This chapter reviews several studies that are relevant to the
relationship of dietary patterns, food choices of bankers and its relation with
obesity. The reviewing of literature is a crucial step to writing a good
research as it gives the researcher a fair idea of how similar researches has
been done in the past and what results were observed. Analysis and criticism on
each of the researches relating to this topic provides the researcher a deeper
insight into the topic and what to expect from the study.
Obesity, which broadly refers
to excess body fat, has become an important public health problem. Overweight
is defined as having more weight than is considered normal or healthy for one’s
age and built (Sterns, 2009). It’s occurrence continues to increase worldwide.
As the prevalence of obesity rises so does the affliction
of its allied co-morbidities. Non- communicable diseases and their risk factors
including obesity are now becoming a significant problem not only in affluent
societies but also in developing countries (Whitson, 2000).
Obesity and other risk factors
of non-comunicable diseases (NCDs) are now emerging complications not only in prosperous
societies but also in emerging countries like Pakistan. In Malawi, the
prevalence of obesity in adults is currently estimated at 4.6%. Obesity is
predicted to rise over the coming years (4 to 6). Interventions should be done
to reduce the burden of obesity partly depend on diagnosing and understanding
the difficulties of obesity. (Watson, 2001) Clinicians are reminded to look for
these complications in obese patients and institute interventions highlighting
the benefits of weight loss in obese patients.
One third population of
American adults are obese, reports the CDS or Centers for Disease Control and
Prevention. While more intrusive procedures, such as gastric bypass, have
gained popularity, diet and exercise is the first step in treating obesity.
Although most people who begin a weight loss plan are serious about changing
their lives, many people fail, simply because they are misinformed (Benjamin,
2.2 Nutritional screening of obesity:
or excessive fat accumulation that may damage health. (WHO, 2016). In this
study, obesity refers to both overweight and obesity. Measuring total body fat
accurately requires refined technology which is not readily accessible for
purposes of the epidemiology of the disease.
BMI: A key index for relating weight to
height. BMI is a person’s weight in kilograms (kg) divided by his or her height
in meters squared. (WHO, 2006). The World
Health Organization (WHO) adopted body mass index (BMI), which is calculated by
dividing the body weight in kilograms (Kg) by the square of the height in meters
(m), as a surrogate measure of total body fat. BMI correlates well with the percentage body fat in
the young and middle aged where obesity is most prevalent. With this index,
obesity is defined when the value is equal to or more than 30Kg/m2.
Nutrition and Dietetics Institution recommends that a sensible approach to
eating and regular exercise will help to encourage a healthy lifestyle and
prevent weight gain in childhood and later life (Wheeler, 2011). Using the Food
Pyramid as a guide to healthy food choices, choosing appropriate food portions
sizes, avoiding excessive amounts of high fat and high sugar foods will help
maintain a healthy weight. Referral for dietetic intervention may be necessary
for guidance with weight loss (Wills, 2017).
The frequency, proportion and the combination of
foods and drinks which are consumed most often (Smith, 2014). Dietary patterns are defined as the quantities, proportions, variety
or combinations of different foods and beverages in diets, and the frequency
with which they are habitually consumed (S.M. Smith, 2014). The pattern of
one’s diet reflects their social, personal, cultural and environmental
experiences and influences (Rand, 2004). The content and nutritional
composition of the types of foods and drinks consumed is the key to assess and
determine the quality of diet. These characteristics are later compared to the
predetermined nutrient requirements of certain age, height, weight and gender
and nutrition adequacy standards which further throw on the quality of
diet. Understanding the array of dietary
patterns in a population and their nutrient quality allows a complete
representation of the individual eating performances and assists in their
examination in relationship with varied health outcomes (Wright, 2015).
2.4 Dietary Habits of obese people
to “A Series of Systematic Reviews on the Relationship Between Dietary Patterns
and Health Outcomes (USDA, 2014)”, a research done by United States Department
of Agriculture in 2014, more promising results associated with body weight and
risk of prevalence of obesity were perceived with enhanced adherence to a
legumes, fruits, vegetables and whole wheat emphasized diet. Some studies also
reported more favorable body weight status over time with regular intake of
fish and legumes, moderate intake of dairy products (particularly low-fat
dairy) and alcohol, and low intake of meat (including red and processed meat),
sugar-sweetened foods and drinks, refined grains, saturated fat, cholesterol,
and sodium (Chan, 2011). There is moderate evidence that in adults increased
adherence to dietary patterns scoring high in fruits, vegetables, whole grains,
legumes, unsaturated oils, and fish; low in total meat, saturated fat,
cholesterol, sugar sweetened foods and drinks and sodium; and moderate in dairy
products and alcohol is associated with more favorable outcomes related to body
weight or risk of obesity, with some reports of variation based on gender,
race, or body weight status (Blanton, 2014). Limited and inconsistent evidence
from epidemiological studies examining dietary patterns derived using factor or
cluster analysis in adults found that consumption of a dietary pattern
characterized by vegetables, fruits, whole grains, and reduced-fat dairy
products tends to be associated with more favorable body weight status over
time than consumption of a dietary pattern characterized by red meat, processed
meats, sugar-sweetened foods and drinks, and refined grains (Cullen, 2014). The
dietary intake when compared to the current BMI will give a relative
relationship between the two variables, depicting that energy intake is the one
of the main reasons of obesity development in children with Down’s
This study is related to the
working class, mainly bankers. Bankers are suffering from this epidemic. Bankers usually spent a lot of time in front
of computers and eating fast food leading them to obesity. This profession is
linked with null activity level. By spending a lot of time in fronts of
computers leads which results in obesity and its co- linked diseases.
are linked with low physical activity. Workers in such jobs spend the most part
of their adult working lives less involved in physical activity if they don’t willfully
exercise outside of employed hours. This upsurges their risk of obesity and its
associated ailments. This study resolute the pervasiveness of obesity and
overweight and associated factors among workers of a financial institution in
Accra Metropolis, Ghana. The overall prevalence of obesity and
overweight among the bank workers was 55.6 % (17.8 % obese and
37.8 % overweight).
Epidemiology and Disease Control, School of Public Health, College of Health
Sciences, University of Ghana, P. O. Box LG 13, Legon, Accra, Ghana
communicable diseases (NCDs) are the foremost causes of indisposition and
mortality in many developed and developing countries. Overwhelming marks from
epidemiological, potential unit and intervention studies, have interrelated
most NCDs to morbid lifestyle. The aim of this study was to limit the
prevalence of obesity and hypertension midst bankers in Lagos State, Nigeria.
Blood pressure, body mass index (BMI) and waist circumference were measured in
260 professional bankers from 56 bank branches in Lagos (AO Sekoni, AB Adelowo, EI Agaba, 2013).
2.6 Disease Factors
linked with obesity
2.6.1 Impaired glucose tolerance and Diabetes
There is currently no dispute that obesity is linked with impaired
glucose tolerance or type 2 diabetes mellitus. The fundamental mechanism is
said to be due to insulin resistance. However, there is at present limited data
precisely quantifying insulin resistance using the standard hyperinsulinemic euglycemic
clamp, essentially because the offensive nature of the procedure
makes it unfitting for general epidemiological studies.
Data presented shows a strong relationship between obesity and
hypertension. In one large group study of 82,473 participants, BMI was
positively associated with hypertension at age 18 and midlife. There was also
noticeable increase in threat of hypertension with weight gain. In the
Framingham study, the comparative possibility of hypertension in overweight men
and women were 1.46 and 1.75, respectively, after modifying for age.
There is explicit indication that there is an increased threat of
coronary artery disease (CAD) in obesity. In the Asian Pacific Cohort
Collaboration study in which more than 300,000 partakers were followed, there
was a 9 percent rise in proceedings of ischaemic heart disease for a unit
change in BMI. Increased risk of CAD was has also been found in the Framingham
and Nurses Health Studies
Dyslipidemia, demonstrated by reduced high density lipoprotein
(HDL) and increased triglycerides, is connected with obesity. The basic
appliance is largely due to insulin resistance. Very low density lipoprotein
(VLDL) approval in plasma is reliant on on the rate of hepatic production and
catabolism by lipoprotein lipase, an enzyme which is also complex in formation
of HDL. In obesity, insulin resistance is accompanied with increased
hepatic synthesis of VLDL and impaired lipoprotein lipase.
Presently existing indication shows that the risk of hemorrhagic
and ischaemic stroke, in relation to obesity, is increased in men. In women
this relation is true with ischaemic stroke but not haemorrhage stroke.
with the set of women with BMI less than 25kg/m2.
Central obesity and insulin resistance, which tips to changed
lipid and glucose metabolism, seem to be the basis for the sorts seen in
metabolic syndrome. The syndrome was originally envisioned for estimate of
the risk of cardiovascular disease, however, this has lately been interrogated
as the sum of the combined risk factors appears not to offer more than the sum
of individual factors.
Another gastrointestinal disorder that has been considered in
relation to obesity is cholelithiasis. Data from the Nurses’ study exposed that
females with BMI of more than 45Kg/m2 had a seven-fold increase in menace of
gallstone disease paralleled to those with BMI of less than 24Kg/m2 Men
have had similar results.
Polycystic ovary syndrome (PCOS), categorized by anovulation,
hyperandrogenism and a polycystic ovary, is allied with obesity as well as
insulin resistance. It has been renowned that increased visceral fat evaluated
by waist circumference of more than 88cm is associated with hyper-androgenemia
in patients with PCOS and that reduction of insulin resistance by weight loss
or drugs that increase peripheral sensitivity of insulin leads to improve
hormonal aberrations and ovulation.
There is significant evidence of an relationship between obesity
and some cancers. These consist of cancer of gallbladder, esophagus
(adenocarcinoma), thyroid, kidney, uterus, colon and breast. This connection
has further been supported by the statement that there is reduced occurrence of
cancer and mortality with weight loss. However the underlying mechanism concerning
these cancers to obesity is not clear. For uterus and breast cancers, it is
thought to be due to higher estrogen levels synthesized from fat tissue in
1. Flegal KM, Carroll MD, Ogden CL, Johnson CL. (1990)
Prevalence and trends in obesity among US adults, 2-7
2. Dietz WH,
Robinson TN (2005) Clinical practice. Overweight children and
adolescents. N Engl J Med. 2005; 352:2100.
3. The Malawi STEPS survey for Chronic Non-Communicable Diseases
and their risk factors. 2010 Jun
4. Lopez AD, Mathers CD (2010). Global Burden of Disease and risk factors. The World Bank and Oxford University page 245-265.
5. Murray C, Lopez A (1996) The
Global Burden of Disease: A comprehensive assessment of mortality and
disability from diseases, injuries, and risk factors Vol. 1.
6. Labeodan S ,Toyosi AH, Ayodej M(2015), Obese Weight Loss Ther,5:6