Tale of the Tape

[Guest guest]

" HSI - Jenny Thompson " <hsiresearch

HSI e-Alert - Tale of the Tape

Mon, 14 Nov 2005 07:00:00 -0400

 

 

 

HSI e-Alert - Tale of the Tape

 

Health Sciences Institute e-Alert

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November 14, 2005

 

 

 

Dear Reader,

 

Obesity is one of the key risk factors for cardiovascular disease.

This fact is well known. But what's the best way to measure obesity to

predict a decline in heart health?

 

One common measure is body mass index (BMI), which is an estimate of

your total body fat based on your weight and height. As I've mentioned

in previous e-Alerts, a BMI above 25 is considered overweight, and 30

or above indicates obesity. (You can calculate your BMI with the

Centers for Disease Control BMI calculator at cdc.gov.)

 

But critics of the BMI point out that many athletes in peak physical

shape actually have high BMI numbers because their superior muscle

tone adds to their weight. So (goes the argument) Shaquille O'Neill

might have a BMI that's in the overweight zone, but he's surely not at

higher risk of heart disease because of it.

 

That's a valid point, but it's academic because after we ask all the

first-class athletes to leave the room, those of us left behind can

feel completely secure in using the BMI to assess weight issues and

heart disease risk. In other words, a borderline couch potato

shouldn't compare Shaq's BMI to his own unless he's trying to get a laugh.

 

So the BMI is a useful measure. Imperfect, perhaps, but useful. And

now that I've defended BMI's honor, it's time to look at a new study

published in this month's Lancet that demonstrates how another obesity

measurement may be the most accurate predictor of heart attack risk.

 

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Measure for measure

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Last year I told you about the INTERHEART study in the e-Alert " Waking

Up is Hard to Do " (9/20/04). The editors of The Lancet called

INTERHEART the most " robust " study ever conduced on heart attack risk

factors.

 

The international team of investigators that conducted the ten-year

INTERHEART research recently finished a new analysis of their data,

gathered from more than 27,000 participants among several major ethnic

groups in 52 countries. More than 12,400 of these subjects had

suffered acute heart attacks. The other subjects - included as

controls - were in good health. Incidence of heart attack was assessed

in relation to subjects' BMI and waist-to-hip ratios (WHR; a

comparison of the circumference of the waist to the circumference of

the hips).

 

The results showed a " modest " association between high BMI and heart

attack risk. But for waist-to-hip ratio the results were more

dramatic. When subjects were grouped from lowest WHR to highest, the

risk of heart attack steadily rose as well. Subjects with the greatest

WHR were found to be at two and a half times greater risk compared to

subjects with the smallest WHR.

 

According to an accompanying article in the Lancet, " This result

suggests that previous estimates of the impact of obesity as a

cardiovascular risk factor have been too low. "

 

Needless to say, a slender hip circumference isn't the problem here;

it's all about the abdominal fat. And heart attack risk is only one

part of the problem. In the e-Alert " Extra Baggage " (5/18/05), I told

you about a 23-year study that showed how excessive abdominal fat

raises the risk of factors associated with metabolic syndrome, such as

type 2 diabetes, high blood pressure and heart disease.

 

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Protein power

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When the INTERHEART researchers first reported on their study last

year, they noted that the relative risk for heart attack can be

lowered by about 80 percent by doing three things: getting regular

exercise, eating plenty of fruits and vegetables, and avoiding smoking.

 

No surprises there, especially with that first item. When it comes to

reducing abdominal fat, regular exercise is a must. To get rid of that

extra baggage around the middle, you're going to have to get up and

get moving.

 

But once you do get moving, there are other ways to help the cause.

 

In the e-Alert " Pretzel Logic " (3/3/05), I looked at a study that

showed how a high-glycemic diet (that is; a diet with plenty of

simple, refined carbohydrates) is strongly associated with obesity and

a tendency to be overweight.

 

And in the e-Alert " Beef 'n' Butter " (4/20/04), I told you how an

intake of a fatty acid called conjugated linoleic acid (CLA) may

provide some help when it comes to getting rid of excess body fat,

especially in the abdominal area. CLA is available in supplement form

and from protein-rich dietary sources such as meat and dairy products.

 

This association between protein intake and a trimmer waist was

confirmed in a study published in the Journal of Nutrition.

Researchers from Canada's Population Health Research Institute

recruited more than 600 male and female subjects with a variety of

ethnic backgrounds. After subjects completed food frequency

questionnaires they were measured to determine WHR. Energy intake from

protein averaged less than 16 percent in subjects with the highest WHR.

 

Those with the lowest WHR averaged 17.4 percent energy intake from

protein. In their conclusion the authors wrote: " Substituting a modest

amount of protein for carbohydrate may reduce abdominal obesity. "

 

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....and another thing

 

Looking for real-world advice on health care issues? Just browse

through a few of the comments on the HSI Healthier Talk forums and

you'll find a wealth of personal testimonials and useful recommendations.

 

For instance...in the Headaches/Migraine forum, a member named Sekeeta

started a thread titled " Migraines...you can stop them cold. " Sekeeta

writes:

 

" " I've had migraines since I was 15...I am now 65...and I've found

something that stops them just like turning off a switch. Chocolate.

Yes, I know chocolate is a trigger, but it works just the same. If you

don't like, or don't want to eat chocolate (it works in any form, by

the way, even chocolate extract, as long as it actually is chocolate.

Nestle won't work, Hershey's works, Godiva is the best!), you can

simply take a magnesium capsule. This has worked for me every single

time I've done it and it has worked for every single person that I've

told about it.

 

" The really nice thing is that, after awhile, the migraines come less

and less frequently. As always, the earlier you eat the chocolate or

take the magnesium, the quicker the migraine will go away. Oh, and if

you decide to eat chocolate to fix the problem, don't just munch a

tiny little square of the stuff...eat the entire bar at one sitting.

It takes a fair amount of chocolate. One capsule of magnesium will do

the trick. "

 

The key phrase here is: " after awhile, the migraines come less and

less frequently. " Whether Sekeeta knows it or not, she's hit upon a

common condition among many migraine patients: magnesium deficiency.

 

Many factors contribute to magnesium depletion. High stress and

menstruation can take their toll on magnesium levels, while a heavy

intake of starches, alcohol, diuretics and some prescription drugs

(such as antibiotics) can increase urinary excretion of magnesium.

 

Magnesium is naturally present in green leafy vegetables, avocados,

nuts and seeds, and whole grains, but usually only in small amounts,

so you'd need to eat a wide variety of these foods regularly to get

all the magnesium you need.

 

In the e-Alert " Mind Over Matter " (5/27/05), HSI Panelist Allan

Spreen,M.D., offered these guidelines on magnesium supplementation:

" I've always recommended 500 mg/day, since absorption of most forms

isn't that great.

 

" Now, bear in mind that that's ELEMENTAL magnesium. In a supplement,

such as magnesium oxide, the tablet that is sold as a 400 mg tablet

only has 241.3 mg of elemental magnesium. So, when you take a '400 mg'

tablet, you aren't getting 400 mg of magnesium anyway. Plus, even the

label says you can take 2/day, or 800 mg. "

 

To find the Healthier Talk community forums, just choose " Forum " on

the HSI home page at hsibaltimore.com.

 

To Your Good Health,

 

Jenny Thompson

 

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Sources:

" Obesity and the Risk of Myocardial Infarction in 27,000 Participants

from 52 Countries: A Case-Control Study " The Lancet, Vol. 366, No.

9497, 11/5/05, thelancet.com " Global Study Confirms Best Heart Risk

Predictor " The Associated Press, 11/3/05, msnbc.com " Protein Intake is

Inversely Associated with Abdominal Obesity in a Multi-Ethnic

Population " Journal of Nutrition, Vol. 135, No. 5, May 2005,

ncbi.nlm.nih.gov

 

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