Obesity
Doubles Risk of Heart Failure
Obesity
alone makes the heart pump poorer, according to a new study that says
extremely overweight people are twice as likely to develop heart failure
as people of normal weight.
The
research also finds that your risk for heart failure increases each
time you find yourself loosening your belt.
First
Study to Report Obesity as Cause of Heart Failure
A report
from the long-running Framingham Heart study is the first to say that
obesity, in and of itself, is a cause of heart failure—a life-threatening
weakened ability to pump blood to the body.
"It
has been known that extreme obesity is associated with an increased
risk of heart failure," says Dr. Ramachandran S. Vasan, associate professor
of medicine at Boston University School of Medicine and the lead author
of the report appearing in the New England Journal of Medicine.
"The
question is whether the risk is independent of the other risk factors
associated with obesity, such as high blood pressure and diabetes,"
he adds. "We show in our investigation that the relationship between
body mass index and heart failure is a continuum. As body mass index
increases from normal to overweight to obesity, the risk of heart failure
increases."
What
Is Body Mass Index (BMI)?
Body
mass index (BMI), which is weight in kilograms divided by the square
of height in meters, is the accepted standard for assessing weight.
A BMI under 25 is regarded as normal. A reading of 25 to 29.9 indicates
overweight and obesity is a BMI of 30 or over.
Calculate
your BMI with our online health tools
The
new report looked at 5,581 participants in the Framingham study over
14 years, during which 498 of them developed heart failure. "After adjustment
for established risk factors, there was an increase in the risk of heart
failure of 5 percent for men and 7 percent for women for each increment
of 1 in BMI," says the journal report.
Obesity
and Heart Failure Risk
The
relationship held up when the researchers adjusted for the effect of
age, sex, smoking status, alcohol consumption, diabetes, and heart valve
disease. Obese women had double the risk of heart failure of normal-weight
women; for men, the risk was increased by 90 percent.
"From
a public health perspective, this is an additional motivation for telling
people to lose weight," Vasan says. "Heart failure is now added to the
list of medical problems associated with obesity."
While
it is possible for some highly muscular people to have a BMI in the
overweight range, it is fat, not muscle, that causes a high reading
in most cases, Vasan says.
Obesity
and Overweight - A Serious Concern for Americans
The
report comes amid growing concern over what medical authorities describe
as an epidemic of obesity in the United States. Nearly 60 percent of
adult Americans are obese or overweight, and weight problems have increased
among young people. The National Heart, Lung and Blood Institute,
which sponsors the Framingham study, estimates that 13 percent of children
ages 6 to 11 are overweight, as are 14 percent of adolescents ages 12
to 19.
For
Dr. Arthur Frank, medical director of the weight management program
at George Washington University, the finding is a call for more research
and early intervention to prevent the damage done by obesity.
Treating
Obesity Should Be the Focus
"We're
very good at treating all the consequences of obesity—high blood
pressure, high cholesterol, diabetes—which is what we end up doing.
But we're not very good at treating obesity," says Frank, who is treasurer
of the Washington-based American Obesity Association.
"That doesn't make sense. Obesity is the mother of them all. If we can
get your weight down, your diabetes looks better, your cholesterol looks
better, your blood pressure looks better."
And
yet, he says, "we haven't directed sufficient resources to solve the
problem. There is not enough research commitment or dedication to solving
the problem. What we do is skirt around it."
Young
people should be a major target of an obesity reduction program, Arthur
adds. "The sooner you deal with it early in life, the better. Everyone
who is now obese was at one time a little overweight. Obesity is a killer
disease and we have to start thinking about early intervention," he
says.
Always
consult your physician for more information.
|
September
2002
First
Study to Report Obesity as Cause of Heart Failure
What
Is Body Mass Index (BMI)?
Obesity
and Heart Failure Risk
Obesity
and Overweight - A Serious Concern for Americans
Treating
Obesity Should Be the Focus
Physicians'
Group Takes Aim at Atkins Diet
Online
Resources
Find
a Sisters of Mercy Health System Physician
In
Other News About Your Health:
Physicians'
Group Takes Aim at Atkins Diet
A
physicians' group called The Physicians Committee for Responsible
Medicine has launched a campaign against the Atkins diet.
Dubbed
"Got a Beef with the Atkins Diet?", it includes an online registry
where people can report health problems they believe were caused
by the controversial weight-loss plan.
The
campaign's goal is to educate the public about the array of health
problems that can be caused by eating the low-carbohydrate, high-protein,
meat-heavy diet, says committee president Dr. Neal Barnard.
"Many
individuals are so desperate to lose weight that they turn to
dangerous methods," Barnard says. "We saw it with Fen-phen, where
people did lose weight but they risked serious heart disease.
We've seen it with amphetamines, and absurd diets that call for
400 calories."
"Now
we see it with the Atkins diet. With a high-protein diet, the
weight loss actually achieved by most people falls short of dramatic
news accounts, and the long-term risks are of grave concern,"
he adds.
However,
the Atkins Center is firing back, claiming the group is a fringe
organization aligned with People for the Ethical Treatment of
Animals (PETA), an animal-rights group.
"[The
doctors' group] is an extremist vegetarian animal-rights group
that has been repeatedly censured by the American Medical
Association," says Michael Bernstein, senior vice president
of Atkins Health and Medical Information Services in New York
City. "Their agenda is neither medical nor scientific; it is political.
As such, there is no reason for us to comment."
The
American Medical Association (AMA) takes no stance
on the Atkins diet, or any other low-carbohydrate, high-protein
diet. The AMA censured the Physicians Committee
for Responsible Medicine several years ago for its campaign against
biomedical research, not for the Atkins diet campaign, an AMA
spokesman says.
The
Physicians Committee for Responsible Medicine cites a long list
of published medical studies about the health dangers of a low-carbohydrate,
high-protein diet. Recent studies have shown such meat-laden diets
could cause everything from kidney stones and osteoporosis to
heart disease and colon cancer.
"The
bottom line is you can lose weight by many different means. The
healthiest ways to do that are going to a low-fat, high-fiber
diet, and using vegetarian choices to the maximum degree," Barnard
says. "The Atkins diet is precisely the opposite of that."
The
Atkins diet, one of several low-carbohydrate, high-protein diets
that are all the rage among the overweight, prescribes a regimen
mainly of meats, dairy products, and some vegetables, but very
few starchy vegetables, fruit, bread, or other grains.
"The
diet relies on a massive carbohydrate restriction, which effectively
eliminates 60 percent of the foods people eat: no bread, no rice,
no pasta, no beans, no starchy vegetables such as potatoes," Barnard
says. "It's very unhealthy."
The
anti-Atkins campaign debuted at the beginning of August 2002 with
a banner ad on the Web site of the Journal of Family Practices.
In
addition, a new Web site, AtkinsDietAlert.org, will begin collecting
stories from people who believe they got sick from the diet. The
group says it will then submit the reports to the US Food
and Drug Administration (FDA) and the National
Institutes of Health (NIH).
Always
consult your physician for more information.
Online
Resources
American
Heart Association
American
Medical Association
American
Medical News, Published By the American Medical Association
American
Obesity Association
US
Food and Drug Administration (FDA)
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