Diseases resulting from nutrient excesses

Malnutrition is defined as a nutritional disorder due to an absolute or relative deficiency or excess of nutrients or their imbalance. Malnutrition can be divided from several points of view:


 * Malnutrition from undernourishment – lack of nutrients.
 * Malnutrition from overnutrition – excess nutrients.


 * General malnutrition - arises from a lack or excess of energy in the diet (protein energy malnutrition, obesity).
 * Specific malnutrition - arises from a deficiency or excess of individual nutrients.


 * Primary (exogenous) malnutrition – caused by insufficient or excessive nutrient intake. Some of the primary malnutrition affects millions of people.
 * Secondary (endogenous) malnutrition – arises due to nutrient absorption disorder, nutrient utilisation disorder (enzyme defects), nutrient interactions with medicines. They are infrequent compared to some primary malnutrition. Environmental factors (xenobiotics, smoking) may also contribute to malnutrition.

The International Classification of Diseases  ''classifies diseases from excess nutrients mostly in the group Diseases of endocrine, nutrition and transformation of substances E65-E68 Obesity and other hyperalimentation (e.g. Excess vitamin A,D)

Malnutrition from overnutrition
Obesity is the general malnutrition of excessive energy intake. Obesity is a civilizational disease and is the most common metabolic disease today. It is defined by an increase in fat in the body.

Excessive intake of certain vitamins, minerals or trace elements can lead to specific malnutrition from overnutrition, most commonly when taking food supplements, only rarely from food (eg hypervitaminosis A after consumption of polar bear liver, fluorosis in excess of fluorine in drinking water).

Definition of the degree and types of obesity
The physiological proportion of fat in the body is 28-30% in women and 23-25% in men. Body mass index, or BMI (body mass index), is most commonly used to express the degree of excess weight. The following formula is used to calculate BMI.

BMI = weight (kg) / height (m)2

Based on BMI, we distinguish between different stages of different stages of excess weight.

The type of obesity is also defined by the distribution of adipose tissue in the body. We distinguish the so-called android type, which is characterized by fat storage on the abdomen (apple). This type occurs mainly in men and is more risky in terms of health complications. Gynoid type obesity with the placement of fat on the buttocks and thighs (pear), which is found mainly in women, is considered less risky. It is not associated with a higher risk of cardiovascular and metabolic complications. The distribution of body fat can also be assessed by the WHR (waist to hip ratio) index. This index is obtained by dividing the waist circumference by the hip circumference. This number should not exceed 0.8 for women and 1.0 for men.
 * 20,0–24,9 – normal body weight
 * 25,0–29,9 – overweight
 * 30,0–39,9 – severe obesity
 * 40,0 and more – pathological malignant obesity

Prevalence of obesity
The prevalence of obesity has risen dramatically in recent years, both in developed and developing countries. In developing countries, it is associated mainly with economic development and the adoption of the Western lifestyle (diet, development of individual transport and spending time on television). It has been shown that together with the increase in gross domestic product, there is also an increase in the prevalence of obesity. The distribution of obesity among the population is also characteristic. In developed countries, especially in North America and Europe, obesity is associated with lower education and economic status. It is more common in rural areas. In contrast, in developing countries, obesity is still an expression of economic prosperity and is more common among urban dwellers. The long-term low prevalence of obesity is in Japan and China. In Europe, the prevalence of obesity is 10-20% for men and 10-25% for women.

Pathogenesis of obesity
Excessive energy value of food intake, low physical activity and a number of exogenous and endogenous factors (genetic and metabolic disorders) play a role in the pathogenesis of obesity. There are a number of mechanisms in the body to maintain a stable body weight. However, these mechanisms protect people more effectively against energy deficits and weight loss than against overweight. This is probably because people have experienced food shortages more often during their development. Therefore, mainly individuals with energy-saving balance survived. They then passed on their genes to their descendants, who now, in times of energy excess, have to deal with being overweight. Of the nutrients, excessive fat intake plays the most important role in the pathogenesis of obesity. They have a high energy value and low saturation capacity. Obese individuals are not able to adequately burn fat during its excessive supply and the body responds by storing fat. They prefer fat mainly for its sensory properties - fullness and texture. Excessive carbohydrate intake does not play a major role because carbohydrate storage is limited. However, consuming carbohydrates in combination with fats (especially in fatty sweets) is risky. Proteins do not play a major role in the pathogenesis of obesity. The one-sidedness of food components and poor eating habits are the cause of the fact that patients suffer from excess fat and at the same time paradoxically lack some nutrients.

Health risks associated with obesity
Obesity is now considered one of the primary health risks in advanced societies. It is associated with a number of complications and associated diseases, which are summarized in the following sections:
 * hypertension;
 * angina pectoris;
 * myocardial infarction;
 * stroke;
 * lower limb varices and deep vein thrombosis;
 * diabetes mellitus;
 * sleep apnea syndrome;
 * lipoprotein metabolism disorders;
 * hyperuricemia;
 * changes in fibrinolytic activity;
 * degenerative diseases of the joints and spine (coxarthrosis, gonarthrosis);
 * higher risk of some tumors;
 * cholelithiasis a cholecystitis;
 * edema;
 * worse wound healing;
 * more frequent injuries and hernias;
 * depression, anxiety;
 * low self-esteem, motivational disorder, self-blame;
 * social exclusion and discrimination;
 * and more.

Obesity therapy
Obesity therapy should be initiated if a BMI greater than 30 is found. The goal of treatment is to reduce and maintain weight. Treatment methods vary depending on the patient's condition. They include dietary treatment, physical activity, cognitive-behavioral treatment and psychotherapeutic support, as well as pharmacological and surgical treatment. The prevention of obesity is very important, especially through knowledge of the nutritional value of food, the correct composition of the diet and the principles of a healthy lifestyle and their application from childhood.

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