Beware of Heart Disease Even If You Have Normal BMI!

Body mass index (BMI) is the ratio of weight to height. The formula used to calculate BMI is:

BMI (kg/m2) = (weight in kg)/(height in meter x height in meter)

With the help of BMI, a person can be classified as underweight or overweight. Based on the guidelines provided by WHO (World Health Organization), people with BMI of 30 and above will be classified as obese, those with 25 to 29.9 as overweight, and those with less than 18.5 as underweight. A healthy person should have a BMI reading between 18.5 and 24.9.

An overweight or obese person tends to have a higher risk of getting heart disease. Therefore, if your BMI falls within the healthy range, you should be relieved. Unfortunately, this might not be true. Why?

During the American College of Cardiology's 57th Annual Scientific Session held in the month of April 2008, findings from Mayo Clinic revealed that patients with a normal BMI could still have a high body fat content that can increase the risk of cardiovascular disease.

The researchers studied on so-called 'Normal Weight Obesity' of 2,127 subjects with a BMI in the normal range. Normal weight obesity was defined as a body fat content higher than 20 percent for men and 30 percent for women.

All the participants’ body composition was measured and a full assessment was made of body size variables and cardiovascular risk factors.

It was found that 1,321 participants had normal weight obesity, while the balance 806 had a normal body fat content. Meanwhile, the investigators also found that 13.6 percent of the normal weight obese individuals met the criteria for metabolic syndrome, comparing to 5.3 percent of those who had a normal weight without a high body fat content.

The metabolic syndrome refers to a cluster of risk factors for cardiovascular disease, including high blood sugar, high levels of the 'bad' cholesterol (LDL) and triglyceride levels, low levels of the 'good' cholesterol (HDL), high blood pressure and excess belly fat.

In the study, those participants found with normal weight obesity actually had a high waist circumference, high triglyceride levels, high fasting blood sugar levels or a diagnosis of diabetes, and other metabolic markers associated with an increased risk of cardiovascular disease.

The researchers suggested that public health measures to prevent heart disease should measure the belly or assess percentage of body fat instead of just tracking weight and BMI.

Eat What You Want and Still Lose Weight!

Overweight or obesity can increase a person’s risk of getting diabetes, high blood pressure, stroke and even heart disease. Therefore, if one gets too heavy, the doctor will advise him or her to watch the diet; cutting down the amount of food is usually recommended.

If someone tells you that you can eat what you want and you can still lose weight, do you believe it? Many of us would just laugh and ignore because this contradicts to the many advices that we have heard so far. However, perhaps in the near future, things may change because scientists had found a breakthrough that could pave the way for fat-burning drugs.

A recent research discovered a way to help people lose weight without cutting back on food. The study was conducted by scientists at the Howard Florey Institute, Victoria University, La Trobe University, Deakin University, the Baker Institute and the University of Melbourne. The findings, which were published on April 29, 2008 in the United States-based Proceedings of the National Academy of Sciences, could be used to develop drugs to assist weight loss.

The Australian researchers found that by manipulating fat cells in mice, they were able to speed up the animals' metabolisms. If a particular enzyme, known as “Angiotensin Converting Enzyme” (ACE), in a mouse was removed, it could eat the same amount as other mice yet burn more calories, and thus gain less weight.

Specifically, mice without ACE were 20 percent lighter than the normal mice and had 50 to 60 percent less body fat. It also appeared that the slimmer mice have less chance of developing diabetes since they processed sugar faster than the normal mice.

Drugs that impair the action of ACE already exist but they are mostly used to combat high blood pressure. Therefore, maybe what the scientists can do is to find the right dosage of hypertension (high blood pressure) medication, or develop a new type of drug of the same class and use it as weight-loss pills.

Nevertheless, the scientists had not found why the genetic manipulation could lead to weight loss, and they do not know whether this will work in humans. Thus, more research may be required to find out the unknown before human trial can begin.

Lower Bad Cholesterol with Dietitian’s Support!

It is not uncommon nowadays to find people with high level of cholesterol, even among the young ones. Person having high cholesterol, especially the bad cholesterol or in short LDL, has a greater chance of getting stroke, high blood pressure, and heart disease.

Doctors will usually ask you to watch your diet if they find your bad cholesterol level reach a certain high level. Unfortunately, it seems that diet alone usually would not help reduce the cholesterol level for most people. Therefore, as the last resort, doctors would have no choice but to put you on medication to cut down your bad cholesterol.

A new study by the University of Michigan Health System in Ann Arbor reported during March 2008 that with the support from dietitian, some people might be able to bring down their bad cholesterol levels without drugs.

The researchers followed 51 registered dietitians who implemented the 1998 Medical Nutrition Therapy Hyperlipidemia Protocol with their patients. You may ask, “What is this protocol?”

The protocol recommends people to:

- eat more fruits and vegetables,
- eat fish twice weekly,
- take more good fats such as olive oil,
- consume less saturated and trans fat,
- exercise more.

Meanwhile, the patients were supposed to meet with a dietitian for an initial one-hour visit, followed by at least 2 or 3 half-hour appointments. More visits may be recommended by the primary care doctor, if necessary. Dietitians have to check the patients’ blood work at the outset of the study and 3 months later.

The study took in 377 patients who met the criteria. Follow-up data was available for 74.3 percent, while 42.9 percent participated in 3 to 4 visits with the dietitian as recommended.

On average, patients working with dietitians cut their fat consumption to less than 30 percent of total calories. Furthermore, they did lose weight and exercise more.

Among the 175 patients whose initial triglyceride levels were below 400 mg/dL, 44.6 percent of them reported a 15 percent drop in their LDL or reached their goal for reducing LDL.

While the protocol only recommended 3 to 4 weeks between appointments, the actual intervals were in fact longer, ranging from an average of 8 weeks between the first and second appointments to nearly 13 weeks between the third and fourth.

Many patients did not make follow-up appointments, or keep scheduled appointments because of the lack of insurance reimbursement or their inability to pay.

The researchers did have difficulty in carrying out the study. Not many registered dietitians wanted to participate because they could not obtain necessary lab tests or lacked time and administrative support.

Quit Smoking Brings Health Benefits To Women!

Smoking is bad for health! This is a fact that is recognized by most people, but it just could not convince those die-hard smokers. In 2000, about 5 million premature deaths were attributed to smoking. World Health Organization has projected that by 2030, each year, tobacco-related deaths will account for 3 million deaths in industrialized countries and 7 million in developing countries.

That is why the governments in many countries such as Germany, France, etc. are forced to pass legislation to ban smoking in public areas since the beginning of 2008. Health experts believe smoking will bring health hazards not only to the smokers themselves but also to the surrounding people in the form of secondhand smoke.

A group of researchers from the Harvard School of Public Health in Boston and colleagues reported in the Journal of the American Medical Association on May 6, 2008 that women smokers who quit could enjoy major health benefits within 5 years, though it could take decades to correct respiratory damage and lower their risk of lung cancer.

The researchers studied more than 121,000 United States female nurses whose health histories were recorded in 1976 and followed during the ensuing years.

The study found that those who stopped smoking had reduced their risk of death from all causes including heart disease and vascular problems within the first 5 years by 13 percent. After 20 years, the risk of death from any cause was actually the same for those who quit and those who had never smoked.

For deaths due specifically to respiratory diseases, there was an 18 percent reduction within 5 to 10 years of quitting, but it would need 20 years to reach the level found in nonsmokers. While there was a 21 percent reduction in the risk of lung cancer death within 5 years, it took 30 years for that excess risk to diminish.

The findings also indicated that 64 percent of deaths in current smokers and 28 percent of deaths in past smokers are attributable to smoking.

In the light of youngsters are taking up cigarettes at early age, the researchers also suggested that women who start smoking later in life would have a lower risk of many lung and heart diseases.

In fact, a survey implemented in 2003 has indicated that 13 percent of smokers started their first cigarette at the age of 13 or 14, and 22 percent of all the United States high school students were smoking at that time.

Although the current study involved only women, other research has already found benefits for men who stop smoking.

Do Fat Kids Come From Fat Moms?

Growing number of obese or fat kids have been worrying many health experts as overweight would place these kids at higher risk of getting other medical complications like diabetes, high blood pressure (hypertension), or even heart disease.

A recent study had found that women who are overweight during their pregnancy tend to deliver overweight children. The report was published by the researchers from Britain's University of Bristol in the Public Library of Science journal PLoS Medicine during March 2008.

The study looked at the developmental “Overnutrition Hypothesis”. It is the idea that if a woman were overweight during pregnancy, the higher levels of sugar and fatty acids in her blood would affect the developing fetus, dooming or at least predisposing the child to poor appetite control and a slower metabolism. The children of these women would then be expected to become more obese themselves.

4,091 mothers, their children born in 1991-1992 and the fathers of these children were involved in the study. The researchers studied the DNA of everyone, height, weight and body mass index (an important measurement of obesity), smoking, education and other factors.

What they found was that if a child became overweight by age of 9 or 11, then the mother was more likely to be overweight or obese mother than was the father. FTO (fat mass and obesity associated) gene was quoted to be responsible for such link. FTO has been shown to predispose people to Type-2 diabetes if they are overweight. The researchers also found that people with certain variants of FTO are more likely to become overweight, and inheritance from the mother seemed to have a stronger effect.

Nevertheless, how FTO could result in increased BMI (body mass index) is not known at current stage. As such, the researchers cannot rule out the fact that such link was due to dietary and physical activity behaviors.

The researchers did conclude that fat pregnant women are probably not responsible for the obesity epidemic by programming their children to get fat as they get older. Mothers are somehow involved in other ways but the link is still unclear. The study was unable to disprove the “Overnutrition hypothesis”.

A copy of the previously mentioned report is available online at the following link:

Exploring the Developmental Overnutrition Hypothesis Using Parental–Offspring Associations and FTO as an Instrumental Variable

Exercise Is Necessary Even If You Are Old!

Exercise seems to be a routine that you cannot afford to miss, whether you are a healthy person or a person with some kind of medical disorder. Especially when you land into the category of overweight or even obese, exercise is even more important as it will somehow assist you manage your body weight.

Recently, a study had found that a week of exercise significantly improved the function of insulin-making beta cells for a group of sedentary older people who are at risk of developing diabetes. The researchers from University of Michigan published their findings during March 2008 in Journal of Clinical Endocrinology and Metabolism. Although the study showed that short-term exercise boosts insulin sensitivity, how it might affect beta cell function remains a mystery.

Beta cell function is known to decline with age though the cause is not clear. Ageing may also make people less sensitive to the blood sugar-regulating effects of insulin and impaired insulin secretion may be developed.

There are 12 sedentary individuals aged 60 and above were examined in the study. They were asked to perform an hour-long workout every day for a week. Stints on a treadmill, exercise bike and cross-training machine were included in the exercise sessions. The participants were required to work out at 60 percent to 70 percent of their maximum allowable heart rate capacity.

At the end of one week, the sensitivity to insulin showed an increase of 53 percent, on average, and the beta cell function (called the disposition index) had raised by 28 percent for the study participants. Meanwhile, the researchers could not find any changes in the fat mass, levels of fat in the blood, or any other factors that might explain the effect of exercise on beta cells.

As such, the researchers indicates that longer-term exercise training studies are required and are in fact in progress currently to evaluate further exercise training effects on beta cell function in age-related glucose intolerance.

Diabetes is a condition, if not managed well, that might lead to other complications like kidney failure, blindness, and neuropathy. Meanwhile, a diabetic may have a higher risk of getting heart disease.

Avandia May Help Prevent Progression of Blockages After Heart Surgery!

It is not uncommon that a drug that is effective in treating one disease may end up a culprit that triggers another unwanted medical condition. Avandia, a diabetes drug, is a good example.

During May 2007, researchers reported in the New England Journal of Medicine that Avandia was found to raise the risk of a heart attack by 43 percent. This set off a stream of controversy, and even forced the regulators to require Avandia carry strong warnings about the heart attack risks.

However, a new study indicated that Avandia might prove to be effective in preventing the progression of blockages after heart surgery.

The study, dubbed “Victory”, was carried out by researchers from Laval University and Hospital Laval in Quebec City, evaluated the benefit and safety of the drug, genetically known as rosiglitazone, in preventing atherosclerosis progression in patients with Type-2 diabetes 1 to 10 years after surgery. Their findings were presented on April 1, 2008 at the American College of Cardiology meeting in Chicago.

The researchers also examined the metabolic effect of the drug. As such, the researchers claimed that this is the first study to look at the cardiovascular and metabolic affects of the drug. 193 patients at 8 centers in Canada and Spain were evaluated and the trial concluded there were no adverse events. Results also showed that the weight gain in patients was subcutaneous fat, not abdominal fat, which is more dangerous.

Although “Victory” is only a moderate size trial, its results provide reassurance about the safety of rosiglitazone. Rosiglitazone has been under strong attack because of the heart attack risk when comparing with Pioglitazone, the other glitazone compound. Pioglitazone, is sold as Actos in the United States and Glustin in Europe.

Other studies that involve a larger number of patients are also evaluating Avandia and the findings will further define its role in patients with Type-2 diabetes and coronary disease.

Over the next 10 years, it is expected that the number of patients with Type-2 diabetes, the most common form of diabetes, and coronary disease will increase dramatically.

Each year, more than 500,000 patients with Type-2 diabetes undergo coronary artery bypass grafts and most will have one or more bypasses using a vein taken from the leg. Sad to say, the grafts of 50 percent of the patients become re-obstructed after 10 years.

If You Have High Cholesterol, Take Statin First!

A person with high cholesterol level is subject to high risk of developing heart disease, stroke, or high blood pressure. This is an undeniable fact. Therefore, when your cholesterol level reaches a dangerous high level, your family doctor will almost certainly advise you to take some cholesterol drug to help control the level. Then, the next question is which drug to take?

On March 31, 2008, a new study reported by American College of Cardiology (ACC) that patients having trouble controlling their cholesterol levels should first take stronger doses of statin drugs before trying Vytorin. The findings reinforced earlier findings that Vytorin worked no better than an older, cheaper statin in reversing the progression of heart disease.

Vytorin combines the statin Zocor with another cholesterol medicine, Zetia (or ezetimibe), is marketed by a joint venture of Merck and Schering-Plough. Vytorin is claimed to be the only product that can help block the absorption of cholesterol coming from food, and reduce the cholesterol made naturally by the body. Vytorin can lower LDL (bad) cholesterol, total cholesterol and triglycerides (fatty substances in the body), as well as raise HDL (good) cholesterol. Nevertheless, it has not been shown to reduce heart attacks or strokes more than Zocor alone.

In the views of the group, representing heart specialists, the results of this new study should be taken into consideration while the National Heart, Lung, and Blood Institute (NHLBI) is working to update its national cholesterol treatment guidelines. The new study, known as “Enhance”, actually mirrored the results obtained in January that found that Vytorin failed to show that it is any better than a cheaper generic statin in reducing the thickness of artery walls in patients with an inherited form of heart disease.

Because of the lack of beneficial evidence, an ACC expert panel recommended that doctors should first put patients on a high-dose statin, and then try other drugs before reaching for Vytorin or Zetia.

The results also suggests it is necessary to stick to the current American College of Cardiology/American Heart Association Guidelines, which recommend statins to the maximally tolerated dose or to goal as first-line treatment for patients with coronary artery disease.

Heart Disease Risk Is Associated with Lipoprotein(a) Level!

Recently, I read an article titled: “blood protein linked to heart disease”. It sounds interesting so I read on. The blood protein actually referred to lipoprotein(a), which is a compound that carries fats in the blood.

A recent study conducted by researchers from the University of Cambridge, UK, linked risk of heart disease to the levels of lipoprotein(a): when one has higher levels of lipoprotein(a), his or her chance of getting heart disease is higher! They published their findings in the “Archives of Internal Medicine”.

In fact, a number of lipoproteins do exist, but lipoprotein(a) differs from others: its levels do not change with diet and exercise. They remain more or less stable and seem to reflect a person's genetic makeup.

By examining data on participants in an Icelandic study that began in 1967, the researchers measured levels of lipoprotein(a) in 2,047 subjects who later died from heart disease, and in 3,921 subjects who did not die from heart disease.

After adjusting for the effect of established risk factors, the subjects with the highest levels of lipoprotein(a) were 60 percent more likely to develop heart disease than those with the lowest levels. Furthermore, the higher the level of lipoprotein(a), the greater the risk of heart disease.

In the study, no correlation was found between risk factors like older age, high cholesterol and high blood pressure and the level of lipoprotein(a). Therefore, measuring lipoprotein(a) levels may provide information above and beyond that obtained from merely looking at the traditional risk factors.

Such deduction undoubtedly provides persuasive evidence that lipoprotein(a) is related to the risk of subsequent heart disease. The researchers felt that the data from the study should generate interest in research that can discover if there is a cause-and-effect relationship between lipoprotein(a) and heart disease, and hope that further studies will be carried out to investigate the value of lipoprotein(a) measurement in preventing heart disease.

Why Bitter Melon Is Good For Diabetics?

The existing drugs for diabetes have been accused of their side effects and limited action. This has therefore prompted for searching of alternatives to treat diabetes.

Bitter melon, also known as balsam pear, is a plant eaten and used medicinally in many parts of Asia. In a recent study, it was found that substances from bitter melon could provide the basis of new drugs for treating diabetes and obesity. As we know, diabetes and obesity are two of the risk factors for heart disease.

The researchers from the Chinese Academy of Sciences in Shanghai reported in the Journal Chemistry and Biology that bitter melon has shown to reduce blood sugar in animal and human studies.

In the current study, the researchers isolated and described several compounds from bitter melon known as cucurbitane triterpenoids, and tested their effects on glucose (sugar) and fat metabolism in cells and in mice.

When tested in muscle and fat cells, the compounds stimulated the glucose receptor GLUT4 to move from the cell interior to the cell surface, thus promoting more effective glucose metabolism. Several of the tested compounds had effects comparable to those of insulin.

When tested in mice, two of the compounds promoted both glucose tolerance and fat burning, and one was particularly effective in promoting glucose tolerance in animals consuming high fat diets.

As revealed in the study, there may be as many as 70 active compounds in bitter melon. The researchers concluded that the present study provided an important basis for further analysis of structure-activity relationship to develop optimized leads from bitter melon for the treatment of insulin resistance and obesity.

Can Risk of Child Diabetes Be Lowered By Taking Vitamin D?

Diabetes is a chronic disease in which human body does not produce enough of the hormone insulin, or cannot make proper use of the insulin it produces (insulin resistance). A diabetic, who does not manage the condition seriously, could likely become a candidate for heart disease.

There are 2 types of diabetes, namely Type-1 and Type-2 diabetes.

Type-1 diabetes is a condition in which beta cells in the pancreas that produce insulin are destroyed in early childhood by the body's immune system. The disease is very common among people of European descent, affecting around 2 million Europeans and North Americans. The reasons are still unclear.

Type 2 diabetes, which is far more common, is associated mainly with an unhealthy diet and sedentary lifestyle. It is becoming epidemic in many developed or fast-developing countries.

New evidence reported on March 13, 2008 in specialist journal “Archives of Disease in Childhood” that taking vitamin D supplements in infancy might help a youngster prevent Type-1 diabetes.

Doctors from St. Mary's Hospital for Women and Children in Manchester, northern England looked at 5 studies in which children were monitored from infancy to early childhood to see if vitamin D supplements could reduce the risk of becoming diabetic.

The risk of getting diabetes was reduced 29 percent in children who took extra vitamin D as compared to those who had not.

Higher Total Cholesterol May Increase The Risk of Plaque Rupture!

We always accuse LDL (so-called bad cholesterol) as the culprit that causes heart attack, stroke, high blood pressure, etc. Not so much attention is given to someone with higher than average total cholesterol level, provided the HDL (good cholesterol) level is at healthy level.

However, the findings of a new study conducted by a group of investigators from Johns Hopkins School of Medicine, Baltimore may change such perspective. Published in February 2008 in the medical journal Stroke, the report revealed that the total blood levels of cholesterol in individuals without symptoms but have thickened walls of the carotid arteries are strongly associated with the presence of a lipid (or fat-based) core within plaque, which can cause the arteries to rupture.

The carotid arteries are two major arteries located on each side of the neck that provide blood and oxygen to the brain.

Made up of fatty dead tissue deposits, a lipid core within an atherosclerotic plaque puts the plaque at risk for causing an adverse clinical event, such as a stroke if the plaque is in the carotid artery or a heart attack if the plaque is in the coronary artery.

By taking part in a study of atherosclerosis (also referred to as hardening of the arteries), the participants were examined by ultrasound to ensure they are free from cardiovascular disease and those with the thickest carotid artery walls were selected.

The researchers used MRI and analysis software to assess the composition of 214 plaques with a thickness of at least 1.5 millimeter and found a lipid core in 151 (71 percent) of these plaques.

Compared with patients with the lowest levels of total blood cholesterol, those with medium levels had a 2.8-fold increased risk of having a lipid core, after adjusting the possible effects of age, sex, high blood pressure and diabetes. Those with the highest cholesterol levels had a 4.6-fold increased risk of having a plaque with a lipid core. None of the cardiovascular risk factors other than high serum cholesterol was associated with having a lipid core.

The researchers concluded that a person’s total cholesterol level is the most important risk factor for developing the dangerous feature of plaque mentioned above. This indeed supports the claim that by lowering a person’s cholesterol level and hence the risk of the formation of lipid core might reduce his or her risk of the possible clinical events.

Salty Food Can Put On Extra Weight On The Kids!

When kids eat too much salty food, they will get thirsty easily, and what they turn to is soda-filled sugary drink instead of plain water. Several studies have shown a link between sugary soft drinks and obesity in children. This may explain why childhood obesity has become an epidemic that both developed and developing countries have found it difficult to handle.

British researchers at St George's University of London found that cutting back on the salt intake for kids might be a good way to cut the calories they consume. This is the findings of a study published on February 20, 2008 in an American Heart Association Journal. Using the diet data from Great Britain's National Diet and Nutrition Survey, the researchers looked at 1,688 British boys and girls, with ages between 4 and18 years old, over a 7-day period in 1997.

The researchers indicated that salt is 'a hidden factor in the obesity epidemic'. About 80 percent of salt actually comes from manufactured food and not from the saltshaker, which only contributed less than 10 to 15 percent.

As pointed out by a health expert, fast foods are just loaded with sodium, but processed foods are all very high in sodium.

Lower intake of salt can reduce the amount of soft drinks and therefore fewer calories consumed by kids. A modest reduction in salt could even help lower blood pressure. It is known that high blood pressure increases the risk of later-in-life heart disease, heart attack and stroke.

The researchers suggested that food manufacturers could reduce the salt gradually without even noticed by the public; a 10 to 20 percent reduction in salt can barely be detected. It is imperative for the food industry to make such a reduction because the study found that cutting in half the amount of salt British children consume (a decrease of about half a teaspoon a day) would lead to an average reduction of about 510 gm of sugar-sweetened soft drinks per week.