The Burden of Obesity in North Carolina Obesity-Related Chronic Disease

Obesity-Related Chronic Disease More than half (53%) of all deaths of North Carolinians are preventable. Overweight and obesity are significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status. Inadequate fruits and vegetables, lack of leisure time physical activity, obesity, and overweight make up 80% of N.C.’s risk factor or behaviors. Overweight and obesity pose significant health issues for both children and adults. Excess weight is not only a risk factor for several serious conditions, but also exacerbates existing conditions.[i] Heart disease, cancer, stroke and chronic lung disease are the leading causes of death in North Carolina. These chronic diseases account for 58 percent of all deaths in the state.[ii] There have been dramatic increases in diabetes and obesity in the past decade; these conditions exacerbate many other health problems. According to a recent study, more than half (53%) of all deaths of North Carolinians are preventable. [iii] In 2006, the two most common estimated preventable causes of death among N.C. adults were tobacco (37 percent) and diet/physical inactivity (35 percent). Together these causes of death make up 72 percent of the state’s preventable causes of death – a larger percentage than alcohol, microbial and toxic agents, motor vehicles, firearms, sexual behavior, and illicit drug use combined. Additionally, inadequate fruit and vegetable consumption and no leisure time physical activity often lead to obesity and overweight. These four risk factors (inadequate fruits and vegetables, no leisure time physical activity, obesity, and overweight) make up 80 percent of North Carolina’s risk factors or behaviors. Overweight and obesity are significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis and poor health status. [i] U.S. Department of Health and Human Services. The Surgeon General’s call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. Department of Health and Human Services; 2001. Available from: www.surgeongeneral.gov/topics/obesity/. [ii] North Carolina Behavioral Risk Factor Surveillance System Survey, State Center for Health Statistics, North Carolina Department of Health and Human Services, (2007). [iii] North Carolina Behavioral Risk Factor Surveillance System Survey, State Center for Health Statistics, North Carolina Department of Health and Human Services, (2007).

Preventable Causes of Death in N.C. In 2007, the two most common adult estimated preventable causes of death were tobacco use (n=13,720) and diet/physical inactivity (n=12,583). Together these causes of death make up 68% of N.C.’s preventable causes of death, more than twice that of alcohol, microbial and toxic agents, motor vehicles, firearms, sexual behavior, and illicit drug use combined. State Center for Health Statistics, North Carolina Department of Health and Human Services, (2007). State Center for Health Statistics, North Carolina Department of Health and Human Services, (2007).

The Burden of Obesity in North Carolina Arthritis

Arthritis and Obesity Obese adults are twice as likely to develop knee osteoarthritis as adults at a healthy weight. For every two-pound increase in weight, the risk of developing arthritis is increased by 9 to 13%. Arthritis affects people of all ages and is the leading cause of disability and work-related disability in our country. About one-half of all North Carolinians age 55-65 have been diagnosed with some form of arthritis by their doctor, and this number increases with age[i]. People with arthritis experience joint pain, stiffness and sometimes loss of immobility in their joints, affecting the quality of their lives. The prevalence of arthritis increases with increasing weight.[ii] For every two-pound increase in weight, the risk of developing arthritis increases by 9 to 13 percent.[iii] [i] North Carolina Behavioral Risk Factor Surveillance System Survey, State Center for Health Statistics, North Carolina Department of Health and Human Services, 2007. Updated May 29, 2008. www.schs.state.nc.us/SCHS/brfss/2007/nc/risk/HAVARTH2.html . [ii] CDC recommandations, www.cdc.gov/arthritis/arthritis/faq.htm . Accessed on January 14, 2009. [iii] Surgeon General’s Report, www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.htm . Last revised: January 11, 2007.

Arthritis and Obesity Obesity is a known risk factor for the development and progression of knee osteoarthritis and possibly osteoarthritis of other joints. Thirty percent of individuals at a healthy weight are at risk of developing knee osteoarthritis with symptoms, compared with 46.9 percent for overweight individuals and 60.5 percent for obese individuals. [i] Therefore, obese adults are twice as likely to develop knee osteoarthritis as are adults of healthy weight. [i] Murphy, L. Arthritis & Rheumatism, September 2008; vol 59: pp 1207-1213.

Suggestions from a Health Professional In 2006, there was a significant difference among the three weight categories in the percentage of adults to whom it had been suggested that they should lose weight to help their arthritis: adults at a healthy weight (10%), adults who were overweight (33%), and adults who were obese (61%). In 2006, there was also a significant difference between the three weight categories in the percentage of adults who had been told to increase physical activity or exercise help their arthritis: adults at a healthy weight (54%), adults who were overweight (61%), and adults who were obese (80%). Source: North Carolina Behavioral Risk Factor Surveillance System Survey, N.C. State Center for Health Statistics, N.C. Department of Health and Human Services, (2007).

Arthritis and Physical Activity Maintaining a healthy weight reduces the risk of developing arthritis and may decrease disease progression. CDC states that a loss of just 11 pounds can decrease the occurrence (incidence) of new knee osteoarthritis.[i] Symptoms of arthritis can improve with weight loss.[ii] Regular physical activities such as walking, bicycling and swimming have been shown to have significant benefits for people with arthritis, including reducing pain and improving physical function, mental health and quality of life[iii]. Among older adults with knee osteoarthritis, engaging in moderate physical activity at least three times per week can reduce the risk of arthritis-related disability by 47 percent.[iv] More than half of adults with either diabetes or heart disease also have arthritis. Physical activity is a crucial element of managing these chronic conditions, but having arthritis presents barriers to increasing physical activity.[v] Research shows that pain, fear of pain, and lack of information on how to exercise safely prevents people with arthritis from exercising, although physical activity decreases pain, improves function, and delays disability. [i] CDC recommandations, www.cdc.gov/arthritis/arthritis/faq.htm . Accessed on January 14, 2009. [ii] Surgeon General’s Report, www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.htm Last revised: January 11, 2007 [iii] CDC recommandations, www.cdc.gov/arthritis/arthritis/faq.htm . Accessed on January 20, 2009. [iv] Arch Intern Med 2001;161(19):2309–2316. [Data Source: FAST Trial] [v] Wilbert, Caroline. (2008) Half of Adults Will Get Knee Arthritis: Study Shows Obese and People With Past Knee Injuries Are More at Risk. WebMD Health News. Content source: National Center for Chronic Disease Prevention and Health Promotion. CDC At-A-glance: www.cdc.gov/nccdphp/publications/AAG/arthritis.htm .Page last viewed: July 29, 2008. Among older adults with knee osteoarthritis, engaging in moderate physical activity at least three times per week can reduce the risk of arthritis-related disability by 47%.