1. Obesity-Related Chronic Disease
The Burden of Obesity
Obesity-Related Chronic Disease
dr shabeel pn

2. 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; Available from:
[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).

3. 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).

4. The Burden of Obesity in North Carolina
Oral Health

5. Oral Health and Obesity
Periodontitis (gum disease) occurs almost twice as frequently in obese individuals as in those at a healthy weight.
Periodontitis was found 76% more frequently in obese adults, aged 18 to 34 years, than in age-matched adults at a healthy weight.
Children who are obese are at an increased risk for dental caries.
Periodontitis (gum disease) occurs more frequently in obese individuals than in those at a healthy weight. In the U.S., 30 percent of adults with periodontitis were obese, compared with 12 percent of the periodontally healthy individuals.[i] Obese individuals also exhibited a significantly higher percentage of sites exhibiting visible plaque.[ii] Periodontitis was found 76 percent more frequently in obese adults aged 18 to 34 years than in age-matched adults at a healthy weight.
Dental caries (cavities) is the most prevalent chronic disease of childhood, affecting 58.6 percent of children aged 5–17 years.[iii] In 2004, an association between dental caries and obesity in childhood was found, suggesting that obese children are at an increased risk for dental caries.[iv],[v],[vi]
Sugars, modified starches and starches are all subject to fermentation; sugared soft drinks, confections and starches baked with sugars are considered highly cariogenic[1].[vii],[viii],[ix],[x],[xi] Frequent consumption of sugars increases this risk.[xii] Children at highest risk for dental caries are disproportionately from minority households and/or live in poverty.[xiii] Both the prevalence of decay and the lack of dental treatment increase with minority status and decreasing resources.[xiv] Public health measures designed to improve both dietary education and access to appropriate foodstuffs could decrease both childhood caries and childhood obesity.[xv]
In North Carolina, approximately 32 percent of adults reported not having visited a dentist within the last year.[xvi] According to 2005 data, one in four North Carolina children (25.5 percent) did not have a dentist or dental clinic they went to regularly. [xvii] The lack of dental care is especially acute among North Carolina’s poor and minority populations. Thirty-nine percent of Native Americans and 42 percent of African Americans reported that they had not visited the dentist in the past year. More than half (56 percent) of Hispanics reported that they did not visit the dentist in the past year and one in five Hispanics (22 percent) reported that it had been five or more years since their last dental visit. Nearly one in ten Hispanics reported that they had never visited the dentist, and this figure was slightly higher for Spanish-speaking Hispanics (13.4 percent).
[1] Cariogenic=causing tooth decay
[i] E.M.H. Mathus-Vliegen, D. Nikkel and H.S. Brand. Oral aspects of obesity. International Dental Journal (2007) 57,
[ii] Haffajee AD, Socransky S, Carpino EA et al. Relation of BMI to periodontal, microbial and host parameters. J Dent Res (Spec Iss A): 173.
[iii] U.S. Department of Health and Human Services. Oral health in America: a report of the Surgeon General—executive summary. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000.
[iv] Reifsnider E, Mobley C, Mendez DB. Childhood obesity and early childhood caries in a WIC population. J Multicultural Nurs Health 2004;10:24–31.
[v] Tuomi T. Pilot study on obesity in caries prediction. Community Dent Oral Epidemiol 1989;17:289–91.
[vi] Willerhausen B, Haas G, Krummenauer F, Hohenfellner, K. Relationship between high weight and caries frequency in German elementary school children. Eur J Med Res 2004;9:400–4.
[vii] Campain AC, Morgan MV, Evans RW, Ugoni A,Adams, GG, Conn JA et al. Sugar-starch combinations in food and the relationship to dental caries in low-risk adolescents. Eur J Oral Sci 2003;111:316–25.
[viii] Lingstrom P, van Houte J, Kashket S. Food starches and dental caries. Crit Rev Oral Biol Med2000;11:366–80.
[ix] Gustaffson BE, Quensel CE, Lanke LS, Lundqvist C, Grahne´n H, Bonow BE et al. The Vipeholm Dental Caries Study. Acta Odontol Scand 1954;11:232–364.
[x] Woodward M, Walker ARP. Sugar consumption and dental caries: evidence from 90 countries. Br Dent J 1994;176:297–302.
[xi] Marshall TA, Levy SM, Broffitt B, Warren JJ, Eichenberger-Gilmore JM, Burns TL et al. Dental caries and beverage consumption in young children. Pediatrics2003;112:e184–91.
[xii] Marshall TA, Broffitt B, Eichenberger-Gilmore J, Warren JJ, Cunningham MA, Levy SM. The roles of meal, snack and daily total food and beverage exposures on caries experience in young children .J Public Health Dent 2005;65:166–73.
[xiii] U.S. Department of Health and Human Services. Oral health in America: a report of the Surgeon General—executive summary. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000.
[xiv] Vargas CM, Crall JJ, Schneider DA. Sociodemographic distribution of pediatric dental caries: NHANESIII, 1988–1994. J Am Dent Assoc 1998;129:1229–38.
[xv] Marshall TA, Eichenberger-Gilmore JM, Broffitt BA, Warren JJ, Levy SM. Dental caries and childhood obesity: roles of diet and socioeconomic status. Community Dent Oral Epidemiology 2007; 35: 449–458.
[xvi] North Carolina Department of Health and Human Services, Division of Public Health, State Center for Health Statistics. Health Profile of North Carolinians: 2007 Update-May Available at:
[xvii] North Carolina Department of Health and Human Services, Division of Public Health, State Center for Health Statistics. Health Profile of North Carolinians: 2007 Update-May Available at: .