Belly Fat Is the Worst for Your Heart

Selma Broeder / CC BY 2.0

You've heard of apple and pear body shapes, right? Well, it's the apple shape - with the extra weight mostly being stored around the waist - that is most associated with heart disease and other diseases like metabolic syndrome and type 2 diabetes. This abdominal fat seems to be more biologically active, potentially secreting inflammatory proteins that contribute to atherosclerosis plaque.

The bigger your waist, the higher your risk of developing heart failure - a condition where the heart isn't pumping enough blood out, and fluid and blood back up into the lungs and/or pool in the feet and legs.

According to a recent animal study:

• Belly fat brought on the most inflammation.
• Belly fat was linked to the worst atherosclerosis (hardening of the arteries).

[Circulation online Jan. 22, 2008]

In adults at the lower end of the "overweight" range in body mass index, an increase in waist circumference of 10 centimeters was associated with a 15% higher risk of heart failure for women and 16% higher for men. [Circulation online April 7.2009]

Putting a Number to Your Waist
Measure your natural waist circumference (just above the navel) with a tape measure. If your body mass index (BMI) is 25 kg/m2 or greater (which is most of us), your goal for waist circumference, according to the American Heart Association, is:

Men: less than 40 inches
Women: less than 35 inches

But there is more to the belly fat story...

Waist-to-Hip Ratio May Be the Best Way to Measure Risk
Here's where it gets interesting. If you want to get the most accurate measure of potential risk from belly fat, measure your hips and calculate your waist-to-hip ratio. Fat around your hips doesn't appear to increase risk of heart disease at all. In fact, it may have a protective effect. Having a big waist with comparably big hips does not appear to be as troublesome as a big waist with small hips.

All of this is why I personally put more value on the waist measurement - and even better is the waist-to-hip ratio - than I do pounds on a scale. Pounds don't take into account your muscle or bone mass or where you tend to deposit extra body fat.

To get your waist-to-hip ratio, measure your waist circumference in inches and divide it by your hip circumference. An abnormal ratio is thought to be:

For women: 0.85 and above
For men: 1.0 and above

Yasser Alghofily / CC BY 2.0

It takes exercise and a healthy diet to lose the belly fat. But given the risks, it's healthier to eat an apple than to be one.


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Less IS More: Less Alcohol Means More Protection

We are about to enter into the holiday season - a time when even people who don't normally drink alcohol suddenly are. So I thought this was the perfect time to think about the upside and the downside of alcohol, from the health perspective of course.

Alcohol is one of those things that can help or hurt the heart. It all has to do with how much you drink per day. Especially for women, a small amount of alcohol helps protect against heart disease, while larger amounts are damaging to the heart. Women who are heavy drinkers, according to a recent study, are four times more likely to die from heart disease and two times as likely to die from stroke compared to nondrinkers. This sends a pretty powerful message that more is not better when it comes to alcohol and heart disease.

The upside of alcohol:

• People who drank small amounts of alcohol (2 1/2 drinks a week) were 16% to 23% less likely to have a stroke than those who didn't drink at all, according to a group of Harvard researchers.


• Moderate amounts of alcohol raise HDL - "good" serum cholesterol.


• Wine contains flavonoid phytochemicals that have powerful antioxidant activity in the body.


• Grape skins contain components (like polyphenols) that help expand or dilate arteries.


• Alcohol discourages platelets from combining together, acting much like a blood thinner.

The downside of alcohol:

• People who drink every day or multiple times a day are at risk, according to a 2009 French Canadian study. The study linked heavy consumption of beer and spirits to seven different cancers (esophageal, stomach, colon, liver, pancreatic, lung, and prostate cancer), with the strongest risk being to esophageal and liver cancer. The good news is that light drinking and wine consumption did not show the same increase in cancer risk in this study. [Journal Cancer Detection and Prevention, Aug-3-09, Benedetti A. et al.]


• Harvard researchers found that people who had at least two drinks a day had 39% to 41% greater risk of stroke compared to light drinkers.


• Alcohol can increase serum triglyceride levels. This is especially pronounced if the drinker already has high triglyceride levels.


• Alcohol addiction is a serious problem for many people. People with any semblance of an addition to alcohol should refrain from alcohol completely.


• Alcohol in any quantity adds extra calories, which is a concern if your health would improve with some weight loss.

So take it easy on the alcohol and enjoy a heart healthy holiday season.

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Taste Test Tuesday: Green Giant Healthy Heart

We all need to eat more whole grains and vegetables. Almost everyone who has been paying attention even a little to science news over the past 5 years knows that. Green Giant brand (the king of frozen vegetables) has come up with a few new single serving frozen side dishes. I picked up the one labeled "healthy heart" and it contains:

• Pearled barley
• Sugar snap peas
• Julienne carrots
• Herb infused extra virgin olive oil sauce

Aha! I thought..."herb infused extra virgin olive oil sauce,"sounds suspicious! The ingredient label reveals that the sauce is innocent enough, made from water, extra virgin olive oil, canola oil, garlic powder, salt, modified corn starch, spice, and monoglycerides).

Each individual serving - a 7-ounce box - adds up to 140 calories, 3 grams protein, 28 grams carbohydrate, 3 grams fat, 0 g saturated fat, 0 grams trans fat, 0 mg cholesterol, 4 grams fiber, 2 grams soluble fiber, 420 mg sodium. Calories from fat: 19 percent.

If I could have a one on one with the Green Giant 's people, I would recommend adding half as much salt so the sodium per serving would be in the 200 milligram ballpark instead. Because if someone at risk of heart disease is trying to follow the newer sodium suggestion of 1500 milligrams of sodium per day, one serving of this side dish would put a major dent in that total.

How did it taste?
It was a little "saucy" for my liking but the flavor and combination of textures was definitely pleasant.

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Make The Switch to 1% or Nonfat Milk and SAVE!

striatic / CC BY 2.0

Some people are big milk drinkers and some people aren't. I'm a lifetime member of the latter group. Nothing against milk, I just don't enjoy drinking it all by itself. I'm big on iced nonfat lattes though. But just in case you ARE a milk drinker, the lower fat milks are the way to go, particularly if you have heart disease.

The fastest way to decrease calories, cholesterol, and saturated fat grams is to decrease the fat in the milk. Nonfat milk and 1% milk fat are your best health options.

Think of the savings per week or month just by switching from whole milk or 2% milk to 1% milk or nonfat. It does add up. Check out the charts below and you'll see what I mean.

If you drink 2 glasses of milk a day (16 ounces total),
this is what you will save PER WEEK:

	Saturated Fat (g)	Fat (g)	Cholesterol (mg)	Calories
Switch from whole milk to 1% milk	43	78	170	615
Switch from 2% milk to nonfat milk	38	59	205	440

If you drink 2 glasses of milk a day (16 ounces),
this is what you will save PER MONTH:

	Saturated Fat (g)	Fat (g)	Cholesterol (mg)	Calories
Switch from whole milk to 1% milk	172	312	680	2460
Switch from 2% milk to nonfat milk	152	236	820	1760

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The Downward Spiral

I saw it with my dad and I've seen it happen to friends' loved ones... I call it the downward spiral. This is when people get so obese or medically challenged that they can't be active. It becomes a downward spiral because the heavier or more medically challenged they get, the harder it is to exercise and be physically active and yet one of the only ways they can improve their situation medically is to be physically active.

Perhaps, like in my dad's case, the window of opportunity to "get with the program" while he still had legs that worked pretty well and the ability to exercise somewhat...came and went. Once there was neurological damage (he had type 2 diabetes) and even small amounts of physical activity were difficult, then it becomes even MORE challenging to lose weight and be active. Enter.... the downward spiral.

Various different reports have been coming out basically telling us that Americans are more (not less) obese than we were 10 years ago. What that tells me is that everything we have been doing as a nation and society to fix this problem over the past 10 years hasn't been working. All those billions of dollars spent (each year) on weight loss products, books and programs...have been a sickening waste of money. Looks like we need a plan B pretty darn quick.

There is no quick fix and America has to face that. Turning this obesity train around is going to take everything we've got...changing the environment we live in (to make healthy eating and regular exercise more possible), it's going to take helping people make permanent lifestyle changes, helping people deal with the personal issues that are contributing to binge-eating and overeating (if this is a factor for them personally), and it's going to take a whole lot of compassion. And we are going to have to do all of this while people still have a chance of turning their health around.

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Can A Sweet Tooth Hurt Your Heart?

The sugar story just got a little more serious. Most of us know that sugar in the diet can lead to dental caries (particularly if the sugary food is sticky) and if the calories from sugar are in excess of our body's needs, it can lead to extra body fat stores. No surprise there.

Then some research uncovered that liquid calories don't seem to register in our stomach like food calories do-they don't fill up and satisfy our hunger as well as solid food calories. Some of you might have figured this out already based on your own experiences.

I've seen various and sundry research over the last few years suggesting that sweetened drinks may be linked to a higher risk of:

• Weight gain
• Metabolic syndrome
• Type 2 diabetes

This is a scary thought considering soft drink sales have been soaring in the United States and worldwide.

Today, the American Heart Association released Dietary Sugars Intake and Cardiovascular Health: A Scientific Statement due to heightened concerns about the adverse effects of "excessive consumption of sugars." Notice the word, "excessive?" That's the part that gets us into trouble. It isn't so much that we have some sugar... it's that we have too much sugar. The daily intake of added sugars for Americans was around 22 teaspoons between 2001 and 2004, according to the American Heart Association. Back in college I remember doing a presentation demonstrating that one 12-ounce soda had the equivalent of 9 teaspoons of sugar in it. That was before Big Gulps and supersized sodas.

Even though the American Heart Association Statement takes issue with the amount of added sugars in the American diet, it can't help but point a big finger toward soft drinks and other sugar-sweetened beverages because these are the main source of added sugars in Americans' diets.

Regular consumption of sugar sweetened beverages was associated with a higher risk of coronary artery disease in women even after the researchers accounted for other unhealthful lifestyle or dietary factors, according to results from the Nurses' Health Study, which followed over 88,000 women for 24 years.

Trading in your regular sodas for non-calorie liquids is a great place to start and one of those drinks might even be a diet soda - artificially sweetened beverages, at least in Nurses' Health Study, were not associated with coronary heart disease. (Not that I recommend drinking large amounts of diet soda.)

The bottom line to the American Heart Association statement is that they recommend we reduce our intake of added sugars. They go on to explain that a prudent upper limit of intake for most American women is no more than 100 calories per day and no more than 150 calories per day from added sugars for most American men. I don't know about you but I opt to spend those added sugar calories on a few bites of chocolate or a scoop of light ice cream instead of sweet drinks.

[Circulation 2009; August 24]

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Got Heart? One More Reason to Watch Your Sodium

There is that well-known benefit of lowering blood pressure associated with eating a lower sodium diet. But more and more researchers are finding that there are definitely desirable long-term benefits as well.

A new study, published in the British Medical Journal April 20, 2007, looked at the data from two trials involving adults age 30-54 with pre-hypertension. Trial #1 with 744 participants included dietary sodium reduction and counseling regarding lower sodium intake for 18 months while Trial #2 involved 2382 participants and lasted 36-48 months.

The researchers followed up on these participants 10-15 years after the original trials.

They found that the people who participated in the sodium lowering interventions had a 25-30% lower risk of experiencing a cardiovascular event.

So, it looks like this is more evidence suggesting the short term benefit to reducing sodium in your diet is a reduction of blood pressure but the long term benefit seems to be a reduced risk of cardiovascular events.

~~Elaine

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