Super brands such as the Veyron belong to a niche category, but such brands let you dream and they let you escape from reality, to an extent so high that you must feel it when you’re at the wheel of this immense machine, which I am sure, must be inescapable for some people. It is your own personal Disney Land, money comes and money goes but for people who fall into the Veyron’s target market I am sure money is not an object. Brands like these exist for the sole purpose of giving their customers the thrill of escaping routine breaking away from reality and for a moment forgetting your worries, your pains and your responsibilities. The Veyron can be evaluated in several different branding theoretical approaches which make it flexible brand and a good option to choose plus explore the different brand approaches. bugatti-veyron-1024×819.gif Personality Approach The personality approach in brand management focuses on how and why people choose brands with certain personalities and how imbuing brands with personality thus can be a powerful tool to create and enhance brand equity. (Heding.T, 2008) The theories and methods of the personality approach come from the fields of human psychology, consumer behaviour and personality research. Brand personality can be referred to as human characteristics that consumers relate with the brand. For brand management however brand personality mainly is a way to differentiate the brand from other brands in the same product category or a driver of consumer taste and preference. The personality approach assumes that the consumers need to express and identify oneself is an important factor in the consumption of the brand. Also, by giving the brand human characteristic will strengthen the brand, and its differentiation. Brand personality can also help in creating an emotional bond between the consumer and the brand because the consumers associate themselves in the personality of the brand and use the brand personality to polish or improve their own or even relate it with their own. For the consumers the brand sometimes represents their personality and is a source of self projection. Brand personality is not only for the consumer inward construction of self but also can be chosen to their outward signalling value. (Heding.T, 2008) Veyrons personality which is an exclusive, powerful, sexy, exotic and fast is attractive and relevant to its consumer, that why it appeals to them because it expressive their own personality and helps construct it. For the Brand it is a great for positioning, differentiating and a tool for building an emotional connection with the consumers. In personality approach to create brand equity the essential factors expression, human personality and consumer identity. The symbolic benefits that the brand provides which are expressed through the brand personality, to its consumer are the measure of brand strength. The Veyron to its consumers is a symbol of wealth, power, elegance and speed; this is the cars personality and with it its strength. In the brand personality approach the main function of the brand is not to provide utility and benefits to the consumers but to allow the consumers to construct and express themselves by proving them with a signal value. The theoretical building blocks of personality approach consist of three supporting themes: personality, consumer self and consumer self congruence (Heding.T, 2008, p. 132). Adapted from (Heding.T, 2008, p. 129) The personality characteristics related with a brand are assumed to be lasting, distinct and stable. The brand personality with its expressive value and the uniqueness influence the attractiveness and the potential strength of the brand. Consumer behaviour research states that consumers utilize brands for symbolic consumption and as ways to express themselves by selecting brands with a specific brand personality. The extent to which consumers are able to use the selected brand for their own construction and signalling of identity relies on the degree of differentiation of the brand from other brands in the same category. Brand personality helps the companies to fill in symbolic cues into the behaviour and communication of the brand. This helps the company to differentiate and gain brand loyalty. In the case of Veyron its personality characteristics power, exotic design and speed relates to the super rich of the world and is targeting a niche market. These consumers have the money and power and in order to relate and construct their identities for both inward and outward signalling. Veyron is the best when it comes to super cars in terms of power, speed and price and the consumer feel that owning a Veyron will help them in creating an identity for themselves and be involved or be related with others owners of this prestigious car. In the minds of the consumer owning a Veyron may even improve their personalities than before since they will inherit the personality the car posses by purchasing it. With the attributes of highest cost and fastest speed Bugatti has been able to set itself apart from its competitors by building a stronger personality in the minds of its consumers. The consume of Veyron even distinguish themselves from other owners of the car by modifying the car or getting it a special paint or extra features which gives them an even more separate and exclusive identity. The Community Approach The community approach explains how communication between consumers about the brand creates brand value. The theory states the by social interaction among dedicated brand consumers connects brand to consumers and consumers to consumers creating goodwill for the brand and brand equity. Brand Traid adapted from (Heding.T, 2008, p. 183) The brand traid shows that for community approach to be successful there has to be interaction between two or more consumers about the same brand. An important point of community consumers is that they are extremely loyal and enthusiastic but are also capable of collective rejection. In this approach the brand management becomes difficult because the marketer is outnumbered in the brand-consumers exchange. The brand equity rests in the hands of the consumers and they can either make or break the brand. Theory of Community approach consists of Brand community as the core theme with two supporting themes of community theory and subcultures of consumption. Community Theory The appropriate definition of community in this case is a key concept in sociology characterised by having three markers or characteristic that go beyond the shapes and forms of a community. According to (Heding.T, 2008, p. 187) “the three markers of community are: consciousness of kind, shared rituals and traditions and a sense of moral responsibility”. The existence of these characteristics is essential to make a community, in theory. In most case communities are bounded by geographical boundaries but not in the case of Veyron thanks to the age of globalisation and internet. Veyron owners exist worldwide though there are very few of them but they are all in the same club and social class. Subculture of consumption Veyron in a way has created its own subculture in the community much like Ferrari enthusiasts or Classic cars clubs all over the world. The role of markets in case of Veyron brand is as an existing market with the consumers as co-creators of brand meaning. Veyron owners are few but the fans or car lovers are in millions or more. Through the affects community approach Veyron has become an icon in the car industry and with various fan clubs and websites dedicated to it. The owners of the car also feel related somehow since there are only a countable number of them; they associate with each other on the bases of ownership and have access to an exclusive club know as ‘La Vie en Bleu’. In these club meetings they show off their cars to each other and to the public. (Bugatti, 2009).

Academy of Computer Education Information & Technology Innovation Paper

Academy of Computer Education Information & Technology Innovation Paper.

how information and communication innovation drives change in educational settings. The key focus of the article was how technology-based leadership has driven the digital age.Also, that the role of technology leadership incorporates with the Technology Acceptance Model (TAM). address the following key concepts: Q1) Define TAM and the components. Q2) Note how TAM is impacting educational settings. Q3) Give an overview of the case study presented and the findings. Note: Use the scholarly research. Google Scholar is also a great source for research.Please be sure that journal articles are peer-reviewed and are published within the last five years. The paper should meet the following requirements: 1) (i) Review the Article link – AKCIL, U., ALTINAY, Z., DAGLI, G., & ALTINAY, F. (2019). The Role of Technology Leadership: Innovation for School Leadership in Digital Age. ELearning & Software for Education, 2, 323.… (ii) Textbook – Bratton, J. (2020). Organizational Leadership 1st Edition Sage Publishing, Thousand Oaks, CA. ISBN: ISBN-13: 978-1526460127 ISBN-10: 1526460122 (iii) Powerpoint attached of Chapter 2 of the Textbook – Bratton_PPT02(1).zip 2) 5 pages in length (not including Title page, Abstract, Conclusion and References) 3) APA format 7th edition guidelines must be followed.The paper must include a cover page, an introduction, a body with fully developed content, and a conclusion with intext citations 4) A minimum of five peer-reviewed journal articles. 5) The writing should be clear and concise.Headings should be used to transition thoughts.Don’t forget that the grade also includes the quality of writing. 6) NO PLAGIARISM 7) Include the Article, Textbook including peer reviewed articles as references in the Reference Section.
Academy of Computer Education Information & Technology Innovation Paper

Reflective case study in counselling

essay help online Reflective case study in counselling. Part I: Case Assessment Report New Territories West Integrated Family Services Centre Case Assessment Report A. Basic Case Information Name of Client: Madam CHAN Sex/ Age of Client: F/36 Name of Worker: Dada Wong Nature of case: Counseling B. Presenting Problem Madam CHAN reported that she has been suffering from low mood, loss of appetite, headaches and insomnia for over a month. She had also lost motivation in doing household chores and would cry sometimes without reasons. C. Social History 1. Genogram 2. Family background Case client, Madam CHAN, moved from Mainland China to Hong Kong 5 years ago. She married with her husband, Mr. LEE, in Mainland China. They have one son, two daughters in total, and living together. Son is 12 years old, will become F. 1 student in secondary school, and daughters are 8 years old and 3 months respectively. Madam Chan got pregnancy last year and Mr. Lee suggested Madam Chan to have abortion but she refused. She insisted to give birth of the youngest daughter because she thinks it belongs to her. She expressed husband does not put much cares, include physical and financial, on the youngest daughter. Madam CHAN reported their marital relationship was fine when lived in Mainland China, but conflicts increase when move to Hong Kong. Client complains Mr. LEE sends most of his income for his parents in Mainland China and does not give much money for their family. They have arguments about this issue always. 3. Emotional condition Madam CHAN suffers from low mood, loss of appetite for over a month. She reported sometimes would cry without reasons and loss of motivation in doing housework at home. Emotional unstable when talking about her situation, she cried twice during the counseling process. 4. Health condition Client expresses loss of appetite, headaches and insomnia for over a month. She feels tired and lack of energy when at home, but no problem at working. 5. Financial condition Madam CHAN now works as a part-time waitress in restaurant, and responsible for taking orders and delivering dishes to customers. She earns around $5000 per month. Mr. LEE is an air-conditioner technician, earning around $12000 per month. Madam CHAN reports Mr. LEE does not contribute much income on own family, around $3000 per month, but gives most of money to his parents in Mainland China. She reported that most of the expenditures of family are supported by her own. 6. Supportive network Madam CHAN pays around $1000 each month for her younger sister to take care the baby when she goes to work. She expressed the money also viewed as a help to sister’s family. Client mentioned that her younger sister and brother have their own financial difficulties, therefore, she also needs to take the responsibility of parents’ financial supporting. Madam CHAN said she only visited for her parents two times after move to Hong Kong in five recent years. D. Case Analysis 1. Underlying problem Based on the information collected from counseling Madam CHAN, it is believed that her headaches and insomnia symptoms are closely related to the stress on family financial situation. Madam CHAN expressed worries of limited income from being part-time waitress, may not be sufficient for supporting the expenditure of whole family. She complained Mr. LEE giving most of the salaries for his parents in Mainland China but little for family expenditures and children. They argued for this issue many times after Madam CHAN moved from Mainland China to Hong Kong. She believes that family financial situation would be improved if Mr. LEE willing to share more monthly income to their family. She tried to ask for more financial supports from Mr. LEE but failed, and thought like begging from him. She feels angry about that and gives up trying anymore. For this reason, she believes she cannot reply on her husband. In addition, client complained Mr. LEE ignores the responsibilities of taking care of the children, especially the new born baby. On the other hand, based on the information got from Mr. LEE during interview, the third child is not he expected and wished. He believed the third child is a real burden on family financial aspect. He expressed the major reason of argument with Madam Chan is money distribution. 2. Assessment Counseling done. From the interviews, Madam CHAN presented the concern about the financial problem of family. She cried twice when talking about the issue of Mr. LEE sends most of the salaries to his family in Mainland China. She said, “Maybe our children are less valued than his family!”. That shows her anger about Mr. LEE behavior toward money distribution. She has expressed her worries about the maintenance of family income as one more child at home nowadays, expenses increase. She reported that feeling lack of energy when at home, suffering from low mood, headaches and insomnia for over a month, however, does not have these problems when working. It is believed that her physical discomfort symptoms like headaches and insomnia are due to the pressure and worries about family financial situation. From the interview with Mr. LEE, he expressed the new born baby is unplanned. He believes family situation in general would be better if without the third child. Mr. LEE expressed he has the money saving plan for children before, likes saving for their future study. That shows Mr. LEE willing to plan about the future of family. However, the new born makes the plan collapsed. He suggested Madam CHAN to have abortion but she insisted to preserve the baby. He was angry about that. Mr. LEE stated that Madam CHAN always ask for more money during the conversation. He has implied the new born may not belongs to him during the interview, but he did not explain further on this point. 3. Intervention It is believed that the emotional problem of Madam CHAN may due to the stresses on worrying about not able to take care of the children and maintain the family income at the same time. According to the information got from interview, Cognitive Behavior Therapy (CBT) Approach would be appropriate to adopt in the intervention. CBT addresses the interactions between how we think, feel and behave (Somers, 2007). It believes that the peoples’ feelings, emotions, thoughts are the responses to the outside world. Therefore, one’s behaviors could be changed from changing their perception and cognition of the situation from the process of therapy (Somers, 2007). According to HallReflective case study in counselling

Prince Georges Community College Medical Surgical Nursing Problems Discussion

Prince Georges Community College Medical Surgical Nursing Problems Discussion.

A 47 y/o executive is speaking with his secretary about a meeting scheduled for the next day and suddenly slumps in his chair and is unable to speak. The secretary immediately calls 911 and the patient is transported immediately to the ED. He is having trouble speaking and is also having some visual irregularities. He has recently been told he has high cholesterol and is also being treated for high blood pressure and GERD.Patient history includes:Works 16 hours a day and last vacation was 3 years agoDrinks 4-6 cups of coffee dailySmokes 10-20 cigarettes a day depending on how stressful his day isUsed to exercise, but “now is too busy”Eats most meals out daily. 1) The ED physician suspects that the patient The nurse is teaching the patient about the following tests and the patient is asking why each one is ordered. Using your book, explain to the patient why each of these diagnostic tests has been ordered. Which one should be completed first and why?CT scan of the head without contrastEchocardiogramMRI of the brainMRA of the brain2) Identify the patient’s risk for stroke and how each increases his risk3) The patient is being considered for fibrinolytic therapy. What is fibrinolytic therapy and what are the major concerns and contraindications? What must be known before fibrinolytic therapy can be considered?4) The patient has been diagnosed with an ischemic stroke and received the fibrinolytic TPA and spendt the first 24 hours in the ICU and is now transferred to the stroke unit. The patient has some residual weakness on the R side, but is otherwise free of long-term disability. The patient has been told he has uncontrolled hypertension and hypercholesteremia and will be discharged home with some outpatient physical therapy.The nurse is teaching the patient about the medications he will go home on. Explain why the patient is being discharged on the following medicationsAn antihypertensiveA statinLow dose Aspirin 5) The nurse is completing discharge teaching and plans to teach the patient how to reduce the risk of having another stroke Considering the risk factors of this patient, what should the nurse teach the patient? ****** The primary source for the answers needs to be your pharmacology and med-surg textbooks. Here are the links for the text books.- citation should be used and do not forget to include the in-text citation.
Prince Georges Community College Medical Surgical Nursing Problems Discussion

Improvements In Life Expectancy India Health And Social Care Essay

Share this: Facebook Twitter Reddit LinkedIn WhatsApp Life expectancy of Indians during the past fifty years has been steadily increasing exponentially matching the trend that took several hundred years shown in Developed countries. 23Some of the possible reasons for such exponential rises gained by Indians in years are controlling deaths caused by epidemics and pandemic infectious diseases, and absence of famines or wars since India’s independence. The high death rates due to infectious diseases were dramatically curtailed due to availability of antibiotics and further with introduction of Universal Immunization program. This was followed by improved living conditions, advances in public health, and availability of advanced medical interventions. Figure.1: Improvements in Life Expectancy-India (1960-2009) Source: The World Bank Group [4] Results from estimates of World Bank indicate that India has share of her good and bad news. The good news so far has been that Life expectancy is increasing until now and bad news is whether such rate of increase can be maintained over next few decades. Currently India has excellent health service delivery mechanisms, which are efficient in extending the lives of her people by treating chronic conditions and cancer. However, the question is whether such “improvements” in technology are addressed only to cure ailing population or can India address preventive programs aimed at decreasing the burden of obesity and chronic conditions. Hence, the next big threat to Life Expectancy improvements appears to be stemming from obesity and chronic diseases in middle and old age, which are directly linked to an increased risk for death and morbidity. Attempts to predict life expectancy of Indian population, in terms of whether it is improving or getting worse becomes even more intricate in the absence of scientific data available for such evaluations. Figure 2. Observed and Projected composition of age-groups for Indians (1960 to 2010). Evidence from studies indicates that obesity and overweight in adulthood are associated with large decreases in life expectancy and increases in early mortality. [5] 678This paper aims at explaining the intricacies involved in the interplay of obesity and old age in their impact on Life expectancy. Challenges in measuring the effects of Obesity and Old Age on Life expectancy “Ice-berg” phenomenon The health risks of obesity in the elderly are mostly underestimated due to survivor bias seen in the elderly people (only those who have survived fatal effects of obesity and chronic diseases), inability to separate competing mortalities due to relatively shortened life expectancy in older persons and longitudinal effects of confounding conditions (eg., smoking) are difficult to measure. [9] Definition of Obesity in Elderly The appropriateness of definition of obesity in the elderly is a debatable issue. Obesity should be defined as the amount of excess fat storage associated with elevated health risk. For this practical definition, Body Mass Index (BMI) has been largely used in younger adults as well in older ages. BMI gets altered in old age due to age-dependent changes in numerator and denominator in calculation. Several studies have shown that there is age-related decline in height, probably because of spinal deformity with thinning of the inter-vertebral discs as well as loss of vertebral body height due to osteoporosis. Hence, age-dependent height decrease leads to incorrect overestimation of obesity. Body weight in old people reflects a higher amount of total fat because of age-dependent loss of lean body mass. This may lead to underestimation of obesity as a result of increase and redistribution of fat inside the body. Hence, aging influences both numerator and denominator of BMI, in opposite directions. Further, larger waist and waist-to-hip ratio have found to be significantly associated with mortality in older subjects, whilst BMI was not. The higher the age, the shorter is the remaining lifespan for persons regardless of degree of obesity. Most obesity related consequences take years to develop even among susceptible population; hence, obesity related complications in old age are not seen if susceptible die of non-obesity-related conditions. It is observed that weight change, both weight loss and weight gain, is a strong predictor of mortality. Further, many studies showed lower mortality in subjects with lower BMI, or at least a U-shaped relation between BMI and mortality. The underlying diseases such as cardiovascular disease and cancer can result in spurious inverse relation between low body weight and increased mortality. [10] Interaction of Obesity, Old Age and their toll on Life Expectancy Weight gain or fat redistribution in older age confers adverse health risks in the form of early mortality and co-morbidities amounting to functional decline. Obesity has been recognized to be associated with several disorders that confer morbidity and may also be related to increased mortality. Obesity, and more importantly body fat distribution are associated with metabolic syndrome even in old ages. [11] There is higher prevalence of both systemic and pulmonary hypertension and a higher risk of cardiovascular disease morbidity and mortality in old age, especially among those with pulmonary complications and obstructive sleep apnea syndrome (OSAS). [12] Role of Smoking There is stronger evidence that smoking plays an important role in the interaction of obesity and old age. It is well known that smokers are thinner and have an elevated mortality compared with nonsmokers. However, when only people who never smoked were studied, there is an observed linear relation between BMI and mortality among older subjects, suggesting that increased mortality associated with the lowest weights were a function of cigarette smoking, and that, among never-smokers, very low weights were associated with the greatest longevity. Summary The steady rise in life expectancy observed in the modern era may soon come to an end and the youth of today may, on average, live less healthy and possibly even have shorter lives than their parents. There are many challenges to delineate the association between obesity and mortality in the elderly. Since confounding effects by different variables in this association accumulate over the lifetime, it is difficult to accurately measure and account for these factors. Mortality is not the only end point that should be considered in the evaluation of the impact of overweight and obesity on health status in older people. There is increasing evidence that obesity is reduces life expectancy due to direct and indirect causes. Obesity will not only increases the risk of death for most people at most ages, but also consistently leads to a much higher level of disability and disease at all ages. Voluntary weight loss may have beneficial health effects in elderly similar to the effects in young age. Studies on the effect of weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5 to 10% of initial body weight) may be beneficial. It is well known that increased physical exercise is associated with decreased mortality risk in middle-aged as well as in older people. [13] India is surpassing through dual burden of diseases and consequences of obesity might take a greater toll. Hence policy makers should focus on promoting prevention and treatment of obesity related conditions, especially among old age. Based on priorities in public health expenditure, the country can effectively implement population-level interventions to reduce obesity. Health care providers should engage in complete evaluation of co morbidity and weight history, in the elderly obese persons to comprehensively address potential adverse health effects of o obesity. Share this: Facebook Twitter Reddit LinkedIn WhatsApp

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