When fat becomes really dangerous! from Fit for Fun, RT by Johanna Fellner (English/German)

When fat becomes really dangerous!
The majority of us are afraid of being overweight. Latest research says: right! How to measure it yourself – and when it becomes dangerous …
From Fit for Fun, Found by Johanna Fellner @FellnerJohanna, Originally in German, English by Google Translate

A few more pounds on the ribs? Och, is not so bad – fitte Thickness are still healthier than slack slender, right?
No, unfortunately probably not.
The latest research at University College London, reported in the summer of 2017, confirms the theory that weight gain is a risk factor even if blood pressure, glucose and cholesterol are normal, “says Camille Lassale, In comparison, 7,000 people with heart disease were already suffering from heart disease. According to this, blood pressure and blood values are the most important and meaningful parameters for their own healthy well-being, however
With increasing weight our metabolism suffers and comes more and more frequently near or in the red area.
The assumption of the researchers: The metabolism in the still “healthy thicknesses” had the negative development only not completed completely, but the “fat end” will follow in the Wortsinne. Your final thesis: “The concept of the healthy overweight is no longer valid!”
• Be that as it may, whoever wants to know precisely about the overweight, should not go after feeling, but should use serious measuring methods. It is best to combine three methods: Then you know exactly whether you are overweight or not!

Overweight Recognize: 1. Body Mass Index

For a long time, it was considered the measure of all things and divided into the categories under, normal and overweight as well as obesity. The formula for calculating the body mass index is: Body weight in kilograms, divided by body size in meters to the square (For our BMI calculator). For example, a woman weighing 68 kilograms, which is 1.70 meters tall, would have a value of 23.5. This would be within the range of normal weight.

Overweight starts at a value of over 25. For values over 30 of overweight or overweight, also called obesity. The problem with the BMI is that the index does not distinguish between fat and muscle mass, so that a well-trained athlete could be in the overweight area, although he is top-fit and extremely muscular. Example: Box World Champion Wladimir Klitschko! Here the formula does not apply, and other factors must be added.

Identify overweight: 2. Body fat percentage

The body fat percentage says something about the distribution of fat and muscle mass.
The value can be a good addition to the BMI and goes beyond simply determining the overweight.
For measuring, there are several methods – for example, the Caliper method, in which the thickness of the fat deposits is measured at different body points with a kind of pincers. Or the impedance measurement: a weak current is sent through the body and an analysis of the tissue is made on the basis of the resistance. The impedance measurement also provides information on the water content of the body. Both should be best done by the doctor.

Body fetuses for private use can also provide an indication and, above all, document a development in diet or training. However, they often only measure the upper or lower body. The lower body measurement, for example, often results in very high values in women with the typical pear figure (rich po and thigh), since they have stored a lot of fat there – but this can not be transferred to the entire body. Women naturally have higher values than men, and are already feeling more often with overweight.
How much body fat you can have: Click here!

Overweight Recognize: 3. Belly circumference

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Sounds banal, however, is quite meaningful – especially with regard to the health risk of overweight. Because the inner stomach fat is particularly metabolic-active and carries the main debt of diseases such as diabetes, hypertension or metabolic disorders.
• For men, an increased risk starts with an extent of 94 centimeters, from 102 it is markedly increased.
• For women: increased risk from 80 cm, markedly increased from 88 cm.
To measure simply place a measuring tape around the abdomen loosely around the belly. It is best to measure in the morning before breakfast and breathe out easily.

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Ab wann Fett wirklich gefährlich wird!
Vor Übergewicht fürchten sich die Meisten von uns. Neueste Forschung sagt: zu recht! Wie du es selbst messen kannst – und wann es gefährlich wird …

Ein paar Pfunde mehr auf den Rippen? Och, ist doch gar nicht so schlimm – fitte Dicke sind doch immer noch gesünder als schlaffe Schlanke, oder?
Nein, leider wohl eher nicht.
Neueste Forschungen am University College London, über die im Sommer 2017 berichtet wird, erhärten die Theorie, dass bei Übergewichtigen “zusätzliches Gewicht ein Risikofaktor ist, auch wenn Blutdruck, Blutzucker und Cholesterin normal sind”, wie es Studienleiterin Camille Lassale ausdrückt. Verglichen wurden dabei 7000 bereits herzkranke Menschen mit herzgesunden Menschen. Demnach sind Blutdruck und Blutwerte für das eigene gesunde Wohlbefinden zwar die wichtigeren und aussagekräftigeren Parameter, aber
mit steigendem Gewicht leidet unser Stoffwechsel und kommt immer häufiger nahe oder in den roten Bereich.
Die Annahme der Forscher: Der Stoffwechsel bei den noch “gesunden Dicken” habe die Negativ-Entwicklung nur noch nicht komplett vollgezogen, das “dicke Ende” werde aber im Wortsinne nachkommen. Ihre finale These: “Das Konzept von den gesunden Übergewichtigen gilt nicht mehr!”
• Wie dem auch sei: Wer es beim Übergewicht genau wissen will, sollte nicht nach dem Gefühl gehen, sondern seriöse Messmethoden anwenden. Am besten ist es sogar, du kombinierst drei Methoden: Dann weißt du genau, ob du übergewichtig bist oder nicht!

Übergewicht erkennen: 1. Body-Mass-Index

Er galt lange als das Maß aller Dinge und teilt in die Kategorien Unter-, Normal- und Übergewicht sowie Fettleibigkeit ein. Die Formel zum Berechnen des Body-Mass-Index lautet: Körpergewicht in Kilogramm, geteilt durch Körpergröße in Metern zum Quadrat (Hier geht´s zu unserem BMI-Rechner). Bei einer 68 Kilogramm schweren Frau, die 1,70 Meter groß ist wäre das zum Beispiel ein Wert von 23,5. Das würde im Bereich des Normalgewichts liegen.

Übergewicht beginnt bei einem Wert von über 25. Bei Werten über 30 von krankhaftem Übergewicht beziehungsweise Fettsucht, auch Adipositas genannt. Das Problem beim BMI: Der Index unterscheidet nicht zwischen Fett und Muskelmasse, so dass ein durchtrainierter Sportler im Übergewichtsbereich landen könnte, obwohl er topfit und extrem muskulös ist. Beispiel dafür: Box-Exweltmeister Wladimir Klitschko! Hier greift die Formel nicht, und es müssen weitere Faktoren hinzugezogen werden.

Übergewicht erkennen: 2. Körperfettanteil
Der Körperfettanteil sagt etwas über die Verteilung von Fett- und Muskelmasse aus.
Der Wert kann eine gute Ergänzung zum BMI darstellen und geht über die reine Ermittlung von Übergewicht hinaus.
Zur Messung gibt es verschiedene Methoden – etwa die Caliper-Methode, bei der mit einer Art Kneifzange die Dicke der Fettfallen an verschiedenen Körperstellen gemessen wird. Oder die Impedanzmessung: Dabei wird ein schwacher Strom durch den Körper geschickt und anhand des Widerstands eine Analyse des Gewebes erstellt. Die Impedanzmessung liefert zusätzlich Informationen über den Wassergehalt des Körpers. Beides sollte am besten vom Arzt gemacht werden.

Körperfettwaagen für den Privatgebrauch können ebenfalls einen Anhaltspunkt liefern und vor allem eine Entwicklung bei Diät oder Training dokumentieren. Sie messen allerdings oft nur den Ober- oder Unterkörper. Die Unterkörpermessung beispielsweise ergibt bei Frauen mit der typischen Birnenfigur (üppiger Po und Schenkel) oft sehr hohe Werte, da sie eben dort viel Fett eingelagert haben – was jedoch nicht auf den gesamten Körper übertragbar ist. Frauen haben naturgemäß ohnehin höhere Werte als Männer und schlagen sich schon deswegen gefühlt öfter mit Übergewicht herum.
Wie viel Körperfett du haben darfst: Klick das hier!
Übergewicht erkennen: 3. Bauchumfang

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Klingt banal, ist jedoch ziemlich aussagefähig – vor allem im Hinblick auf das gesundheitliche Risiko von Übergewicht. Denn das innere Bauchfett ist besonders stoffwechselaktiv und trägt die Hauptschuld an Krankheiten wie Diabetes, Bluthochdruck oder Stoffwechselstörungen.
• Für Männer beginnt ein erhöhtes Risiko ab einem Umfang von 94 Zentimetern, ab 102 ist es deutlich erhöht.
• Für Frauen: erhöhtes Risiko ab 80 cm, deutlich erhöht ab 88 cm.
Zur Messung einfach ein Maßband etwa in Bauchnabelhöhe locker um den Bauch legen. Am besten misst du morgens vor dem Frühstück und atmest dabei leicht aus.

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When fat becomes really dangerous!

“Asthma-COPD Overlap Syndrome (ACOS),” Footnotes & a Commentary from a Patient (6th Edition), by J.D. Meyer

 

“Asthma-COPD Overlap Syndrome (ACOS): A diagnostic challenge,” was a Top 100 WebxMD article for 2015. http://onlinelibrary.wiley.com/doi/10.1111/resp.12653/full It caught my attention because I’ve had this condition for ten years; however, I never heard the two described as a unit in this manner! Three symptoms stood out on my first reading: increased sputum, more dyspnea (breathlessness), but better response to inhaled corticosteroids. At once, I told all my local health connections about ACOS. This article was written by three doctors in the Far East: Vietnam, Korea, and Japan. “Tho, N. V., Park, H. Y. and Nakano, Y. (2015), Asthma–COPD overlap syndrome (ACOS): A diagnostic challenge. Respirology. doi: 10.1111/resp.12653.”

Furthermore, a Google search for ACOS yielded nothing unless I entered the complete term. So the breakthroughs didn’t happen around here—adding to this disabled Developmental English/Writing—ESOL teacher’s sense of urgency!

Definition of Terms

I printed this article and started highlighting and making notes. Fortunately for me, many of these technical terms corresponded to familiar brand names for my many ACOS drugs. Symbicort is a Long-Acting Beta2-Agonist (LABA) and an Inhaled Corticosteroid (ICS). A LABA is a long-term brochodilator while an ICS decreases inflammation. Rinse your mouth with water after each use, and don’t swallow the water; spit it out. I was switched back to Advair (another LABA +ICS drug), which has bee my usual inhaled corticosteroid. Both drugs are used for asthma &COPD. A Muscarinic Antagonist is also a bronchodilator, such as tiotropium (Spiriva) and aclidinium.

Spiriva, an inhaled capsule, is used for COPD, including emphysema and chronic bronchitis. Later, I was switched to Montelukast, the pill version of Singulair.

There is only one PDE4 inhibitor—Daliresp (roflumilast), and it works against excess bronchitis and phlegm. Daliresp decreases the number of exacerbations in severe COPD, and it’s not a bronchodilator. Daliresp decreases lung inflammation and prevents COPD flare-ups. Don’t use Symbicort, Spiriva, or Daliresp for an acute attack.

For an acute attack, use your “inhaler,” such as ProAir and Proventil; they’re examples of Short-Acting Beta2-Agonists (SABA); both are albuterol. Proair will open the airways and prevent a bronchospasm. You could go for your nebulizer for an acute attack, especially a bad attack. Our albuterol vials for the nebulizer could be called an”extra-strength” SABA. Iprat-Albut (Albuterol & Ipratropium) are two bronchodilators for the COPD patients’ nebulizer. For two decades, I was on pure Albuterol for my nebulizer. Now my inhaler is Combivent–a stronger ipratropium-albuterol inhaler.

Atopic is an allergic reaction, often hereditary. Atopy is a feature of ACOS and associated with a higher prevalence of chronic cough and sputum production, according to Tho, Park, and Nakano. Eosinophilic airway inflammation means there’s a higher than average number of white blood cells. It can be detected in mucus if it’s tissue eosinophilia. Tho, Park, and Nakano note that ACOS patients have higher sputum eosinophil counts than those with COPD alone, but sputum count profiles may change over time. Blood eosinophilia is over 500 in a microliter of blood. I found these definitions at Medicine Net and the Mayo Clinic websites too.  Much of the drug definitions came from the pharmacy’s medicine sheets themselves.

Economic Burden & Disability

Tho, Park, & Nakano note that the percentage of ACOS patients visiting the ER or admitted to hospitals is significantly higher than COPD alone in South Korea. A United States Medicaid population reports that ACOS patients have a higher rate of utilizing any service versus asthma or COPD alone. Moreover, the average annual medical cost for an ACOS patient in the US is $14, 914–much higher than asthma, $2307 or COPD,  $4879. ACOS is common in the elderly. It features more dyspnea (breathlessness), wheezing, and more frequent exacerbations. The respiratory quality of life and amount of physical activity for those with COPD alone.

Addendum to Tho, Park, & Nakano

Using my peak flow meter to check my forced exhale volume (FEV) always has been one of my strong points in managing my ACOS. I check my peak flow meter before I go for a walk, and if I’m under my usual low moderate level of impairment, I head for the albuterol nebulizer. Check my article https://www.newscastic.com/news/forced-exhale-volume-fev-lung-disease-your-peak-flow-meter-1155949/ The “whole story” includes a link to an About.com article on Pulmonary Function tests, by Deborah Leader, RN, COPD Expert.

Returning to the Tho, Park, and Nakano article, we see that a staggering 49% of smokers develop chronic bronchitis and 24% get emphysema or COPD. “Smoker’s cough” is worst upon arising. Dyspnea increases as the disease worsens. Quit smoking or else!

Guaifenesin (Mucinex) has been one of my favorite OTC medicines for years because it’s an expectorant. You can find a cheaper generic version in the dollar store too. Warn the doctor if you smoke, or have asthma or emphysema. It thins the mucus, so it’s less sticky and easier to cough up, according to www.drugs.com/mucinex.html  Take guaifenesin when you have a cold, bronchitis, flu, or allergies–whatever got your chest full of phlegm. Still drink plenty of fluids. www.webmd.com/drugs/2/drug-63818/mucinex-oral/details I’ve been told by my doctor to take a larger than average dose of guaifenesin during an ACOS attack.

I also take an over-the-counter allergy pill, for I’m allergic to Bermuda and Johnson grass. My choice is non-drowsy Loratadine Tablets, an antihistamine that’s another find at Family Dollar. Loratadine is a generic form of Claritin.

Beware of drinks with carbon dioxide (CO2) also, such as beer and soda. http://respiratorytherapycave.blogspot.com/2008/06/asthmacopders-should-avoid-pop-beer.html The ability to exhale carbon dioxide is vastly impaired for the bad lung crowd. “The normal human body breathes to eliminate CO2, producing 200 cc./minute. However, one can of soda has up to 1000 cc. of dissolved CO2. Most is absorbed by into the blood stream by the intestines.” This can lead to more dyspnea (breathlessness) in those with lung disease. Furthermore, beer can cause dehydration too–another cause of dyspnea. Maybe gas pills help; time will tell.

On the other hand, if you like alcoholic drinks and wish to be more careful, then try red wine. First of all, you won’t have to worry about bubbles. Red wine increases antioxidant status and decreases oxidative stress in circulation, mainly because of glutathione (GSH). The “French Paradox” is explained by their love of red wine lessening coronary heart disease despite a fatty diet. https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-6-27

In closing, there’s a rich amount of literature on asthma, bronchitis, and COPD. Learn to manage your illness before you continue to deteriorate, and get a pulmonologist if you don’t have one already.

Slice of Life March 2015: Walk to Pharmacy & Pulmonologist/Allergist, So Many Hills

I moved to the hospital district of Tyler in August 2012, so I could be near the hospitals because I have COPD. Now our area in east-central Tyler is called, “Midtown,” complete with attractive blue street signs. Tyler finally went damp in December 2012, so one can get beer and products as strong as 17% alcohol at a gas stations, such as Speedy Shell. I prefer living in a business neighborhood rather than residential, simply because services are readily available. Walking past house after house is dreary. I either walk or ride the bus. I no longer drive.

Today brought the return of my Daliresp prescription after considerable haggling between my pulmonologist/allergist, pharmacy, and Cigna Health Spring–my new extra service for those on Medicaid/Medicare. Dalisresp reduces inflammation and sputum production. Don’t get me wrong, for I like all three of those health groups–especially Pulmonary Associates. Theophylline (Theo-dur) used to be the super-pill for asthmatics. Then I walked past the hospitals to my pulmonologist/allergist for a shot. Bermuda and Johnson grass hurt me; praise God I’m not allergic to kitties although cat hording can lead to fur-related bronchitis without having a dander allergy.

The walk to the pharmacy is up hill at a 30 degree angle. The walk to the pulmonologist is up a very steep hill, more like 70 degrees. Unaffectionately, I call it “Heartbreak Hill.” It’s easier to walk much further on flatter land.

The general practitioner is the one who is supposed to sign papers for my electricity not being cut off because of my life-threatening condition. I need electricity first for my nebulizer. An oxygen machine with canula and C-PAP for sleep apnea followed once I got a pulmonologist with my Medicaid that followed Medicare in my case.

Expensive monthly ER visits are a thing of the past, which was the rule from 2008-11. Of course, I didn’t pay; the country did. Why does Texas block the expansion of Medicaid/Medicare? Lucky for me, I’m slick. I presented 3-4 years of ER bill records to my social worker and got Medicaid on the second try!

I went to the Fleishel Shell for beer/wine with my plastic coated canvas bag on the way home from the pulmonologist. When I made it back home, I got out of my long jeans and switched to blue jean shorts. It’s definitely spring here. Plus the shorts show off a pair of my new extra fancy socks form the Stanley’s BBQ birthday party. Bye, y’all!