Ngenkathi yomlando wesintu, kuye kwaba nezinguquko ezingavamile embonweni wokukhuluphala. Ngezikhathi eziphakathi, isibonelo, kwakubhekwa njengento ecacile yesimo sezenhlalakahle esiphakeme. Owesifazane ophelele wayeyisibonelo sempilo nobulili, futhi ukukhuluphala kulesi simo akuvamile ukuholela ezinkingeni zokuhleleka. Njengamanje, ngenxa yengozi yezempilo, ukukhuluphala kuchazwa njengenye yezingqinamba ezinkulu kakhulu zokungcolisa umzimba. Ukukhuluphala njengenkinga yomphakathi wamanje kuyisihloko sengxoxo yanamuhla.
Kuyini ukukhuluphala?
Ukukhuluphala kungachazwa njengokunwebeka kwesisindo, okuvezwe ngamakhokhethi angavamile we-triglyceride emaqenjini amafutha anemiphumela emibi emzimbeni. Yilokho, hhayi konke ukugcwala ukukhuluphala. Njengoba ukulinganisa okunembile kwamafutha omzimba kufana nokuhlola okubizayo nokungenakufinyeleleka, indlela ejwayelekile yokunquma ukukhuluphala ngokweqile, okuthiwa "inqwaba yezinhlamvu zomzimba", yamukelwa emkhakheni wezempilo. Ubuhlobo obuphakathi kwesisindo somuntu ngo-kilogram kanye nokuphakama ngamamitha kusikwele esichazwe kude no 1896 A. Quetelet futhi kwanikezela ekudaleni uhlelo olujwayelekile lokubala inkomba enkulu:
Isisindo somzimba esincane - ngaphansi kuka-18.5 kg / m 2
Isisindo esihle - 18,5 - 24,9 kg / m 2
Ukwedlula ngokweqile - 25 - 29.9 kg / m 2
Ukukhuluphala ngokweqile 1 - 30 - 34.9 kg / m 2
Ukudla ngokweqile 2 - 35 - 39.9 kg / m 2
Ukukhuluphala kuka-3 degree - ngaphezu kuka-40 kg / m 2
Ngo-1997, i-World Health Organization (WHO) yamukele izinga lokuhlukanisa isisindo ngokuhambisana nalolu hlelo. Kodwa-ke ososayensi baphawula ukuthi le nkhomba ayinikezi ulwazi ngamafutha, futhi okubaluleke kakhulu, lapho ikhona emzimbeni. Ngokufanayo, lokhu kuyisici esiyinhloko ekuthuthukiseni ukukhuluphala. Ukusatshalaliswa kwesifunda kwezicubu ze-adipose kuyisici esibalulekile sokuhlonza izinga lokukhuluphala, ukubeka imvamisa nokuqina kwemibonakalo yezifo ezivumelanako. Ukuqoqwa kwamafutha esifundeni esiswini, okubizwa ngokuthi i-Android (emaphakathi, emasimini) kuhlotshaniswa nokwanda okuphawulekayo engozini yezempilo, okukhulu kakhulu kunhlobo lwesifazane yokukhuluphala. Ngakho-ke, incazelo ye-index mass body ngokuvamile ihambisana nokulinganisa umthamo wokhuni. Kutholakale ukuthi inkomba yomzimba womzimba ≥ 25 kg / m 2 ehlangene nobubanzi besikhumba ≥ 102 cm emadodeni futhi u-≥88 cm kwabesifazane kukhulisa kakhulu amathuba okuba nezinkinga. Phakathi kwabo: ukucindezeleka komzimba, i-dyslipidemia (ukungasebenzi kahle kwe-lipid metabolism), isifo sokuqina kwesifo sofuba, ukushukela kwe-insulin, uhlobo lwesifo sikashukela sesibili, isifo sofuba nesifo se-myocardial.
Izibalo zokukhuluphala emhlabeni
Inani lamacala okukhuluphala ngokweqile likhula emhlabeni jikelele ngesivinini esisheshayo, sifinyelele isilinganiso se-epidemiological. Inkinga yokukhuluphala emphakathini wanamuhla uye waba masinyane - phezu kwamabili eminyaka edlule. Ngokusho kwezibalo ezisemthethweni, njengamanje abantu abayizigidi ezingu-250 emhlabeni batholakala benesisindo sokudla ngokweqile kanti izigidi eziyizinkulungwane ezingu-1,1 zikhulu ngokweqile. Lo mkhuba uzoholela eqinisweni lokuthi ngo-2015, lezi zikhombisi zizokhula zibe yizigidi ezingu-700 kanye nabantu abayizigidi ezingu-2.3, ngokulandelana. Iningi lokukhathazeka ukwanda kwenani labantwana abakhuluphele abangaphansi kweminyaka emihlanu - kungaphezu kwezigidi ezingu-5 emhlabeni wonke. Okunye okukhathazayo ukusabalalisa kohlobo lwe-3 ukukhuluphala (≥ 40 kg / m 2 ) - kuye kwanda cishe iminyaka eyisithupha kule minyaka eyishumi eyedlule.
Kuyo yonke iYurophu, ukukhuluphala kunomthelela ku-50% nokuqhathanisa ngokweqile - cishe u-20% wabantu, ne-Central neMpumalanga Yurophu - izindawo ezithintekile kakhulu. E-Russia, isimo sinzima nakakhulu - amadoda angama-63% nabesifazane abangu-46% eminyakeni yobudala abakhuthele ngokweqile, bathinteka ngokweqile, kuyilapho u-17% no-19%, ngokulandelana, bekhululekile. Izwe elinesisindo esiphakeme kakhulu sokukhuluphala emhlabeni - Nauru (Oceania) - amadoda angama-85% nabesifazane abangu-93%.
Okuholela ekuthuthukiseni ukukhuluphala
Ukukhuluphala ngokweqile ukuhlukunyezwa kwesimiso somzimba esingapheli, ngenxa yokusebenzisana okuyinkimbinkimbi kwezinto ezingapheli (izici zofuzo, ibhalansi ye-hormone) nezimo zangaphandle. Isizathu esiyinhloko sokuthuthukiswa kwayo kubhekwa ukuthi silondoloza ukulinganisela kwamandla kagesi ngenxa yokwanda kwamandla kagesi, ukunciphisa ukusetshenziswa kwamandla noma ukuhlanganiswa kokubili kokubili. Njengoba umthombo omkhulu wamandla kubantu kukhona izakhi, ukusetshenziswa kwamandla ngokuyinhloko kuhlotshaniswa nokusebenza ngokomzimba. Ngaphandle kokwenziwa komsebenzi okwanele, amandla asetshenziswe buthakathaka, izinto azifakwanga ngendlela efanele, ekugcineni okuholela ekuzuzeni isisindo, ukukhuluphala nokuthuthukiswa kwezifo ezihambisanayo.
Ukudla okunomsoco ku-etiology yokukhuluphala
Uma emashumini eminyaka edlule kwakungabaza ngokubaluleka kokudla okunomsoco ku-etiology yokukhuluphala, namhlanje, emphakathini wanamuhla, kubonakala ukuthi ukudla kubaluleke kakhulu lapha. Ukuqapha kokudla kubonisa ukuthi phakathi neminyaka engu-30-40 yokugcina, ukusetshenziswa kwamandla kagesi ngamunye kuye kwanda, futhi le nkinga izoqhubeka esikhathini esizayo. Ngaphezu kwalokho, izinguquko eziningi zihambisana nezinguquko ezihambisana nokudla okunomsoco. Ukusetshenziswa kwamafutha eminyakeni yamuva kuye kwaphakama kakhulu, njengoba i-fatty acids i-mono-ne-polyunsaturated fatty acids "yazinika" kumafutha amaningi agcwele. Ngesikhathi esifanayo, kukhona ukujula ekusetshenzisweni kwe-ushukela elula, nokusetshenziswa kwama-carbohydrate okuyinkimbinkimbi kanye ne-fiber kuye kwehla. Ukudla okunamafutha amaningi kanye nama-carbohydrate elula kukhethwa ukudla ngenxa yokunambitheka kwabo okuhle. Noma kunjalo, banekhono elibi kakhulu kanye nokwanda kwamandla kagesi (ama-calories ngalinye ngesisindo) - izinto eziholela kalula ekulinganiseni kwamandla nokukhuluphala okulandelayo.
Kubaluleka kokusebenza ngokomzimba
Ukukhula kwezomnotho okuqhubekayo, ijubane elinomthelela ekuthuthukisweni kwezamabhizinisi kanye nasezindaweni zasemadolobheni kunganciphisa isidingo semisebenzi edinga umzamo womzimba. Okhokho bethu akudingeki bakhokhele umsebenzi womzimba futhi bathole imithwalo. Baphoqeleka ukwenza lokhu ngempilo ngokwayo. Thina, ohlala emadolobheni, kudingeka ukhokhe isamba esikhulu ukuvakashela isikhungo samanje sokuzivocavoca noma i-pool yokubhukuda, ukuzivocavoca noma ukuhamba ngesigaba sokwelashwa. Okwamanje, ukunyakaza kubalulekile ukugcina isakhiwo evamile kanye nomsebenzi cishe zonke izitho kanye nezinhlelo emzimbeni wethu. Ukungabi khona kwazo ngaphandle kwezizathu ezizwakalayo kuzokwenzeka ngokushesha noma kamuva kuguqulwe izinguquko ezithombeni ezithombeni nasezikhunjini zomzimba, ezinkingeni zezempilo jikelele nasekugugeni kwasekuqaleni.
Izifundo eziningi ze-epidemiological ziye zabonisa ukuthi ukuhlala ngasendlini ngokuvamile kuhlotshaniswa nokwanda kwenani lezinkinga zemithi, ikakhulukazi, ukwedlula ngokweqile nokukhuluphala. Kuyathakazelisa ukuthi iqiniso lokuthi isilinganiso sokunciphisa ukukhuluphala ngokweqile komzimba kunesimo esiqondisayo, okungukuthi, ukungabi nokusebenza komzimba kuholela ekuzuzeni isisindo, futhi kunzima kakhulu kubantu abanesisindo sokweqisa ukuqala ukusebenza komzimba. Ngakho-ke, ukuqoqwa kwesisindo esiningi kunciphisa futhi kuholela ekusungulweni kwendilinga engavamile. Kuyinto yokwandisa amandla okudla nokunciphisa umsebenzi owenziwe ngokomzimba obangelwa ukuqhuma okuphawulekayo ekusakazeni kokukhuluphala okwamanje. Kukholelwa ukuthi ukudla okunomsoco kunengxenye enkulu yengozi, ngoba lapho singakwazi ukukhiqiza kangcono ukulinganisela kwamandla kunokusibuyisela emuva kamuva ngomsebenzi womzimba.
Ukukhuluphala ngokwemvelo nokuzalwa
Nakuba ukukhuluphala ngokucacile kuthatha ingxenye yefa, izinqubo eziqondile ezisekelwe kuso azikaqondi kahle. Ama-"amakhodi" asobufuba obuningi bomuntu kunzima ukuhlukanisa, ngoba inani elikhulu kakhulu lama-genotypes lihlukanisa ngaphansi kwethonya lezinto zangaphandle. Isayensi iyazi ukuthi iziphi izinhlanga ezihlukene kanye nemindeni ezithandana nokukhuluphala ziye zazikhethela izakhi zofuzo, kodwa kusalokhu ukuthi kunzima ukusho ukuthi lokhu kuyi-100% yefa, ngoba amalungu ala maqembu adla ukudla okufanayo futhi anamakhono afanayo okuhamba ngamandla.
Izifundo eziqhutshwa phakathi kwamaqembu amakhulu abantu abanezinhlobo eziphawulekayo kwinani lomzimba womzimba kanye nenani lamafutha, kanye namawele, kubonisa ukuthi u-40% kuya ku-70% wezingxabano zomuntu ngokwawo ahloswe ngokofuzo. Ngaphezu kwalokho, izici zofuzo zithinta kakhulu ukusetshenziswa kwamandla kanye nokwehlisa izakhi. Njengamanje, naphezu kwentuthuko yesayensi nezobuchwepheshe, kunzima ukukusho ngokuqiniseka ukuthi lokhu kuyinto yokuzalwa ngokweqile - ukukhuluphala.
Ukubaluleka kwamanye ama-hormone ekuthuthukiseni ukukhuluphala
Ngo-1994, kwatholakala ukuthi amafutha awuhlobo lwe-endocrine. Ukukhululwa kwe-hormone ye-leptin (kusukela e-Greek Leptos - ephansi) inikeza ithemba lokuthola isidakamizwa sokulwa nokukhuluphala. Ososayensi abaningi baye baqala ukufuna amaphilisi efana namvelo ukuze awanikeze emzimbeni womuntu.
- I-Leptin iyi- hormone yezinyosi ze-adipose, ezisezingeni le-vascular lilinganisa nomthamo wayo. I-Leptin isebenza kuma-receptors akhethekile ase-hypothalamus, athumela izimpawu zesifo ebuchosheni. Uvumela ukwazi uma umzimba uthola inani elanele lezinto ezivela ekudleni. Ngezinye izikhathi izinguquko zegeneli ezithinta ukukhiqizwa kwe-leptin zenzeka. Abantu ababhekene nalesi shintsho banesisindo esiphansi sama-vascular leptin futhi bahlale bezwa isidingo sokungenisa ukudla. Abantu bazizwa belambile futhi, bezama ukugcwala, bona ngokwabo bavusa ukuthuthukiswa kokukhuluphala kwengqondo. Ukunikeza i-leptin ngaphandle kwalaba bantu kuyiphuzu elibaluleke kakhulu. Kodwa-ke, noma kunjalo, kaningi ezigulini ezikhulu kakhulu, kunezigaba eziphakeme ze-serum leptin, kodwa ngesikhathi esifanayo, ukwanda kwamanani. Ezimweni ezinjalo, ukuphikiswa kanye nokwelashwa kwe-leptin okungenalo ithonya.
- I-Grelinate iyi -hormone yepheshana lomzimba, isenzo saso sifana neloptin. Ichazwa njengehomoni yindlala. Izinga lakhe liphakama ngaphambi kokudla futhi liyehla ngokushesha ngemva kokudla. I-grelinate isetshenziselwa ukuthuthukisa umgomo wokulwa nokukhuluphala okungeke ukuyivumele ukuba ifinyelele izilaleli kwisistimu yezinzwa zomphakathi futhi iholele indlala. Ngokuvame ukukhuluphala, lo mzwa uphenduka ungamanga, ngakho kungaba ngcono ukuyeka ukuthola i-hormone yindlala ebuchosheni nhlobo. Lena yithuba lesiguli ngokukhuluphala ukuqala ukuhola impilo evamile.
- I-Peptide YY enye i-hormone ehlanganyela ekuthandweni kwezintuthwane. Ekhiqizwa ezingxenyeni ezihlukene zamathumbu amancane namakhulu ngemuva kokungenisa, leli hormone liyehlisa ukunciphisa isisu, ngaleyo ndlela kuthuthukiswe ukugaya nokumunwa kwezakhi futhi kwandisa umuzwa wokuzizwa. Abantu abahlushwa ukukhuluphala banamazinga aphansi we-YY peptide. Kutholakale ukuthi ukusetshenziswa kokudla neziphuzo kucebile amaprotheni, kwandisa ukufihla kwe-peptide YY futhi kwandisa umuzwa wokuzizwa.
- I-Adiponectin ingenye i- hormone ekhiqizwa emathisini e-adipose, enomthelela omuhle ekuthuthukiseni ukukhuluphala. Nakuba indima yayo emzimbeni ingazange ihlolwe ngokugcwele, kuboniswa ngokucacile ukuthi iziguli zihlushwa ukukhuluphala ngokweqile, zinezinga eliphansi le-adiponectin futhi ngokuphambene - ngemuva kokuncipha kwesisindo somzimba, ukuhlushwa kwalo kukhula. Ukuhlolwa okwenziwe kumazinyamu we-laboratory kwafakazela ukulahlekelwa kwesisindo ngokushesha ngemuva kwesicelo sangaphandle se-adiponectin. Ngaphambi kokulingwa kwabantu, noma kunjalo, imibuzo eminingi kufanele iphendulwe.
Kungani ukukhuluphala okunjalo kuyisifo esibalulekile?
Ukubaluleka komphakathi kokukhuluphala kunqunywa hhayi nje kuphela ngobukhulu besisindo, ukuthi bufinyelele phakathi kwabantu bomhlaba, kodwa futhi kubungozi bezempilo obunikezayo. Yiqiniso, ubuhlobo phakathi kokuqhathanisa ngokweqile, ukukhuluphala ngokweqile nokufa kwangaphambi kwesikhathi sekuye kwafakazelwa. Ngaphezu kwalokho, ukukhuluphala kunesinye sezici eziyinhloko ze-etiological ku-pathogenesis yesibalo esikhulu sezifo ezithinta inani labantu abasebenzayo ngokwezomnotho emhlabeni futhi okuholela ekukhubazekeni nasekukhubazekeni. Ngokusho kwedatha esemthethweni, cishe u-7% wezindleko eziphelele ezempilo emazweni athile athuthukile anikezwa ukuphatha imiphumela yokukhuluphala. Eqinisweni, lesi sibalo singaba ngaphezulu izikhathi eziningana, ngoba eziningi zezifo ezikhulu kakhulu ezihlobene nokukhuluphala cishe cishe azifakiwe ekubalweni. Nazi ezinye zezifo ezivame kakhulu ezibangelwa ukukhuluphala, kanye nezinga lokubeka engozini ekuthuthukiseni kwabo:
Izifo ezivame kakhulu ezibangelwa ukukhuluphala:
Ingozi ephawulekayo yokwandisa | Ingozi elinganiselwe | Ingozi encane eyanda |
I-hypertension | Izifo zenhliziyo | I-Cancer |
I-Dyslipidaemia | I-osteoarthritis | Ubuhlungu obubuyela emuva |
Ukuphikiswa kwe-insulin | Gout | Amaphutha okuthuthukiswa |
Isifo sikashukela soluhlobo lwesibili I-apnea yokulala Isifo seGallstone | I-asthma |
Ukukhuluphala ngokweqile kuyinkimbinkimbi engapheli yemithi ene imiphumela embi kakhulu yezempilo. Nakuba ngezinga elithile ukuthuthukiswa kwalo kugcizelelwe ngokofuzo, izici zokuziphatha, ikakhulukazi, ukudla okunomsoco kanye nokusebenza komzimba, ukudlala indima eqondile kwi-etiology. Ngakho ukubonakala kwesisindo esiningi ngokweqile noma ngisho nokukhuluphala - konke lokhu kuzoxhomeka ikakhulukazi kithi, futhi konke okunye kuyisisusa.