2015年7月1日 星期三

Poor diet blamed for rise in metabolic condition



 

The number of overweight Hongkongers with metabolic syndrome, which greatly increases the risk of stroke, has almost trebled in the last quarter of a century, a health expert says.

More than one in four local adults has the condition, which also increases the risk of heart disease and diabetes, according to Dr Dennis Wong Chung-tak.

In 1990, the figure was less than one in 10 - and he believes the growing popularity of Western-style fast food is to blame.

"I believe the main reason for the increase is the change of diet," said Wong, a consultant surgeon at St Teresa's Hospital. "Unhealthy diet and lifestyle leads to obesity - the main cause of metabolic syndrome."

A person has the syndrome if they are overweight and have at least two of five symptoms: abdominal obesity, elevated triglycerides, low high-density lipoprotein cholesterol, hypertension and impaired fasting blood glucose. The risk of stroke is trebled, while the chance of heart disease and diabetes also rises.

Figures from the Centre for Health Protection show that one-third of local adults are overweight or obese based on their body mass index. The global average is just 14 per cent; for Southeast Asia, it is 3.7 per cent.

Citing figures from a study in the journal Metabolic Syndrome and Related Disorders last year, Wong said 28.8 per cent of Hong Kong adults could be considered to have metabolic syndrome. It was just 9.6 per cent in 1990.

Cardiologist Ho Hung-kwong said people with metabolic syndrome had a higher risk of blood vessel blockage, which, if occurring in the brain or heart, would result in a stroke or heart attack.

But Hongkongers were becoming more health-conscious and improving their diets in recent years, he said. The rise in patients with the condition could be due to genetic factors or a growing trend for people to have regular health checks, he said.

Wong said patients could reduce metabolic risk factors by losing weight, adding that they should try to lose weight through diet or exercise before considering more radical action.

But another option - weight-reduction surgery - should be considered for those who failed to shed the kilograms by more conventional means, he said.

Wong, who specialises in such procedures, said only about 100 such operations were performed in the city last year. He said patients could undergo bariatric operations, such as laparoscopic sleeve gastrectomy - which reduces the stomach from the size of a football to that of a banana.

In Hong Kong, the stomach-reduction operation has a mortality rate of 0.3 per cent and a complication rate of 9 per cent.

 


Reference information: www.scmp.com
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

2015年6月22日 星期一

減重手術 VS 傳統藥物治療

另一項研究邀請了60位BMI超過35,患有二型糖尿,而且HbA1c 水平超過7%,並分成兩組,分別接受傳統藥物治療及減重手術。研究中選用了兩種減重手術,一種是胃繞道術,另一種是膽胰分流術。研究以兩年內糖尿病病情控 制、空腹血糖少於5.6mmol/L及沒有服用藥物的HbA1c水平少於6.5%作指標。


兩年的跟進期內,接受減重手術的患者有較顯着的效果,血糖控制較只服用藥物的患者低,並有較好的病情控制,75%接受胃繞道術的患者及95%接受膽 胰分流術的患者糖尿病病情好轉(見圖二),比起只有一個能成功改善病情的藥物組別為好。另外,兩組治療對血糖控制均有功效,但手術治療的效果更佳。
 
[2] Mingrone G, et al. NEJM 2012; 366(17): 1577-1585













參考資料: www.obesitysurgery.com.hk
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的外科醫生查詢,而不應單倚賴以上提供的資料。

2015年6月15日 星期一

肥胖與BMI

怎樣才算肥胖
 
世界衛生組織警告,肥胖已成為二十一世紀重要文明病!肥胖為健康之殺手,「腰圍越長、壽命越短」更是當紅的減重口號,過去對於肥胖有多種衡量標準,現在則以測定身體質量指數 (BMI)、腰圍及腰臀比為主流。以下對於你(妳)是否出現體重過重的問題,有五種評估方式︰



評估方式
測量
範圍
1.
腰圍測量
公分
男性≧90公分(過重)
女性≧80公分(過重)
2.
腰臀圍比測量
腰圍 ÷ 臀圍
男性≧90公分(過重)
女性≧80公分(過重)
3.
身體質量指數 (BMI)
體重(公斤)÷ 身高平方(公尺)
BMI<18.5(體重過輕)
18.5≦BMI<24(正常範圍)
24≦BMI<27(體重過重)
27≦BMI<30(輕度肥胖)
30≦BMI<35(中度肥胖)
35≦BMI<40(重度肥胖)
40≦BMI<50(病態性肥胖)
50≦BMI(超級肥胖)
4.
身體脂肪測量
身體脂肪儀器
男>25%(過重)
女>30%(過重)
5.
國人理想體重計算方法
男性:[身高(公分)-80] × 0.7
女性:[身高(公分)-70] × 0.6
大於20%(肥胖)
大於10–20%(體重過重)
介於±10%(正常範圍)
小於10–20%(體重過輕)



資料來源:   www.antifat.tv
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的外科醫生查詢,而不應單倚賴以上提供的資料。

2015年6月11日 星期四

狂食零食減壓 患糖尿高血壓

210磅女縮胃八成減70磅

港人肥胖問題日趨嚴重,有四十多歲女士自少因精神緊張,靠「狂食」零食減壓,又錯用屙油丸、食肉減肥法,致令「愈減愈肥」,結果體重二百一十多磅,兼確診 糖尿病和高血壓,終要接受縮胃手術,成功一年後減去七十磅。有醫生表示,本港因肥胖引致的代謝綜合症近年趨增,發病率升至百分之二十八點八,增加患中風、 心臟病發和糖尿病風險。

衛生防護中心數字顯示,本港最新超重比率達百分之三十六點六,當中以四十五至五十四歲中年男性居多。如果身高體重指數(BMI)超過二十七點五,有中央肥 胖(男性腰圍逾90釐米、女性逾八十釐米),以及兩種以上代謝綜合症病徵,如糖尿、血壓、甘油三酯上升等,即屬代謝綜合征患者,其患上中風或心臟病發的風 險較正常人高出三倍、患糖尿病風險高出五倍。

代謝綜合症發病率趨增

聖德肋撒醫院外科顧問醫生黃頌德表示,代謝綜合症在本港的發病率近年有增加趨勢,由二OO一年的百分之二十三,增加至去年百分之二十點八,相信與進食過多西式快餐及食量增加有關。

現年四十多歲的許小姐,中學時因備戰會考而精神緊張,要「狂食」零食減壓,加上缺少運動,體重激增至亞百一十多磅,「食減肥產品、屙油丸、食肉減肥法,可以試的方法統統試過,都沒有效果,反而愈減愈肥,甚至要撐住張凳才可以起身」。

她在數年前更確診糖尿病和高血壓,「每日由家中行去港鐵站都不行,想搭的士慳路程,結果經常返工遲到,很影響工作和拍拖」。

手術費約10萬 住院兩三天

她在二O一一年中接受縮胃手術,切走八成胃部,術後一年減去七十磅,體重由九十七公斤回落至六十五公斤;BMI則由癡肥程度的三十八,回落至二十二,可以 停服糖尿藥和減少血壓藥分量,「現在每餐只食少少已經見飽,亦有定期做運動,例如在家中會邊看電視邊做柔軟體操,每個星期跑步四次,每次三十分鐘以上」。

本港每年約有一百人接受減重手術,當中八成為縮胃手術。黃頌德指,如果BMI超過二十七點五,曾試過運動或控制飲食但效果欠佳,均適合接受減重手術,術後 一般需留院約兩、三日,並在一個月後開始配合運動減重;胃潰瘍、胃酸倒流和癌症患者不宜接受此手術。有關手術費用約需十萬元。





資料來源: 星島日報
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的外科醫生查詢,而不應單倚賴以上提供的資料。