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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Obesity in Mexico is a relatively recent phenomenon, having been widespread since the 1980s with the introduction of processed food into much of the Mexican food market. Prior to that, dietary issues were limited to under and malnutrition, which is still a problem in various parts of the country. Following trends already ongoing in other parts of the world, Mexicans have been foregoing traditional whole grains and vegetables in favor of a diet with more animal products, more fat, and more sugar much of which is a consequence of processed food. It has seen dietary energy intake and rates of overweight and obese people rise with seven out of ten at least overweight and a third clinically obese.
Obesity in North Africa and the Middle East is a notable health issue. In 2005, the World Health Organization measured that 1.6 billion people were overweight and 400 million were obese. It estimates that by the year 2015, 2.3 billion people will be overweight and 700 million will be obese. The Middle East, including the Arabian Peninsula, Eastern Mediterranean, Turkey and Iran, and North Africa, are no exception to the worldwide increase in obesity. Subsequently, some call this trend the New World Syndrome. The lifestyle changes associated with the discovery of oil and the subsequent increase in wealth is one contributing factor.
Urbanization has occurred rapidly and has been accompanied by new technologies that promote sedentary lifestyles. Due to accessibility of private cars, television, and household appliances, the population as a whole is engaging in less physical activity. The rise in caloric and fat intake in a region where exercise is not a defining part of the culture has added to the overall increased percentages of overweight and obese populations. In addition, women are more likely to be overweight or obese due to cultural norms and perceptions of appropriate female behavior and occupations inside and outside of the home.
Until the late 20th century, dietary issues in Mexico were solely a question of undernutrition or malnutrition, generally because of poverty and distribution issues. For this reason, obesity was associated with wealth and health, the latter especially in children. Despite changes in the Mexican diet and food distribution, malnutrition still remains problematic in various parts of the country.
Obesity in Germany has been increasingly cited as a major health issue in recent years. The federal government has declared this to be a major issue.
Data released by the World Health Organisation in 2014 showed that while an issue of growing concern, within the European Union, Germany had a lower incidence of overweight and obese adults as a percentage of the total population at 54.8% in comparison with France at 60.7%, Spain at 60.9% or the United Kingdom at 63.4%.
Obesity in India has reached epidemic proportions in the 21st century, with morbid obesity affecting 5% of the country's population. India is following a trend of other developing countries that are steadily becoming more obese. Unhealthy, processed food has become much more accessible following India's continued integration in global food markets. This, combined with rising middle class incomes, is increasing the average caloric intake per individual among the middle class and above income households. Obesity is a major risk factor for cardiovascular disease, NGOs such as the Indian Heart Association have been raising awareness about this issue.
While studying 22 different SNPs near to MC-R gene, scientists have identified a SNP (single nucleotide polymorphism) named rs12970134 to be mostly associated with waist circumference. In this study more than two thousand individuals of Indian origin participated and the aforementioned SNP is highly prevalent in this group.
Internationally, a BMI over 25 kg/m2 is considered overweight. Due to genetic tendency of Indians towards abdominal obesity and its associated risk of related lifestyle diseases like Diabetes & Heart Disease, Guidelines for diagnosis of obesity and abdominal obesity for India have been published in JAPI (2009) that a BMI over 23 kg/m2 is considered overweight. Further definitions: Normal BMI: 18.0-22.9 kg/m2, Overweight: 23.0-24.9 kg/m2, Obesity: >25 kg/m2.
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors. BMI is closely related to both percentage body fat and total body fat.
In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined not as an absolute number but in relation to a historical normal group, such that obesity is a BMI greater than the 95th percentile. The reference data on which these percentiles were based date from 1963 to 1994, and thus have not been affected by the recent increases in weight. BMI is defined as the subject's weight divided by the square of their height and is calculated as follows.
BMI is usually expressed in kilograms per square metre, resulting when weight is measured in kilograms and height in metres. To convert from pounds per square inch multiply by .
The most commonly used definitions, established by the World Health Organization (WHO) in 1997 and published in 2000, provide the values listed in the table.
Some modifications to the WHO definitions have been made by particular organizations. The surgical literature breaks down class II and III obesity into further categories whose exact values are still disputed.
- Any BMI ≥ 35 or 40 kg/m is "severe obesity".
- A BMI of ≥ 35 kg/m and experiencing obesity-related health conditions or ≥40–44.9 kg/m is "morbid obesity".
- A BMI of ≥ 45 or 50 kg/m is "super obesity".
As Asian populations develop negative health consequences at a lower BMI than Caucasians, some nations have redefined obesity; Japan have defined obesity as any BMI greater than 25 kg/m while China uses a BMI of greater than 28 kg/m.
Obesity has been observed throughout human history. Many early depictions of the human form in art and sculpture appear obese. However, it was not until the 20th century that obesity became common — so much so that, in 1997, the World Health Organization (WHO) formally recognized obesity as a global epidemic. Obesity is defined as having a body mass index (BMI) greater than or equal to 30 kg/m, and in June 2013 the American Medical Association classified it as a disease, with much controversy.
In countries of the Organisation for Economic Co-operation and Development (OECD), one child out of five is overweight or obese. Once considered a problem only of high-income countries, obesity rates are rising worldwide. Globally, there are now more people who are obese than who are underweight, a trend observed in every region over the world except parts of sub-Saharan Africa and Asia. In 2013, an estimated 2.1 billion adults were overweight, as compared with 857 million in 1980. Of adults who are overweight, 31% are obese. Increases in obesity have been seen most in urban settings.
Since body fat can be measured in several ways, statistics on the epidemiology of obesity vary between sources. While BMI is the most basic and commonly used indicator of obesity, other measures include waist circumference, waist-to-hip ratio, skinfold thicknesses, and bioelectrical impedance. The rate of obesity increases with age at least up to 50 or 60 years old.
The OECD notes that — given the health, economic, and social consequences of obesity — many countries have built multi-stakeholder networks involving civil society and the business sector in order to devise appropriate public health policies and solutions for obesity prevention.
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have a negative effect on health. People are generally considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight by the square of the person's height, is over , with the range defined as overweight. Some East Asian countries use lower values. Obesity increases the likelihood of various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, osteoarthritis and depression.
Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity, and genetic susceptibility. A few cases are caused primarily by genes, endocrine disorders, medications, or mental disorder. The view that obese people eat little yet gain weight due to a slow metabolism is not generally supported. On average, obese people have a greater energy expenditure than their normal counterparts due to the energy required to maintain an increased body mass.
Obesity is mostly preventable through a combination of social changes and personal choices. Changes to diet and exercising are the main treatments. Diet quality can be improved by reducing the consumption of energy-dense foods, such as those high in fat and sugars, and by increasing the intake of dietary fiber. Medications may be used, along with a suitable diet, to reduce appetite or decrease fat absorption. If diet, exercise, and medication are not effective, a gastric balloon or surgery may be performed to reduce stomach volume or length of the intestines, leading to feeling full earlier or a reduced ability to absorb nutrients from food.
Obesity is a leading preventable cause of death worldwide, with increasing rates in adults and children. In 2015, 600 million adults (12%) and 100 million children were obese. Obesity is more common in women than men. Authorities view it as one of the most serious public health problems of the 21st century. Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was seen as a symbol of wealth and fertility at other times in history and still is in some parts of the world. In 2013, the American Medical Association classified obesity as a disease.
The medical condition of being overweight or obesity is defined as "abnormal or excessive fat accumulation that may impair health". It is measured through the Body Mass Index (BMI), defined as a person's weight, in kilograms, divided by the square of the person's height, in meters. If an individual has a BMI of 25–29, he or she is overweight. Having a BMI of 30 or more means an individual is obese. The greater the BMI, the greater the risk of chronic diseases as a result of obesity. These diseases include cardiovascular diseases, diabetes, musculoskeletal disorders, cancer, and premature death.
Obesity in the United Kingdom is a significant contemporary health concern, with officials stating that it is one of the leading preventable causes of death. In February 2016, Health Secretary Jeremy Hunt described rising rates of childhood obesity as a "national emergency".
Data published as a part of the World Health Organisation (WHO) study in 2014 indicated that 28.1% of adults in the United Kingdom were recognised as clinically obese with a Body Mass Index (BMI) greater than 30. In 2014 62% of adults in England were classified as overweight (a body mass index of 25 or above) or obese, compared to 53% 20 years earlier. More than two-thirds of men and almost six in 10 women are overweight or obese.
Experts have predicted that by the year 2020 one third of the United Kingdom population could be obese. Rising levels of obesity are a major challenge to public health. There are expected to be 11 million more obese adults in the UK by 2030, accruing up to 668,000 additional cases of diabetes mellitus, 461,000 cases of heart disease and stroke, 130,000 cases of cancer, with associated medical costs set to increase by £1.9–2.0B per year by 2030. Adult obesity rates have almost quadrupled in the last 25 years.
For children, data from the Health Survey for England (HSE) conducted in 2014 and examining patterns of overweight and obesity among children aged 2–15, showed that 17% of children were obese and an additional 14% of children were overweight.
Combing three years of data (2012, 2013 and 2014) Public Health England identified Barnsley, South Yorkshire as the local authority with the highest incidence of adult obesity (BMI greater than 30) with 35.1%. Data from the same study revealed that Doncaster, South Yorkshire was the local authority with the highest overall excess weight with 74.8% of adults (16 years and over) with a BMI greater than 25. In previous Public Health England studies based on 2012 data, Tamworth in Staffordshire had been identified as the fattest town in England with a 30.7% obesity rate.
Obesity in the United States has been increasingly cited as a major health issue in recent decades, resulting in diseases such as coronary heart disease that lead to mortality. While many industrialized countries have experienced similar increases, obesity rates in the United States are the highest in the world.
Obesity has continued to grow within the United States. Two of every three American men are considered to be overweight or obese, but the rates for women are far higher. The United States contains one of the highest percentage of obese people in the world. An obese person in America incurs an average of $1,429 more in medical expenses annually. Approximately $147 billion is spent in added medical expenses per year within the United States. This number is suspected to increase approximately $1.24 billion per year until the year 2030.
The United States had the highest rate of obesity within the OECD grouping of large trading economies. From 23% obesity in 1962, estimates have steadily increased. The following statistics comprise adults age 20 and over. The overweight percentages for the overall US population are higher reaching 39.4% in 1997, 44.5% in 2004, 56.6% in 2007, and 63.8% (adults) and 17% (children) in 2008. In 2010, the Centers for Disease Control and Prevention (CDC) reported higher numbers once more, counting 65.7% of American adults as overweight, and 17% of American children, and according to the CDC, 63% of teenage girls become overweight by age 11. In 2013 the Organisation for Economic Co-operation and Development (OECD) found that 57.6% of American citizens were obese. The organization estimates that 3/4 of the American population will likely be overweight or obese by 2020. The latest figures from the CDC as of 2014 show that more than one-third (36.5%) of U.S. adults age 20 and older and 17% of children and adolescents aged 2–19 years were obese. A second study from the National Center for Health Statistics at the CDC showed that 39.6% of US adults age 20 and older were obese as of 2015-2016 (37.9% for men and 41.1% for women).
Obesity has been cited as a contributing factor to approximately 100–400 000 deaths in the United States per year and has increased health care use and expenditures, costing society an estimated $117 billion in direct (preventive, diagnostic, and treatment services related to weight) and indirect (absenteeism, loss of future earnings due to premature death) costs. This exceeds health care costs associated with smoking and accounts for 6% to 12% of national health care expenditures in the United States.
Cardiovascular disease is the principal cause of death in the UAE, constituting 28 percent of total deaths; other major causes are accidents and injuries, malignancies, and congenital anomalies.
This is a list of the states of India ranked in order of percentage of people who are overweight or obese, based on data from the 2007 National Family Health Survey.
Several studies have shown that obese men tend to have a lower sperm count, fewer rapidly mobile sperm and fewer progressively motile sperm compared to normal-weight men.
Obesity in Germany has created a cholesterol problem. High cholesterol is known to cause premature death, angina, heart disease and strokes.
There has been an increase of children with Type 1 diabetes between 1996 and 2011. Diabetics are at higher risk for complications such as heart attack and stroke. In Germany, 600,000 people suffered from diabetes near the end of World War II compared to eight million now.
Obesity can increased risk for secondary diseases such as diabetes, cardiovascular disease, certain cancers and Alzheimer's. Children who get diabetes can expect to lose 10 to 15 years off of their lives. Diabetes also affect the eyes, kidneys and nerves in the legs.
Obesity is a "very strong promoter of cancer." Obesity causes an increased risk for colon cancer and breast cancer.
Stunted growth, also known as stunting and nutritional stunting, is a reduced growth rate in human development. It is a primary manifestation of malnutrition (or more precisely undernutrition) and recurrent infections, such as diarrhea and helminthiasis, in early childhood and even before birth, due to malnutrition during fetal development brought on by a malnourished mother. The definition of stunting according to the World Health Organisation (WHO) is for the "height for age" value to be less than two standard deviations of the WHO Child Growth Standards median.
As of 2012 an estimated 162 million children under 5 years of age, or 25%, were stunted in 2012. More than 90% of the world's stunted children live in Africa and Asia, where respectively 36% and 56% of children are affected. Once established, stunting and its effects typically become permanent. Stunted children may never regain the height lost as a result of stunting, and most children will never gain the corresponding body weight. Living in an environment where many people defecate in the open due to lack of sanitation, is an important cause of stunted growth in children, for example in India.
Causes cited for the growing rates of obesity in the United Kingdom are multiple and the degree of influence of any one factor is often a source of debate. At an individual level, a combination of excessive food energy intake and a lack of physical activity is thought to explain most cases of obesity. Reduced levels of physical activity due to increased use of private cars, desk bound employment, a decline in home cooking skills and the ready availability of processed foods high in sugar, salt and saturated fats, are variously cited as contributing factors.
In 2009, 119 genetic disorders were identified among Emiratis and 241 among Arab citizens and expatriates combined in the UAE. This is the second-highest incidence of genetic disorders in the Arab world (after Oman). Autosomal recessive disorders are common in the UAE. Hemoglobinopathies are one of the most common disorders among the UAE nationals. Beta-thalassemia constitutes a major public health problem in the UAE. During 1989-2004, more than 850 patients have been registered at the Dubai Genetics and Thalassemia Center. Surveys have shown that the UAE exhibits one of the highest carrier frequencies of β-thalassemia in the Persian Gulf region which is 8.5%. Pre-marital medical examinations in the UAE, excluding the HAAD, include blood group tests, sickle cell anaemia, hepatitis B and C, German measles, haemoglobin variance, HIV/AIDS, thalassaemia, and syphilis.
The Health Authority – Abu Dhabi introduced premarital screening and counselling in 2011. 56,226 men and women preparing for marriage were tested for genetic and infectious disorders were tested between 2011 and the end of 2014. in 2014 16,247 people were tested, 342 were Beta-thalassaemia carriers, 8 had sickle-cell anaemia, 205 were sickle-cell anaemia carriers, 36 had syphilis and 140 had hepatitis B.
Some newborns are oversized. This is more often a problem associated with a medical disorder. Unlike adults, neonates do not develop obesity. The number one cause of big babies is diabetes in their mother. The baby is not considered obese. Newborns who are born to mothers who are considered obese have a 49% decrease in likelihood of mortality.
Stunted growth in children has the following public health impacts apart from the obvious impact of shorter stature of the person affected:
- greater risk for illness and premature death
- may result in delayed mental development and therefore poorer school performance and later on reduced productivity in the work force
- reduced cognitive capacity
- Women of shorter stature have a greater risk for complications during child birth due to their smaller pelvis, and are at risk of delivering a baby with low birth weight
- Stunted growth can even be passed on to the next generation (this is called the "intergenerational cycle of malnutrition")
The impact of stunting on child development has been established in multiple studies. If a child is stunted at age 2 they will have higher risk of poor cognitive and educational achievement in life, with subsequent socio-economic and inter-generational consequences. Multi-country studies have also suggested that stunting is associated with reductions in schooling, decreased economic productivity and poverty. Stunted children also display higher risk of developing chronic non-communicable conditions such as diabetes and obesity as adults. If a stunted child undergoes substantial weight gain after age 2, there is a higher chance of becoming obese. This is believed to be caused by metabolic changes produced by chronic malnutrition, that can produce metabolic imbalances if the individual is exposed to excessive or poor quality diets as an adult. This can lead to higher risk of developing other related non-communicable diseases such as hypertension, coronary heart disease, metabolic syndrome and stroke.
At societal level, stunted individuals do not fulfill their physical and cognitive developmental potential and will not be able to contribute maximally to society. Stunting can therefore limit economic development and productivity, and it has been estimated that it can affect a country's GDP up to 3%.
Obesity rates in Western Africa are estimated to be 10%. Rates of obesity among women are three times those found in men. In urban West Africa rates of obesity have more than doubled in the last 15 years.
A lallation (also called cambia-letras or troca-letra, "letter changer", in Latin American countries) is an imperfect enunciation of the letter "L", in which it sounds like "R" (or vice versa), as frequently found in infantile speech.
The speech pattern has been particularly associated with the use of the Portuguese, Spanish and English languages by Chinese, Korean, and Japanese people. The use of lallation has thus been a common feature of Western stereotypes of East Asian people. It is also common among English-speakers in parts of East Africa.
The symptoms of jet lag can be quite varied, depending on the amount of time zone alteration, time of day, and individual differences. Sleep disturbance occurs, with poor sleep upon arrival and/or sleep disruptions such as trouble falling asleep (when flying east), early awakening (when flying west), and trouble remaining asleep. Cognitive effects include poorer performance on mental tasks and concentration; increased fatigue, headaches, and irritability; and problems with digestion, including indigestion, changes in the frequency of defecation and consistency of faeces, and reduced interest in and enjoyment of food. The symptoms are caused by a circadian rhythm that is out of sync with the day-night cycle of the destination, as well as the possibility of internal desynchronisation. Jet lag has been measured with simple analogue scales, but a study has shown that these are relatively blunt for assessing all the problems associated with jet lag. The Liverpool Jet Lag Questionnaire was developed to measure all the symptoms of jet lag at several times of day, and this dedicated measurement tool has been used to assess jet lag in athletes.
Jet lag may require a change of three time zones or more to occur, though some individuals can be affected by as little as a single time zone or the single-hour shift to or from daylight saving time. Symptoms and consequences of jet lag can be a significant concern for athletes travelling east or west to competitions, as performance is often dependent on a combination of physical and mental characteristics that are impacted by jet lag.
Jet lag is a physiological condition which results from alterations to the body's circadian rhythms resulting from rapid long-distance trans-meridian (east–west or west–east) travel. For example, someone travelling from New York to London feels as if the time were five hours earlier than local time. Jet lag was previously classified as one of the circadian rhythm sleep disorders.
The condition of jet lag may last several days before the traveller is fully adjusted to the new time zone; a recovery period of one day per time zone crossed is a suggested guideline. Jet lag is especially an issue for airline pilots, crew, and frequent travellers. Airlines have regulations aimed at combating pilot fatigue caused by jet lag.
The term "jet lag" is used because before the arrival of passenger jet aircraft, it was uncommon to travel far and fast enough to cause desynchronosis. Travel by propeller-driven aircraft, by ship or by train was slower and of more limited distance than jet flights, and thus did not contribute widely to the problem.
Other features include:
- Stunting
- Small hands and feet with long, tapering fingers and clinodactyly
- Dental anomalies in the form of malalignment and malocclusion
In another study of six patients, the patients were investigated further. They were found to have low levels of IGF-1 and markedly retarded bone age.
Children with the Sanjad Sakati syndrome have a triad of:
a) hypoparathyroidism (with episodes of hypocalcemia, hypocalcemic tetany and hypocalcemic seizures.
b) severe mental retardation and
c) dysmorphism.
Typically, children with this syndrome are born low-birth-weight due to intrauterine growth retardation. At birth, there is dysmorphism, which is later typified into the features described below. The child is stunted, often with demonstrable growth hormone deficiency and has moderate to severe mental retardation, mainly as a consequence of repeated seizures brought on by the low blood ionic calcium levels. The immuno-reactive parathormone levels are low to undetectable, with low calcium and high phosphate levels in the blood.
"Dysmorphism" is most evident on the face, with the following features:
- Long narrow face
- Deep-set, small eyes
- Beaked nose
- Large, floppy ears
- Small head (microcephaly) and
- Thin lips with a long philtrum.