Obesity: Some Heavy Numbers

There’s no two ways about it — America is getting fatter. The nationwide trend toward obesity threatens to outpace the great strides made over the last 30 years in preventive cardiology as well as related healthcare technologies and treatments. It’s sad to report that, as a practicing cardiologist, I’m preparing for the looming storm of heart attacks and strokes that will strike our young, overweight population. In addition to the sedentary lifestyle that is plaguing our nation, the shift to a high carbohydrate diet dominated by processed foods is largely to blame for widespread obesity, and a wide range of other debilitating ailments and conditions.

Some statistics from the National Institute of Health and the Center for Disease Control may help drive this point home:

A growing problem

  • The number of states with an obesity prevalence of 30% or more has increased to 12 states in 2010. In 2009, nine states had obesity rates of 30% or more. In 2000, no state had an obesity prevalence of 30% or more.
  • Over two-thirds of adults in the U.S. are overweight or obese
    All adults: 68 percent
    Women: 64.1 percent
    Men: 72.3 percent
  • Fewer than one-third of all U.S. adults are at a healthful weight.
  • Only 31% of U.S. adults report that they engage in regular leisure-time physical activity (definition: three sessions per week of vigorous physical activity lasting 20 minutes or more, or five sessions per week of light-to-moderate physical activity lasting 30 minutes or more). About 40 percent of adults report no leisure-time physical activity.

The damage

  • Obesity is associated with over 112,000 excess deaths due to cardiovascular disease, over 15,000 excess deaths due to cancer, and over 35,000 excess deaths due to non-cancer, non-cardiovascular disease causes per year in the U.S. population, relative to healthy-weight individuals.
  • In 2008, medical costs associated with obesity were estimated at $147 billion.
  • On average, people who are considered obese pay $1,429 (42%) more in health care costs than normal-weight individuals.

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Inflammation: From Discovery to Defense

Inflammation is the body’s appropriate and healthy immune response to an injury or infection.  Pull a muscle, catch a cold, or get a bee sting and your body responds with pain and swelling and a healing process begins.  But if the immune system goes awry and fails to shut off, inflammation may become chronic and cause permanent damage to the body.  Chronic inflammation refers to a maladaptive process that is believed to contribute to a variety of medical conditions including heart disease, arthritis, osteoporosis, diabetes, cancer, and Alzheimer’s disease. This kind of inflammation may not be so readily apparent, but can be detected by high levels of certain established biomarkers like C-reactive protein (CRP) and interleukin-6 (IL-6) in the blood. Reducing levels of these biomarkers has been a target for a number of nutrition studies. Omega-3s, L-carnitine, lycopene, astaxanthin, folic acid, CoQ10, resveratrol, and vitamins C and D are a few nutrients that are gaining attention as natural anti-inflammatories.  Perhaps the best studied are the omega-3 fatty acids; researchers have found that increased blood levels of the omega-3s DHA and EPA were associated with reduced levels of the inflammatory biomarker CRP.

Researchers have pointed to western diets and lifestyles as major culprits in the rise of chronic inflammation. Although these may appear hackneyed, the following healthful lifestyle choices are your best defense against inflammation:

  • Maintain a healthy weight.  Excess weight can definitely induce a pro-inflammatory state.  Doctors are concerned about your waistline because studies show that visceral fat, located deep in the abdominal area, causes more inflammation than general obesity.  Lose the weight and you will gain the benefits of reducing or even eliminating inappropriate inflammation.
  • Eat a diet low in saturated fats and rich in complex carbohydrates, including fiber-rich fruits, vegetables and whole grains.  Avoid trans fats and sugar that promote inflammation and incorporate the healthful fats, the omega-3 fatty acids, DHA and EPA, which can boast powerful anti-inflammatory properties.
  • Take an omega-3 supplement containing 1000 mg DHA+EPA. Increasing omega-3s DHA + EPA while maintaining low saturated and trans fats also helps all lipid parameters – lowers LDL and total cholesterol, raises HDL and decreases TG.
  • Exercise more.  While helping to maintain a healthy weight, exercise can decrease inflammation and CRP levels, as well as lower LDL, increase HDL, lower blood pressure and reduce your risk of heart disease, and on and on and on…
  • Don’t smoke or linger in smoke-filled areas.  Air pollution and, of course, smoking have been linked to an increased incidence of heart disease, asthma, and other inflammation-related conditions.
  • Reduce stress. At the very least make an effort to manage stress in all ways possible: set limits on the demands you face and give yourself regular time out, exercise, make proper sleep and nutrition a priority, seek out laughter and love.

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Fusilli with Spinach, Chickpeas, and Feta

1-16 oz. box fusilli (spiral-shaped) pasta

Fusilli with Spinach, Chickpeas, and Feta

2 garlic cloves, crushed

1/4 cup olive oil

2 tablespoons fresh lemon juice

1/2  teaspoon salt

1/2  teaspoon black pepper

2 (15-oz) cans chickpeas, drained

9-ounce bag fresh spinach, coarsely chopped

1 cup (4 ounces) crumbled feta cheese

In a large serving bowl, combine crushed garlic, olive oil, lemon juice, salt and pepper and chickpeas.  Cook pasta according to package directions until al dente. While pasta is cooking, chop spinach leaves and add to bowl.  Add crumbled feta and toss well.  Drain pasta and add to bowl; toss again.  Serve warm.  (10-12 servings)

This is one of my favorites and makes a  frequent appearance at family barbecues. It is simple and most of the steps can be completed well in advance of the crowd’s arrival (just short of cooking and adding the pasta).  Make sure you cook your pasta just until firm (al dente) as over cooking pasta causes the starch to be broken down into sugar more readily.  Chickpeas are legumes; they are a healthful carbohydrate with a low glycemic index (producing very little blood sugar).  They are a healthful source of  protein,  folate, magnesium, and zinc, and they are low in fat.  Spinach is rich in iron, calcium, and lutein (good for eye health).

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Cholesterol-Lowering Foods

Just as a diet rich in cholesterol-boosting foods and saturated fats may have given you high cholesterol, one rich in cholesterol-lowering foods may help you lower your “bad” cholesterol levels.

woman holding flower in fieldTransitioning to a “dietary portfolio” that combines a variety of cholesterol-lowering foods can be an effective way to lower your “bad” cholesterol levels and improve your overall health.

A study conducted by Dr. David A. Jenkins of St. Michael’s Hospital in Toronto found that combining foods with recognized cholesterol-lowering properties proved very effective in lowering serum cholesterol under metabolically controlled conditions.
The study concluded that use of a cholesterol-lowering dietary portfolio resulted in greater LDL-C lowering during 6 months of follow-up.

Foods that can lower cholesterol

  • Fatty fish: eating two servings of fatty fish (good fat) like salmon, tuna, mackerel or bluefish per week will not only increase your intake of cholesterol-cutting omega-3s, but potentially reduce consumption of meats and protein sources containing LDL-boosting saturated fats (bad fats).
  • Nuts: whole almonds, walnuts and peanuts (unsalted of course) have been shown to slightly lower LDL cholesterol levels.
  • Beans: including navy, lentils, garbanzo, and kidney.
  • Vegetables: garlic, okra, spinach, eggplant and other veggies rich in soluble fiber.
  • Fruit: including avocado, apples, strawberries, grapes and citrus.
  • Grains: oats, barley, psyllium and other whole grains.
  • Liquid vegetable oils: canola, sunflower, safflower, and others and margarine enriched with plant sterols in place of butter, lard, or shortening when cooking or as condiments.
  • Soy products and tofu: products made from soybeans can have a modest impact on lowering cholesterol and can have the added bonus of replacing some animal protein in your diet.

Conclusions:

Don’t eat:

  • Fatty meats.
  • Fat-rich dairy products like whole milk and cheeses.
  • Processed foods loaded with trans fats, saturated fats, salt and chemicals.

Do eat:

  • Foods high in omega-3s, including fatty fishes.
  • Foods high in soluble fiber.
  • Whole grains.
  • Low-fat dairy products.
  • Lean meats and poultry.

Exercise regularly: Excess weight boosts harmful LDL levels.

Note: Genetics play a major role in our cholesterol levels and overall heart-health. Have your cholesterol levels tested regularly and heed your doctor’s advice on cholesterol-lowering medications, statins and daily dietary supplementation.

Additional sources:

The Harvard Heart Letter 

Mayo Clinic

Related: more articles on heart health featured on the FPIM blog

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Is Sugar Making You Stupid? Omega-3 Fatty Acids Can MInimize the Damage

I’ve always been of the opinion that eating processed foods loaded with high-fructose corn syrup or other sugars is neither smart nor healthful, and now a new study takes that premise one step further — sugar may actually be making us “stupid”.

In the past decade the increased consumption of processed foods laden with high fructose corn syrup has led Americans to gain weight; a lot of weight. In fact, 2/3 of Americans are now overweight and 1/3 are genuinely obese. This trend threatens to erode the great cardiovascular strides we’ve enjoyed over the last 30 years. In preventive cardiology we are all preparing for the looming storm of heart attacks and strokes that will strike our young population. In addition to the sedentary life style that is plaguing our nation, the shift to high carbohydrate diets is largely to blame for widespread obesity and a wide range of other debilitating ailments and conditions.

A new UCLA study has found an additional problem associated with the intake of high fructose corn syrup — binging on soda and sweets for as little as six weeks may negatively impact one’s intelligence – in addition to expanding our waistline! The study is the first to show that a diet high in fructose slows the brain, impairing memory and learning. The study also found that consuming omega-3 fatty acids could effectively counteract the disruptive effects of the sugar. (No, that does not mean you should follow your cookies with a fish oil chaser! You need to avoid the sugar in the first place.)

While many studies have revealed how fructose harms the body through diabetes, obesity and fatty liver, the UCLA study is the first to reveal the sweetener’s negative influence on brain function.  Read More…

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Vitamin D – an Important Daily Vitamin

Hands and Sunset

I’ve felt for quite some time that vitamin D — and D3 in particular — should be an important component of a healthy individual’s daily vitamin intake, often in the form of supplementation.

As we learn more and more about the promising role of vitamin D, additional patients with D deficiencies are being identified. Unfortunately, vitamin D is not found naturally in many foods, so most of our vitamin D is produced in our bodies by the action of sunlight on the skin.

Aging decreases our synthesis of vitamin D
Most vitamin D is produced in our bodies when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. As humans age, however, we often lose the ability to manufacture adequate amounts of vitamin D.  Research indicates that vitamin D is important not only for proper absorption of calcium and the maintenance of bone health, but also for maintaining healthy joints, a healthy cardiovascular system and healthy moods. In addition, vitamin D plays an important role in regulating cell division and differentiation and supports immune system function through its effects on macrophages, natural killer cells (NK), and T cells. Scientific data indicate that vitamin D also has a role in helping to maintain breast, prostate, colon, and kidney health. In other words, its impact in our bodies is far-reaching.

Vitamin D3 more effective than D2
A recent study published in The American Journal of Clinical Nutrition* further supports my evidence-based belief that vitamin D3 is more effective than D2 (it can raise blood levels of vitamin D up to 70% better than D2). AJCN’s first-ever systematic review and meta-analysis comparing the effectiveness of the vitamin D forms supports the findings of many other researchers and studies.  (Note: vitamin D is found in two forms D3 or Cholecalciferol and D2, or Ergocalciferol. In contrast to Cholecalciferol, Ergocalciferol is not natural; it is a byproduct of irradiated fungi).

Check your vitamin D level
Ask your doctor to do a simple blood test for 25-hydroxyvitamin D [25(OH)D] that will provide the best measure of your vitamin D status. A 25(OH)D level of 40-50 ng/ml is currently thought to be optimal. If necessary, supplement with a daily multivitamin with adequate levels of vitamin D3 and then additional vitamin D3 as needed. A general rule of thumb is that your vitamin D level will rise 10 points for every 1,000 IU D3 taken daily.

Read that label
Look for the terms vitamin D3 or cholecalciferol on supplement labels. The D2 form of the vitamin (ergocalciferol) though widely used in fortification and supplements, is less potent and artificially derived.

Source:
*Study: “Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis1–3” — Laura Tripkovic, Helen Lambert, Kathryn Hart, Colin P Smith, Giselda Bucca, Simon Penson, Gemma Chope, Elina Hyppo ̈nen, Jacqueline Berry, Reinhold Vieth, and Susan Lanham-New

Learn more about the highest quality vitamins, minerals, and omega-3’s – created by a leading preventive cardiologist. vitalremedymd.com

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