Archive for the ‘Cardiometabolic Risk factors’ Category

Heart attacks Part 2: Prevention: risk factors & our kids

Wednesday, May 23rd, 2012

Here's a risk factor you can eliminate

This post pings off the April 17, 2012 article in The Wall Street Journal, "The Guide to Beating a Heart Attack." I initially wrote about surviving a heart attack (myocardial infarction {MI} is the medical term). Next I wanted to turn toward the prevention side.

I first found the Interheart study's article from 2004, "Nine modifiable risk factors predict 90% of acute MI." The study followed 29,000 people from 262 sites in 52 countries and concluded that the common belief that half of heart attacks can be predicted was clearly an underestimate.

The research group found the same impact of the nine variables everywhere in the world: abnormal blood lipids (fats, like cholesterol) and smoking were at the top of their list. Then came diabetes, high blood pressure, abdominal obesity, stress & depression, exercise, diet and alcohol intake.

I was used to measuring cholesterol and its HDL (so-called good cholesterol)  and LDL (bad cholesterol) components. This study actually used a more sophisticated lipid approach.

They measured the ratios of  the proteins that bind to and carry fats, apolipoproteins A and B. APOA is associated with HDL lipids while APOB is said to unlock the door to cells and in doing so acts as an unwelcome delivery van for cholesterol. When present in high levels, APOB can lead to plaque formation in blood vessels and an increased risk of coronary heart disease (CHD).

They also found some good news: as expected, eating fruits and vegetables daily, exercising and perhaps moderate alcohol intake were associated with lower risks of CHD. Again this was true everywhere in the world.

The WSJ article mentioned that hospital admissions for heart attacks had actually decreased among the elderly; these nine factors were better predictors in younger groups. What can be done to stop the looming specter of CHD among our younger population?

The CDC examined the parameters in a recent online article titled "A Growing Problem." One issue was "screen time." Our kids eight to eighteen average four an a half hours a day watching TV and three more on cell phones, movies, computers and video games. I even read an article about a two-year-old whose parents think learns a lot from their iPad. Maybe so, but how much exercise does that kid (and his older compatriots) get?

The CDC feels there is a dearth of quality physical activity in our schools; as of 2009 only a third of them provided daily PE for our kids. And after they leave school or when they're on vacation, many don't have safe access to biking, hiking, running, playing areas and trails.

Somerville chose healthier food in their schools

One Massachusetts community, Somerville, has gotten attention for their anti-obesity integrated program, "Shape Up Sommerville"  (You can watch the thirteen minute PBS special on their community-wide progress). The Robert Wood Johnson Foundation is attempting to help similar programs get started across the country, especially focusing on childhood obesity.

Recently I heard a NPR comment that caught my attention. If we don't do something to stop the epidemic of childhood obesity, we'll soon be seeing CHD rates soar in people in their 20s and 30s and maybe even younger.

A French researcher said, "Mankind is doing a good job of killing himself."

We need to try new approaches to help our kids. The Somerville plan sound like a good place to start.

 

 

 

Tags: , , , ,
Posted in anti-obesity programs, Cardiometabolic Risk factors, cholesterol, coronary heart disease, depression, diabetes type 2, Healthy eating, medical research, medically-oriented background info, mental health issues, Unhealthy eating, Vegetables | 1 Comment »

Chocolate, Part Two: the French paradox, free radicals and flavonoids

Monday, April 2nd, 2012

I need his size of brain to take in all the background material

I wanted to examine the possible health benefits of chocolate further and found myself immersed in nutritional and biochemical articles. So now I've slogged though eight different sources, ranging from a University of Mumbai review of health benefits of some of the chemicals in chocolate (and green tea, onions, red wine and apples) to three nutrition journals, a WebMD piece on antioxidants and a Harvard School of Public Health article titled, "Antioxidants: Beyond the Hype."

There's a concept known as the French paradox, first popularized in a 1991 segment on CBS's show, "Sixty Minutes." The French eat chocolate and cheeses and drink red wine, yet  their obesity rate is the lowest in Europe, and although they smoke and eat a moderately high-fat diet their cardiovascular death is also fairly low. Those statistics are worsening as the invasion of the Western Diet spreads through the country, but they still hold true.

Let's concentrate on chocolate for now and I'll return to that paradox some other time

In simplest terms I think of atoms as being like tiny solar systems with a sun (the nucleus) in the middle and "planets," electrons circling around. The center has relatively large particles with no charge (neutrons) and positive electrical charges (protons); the shells have tiny particles with negative charges (electrons). The latter are not just arranged in orbits like planets; a closer analogy would be Russian Nesting Dolls.

When you eat, your body uses glucose for fuel. In doing so it produces some extremely harmful molecules called free radicals. These are atoms with an electron missing and they try to regain electrical balance by stealing negatively charged particles from other atoms. You can also pick up free radicals from air, food or sunlight's effect on your skin. They can harm your DNA, cause "bad cholesterol' to get stuck in the wall of a blood vessel, or speed up the aging process of your skin.

We do have some defences against those nasty free radicals and they're called antioxidants. A variety of studies done on these chemical weapons have yielded inconclusive results, but one long-term study, part of the Physicians Health Study, appeared to show a significant benefit in cognitive function and another showed a decrease in the risk of heart attacks in men aged 50 or older.

Even these mixed results led to a huge antioxidant supplement industry with sales estimated over $500 million a year.

another antioxidant source

We're much better off, many think, consuming natural sources, especially fruits and vegetables and red wine (not beer or white wine).

And now there's chocolate. Dark, bitter chocolate appears to lower blood pressure, improve blood flow and improve insulin sensitivity. Dean Ornish's Newsweek  article, mentioned in my last post, says there's four times as much cocoa flavonoids per serving than in red wine or tea.

I asked my wife to buy some dark chocolate and ate a half a bar last night and the other half tonight. I ate it slowly, savored each taste and put the half remaining in the refrigerator last evening.
I plan to buy more tomorrow.

 

Tags: , , ,
Posted in antioxidants, Cardiometabolic Risk factors, chocolate, flavonoids, free radicals, French paradox, medically-oriented background info | No Comments »

Exercise counts most for kids

Saturday, February 18th, 2012

thumbs up on this activity

In a previous post I mentioned former neighbors whose two boys had to run around outside for an hour a day (and they did spend most of that hour literally running), before they got any "screen time." I thought that was admirable and noted both kids were slender.

Now I found an article in the February 15, 2102 issue of JAMA that confirms the wisdom of the approach my friends took toward this issue. A sextet of authors from the UK, Norway, Sweden and Canada published results for the International Children's Accelerometry Database Collaborators (ICAD).

First I had to make sure what accelerometry meant in this context. The dictionary definition was only somewhat useful. It obviously refers to a gadget for measuring acceleration, but when I returned to a prior study  of 1,862 British children aged 9 or 10 published in 2009 in the American Journal of Clinical Nutrition, I learned it's a very expensive and sophisticated gadget. My wife has a step counter that our local hospital seniors' organization, the Aspen Club, gave her free. The device used in the large-scale research project, sold by a Florida firm, does lots more than just count steps. Among other thing it also monitors how much energy you expend and what your activity intensity has been. Of course the current model I found online costs $1,249, but there is a volume discount.

That earlier study concluded we need to get our youngsters really moving in order to "curb the growing obesity epidemic."

The current paper offers a more nuanced viewpoint. It has a daunting title: "Moderate to Vigorous Physical Activity and Sedentary Time and Cardiometabolic Risk Factors in Children and Adolescents."  The study looked at exercise levels and screen time in over 20,000 kids ages 4 to 18. Overall those who got more exercise improved all the risk factors measured: waist size, blood pressure, insulin levels, triglycerides and HDL cholesterol.

thumbs down on this one

Once levels of physical activity were factored in, sedentary time seemed relatively unimportant. But a smaller group, 6413 kids, was followed  for a little over two years and neither screen time nor exercise seemed important in changes in waist size, while kids who, at the start of the various studies, had bigger bellies, also had them later. I'd bet most of those were quite TV-addicted, since the paper warns that activity (or lack of activity actually) is often a clue to snacking and soft drinks.

I may show the short form of this paper to the principal of the nearby grade school I've mentioned previously. All those kids, starting in kindergarden, have a one-hour exercise period mostly spent running. I think it's a school-district-wide program and just confirms what to me is common sense.

Lots of our youngsters are spending their days sitting in front of a screen of some sort instead of playing active games outdoors. Even in the age group followed in the recent article, a quarter of the kids were at least overweight; 7% were already obese. The average time for active play was a half an hour a day and the average for screen time was close to six hours a day.

I doubt we can totally reverse those numbers, but it's a good idea.

Tags: , ,
Posted in body mass index (BMI), Cardiometabolic Risk factors, coronary artery disease, medically-oriented background info, our kids and their weight issues, Publications | No Comments »