Preventing a second, or a first, heart attack: Part 2

The obvious:

If you smoke, quit. Smoking is the single leading cause of heart disease: smokers are 2-3 times more likely to die from a coronary heart disease than non-smokers. Smoking disrupts your heart rhythm, decreases your "Healthy" HDL cholesterol (that gets rid of artery-clogging plaque) and damages your arteries. Smoking also doubles your risk of a second heart attack. Stay away from second-hand smoke too!

Lose weight, if you need to. Lots of studies have shown that BMIs over 25 increase the risk of dying young, mainly from heart disease. Click here to calculate your BMI. An alternative to the BMI is to measure your waist measurement. The more fat you have around your middle, the greater your risk of high blood pressure, high cholesterol, high blood sugar and heart disease. Men should keep their waists circumferences (measured at the belly button) to less than 37 inches or 94 cm, women to less than 31 inches or 80cm. What's your waist circumference?

Exercise regularly. Regular exercise will go a long way in preventing a second heart attack, even if you don't lose weight. Exercise strengthens your heart, increases your "Healthy" HDL cholesterol, decreases your "Lousy" LDL cholesterol (that clogs up your arteries) and also can help prevent depression often associated with a heart attack. A study found that people that have had a heart attack and that increased their physical activity levels were nearly twice as likely to be alive after 7 years compared to those that stayed inactive.

The American Heart Association recommends a minimum of 30 minutes of walking or other moderately vigorous exercise at least five times each week, or 20 minutes of vigorous exercise at least three times each week, along with activities to increase or maintain muscular strength twice a week as well as daily activities like gardening and housework.

Not everybody can tolerate exerise the same way after a heart attack. Talk to your doctor who will probably ask you to do a stress test- your heart is monitored while walking on a treadmill or riding a stationnary bike. Many people participate in a cardiac rehabilitation program after their first heart attack where the heart is monitred during exercise to ensure the intensity is safe.

Japan takes drastic measures to fight obesity

Japan is currently undertaking the world’s most ambitious anti-obesity campaign. A national law came into effect a couple of months ago that requires companies and local governments to measure the waistlines of their employees that are between the ages of 40 and 75. This in itself is a huge undertaking given that that represents 56 million waistlines.

Those that exceed the state-prescribed limits of 33.5 inches (85cm) for men and 35.4 inches (90cm) for women- as defined by the International Diabetes Federation- and have weight-related issues, will be told to lose weight. If they don’t succeed in 3 months, they will be given dietary guidelines. If unsuccessful after 6 months, they will have to have addition education.

These efforts have been put in place to curb the growth of metabolic syndrome in Japan, to reduce the overweight population by 10% in the next 4 years and by 25% in the next 7 years, and, of course, to cut health care costs.

Metabolic syndrome is a term used to describe a collection of risk factors for heart disease including abdominal obesity, diabetes, high blood pressure and high cholesterol. The term ‘metabo’ has become widely used in Japan and has become synonymous with ‘overweight’.

Companies must get 10% of those deemed metabo to lose weight by 2012 and 25% to lose weight by 2015. If these targets aren’t met, the government will impose financial penalties. And the penalty isn’t trivial. NEC, Japan’s largest maker of personal computers, could incur a penalty of up to $19 million. As a result, the company is taking action, measuring the waists of all employees over the age of 30 and sponsoring metabo education days for employees and their families.

Opponents to the new government crackdown claim the criteria is too strict, the results will result in overmedication and therefore increase healthcare costs.

For a while now, health professionals have been saying that waist circumference is a better predictor of long-term health than the scale. Fat around the waist is linked with an increased risk of heart disease, type 2 diabetes, stroke, high blood pressure, as well as back pain, some cancers, breathing problems and even death.

Perhaps the Canadian and American governments should start a similar campaign? The waist circumference criteria for North Americans is less than 40 inches (102cm) for men and less than 35 inches (88cm) for women- higher than in Asian. American health surveys show that over the past forty years, the average waist size for men has grown from 35 inches to 39 inches; for women, from 30 inches to 37 inches.

39% of men and 60% of women have waist circumferences above target.

According to a 2002 study, people with 41-inch waists pay about $2,600 more per year in annual medical expenses than do those with 32-inch waists.

The National Institutes of Health recommends that men with waists measuring 37 inches or greater and women with waists larger than 31.5 inches modify their lifestyles to reduce their waists and resulting health risks.

Sources:

http://www.nytimes.com/2008/06/13/world/asia/13fat.html?pagewanted=2&_r=2&ref=health
http://www.idf.org/webdata/docs/MetSyndrome_FINAL.pdf
http://www.healthnews.com/family-health/aging-getter-older/japanese-government-declares-war-fat-1221.html

I'll have a burger, fries, a diet soda and a heart attack, please

Researchers have found another reason to cut back on red meat, fried foods and diet soda. Wait, diet soda?!

The Atherosclerosis Risk in Communities (ARIC) study, funded by the National Heart, Lung and Blood Institute, studied the food intake (using a 66-item food frequency questionnaires) of 9514 people aged 45-64 years old for at least 9 years.

In general, a Western-diet that was heavy on refined grains, processed meats, fried food, red meat, eggs and soda and light on fish, fruit, vegetables and whole grains, was associated with an 18% increased risk for metabolic syndrome, even after adjusting for smoking, physical activity and caloric intake.

Metabolic syndrome is a cluster of heart disease risk factors that include:
a high waist circumference, high blood pressure, high triglycerides, low "Healthy" HDL cholesterol and high fasting blood glucose levels. Having 3 or more of these risk factors increases greatly your risk of developing heart disease and diabetes.

The adults who ate 2 or more servings of meat a day increased their risk of developing metabolic syndrome by 25% compared to those that ate meat twice a week or less.

Fried food was also associated with a higher rate of metabolic syndrome, as was diet soda. Risk of developing metabolic syndrome was 34% higher among those that drank one can diet soda a day compared to those that didn't drink any.

Interestingly, other studies have found a link between diet soda intake, metabolic syndrome and obesity. For example, the Framingham Heart Study- a huge cardiovascular study based in Framingham, Massachusetts that started in 1948 with 5209 participants and is now on its 3rd generation participants and has taught us most of what we know about heart disease- recently released that they found that people who drank one or more 12-oz soda- diet or regular- had a higher risk of developing metabolic syndrome and of being obese. We know regular soda is associated with increased obesity rates and metabolic syndrome, but why diet soda?

Marion Nesltle points out in her book What to Eat that rates of overweight and obesity have risen in parallel with the increase in use of artificial sweetener. Coincidence? Probably not. Although sweeteners can help some people to reduce caloric intake and therefore, their weight, it seems that most people over-compensate and make up the calories saved, and a lot more!

Another theory, that needs to be researched further, states that because sweetener is very sweet, it signals the body that sugar is coming. Because sweeteners have no calories, we end up craving the calories that were promised but not delivered.

Regardless, the ARIC study results are clear: too much meat, fried foods and diet soda do not add up to a healthy diet or life.