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Abstract During the last 20 years obesity became a major public health problem in advanced and developing countries (De Ferranti and Osganian, 2007; Alicioglu et al., 2008). Obesity-related diseases represent a serious of public health concern that contributes to significantly deteriorate the quality of life in people of most countries (Rossetti et al., 2014). Recently, concerns about disease prevention and health promotion have led to trying to resolve problems of obesity (Filippidi et al., 2014). I. 1. Obesity Obesity is a condition of abnormal or extensive fat accumulation that negatively affects health (Stenholm et al., 2008). Fat accumulation is measured by body mass index (BMI) which is used in monitoring weight gain (Garrow and Webster, 1985). BMI = In addition, Obesity is a serious risk factor for several complications and metabolic disturbances, including type 2 diabetes mellitus (T2DM), insulin resistance, systemic hypertension, dyslipidemia, coronary artery disease (CAD), cancer and osteoarthritis (Haslam and James, 2005; Wildman et al., 2011). One of the major problems in obese patients is impaired cardiovascular and metabolic functions, which are closely associated with increased mortality and morbidity (Kodama et al., 2009; Fogelholm, 2010). Introduction 2 I.1.1. Causes of Obesity I.1.1.1. Nutrition The principal cause of obesity is energy imbalance: the calories consumed are greater than that utilized by bodily processes, e.g., breathing, digestion and thermogenesis (Tseng et al., 2010). Current food habits as high consumption of industrial food (Molenaar et al., 2009) with increased intake of carbohydrates, fats and sugars with fewer intake of fruits and vegetables, increase body weight and cause obesity (Anderson and Matsa, 2011). Accordingly, higher intake of saturated fatty acids has been found to promote visceral fat deposition and mood alterations (Akbaraly et al., 2009; Jacka et al., 2010). I.1.1.2. Lack of physical activity Sustained physical activity protects against weight increase and obesity, as well as enhancing fitness (Michaud et al., 2007; Bonomi and Westerterp, 2011). Environment that promote an inactive lifestyle increase the incidence of obesity and cardiovascular disease (Sallis et al., 2012). Also, regular exercise is linked to reduced risk of chronic diseases, such as cardiovascular disease, Type-II diabetes, osteoporosis, and cancer (Conroy et al., 2005). I.1.1.3. Genetic The genetic makeup of individuals shows strong associations with the predisposition to become obese (Bouchard, 2007). A person is more likely to develop obesity if one or both parents are obese. Genetics also affect hormones involved in fat regulation, for example, one genetic cause of obesity is leptin deficiency (Farooqi et al., 1999). Introduction 3 I.1.1.4. Socio-economic factors Impaired sleep and/or circadian cycles deteriorate mood increase body weight and cause obesity (Luppino et al., 2010). Recurrent psychological stress and early life trauma have been shown to contribute to a late-onset obesity and depression. |