FULL TEXT - Antropomotoryka

NR 47
AN TRO PO MO TO RY KA
2009
OVERWEIGHT AND OBESITY AMONG ADULT WOMEN
NADWAGA I OTYŁOŚĆ U KOBIET
Anna Demuth*, Urszula Czerniak*
**Dr, Department of Anthropology and Biometry, University School of Physical Education, Poznań, Poland
Key words: mastectomy, obesity, breast cancer, healthy women
Słowa kluczowe: mastektomia, otyłość, rak piersi, zdrowe kobiety
SUMMARY • STRESZCZENIE
The aim of the study. Specifying the type of adiposity, overweight and obesity among women after mastectomy.
Material and methods. The material of study contains anthropometric measurements of somatic features
made in the group of 550 women after mastectomy, gathered in Amazon clubs all over Poland and women
working in Poznan in different government administration institutions. The age of the subjects ranged from
30 to 79 years.
Results and conclusions. The study of the factors characterizing biological properties of women after
mastectomy makes it possible to conclude that increased adiposity of body may be included in the group of
increased risk factors of cancer among Polish women, similar as it is elsewhere in the world.
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Cel pracy. Określenie typu otłuszczenia, nadwagi i otyłości kobiet po mastektomii.
Materiał i metody. Materiał uzyskany w trakcie badań obejmuje pomiary antropometryczne 550 członkiń klubu
„Amazonki” z całej Polski oraz kobiet po mastektomii pracujących w różnych instytucjach administracji rządowej
w Poznaniu. Wiek badanych wahał się od 30 do 79 lat.
Wyniki i wnioski. Badanie czynników charakteryzujących właściwości biologiczne kobiet po mastektomii
pozwala uznać wzrost otłuszczenia ciała za jeden z czynników zwiększonego ryzyka zachorowania na raka u Polek.
Z podobną sytuacją mamy do czynienia także w innych częściach świata.
Introduction
The aim of the study
In anthropological studies of groups of ill people attempts were made many times to answer the question
what it the nature of relation between morphological
properties and a given illness. On the basis of data in
the literature we get a confirmation of traces of disease
process on the morphological picture of an ill individual,
although it is difficult to separate in a clear-cut way the
effects of specific illnesses. One of the factors which
significantly predispose the body to specific illnesses
(e.g. diseases of cardiovascular system, diabetes,
stroke) is the level of development of subcutaneous and
visceral adipose tissue and its distribution.
The aim of the study is specifying the type of adiposity,
overweight and obesity among women after mastectomy
Material of study
The material of study contains anthropometric measurements of somatic features made in the group of
550 women after mastectomy, gathered in Amazon
clubs all over Poland. The age of subjects ranged from
30 to 79 years. The average time elapsed since surgery
was 2.5 years. The assessment of the type of body adi-
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Anna Demuth, Urszula Czerniak
posity of women after mastectomy was made on the
basis of the analysis of skin folds, sub-scapular and
abdominal, as well as the analysis of the Waist to Hip
Ratio. The leanness was assessed on the basis of the
analysis of the Body Mass Index with classification. The
comparative group were women working in Poznan in
different government administration institutions at the
age of 40–601.
Analysis
In order to isolate the type of subcutaneous adiposity
the following classification was used [1]:
Scapula skin fold > abdomen skin fold –
– back adiposity type
Scapula skin fold < abdomen skin fold –
– abdominal adiposity type
Scapula skin fold = abdomen skin fold –
– balanced adiposity type
Additionally the analysis of the Waist to Hip Ratio was
used describing the type of adiposity as androidal (male
– adiposity of abdominal part) or gynoidal (female – adiposity of hips and thights). The following categories of the
Waist to Hip Ratio were adopted for women [2, 3]:
WHR ≤ 0.83 – gynoidal type
WHR > 0.83 androidal type
The summary of the results of the assessment of relations between thickness of skin folds of the Amazons
(Fig.1) leads to a conclusion that in almost 75% of the
subjects the thickness of abdominal skin fold is greater
than the thickness of skin fold under the lower angle
of scapula. Thus according to the classification – the
dominant type of adiposity of women after mastectomy
is abdominal type. The balanced type is very rare (less
the 5% of cases).
It is also interesting that the most frequently represented types of adiposity (abdominal and back) indicate ontogentical changeability consistent with a linear
trend. The frequency of the abdominal type of adiposity
increases in subsequent decades of age at the expense
of the frequency of back type.
The supporting assessment of the type of adiposity
using the Waist to Hip Ratio indicates that the dominant type in terms of frequency is the gynoidal type,
and the recessive one is the androidal type (Fig. 2)
The frequency of both types of adiposity is a subject
to ontogenetic changeability which is manifested in
the decrease in the percentage of gynoidal type and
the increase of frequency of androidal type with age.
% 100
80
60
40
20
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0
gynoidal
androidal
30-39
40-49
50-59
gynoidal
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androidal
Fig. 1. Adiposity type of Amazons in age groups
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1
60-79
Grant No N40402932/0534
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Overweight and obesity among adult women
% 100
80
60
40
abdominal
back
balanced
20
0
30-39
40-49
balanced
50-59
back
60-79
abdominal
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Fig. 2. Adiposity type (WHR) of Amazons in age groups
In spite of the above ontogenetic changes we always
note large adiposity of lower pats of the body of women
after mastectomy (both in case of relations between
skin folds studies and types of adiposity using Waist
to Hip Ratio studies). However the fact of ontogenetic
changeability of the type of adiposity is in line with what
we now know about the changes in the adipose layer
with age, the fact of dominating abdominal type adiposity may be considered a characteristic property of
women with breast cancer.
Regardless of the degree and the type of the body
adiposity a lot of information about the general degree
of nutrition of the body may be obtained on the basis of
the analysis of weight and height indicators. Whatever
the treatment of changes in the body weight (e.g. two
and three-element models of body components) and
mutual relations between height and weight, we may
be convinced that in the large majority of human population changes in body weight are the result of changes
in proportion of fat mass and lean body mass. Hence
the relative overweight and underweight of an individual
may be interpreted with a large precision from the analyses of weight and height indicators. The indications
used most frequently in anthropological analyses are:
Rohrers’, Queteletes’ indexes and – more and more
frequently used – Body Mass Index (BMI) which was
used below in the assessment of the degree of body
leanness of women after mastectomy. Additionally
a seven-degree classification model (norm and 3 degrees of overweight and underweight each) presented
by Zb. Drozdowski [4] was used here:
x – 16.00
– 3rd degree of leanness
16.00 – 16.99 – 2nd degree of leanness
17.00 – 18.49 – 1st degree of leanness
18.50 – 24.99 – range of normal changeability
25.00 – 29.99 – 1st degree of overweight
30.00 – 39.99 – 2nd degree of overweight
40.00 – x
– 3rd degree of overweight
The classification of the BMI of the Amazons (Table
1) indicate that except for two cases there are no individuals representing any degree of leanness in the
studied group. A quarter of all Amazons display weight
and height proportions which are within the range of
statistical norm (except for the youngest group – here
over 60% of women have correct height-weight relation).
The analysis shows that most often we are dealing in the studied groups with the first degree of overweight, and sporadically also second and third degree.
The overweight displays some ontogenetic fluctuation
of women representing subsequent degrees o overweight increases in subsequent age groups, as a result
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Anna Demuth, Urszula Czerniak
of which in the oldest groups we are dealing with the
inversion of proportions in comparisons with the youngest Amazons – over 80% of studied ones have overweight.
In the course of further analyze of gather material
the BMI factor values of researched amazons were
compared to weight/height proportions typical for
healthy women living in the same area of Poland (Table
2). Under analyze were women at the age of 40–60
years. As the result of analyze can be observed that
Amazons are characterized with greater percentage of
overweight and obesity what confirms in a way earlier
conclusions stating that higher values of fat mass predispose the breast cancer illness.
cancer [9]. PG Tonioloet al. [10] studied a large group
of women aged from 35 to 65 from New York and found
that if the risk of contracting cancer of 1.0 is assumed for
women with BMI < 22.35 kg/m2 . In this case the results
of our study seem to confirm this point of view in relation to Polish women. The studies of M. Chrzanowska
[11] relating to healthy women make it possible to make
comparative summaries. They indicate on the basis of
the value of the BMI that 20% of Polish women from
small towns in the South and Eastern part of the country are overweight and 10% are obese – these are percentages lower than among Amazons.
Discussion
To sum up the results of the study of the degree of adiposity of leanness of women after mastectomy it should
be stated that women who contract cancer are overweight and characterized by adiposity of lower parts of
the body, and the frequency of overweight and adiposity increases with age. Taking into consideration the
fact that breast cancer attacks most often women at
peri- and post-menopause age, a certain relation between this fact and the results obtained above can be
observed. It is puzzling whether both can be treated as
increased risk factor n the case of breast cancer.
The study of factors characterizing biological properties of women after mastectomy makes it possible
to conclude that increased adiposity of body may be
influenced in the group of increased risk factors of cancer in Polish women, similar as it is in elsewhere in the
world.
Thorough analysis of the type of body adiposity and
type of leanness of women after mastectomy indicates
that abdominal type of adiposity dominates among the
Amazons, and in terms of WHR a gynoidal type characteristic for women and the assessment of the degree
of leanness in terms of BMI with the assessment of the
degree of leanness and overweight allows to notice the
overweight and obesity earlier than the specified degree of leanness in those groups of women.
The result of scientific studies indicate that obesity
among women, in particular in the post-menopause period, may play a role of an increased risk factor in contracting breast cancer [5, 6, 7, 8]. This is also confirmed
by analyze of researched Amazons and women living in
Poznan. The literature also indicates the relation of the
value of BMI with the risk of cancers, including breast
Summary and conclusion
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LITERATURE • PIŚMIENNICTWO
[1] Czerniak U, Ziółkowska E: Komponenta tłuszczowa –
próba oceny różnic w dwu porównywanych zespołach
kobiet chorych. Fizjoterapia, 1999; 7, Supl. 1: 33-36.
[2] Lapidus L, Bentsson C, Larsson B, Pennert K, Rybo
E, Sjostrom L: Distribution of adipose tissue and risk of
cardiovascular disease and health: a 12 year follow up of
participants in the population study of women in Gothenburg, Sweden. Br. Med. J., 1984; 289: 1257–1261.
[3] Larsson B, Svardsudd K, Welin L, Wilhelmsen L, BjornTorp
P, Tibblin G: Abdominal adipose tissue distribution, obesity
and risk of cardiovascular disease and death: a 13 year
follow up of participants in the study of men born in 1913.
Br. Med. J., 1984; 288: 1401–1404.
[4] Drozdowski Zb: Antropometria w wychowaniu fizycznym.
AWF Poznań, 1992.
[5] Howe GR: High-fat diets and Brest cancer risk: the epidemiologic evidence. JAMA,1992; 268, 2080–2081.
[6] Hulka BS, Liu ET, Lininger RA: Steroid hormones and risk
of breast cancer. Cancer, 1994; 74: 1111–1124.
[7] Iyothish B, Anakathil R, Chaudini R: DNA repair proficiency: a potential marker for identification high risk members
in breast cancer families. Cancer Lett, 1998; 124: 9–13.
[8] Park AJ, Chetty U, Watson CH: Silicone breast implants
and breast cancer. Cancer, 1998; 7: 22–26.
[9] Shepard RJ, Shek PN: Association between physical
activity and susceptibility to cancer: possible mechanisms.
Sports Med., 1998; 26: 293–315.
[10] Toniolo PG, Levitz M, Zeleniuch-Jacquotte A, Banerjee
S, Koennig KL, Shore RE, Strax PG, Pasternack BS: A
prospective study of endogenous estrgens and breast
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Overweight and obesity among adult women
cancer in postmenopausal women. J. Natl. Cancer Inst.,
1995; 87: 190–197.
[11] Chrzanowska M: Niektóre epidemiologiczne I społeczno-kulturowe aspekty nadwagi i otyłości na przykładzie popu-
lacji dorosłych z regionu Polski południowo-wschodniej; in
Charzewski J (ed.): Społeczne kontrasty w stanie zdrowia
Polaków; Warszawa, AWF, 1998: 41–54.
Annexes:
Table 1. Type leanness of Amazons according to BMI categories
Age
30–39 years
40–49 years
50–59 years
60–79 years
Type
n
%
n
%
n
%
n
%
n
%
1 leanness
0
0
1
0.5
0
0
0
0
1
0.2
NORMAL
19
61.3
60
32.1
41
21.8
30
20.8
150
27.3
1 overweight
12
38.7
92
49.2
96
51.1
57
39.6
257
46.7
2ooverweight
0
0
6
3.2
19
10.1
12
8.3
37
6.7
3ooverweight
0
0
28
15
32
17.0
45
31.3
105
19.1
o
o
Total
Table 2. The characteristic of the researched group regarding overweight and fatness
Average BMI value
Underweight
(%)
Normal
(%)
Obesity
(%)
FAT
(%)
Amazons
0.50
26.95
50.35
22.20
Healthy women
5.50
67.03
24.18
3.29
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Groups
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