Today's Post: Friday, 12-11-2009
It starts with how we can find out our current risk of heart disease.
We begin this post with the several risk factors for heart disease and heart attacks we now know are important and which predict your risk well.
But after them, we include an easier and cheaper indicator based on how fat you are that is just a predictive an indicator as the others.
Some people have only heard that high total cholesterol is a risk factor.
We now know that a set of several factors gives a much better picture of your real risk of heart disease.
That’s good news for 2 reasons.
First, if they are all in the danger zone, you know you should make out your will or update it right away -- AND do something to improve these measures if you’d like to live a bit longer or avoid a heart attack.
Second, there are several things & several things other than drugs that you can do to improve each one or prevent it from getting worse if it’s still good or OK.
a) The ratio of your HDL to your triglycerides, researchers and research doctors found, gives you an a very accurate picture of your blood level of the small particle LDL that is a direct cause of cardiovascular disease.
If your HDL reading is greater than your triglyceride reading, that’s excellent and safest. Conversely, if your triglyceride reading is more than 6 times your HDL, you are at very high risk. (Exercise AND never ingesting trans fats or hydrogenated oils lower small particle LDL directly. And you can do other things that increase HDL & others that lower triglycerides.)
b) Exposure to tobacco smoke.
If you smoke heavily or even a few cigarettes a day and are around second hand smoke, you ALREADY HAVE cardiovascular disease; it’s getting worse every day because or your smoke exposure; and are at extra risk of having a heart attack be triggered by the smoke. Very few smokers have ever learned just how severe this risk is. All too often now, they find out as they experience a fatal heart attack. (Not beginning to smoke or quitting helps. Coming close to completely avoiding second hand smoke helps. And voting for laws restricting where people can smoke and increased taxes on tobacco products and even higher taxes on the smokable kinds such as cigarettes, cigars, and pipe tobacco each help.)
c) CRP, c-reactive protein, a measure of inflammation, often measured by HSCRP test.
(The HS stands for high sensitivity.)
Less than 0.3 is excellent; over 1.0 is risky; & over 2.0 begins to be quite dangerous. (Regular exercise, getting lots of the omega 3 oils, DHA & EPA; NOT ingesting meat from grain fed animals or doing it often; NOT ingesting soy, corn, or other high omega 6 oils –extra virgin olive oil is an OK & health supporting alternative, and cutting way back on eating refined grain foods or sugars each lowers inflammation. Taking enough vitamin D to get fewer infections and avoiding tobacco smoke also probably helps.)
8.0 or less is ideal; above 9.0 begins to indicate risk; & 12.0 or higher is high risk though because such readings have been so common, some doctors have though they were less risky since so many people scored that high. You can lower the readings by taking B complex vitamins, eating a lot of foods high in folic acid, and taking the supplements NAC and TMG.
But your real risk may not go down if you don’t optimize all the other readings since your homocysteine may be more a reflection of them and not a causative agent. And, to the extent homocysteine itself is a cause of heart disease, if your blood vessels are already clogged with plaque from having a had that high level for too long, lowering it then may be like locking the barn door after your horse has been stolen – too late to do any good. That said, those supplements and the green vegetables high in folic acid each have abundant other health benefits.
e) High blood sugar &/or type 2 diabetes.
Fasting glucose of less than 90 & HBA1C less than 5.7 are lower risk of creating damage your blood vessels and creating or worsening heart disease; & fasting glucose of more than 120 & HBA1C more than 5.9 begin to be indicative of type 2 diabetes and indicate very high risk. (Eating very little sugar, NOT eating starchy foods or foods made from refined grains, and getting regular vigorous exercise such as interval cardio &/or strength training tend to help. Taking some supplements such as alpha lipoic acid, chromium, and some others also can help.)
f) High blood pressure.
119 over 79 or a bit less is low risk; over 140 over 90 is considered low level high blood pressure; and over 160 over 100 is dangerous enough as bad as the side effects tend to be taking drugs to lower it is safer for you according to the tests that have been done.
(Most vitamins and many minerals and some supplements help keep blood pressure lower to some degree; CoQ10 or its end result version, ubiquinol, lower high blood pressure as well or better than most drugs; getting physical stress relief is sometimes more effective than drugs and can help even when they are ineffective; combining eating several servings a day of vegetables and some of whole fresh fruit – all high in potassium – with eating very little salt and no foods containing lots of salt works well for many; exercise helps; but one of the best and most effective methods is to lose your excess fat if you have much of it.)
g) This is the new one to make 7 indicators we can use. <<<<<
Waist measurement at the navel.
Now, in addition to those 6 indicators, we have one that relates to each of them except smoking; but is so easy to do and inexpensive and low tech and noninvasive, you can easily do it yourself at home. And it is every bit as predictive a measure of heart attack risk research has found.
If you relax your gut to the level that is natural for you as you walk or sit and, as you are standing, you measure your waist with the tape going right over your navel – not lower down or higher, that we now know is that good an indicator of heart attack risk.
On Monday this week Reuters reported a story they titled,
“Body mass and waist size can predict heart disease.”
A 10 year study by Dutch researchers found that how fat people are is a very good predictor of heart attack risk and an even better predictor of fatal heart attacks.
They did use BMI readings too. But the most accurate measure of how much excess fat you have is your waist size which they also used.
"…. more than half (53 percent) of all fatal heart disease cases and around a quarter (25-30 percent) of all non-fatal cases were in people defined as overweight and obese.”
For men, they counted waist sizes of 36.9 inches or less as being OK fat wise; 37.0 inches to 40.0 inches as being overweight (somewhat to definitely too fat but not dreadfully so); & 40.1 or more as obese ( really fat.)
For women these they counted waist sizes of 31.4 inches or less as being OK fat wise; 31.5 inches to 34.5 inches as being overweight (somewhat to definitely too fat but not dreadfully so); & 34.6 inches or more as obese ( really fat.)
Other researchers have made similar findings; & the consensus is that in men, it’s important to keep your waist size below 40 inches and below 35 inches in women. And as we’ve seen 36 inches or a bit less in men is better and 31 inches or a bit less in women is better also.
The reason is pretty clear, people who eat the things that cause problems in all the other indicators except smoking and who don’t exercise will virtually all be too fat. In addition, being too fat directly and separately causes high blood pressure.
Fat loss and the lifestyle that creates it and sustains it, have been shown to improve virtually all the other heart attack risk factors except smoking.
So, if you are fatter than you should be, if you lose that fat – and do so largely by eating much better and exercising, your heart attack risk will go down a lot. And, it will go down as well if you also lose a bit more fat with some kind of sustainable calorie restriction.