Excess Weight and Heart Disease

Heart disease kills more than 700,000 people each year, a number which can be dramatically decreased through a weight loss regimen including proper diet, nutrition, stress management, and exercise. The number of Americans who are overweight or obese continues to skyrocket at a staggering rate, however, which effectively doubles the risk of sudden death from a heart attack within that segment of the population. According to the Centers for Disease Control, heart disease is the leading cause of death in the United States and is a major cause of disability.

Body mass index, or BMI, is a ratio of height to weight used to define obesity. Doctors have long known that obesity increases a person’s risk of heart disease, but in recent years the picture has actually grown more complicated. Several studies have found that a high body mass index can be associated with a lower risk of dying from heart disease and other chronic illnesses — a mysterious phenomenon that has come to be known as The Obesity Paradox.

According to a new analysis in the Journal of the American College of Cardiology, the paradox appears to be explained by the simple fact that BMI is in reality a fairly inaccurate measure of risk for heart disease. Waist size provides a much more accurate method for predicting a heart patients chances of heart attack or stroke, the study found.

Researchers found that heart patients with a high ratio of waist-to-hip circumference or a large waist size—greater than 35 inches for women, or 40 inches for men—were 70 percent more likely to display the other symptoms of heart disease (high blood pressure, cholesterol and triglycerides) than those with smaller waists. The combination of a large waist and a high BMI increased the risk of cardiac disease even more. This is because the presence of belly fat is directly linked to the presence of of visceral fat, or fat that gathers around the organs in the abdomen. This type of fat is strongly associated with insulin resistance and unhealthy cholesterol numbers, and may also boost inflammation.

“What matters the most is probably the distribution of fat, more than anything else,” says the lead researcher, Francisco Lopez-Jimenez, M.D., a cardiologist at the Mayo Clinic in Rochester, Minn. “The new study provides more evidence of BMI’s shortcomings in assessing heart risk”, says Jean-Pierre Després, Ph.D., the director of research at the Quebec Heart and Lung Institute at Laval University, in Quebec City:”I’m not saying BMI is useless. It’s just that we need to go beyond that.”

“If you measure body mass index, you don’t assess body shape, you don’t assess body fat distribution,” says Després, who wrote an editorial accompanying the study. Nor does BMI distinguish between fat and muscle, Després adds. Heart patients who lead a sedentary lifestyle may see a drop in BMI as they lose muscle mass, while heart-disease patients who become more active may actually put on weight and raise their BMI because they are adding lean muscle.

Dropping excess pounds, especially for those more than 20% over their ideal weight, can significantly reduce the risks associated with a heart attack. The best way to lose weight and bring critical metabolic markers back to the normal range is through a healthy diet plan, along with a regular program of exercise. The American Heart Association recommends a diet that contains no more than 25%-35% of daily calories from fat (for example, if you eat a diet of 2,000 calories per day, no more than 400-700 calories should come from fat) with the majority of nutrients sourced from vegetables, nuts, seeds, fruit, and lean  proteins.

As for exercise, moderation is naturally encouraged at first, and anyone who has already suffered a heart attack or stroke should consider it absolutely mandatory to clear any program of exercise with their physician. Otherwise, as the weeks and months go by, with body fat dropping while other capacities increase, it is generally safe (and even advisable) to increase intensity or volume of exercise as proper recovery will allow. The better the physical condition one maintains, the greater their odds of avoiding a heart attack in the first place, but also the greater their chances of survival in the event of such an unthinkable occurrence.

The health benefits of weight loss begin to take effect after losing as little as 5 to 10 percent of your body weight, as blood pressure, triglycerides and blood sugar levels fall back into the normal range. It does take time, planning and concentrated effort to begin losing weight, but the long-term advantages are not only in the realm of general health, but also include improved self-esteem, a more positive outlook and the simple understanding that you have the ability to lengthen and improve the quality of your life. This leads not only to more years in your life, but more life in your years!

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