Overvægt, tal og data
Generelt anses overvægt som en konsekvens af en stadig ubalance mellem energi-indtag og energiforbrug forårsaget af et komplekst sammenspil mellem genetisk modtagelighed og ernæringsmæssige, sociale, psykologiske og miljømæssige faktorer (4).
WHO definerer personer som overvægtige hvis de har et body mass index (BMI) ≥25.0 kg/m2 og som fede (obese) når de har et BMI på ≥30.0 kg/m2 (5). I denne opgave benyttes betegnelsen overvægtig da den også inkluderer fedme og da der på dansk ligger en værdiladning i ordet fed/fedme der ikke på samme måde eksisterer på engelsk.
• I år 2000 var 10% af danske mænd og 9% af danske kvinder svært overvægtige
• Hvert år er ~2% af alle dødsfald på grund af overvægt
• Svært overvægtige dør i gennemsnit 2-3 år for tidligt
• Hvert år er 55.000 hospitalsindlæggelser relateret til overvægt.
(6).
I 2008 var ca. 52% af den voksne befolkning i Danmark overvægtige, heraf var 18% svært overvægtige. Fremskriver man disse tal vil ca. 27% af befolkningen være svært overvægtige i 2030 (7).
2022: Antallet af overvægtige er steget drastisk over de sidste 50 år. Overvægt betragtes nu som en global helbredsudfordring som af WHO defineres som havende karakter af en pandemi. I globale tal var over 650 millioner voksne mennesker overvægtige i 2019.
Årsagen til at overvægt bliver betragtet som en helbredsudfordring er, at overvægtige statistisk set har en større risiko for at få type 2 diabetes, fedtlever, hjerte-kar sygdomme, forhøjet blodtryk, hjertetilfælde, demens, søvnapnø og visse kræfttyper; altså mange af de sygdomme vi generelt betragter som livsstilssygdomme (A).
Mikrobiom / mikrobiota – definitioner og forklaring
I min opgave brugte jeg følgende definitioner:
Mikrobiota: Et mikrobielt miljø der almindeligvis henviser til det område, som det optager (f.eks. tarmmikrobiotaen).
Mikrobiom: Helheden af det samlede genomer og gener af alle kroppens mikroorganismer
(8). Idet der fokuseres på miljøet i tarmen, vil betegnelserne mikrobiota/mikrobiom og ikke tarm-mikrobiota og tarm-mikrobiom blive anvendt (dvs. uden ”tarm”).
Mikrobiotaen udgør et komplekst økosystem der har >1000 arter med >7000 stammer og indeholder > 150 gange flere gener end det menneskelige genom (9). Den menneskelige tarm rummer trillioner af mikrober fra alle områder: Eukaryoter, bakterier og archaea, med dominans af bakterieceller. Der er bakterier i mavesæk og tyndtarm, men langt den største del findes i tyktarmen hvor ca. 90% af bakterierne hører til de to phyla Firmicuter og Bacteroidetes (4).
– Bacteroidetes er gramnegative, anaerobe, ikke-spore-dannende bakterier der indeholder enzymer der kan nedbryde kulhydrater
– Firmicuter er grampositive, anaerobe sporedannende bakterier der fermenterer simple sukkerarter således at der dannes forskellige kortkædede fedtsyrer (short chain fatty acids – SCFA)
(9).
De andre repræsenterede phylaer er vist i Figur 1 der fremstiller det bakterielle hierarki i mikrobiotaen (10) (11).
Figur 1 Skematisk fremstilling af det bakterielle hierarki i mikrobiotaen (11).
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(C) Mette Brahm, 2022