1. By: Jennifer Brierley A Growing Epidemic

2. Section One Developing a Thesis and Finding Data

3. What is obesity? What is diabetes? How are obesity and diabetes related?

4. Obesity by definition is an increase body weight caused by excessive accumulation of fat. How do you know if someone is obese? A person is obese when their Body Mass Index (BMI) exceeds 30 and a person is considered overweight when their Body Mass Index is between 25 and 30. What is a Body Mass Index? A Body Mass Index commonly known as your BMI is a common measure expressing the relationship of weight-to-height. BMI = mass (kg) (height (m)) 2

5. Quick Data Fact The Body Mass Index Formula is a Mathematical Index A mathematical index is an arbitrarily defined number that provides a measure of scale. It is determined by a mathematical calculation that combines various attributes of each case in order to make comparisons. Mathematical Indices are found in Unit 3 (Tools for Analyzing Data) Jen Brierley’s BMI Weight = 52 kilograms Height = 1.57 meters BMI = mass (kg) height (m) 2 BMI = 52 (1.57) 2 BMI =21 I am not obese!

6. There are 3 types of diabetes: 1.Type 1 Diabetes 2.Type 2 Diabetes 3.Gestational Diabetes Diabetes is a chronic, metabolic condition that results from the body’s inability to sufficiently produce and/or properly use insulin Quick Fact! Type 2 Diabetes is one of the fastest growing diseases in Canada with more than 60,000 new cases yearly. Type 2 Diabetes can be prevented!

7. I researched the risk factors, health risks, symptoms, and prevention methods for obesity and diabetes. I then drew a mind map in order to examine how obesity and diabetes are related.

8. MIND MAP

9. After analyzing the connections I was interested in whether or not Canadians could reduce the risk of diabetes if in fact they started to live a healthy lifestyle. What effect do Canadian’s knowledge, attitudes and behaviors concerning obesity have on type 2 diabetes? Thesis Question

10. The better Canadian’s knowledge, attitudes and behaviors are concerning obesity, the lower the chance of developing type 2 diabetes will be Obesity and diabetes are directly correlated As the population as a whole becomes healthier, the prevalence of type 2 diabetes will decrease among Canadians What do knowledge, attitudes and behavior mean? Knowledge is if the population knows the facts and the statistics related to the topic Attitude is how much the population care about the issue and whether they are willing to engage in the topic. Behavior is what the population is doing. Are they dealing with the topic issue? Are they putting their knowledge and attitudes into effect? Will examine Canadian’s knowledge, attitudes, and behaviors related to obesity in order to determine what type of intervention would lead to reducing obesity. Will examine Canadian’s knowledge concerning the health factors related to obesity and whether or not Canadian’s are aware of the effect obesity has on developing type 2 diabetes. Objectives:

11. Using Diagrams to find Connections and Organize Ideas Section Two

12. Cause and Effect

13. . Does a person have knowledge about diet? Does the person have poor diet? No Yes Does a person have a good attitude towards their diet? No Does a person have good behaviors towards their diet? Yes No unhealthy Yes healthy Low risk of developing diabetes Is the person overweight? No High risk of developing diabetes Diet’s Role in Developing Diabetes

14. Obesity Genetics Had gestational diabetes Being age 40 +High cholesterol High blood pressure High risk ethnic groups Given birth to a baby >9 lb’s Network Diagram

15. Causes of type 2 diabetes that relate to each other ObesityHad gestational diabetes Gave birth to a baby > 9lb’s High blood pressure High cholesterol High risk ethnic groups GeneticsBeing age 40 + Obesity--------------++++- Had gestational diabetes -------------------+--+++ Gave birth to a baby > 9lb’s -+-------------------+ High blood pressure+----------------+++ High cholesterol+--+-------------+++ High risk ethnic groups -------------------- Genetics-----_------------ Being age 40 +-----_------------ Table that corresponds with network diagram. + represents a relationship -represents no relationship ------ represents that there is no relationship with itself Network Diagram

16. Canada MaleFemale Age 14 and under15 - 2526 - 4950 + Level of education obtained Elementary schoolHigh schoolCollegeUniversityPost graduate OntarioQuebec Sex Organization Chart

17. Diabetes Type 1Type 2 Does not apply to project Causes (risk factors) Obesity AbdominalNon abdominal Does not apply to project Prevention GeneticsHigh risk ethnic groups Had gestational diabetes High cholesterol High blood pressure Given birth to a baby > 9 lb’s Being age 40+ Be physically activeAchieve healthy weight and maintain it Don’t smokeLimit intake of fat and sugar Maintain normal blood pressure Eat regular, balanced meals (include 4 food groups) Keep cholesterol and other fats within target level Tree Diagram

18. Part One: Obesity in Canada Part Two: Diabetes in Canada Part Three: Effects of Obesity on Diabetes (correlation between the two) Section Three

20. The distribution of this graph is left skewed because the greatest frequencies are near the right end of the bar graph, although the 2004 data could be viewed as a mound shaped distribution. The greatest obesity rates occur among adults ages 45 to 64. This is accurate as the onset of type two diabetes is around age 40 Obesity Rates in 1978/79 and 2004 by Age Group

21. Median 1978/79 = 17 Median 2004 = 30 30 –17 = 13 The median and mode also display the increase in obesity rates since 1980. The median increase by 13 % and the mode by 10%. Mode 1978/79 = 20 Mode 2004 = 30 Mean 1978/79 = 6+9+13+17+20+20+11 7 =13.7 Mean 2004 = 11+21+20+30+30+25+24 7 = 23.0 23.0 –13.7 = 9.3 This is showing that the average percent of obese people in Canada has risen about 9% since 1980.

22. Trends in Obesity Rates Calculation: Coefficient of determination (r 2 ) = 0.8296 83% of the variation in the percentage of obese people is due to the variation of the year. This graph clearly and effectively shows that Canadians need to pay attention to their weight because since 1991 obesity rates have increased by rapidly compared to the obesity rates from 1978 to 1991.

23. Obesity Prevalence in 2000/01 of the population ages 20 to 64 (in this graph obesity is measured by someone with a BMI>27)

24. Prevalence of Obesity in Canada from 1985 to 1998

25. Percentage distribution of body mass index (BMI) by sex (2004) This shows that obesity is a rising problem in Canada because in men the percentage of obesity is only 10% below the percentage of the population with a normal weight and in women it is only 20% below. Mound Shaped Distribution

26. Obesity Rates by Fruit and Vegetable Consumption (2004) Left Skewed Distribution MMMM M

27. Obesity Rates by Physical Activity Level (2004) Left Skewed Distribution

28. Obesity Rates by Level of Education Obtained (2004)

30. Prevalence Rate of Diagnosed Diabetes by Age and Sex (1998/99)

31. Trends in the prevalence of diabetes (1994 to 2002) Coefficient of determination (r 2 ) = 0.974 This graph evidently displays the increase in the prevalence of diabetes over the years. Did you know that diabetes is the 7 th leading cause of death in Canada!!!!

32. Mortality Rates due to Diabetes Estimated Future Deaths from Diabetes (Number of actual and projected deaths due to diabetes by sex, Canada, 1970 - 2050)

34. Prevalence of Diabetes by Body Mass Index (BMI) Category

35. Relative Risk for Comorbidities in Obese Subjects (1997)

36. Observations and Conclusions based on Secondary Data Obesity is an rapidly increasing health risk in Canadian society Obesity and diabetes are directly correlated. Obesity is a modifiable risk factor of diabetes Diet and Physical Exercise prevent both diseases Diabetes prevalence in Canada is on the rise. It is already the 7 th leading cause of death. If it continues to increase it will produce a major health epidemic in our society.

37. How can we fix this fast approaching epidemic? What effect do Canadian’s knowledge, attitudes, and behaviors concerning obesity have on type two diabetes?

38. Section Four Analyzing Primary Source Data Surveyed 100 people Objectives: 1.Obtain information to back up secondary sources 2.Explore my thesis and come to some concrete conclusions

39. Gender Response Frequency 0 10 20 30 40 50 60 Frequency MaleFemaleUnknown Gender Gender Distribution of Survey Respondents

40. Age Distribution

48. Section Five Conclusion Data Sources and Limitations Bias

49. Conclusion Obesity rates in Canada are increasing rapidly. Why? Do Canadians not know about how to live a healthy life? Do they not care? Are they just choosing not to live a healthy life? 23% of the population is obese. Obesity has many serious health consequences, one being diabetes, which is directly correlated. Diabetes in Canada is on the rise as well. Diabetes is the 7th leading cause of death in Canada at the moment. If obesity leads to the development of type two diabetes then as obesity continues to rise so will the development of diabetes and ultimately more deaths.

50. After many hours of research and analysis of graphs I realized that the Canadian’s knowledge about obesity and its consequences is reasonably good and their attitude towards solving the problem and reducing obesity rates is good. Then why are obesity rates still so high. The reason is behavior. Canadians are not acting upon their knowledge and attitudes toward obesity. In my survey almost 80% of the people new the correct number of servings of fruit and vegetables you need per day but in the secondary source graph 80% were not eating the correct amount. In order to solve the rising epidemic I believe that the government should develop programs to encourage the behaviors of Canadians towards a healthy living in order to reduce obesity and thus reduce diabetes. Obesity is a modifiable risk factor for diabetes and stats show that an intensive healthy lifestyle (physical exercise) can reduce the risk of developing type two diabetes in an obese person by 58%. A person can reduce symptoms of diabetes through physical activity and proper diet. With obesity being a modifiable risk factor for diabetes, by improving Canadians behaviors towards obesity we can solve two major health issues as well as other benefits such as health care costs. If Canada could increase the number of physically active Canadians by 1% then the annual saving in the cost of treating type two diabetes would be $877,000. In conclusion obesity is a huge factor in reducing diabetes and in order to accomplish that the behaviors of Canadians need to be addressed because that is what the general population is lacking, not the knowledge, not the attitudes, but the behaviors. Conclusion Continued

51. Data Sources and Limitations Data Sources The majority of my data was found using reputable statistic sources. The main two data sources I used were: Statistics Canada – I found the majority of my raw data for my secondary sources there. Health Canada – I found many published and approved reports on obesity, diabetes, and the correlation between the two. Limitations For the obesity data there were a few limitations in the secondary sources. There was not a lot of available data that included the under 18 age group because the body mass index standards differ for adults and children. This was a limitation because my survey evaluated data from people under 18. Data was not collected from the territories. For the diabetes data there was one big limitation and that was the fact that statistics do not differ from the various types of diabetes. The stats represented all 3 types: type 1, type 2, and gestational. Although it might have skewed the data slightly, type 2 diabetes accounts for 90% of all cases so it wasn’t too much of a problem.

52. sampling interval =population size sample size = 32270500 100 = 322705 I encountered a few bias in my survey. The first was a sampling bias. I sampled 100 people to represent the population of Canada. My sample didn’t accurately represent the population. No non-response bias, which was surprising because I thought I would run into that problem. Household bias occurred in my survey analysis because I did not survey equal amounts of males and females, and my age groups were not equally weighted. The bias did not affect my overall results.