To your health: Have a heart and shed some pounds
COURTESY WIKIMEDIA COMMONS
Breaking down barriers to weight loss
Community lecture on how being overweight impacts your heart and overall health, and what you can do about it.
Thursday, Feb. 28, 6-7:30 p.m.
Montclair Public Library, 50 South Fullerton Ave.
Reservations are required: summitmedicalgroup.com/events or call 908-277-8889
By DR. KENNETH S. BANNERMAN
For Montclair Local
This series is written by practitioners in Summit Medical Group on health-related topics. This one is by cardiologist Dr. Kenneth S. Bannerman. He was Chief of Cardiology at Mountainside Hospital from 1996 until 2009, and is currently an Assistant Professor in the Department of Cardiology at the newly formed Hackensack Meridian School of Medicine at Seton Hall University. Dr. Bannerman also studied bass at the Oberlin Conservatory of Music.
For me, the month of February is bittersweet. My parents’ 27th anniversary was on Feb. 7 and my father died suddenly on Feb. 8, five months after his first heart attack. He was 50 years old, and I was four months shy of medical school graduation.
My wife says that was the moment a cardiologist was born.
It was 1975 — the height of the heart disease epidemic. Smoking was rampant and no one thought twice about filling up on highly saturated fatty foods. In the decades following my father’s death there has been a steady decline in heart disease for younger and middle age men and women. Heart disease has changed from a disease of middle age to a disease of old age. But how?
One major reason is that the medical profession was able to identify risk factors that could be modified to reduce the risk of developing heart disease at an early age. I like to divide these risk factors into two categories: things you can control and things you unfortunately have to live with. Non-modifiable risk factors include older age, male sex, and family history, while modifiable risk factors are smoking, elevated cholesterol, insulin resistance/diabetes, hypertension, social isolation, and a sedentary lifestyle.
Some 86 percent of patients who present with a first heart attack have at least one of these major red flags. So what does this list have in common? The answer is obesity, and more specifically, abdominal obesity (defined as a waist circumference above 40 inches in men or 35 inches in women).
From 1976 to 2000, the number of obese Americans doubled from 15 to 31 percent. At the same time, there was a parallel increase in the rate of diabetes. Daily calorie consumption soared and the prevalence of electronic devices perpetuated sedentary lifestyles.
The association between abdominal obesity and a cluster of other serious health conditions — including abnormal cholesterol levels, high blood pressure, and elevated fasting blood sugar or diabetes — is so common that it has its own name: metabolic syndrome. Studies have shown that the combination of metabolic syndrome and obesity can increase your risk of developing cardiovascular disease by a factor of two.
It is easy to find out if you are at risk for metabolic syndrome. All you have to do is weigh yourself. If you are overweight you have a 22 percent chance of having metabolic syndrome, and if you are obese your chances increase to 60 percent.
The effects of obesity do not stop there. Fat cells produce messengers known as cytokines that influence other cells. These cytokines elevate blood pressure, cause insulin resistance that can lead to diabetes, and trigger chronic inflammation that is associated with heart and kidney failure, cirrhosis, arthritis, and several cancers. Obesity can affect almost every organ of the body, increasing the likelihood of sleep apnea, dementia, blood clots, gallstones, decreased fertility, and erectile dysfunction.
Despite all of these problems, we are still the lucky ones. In 1975, when my father passed, we had few drugs to control his high blood pressure, no drugs to lower his elevated cholesterol, and no miracle stents to open the clogged artery that resulted in his heart attack.
Knowing and addressing risk factors is the best way to avoid heart disease.
Start by maintaining a healthy weight. One of the few promises I can make to my patients is that if you shed extra pounds your blood pressure and blood sugar will come down, and if you exercise for 20 to 30 minutes daily you will significantly reduce your risk of developing heart disease at any age. So bring out the scale, weigh in, and take your first step towards a healthier heart today.