Overcoming Obesity: Educating the Family PDF Print E-mail
Written by Dr. Ramin Manshadi MD   
Tuesday, 04 June 2013 19:57


An estimated 300,000 deaths per year are attributed to Obesity. The risk of death rises with increasing weight. Individuals that are obese defined as Body Mass Index more than 30, have a 50-100% increased risk of premature death from all causes, compared to individuals with a healthy weight. The prevalence of Obesity is 35% in United States.

Let us examine the negative effects of obesity on our health:

Heart Disease

. Obesity can raise the incidence heart disease including heart failure, angina, and cardiac death
. High blood pressure is twice as common in obese individuals than in those who maintain a healthy weight
. It can lead to abnormal cholesterol levels which can cause arterial blockages


. An average weight gain of 15 pounds can increase a person’s risk of developing type 2 Diabetes to twice that of individuals without the gain.
. over 80 percent of patients with diabetes are obese


. Obesity raises the risk for certain cancers including breast, colon, gall bladder, prostate, kidney, and endometrial cancer.

Breathing and Arthritis

. Sleep Apnea is more common in obese patients
. obesity is associated with a higher prevalence of asthma
. For every increase of weight by 2 pounds, the risk of Arthritis is increased 10 percent.

It is rather clear and evident that obesity is harmful. Yet, 35% of individuals in United States are obese. Some cases of obesity are due to genetic predisposition but most relate to lack of education. Studies have shown that less educated individuals have a higher prevalence of obesity than educated individuals.

Education about obesity should start early. Children and Adolescents should be educated. Risk factors for heart disease such as hypertension and hyperlipidemia occur with increased frequency in over weight children and adolescents. Obesity can lead to Diabetes. We use to think that diabetes is a disease of the adults, yet given the higher prevalence of childhood obesity, we see more and more younger patients presenting with diabetes. This is true with prevalence of hypertension. In my own Cardiovascular practice, I have noted a significant incidence of hypertension in the young obese teenagers. More than 70 percent of obese adolescents will end up obese as adults.

A recent study from the National Health and Nutrition Examination Survey of 4600 teenagers has shown that only 1 percent of these teenagers met the ideal guidelines of healthy diet which includes 4.5 cups a day of fruits and vegetables, two serving of fish a week, 3 ounces day of whole grains, less than 1500mg of salt a day and no more than 450 calories worth of sugar-sweetened drinks a week. Most children and teenagers consume their food from fast food chains. The foods from these fast food chains have too much calories, salt, fat and not enough healthy ingredients. 91 percent of these restaurants do not meet the standards set by the National Restaurant Associations’s kids LiveWell program.

Some interventions that can help prevent obesity in children and teenagers are simple. Researches from Temple University conducted a study that found reducing the size of the children’s plates and bowls cause them to eat less. They have noted that by simply using child size plates rather than adult size plates, then these children on average ate 90 less calories per plate. This is an important observation since we should not only focus on the nutrient content but portion sizes. The formula for weight gain or loss is caloric balance. If the balance is positive, then one gains weight. If the balance is negative, then one looses weight. A simple formula is that we have reduced our caloric intake by 500 calories per day to be able to drop one pound in one week. Another study that was published earlier this year in Diabetologia looked the negative effects of sweet and soft drinks. This study looked at 350,000 individuals from Europe that drank these soft drinks. They found out that drinking just one of these drinks daily can raise the risk of diabetes by 22 percent. In fact, if one drinks 2 sodas a day, then the risk of stroke is 2 times as much as those individuals that drink one soda a day. Interestingly, these negative effects of sugar drinks were not observed from individuals that drank fruit juice rather than sweetened soft drinks. This further proves the importance of consuming diet that is from natural sources such as fruits and vegetables. Processed foods and sugary drinks just do not have the same nutritional values of sugar source from natural resources.

Another Study from Cornell has shown that grocery shopping should not be done when one is hungry. The study has shown that shoppers that were hungry tend to shop for much less (23%) nutritious food. They are likely to purchase high-calorie items, such as junk food and pre-processed meals.

One of the most important interventions is prevention. If one is not yet overweight or obese, then try to stay that way. As we age, the proportion of muscle decreases and the proportion of fat increases. Less muscle leads to slow metabolism leading to weight gain. The key here is to monitor food intake and keep active.

In general, we need to do a moderate exercise such as brisk walk for 30 minutes daily, five days a week. For teenagers and children it should be 60 minutes a day for seven days a week.

Intervention should start at the family level. Parents should themselves eat healthy and be a role model. One way to do this is to remove calorie-rich temptations. Stay away from high fat and high sugar snacks even if it is called a low fat snack. Normally, it is replaced by sugar instead. A healthy snack would be fruits like an apple, a medium sized banana, one cup blueberries, or bell peppers with 2 table spoon Hummus.

Keeping active is not just a must for adults but especially with children. Habits start early in life. This is the time to teach healthy habits such as keeping active. Living in life full of video games such as Wii and Xbox games promoting minor activity further deteriorates healthy habits. The advantage of keeping kids active are strengthening bones, decreasing blood pressure, reducing stress and anxiety, increasing self-esteem, and help with weight management.

Overcoming obesity is not a difficult task. It starts with educating not only individuals but family as a unit from the young to the old. This should be a team approach. Sometimes regressing back to the way our forefathers lived (more activity along with eating more fruits and vegetables) can actually help us live longer and healthier.


Dr. Manshadi MD, FACC, FSCAI, FAHA, FACP is among the top American cardiologists. He is the author of The Wisdom of Heart Health.  The physician is an Interventional Cardiologist who treats patients from prevention to intervention. He is a CMA (California Medical Association) member since 2001. He is a Board-Certified physician with the American Board of Interventional Cardiology, American Board of Cardiology. He combines private practice with Academic Medicine. Presently, he serves as Associate Clinical Professor at UC Davis Medical Center and as Clinical Professor at University of the Pacific among other positions. In addition, he is the Chair of Media Relations for American College of Cardiology, California Chapter. The multi-faceted physician is licensed and certified in nuclear medicine, a subspecialty of radiology. In this regard, he is a member of the American Board of Nuclear Cardiology. It is noteworthy to mention that in his practice, he likes to use innovative tests. If you want to know more about Dr. Manshadi, you can click here: Dr. Ramin Manshadi-Cardiologist. Dr. Manshadi is our health columnist and  is available to answer your questions. You can e-mail him at  This e-mail address is being protected from spambots. You need JavaScript enabled to view it  and the address of his official website is www.DrManshadi.com.