Prevention Research for Cardiovascular Disease

The Hope Heart Institute - Changing The Course Of Cardiovascular Disease

Obesity and Heart Disease

Why should we care about managing our families’ weight? Obesity in America has been on the rise since the 1970s. Today, approximately 65% of adults are overweight, with sixty-one million of them considered obese. Overweight and obese adults will have a shorter life span than previous generations. The causes of being overweight and obese include ultra-processed food, fast-food, increased caloric-intake, decreased activity and exercise, increased stress, poor parenting, and inadequate weight loss programs. All of the commercial weight loss programs fail to keep weight off post program. In addition, they can cause decreased calorie burn and hunger, and do not address lifestyle change. The commercial diets we see advertised can cause loss of muscle (which decreases metabolism) and change the microbiomes of the intestinal tract causing hunger and further loss of metabolism.

About 30 years ago, the weight of children and adolescents began to increase. We were aware of this at The Hope Heart Institute and started our research on how to treat the adult obesity epidemic and expanded our research into childhood obesity. Today we not only have obese children, but many are super obese. In the period of 2015 – 2016, of children 2 to 5 years old, 15% were obese and 2% severely obese: of Children 6 – 11 years old, 18% were obese and 5% severely obese: of Adolescents 12 – 19 years old, 21% were obese and 8% severely obese. Long term, childhood obesity is associated with increased cardiovascular disease, hip and knee osteoarthritis and multiple cancers.

Any extra pounds usually add up to health problems. In adults, overweight and obesity are linked to increased body inflammation which results in heart disease, high cholesterol, high blood pressure, diabetes, many cancers, osteoarthritis, depression, sleep problems, and many other conditions.

For children, being overweight starts “body inflammation” earlier in life. This can result in the same disorders found in adults: High cholesterol, high blood pressure and Type 2 Diabetes. A generation ago, Type 2 Diabetes in children was unheard of. Now physicians are treating this disease in kids as young as four years old. Overweight children are also more likely to become overweight or obese adults about 80% of the time.

A person’s weight is the result of many things working together – genes, microbiomes, activity level, behavior, and environment to name just a few.

Changes in our environment that are making it harder to engage in healthy behavior have a lot to do with our overall increase in weight over the past few decades. For example:
• We’re an in-the-car and sit-behind-a-desk society. For many of us – parents and children alike – daily life doesn’t involve a lot of physical activity. So we need fewer calories than the previous generation. If we want to be active, we have to make an effort.
• Food is everywhere, along with messages telling us to eat, drink and feel good. We can get something to eat in places where it was never available before – like the gas station. Going out to eat or buying carryout is easy. The foods we consume away from home are high in calories, saturated fat and salt. Today over 50% of meals are eaten away from home and another 15% - 20% are meals that are prepared in restaurants and carried home to the family.
• Food portions at restaurants, and at home, are bigger than they used to be. Restaurants don’t want us to go away hungry so they serve two to three times the amount our bodies need.

In the 1980s we started researching how to successfully treat the overweight/obese epidemic and continue today with programs like 20/20 LifeStyles, which has added the review of patient’s genetics to further personalize their program. For the last several years, we have been studying gut microbiomes to determine their relationship to weight gain, diseases and disorders like Type 2 Diabetes.

We also created a children’s program called Committed to Kids which had great long term weight maintenance results of more than 75% after three years. The program saw the most success when parents were engaged in their child’s weight loss program since parents play a key role in their children’s choices and behaviors. We have found that some parents, who do not engage, are in denial regarding their child’s unhealthy lifestyle behaviors, such as poor diet and lack of exercise. Our psychology team is searching for the right message to overcome this resistance. We hope that the addition of genetic screening and the ability to review the child’s genetic profile will aid in parental participation.

Aiming for a Healthy Weight

To help your family get on the road to maintaining a healthy weight, here's a list of small steps to eat well (ENERGY IN) and move more (ENERGY OUT) that you or the family can do together to balance your energy everyday. Choose a different "eat well" and "move more" tip each week for you and your family to try.

Eat Well (ENERGY IN) Move More (ENERGY OUT)

  • Drink water before a meal.
  • Share dessert, or choose fruit instead.
  • Serve food portions no larger than your fist.
  • Eat off smaller plates.
  • Don't eat late at night.
  • Skip buffets.
  • Grill, steam, or bake instead of frying.
  • Share an entree with a family member or friend.
  • Eat before grocery shopping.
  • Choose a checkout line without a candy display.
  • Make a grocery list before you shop.
  • Serve water or low-fat milk at meals instead of soda or sugary drinks.
  • Flavor foods with herbs, spices, and low-fat seasonings.
  • Keep to a regular eating schedule. Eat together as a family most days of the week.
  • Eat before you get too hungry.
  • Ensure your family eats breakfast everyday.
  • Stop eating when you are full.
  • Provide plenty of fruits and vegetables for snacks.
  • Provide sliced apples or bananas for your family to top their favorite cereal.
  • Serve several whole grain foods daily.
  • If entrees are large, choose an appetizer or side dish.
  • Ask for salad dressing "on the side."
  • Don't serve seconds.
  • Try a green salad instead of fries.
  • Walk your children to school.
  • Do sit-ups in front of the TV. Challenge your children to see who can do the most sit-ups in one minute.
  • Walk instead of drive whenever you can.
  • Take a family walk after dinner.
  • Join an exercise group and enroll your children in community sports teams or lessons.
  • Replace a Sunday drive with a Sunday walk.
  • Do yard work. Get your children to help rake, weed, or plant.
  • Get off the bus a stop early and walk.
  • Work around the house. Ask your children for help doing active chores.
  • Take the dog to the park.
  • Go for a half-hour walk instead of watching TV.
  • Wash the car by hand.
  • Pace the sidelines at kids' athletic games.
  • Choose an activity that fits into your daily life. Being physically active with your family is a great way to spend time together.
  • Park farther from the store and walk.
  • Use an exercise video if the weather is bad.
  • Perform gardening or home repair activities.
  • Avoid labor-saving devices, such as a remote control or electric mixers.
  • Play with your kids 30 minutes a day.
  • Dance to music. Play your favorite dance music for your children and have them play their favorites for you.
  • Make a Saturday morning walk a family habit.
  • Walk briskly in the mall.
  • Choose activities you enjoy—you'll be more likely to stick with them. Ask children what activities they want to do.

Body Mass Index (BMI)

For adults, a healthy weight is defined as the appropriate weight in relation to height. This ratio of weight to height is known as the body mass index (BMI). People who are overweight might have too much body weight for their height. People who are obese almost always have a large amount of body fat in relation to their height. There are exceptions, of course. Big athletes with lots of muscle might have a BMI over 30.0 but would not be considered obese from the perspective of health risk.
Use a BMI calculator for adults and learn your BMI by entering your height and weight.

For children and teens, overweight is defined differently than it is for adults. Because children are still growing, and boys and girls develop at different rates, BMIs for children 2 to 20 years old are determined by comparing their weight and height against growth charts that take their age and gender into account.

A child's "BMI-for-age" shows how his or her BMI compares with other boys or girls of the same age. A child or teen who is between the 85th and 95th percentile on the growth chart is considered at risk of overweight. A child or teen who is at the 95th percentile or above is considered overweight.

Ask your family doctor, pediatrician, or other health care provider about your child's BMI-for-age. Click here for more information about BMI-for-age and growth charts for children.

Study: Fruit, veggies good for the heart

A multiyear study involving more than 100,000 participants provides added support that eating lots of fruit and vegetables is good for the heart. The report supports the American Heart Association's recommendations to consume at least five servings of fruit and vegetables per day.

Fruits were more strongly associated with reduced heart disease than vegetables, the researchers said. Among vegetables, those most closely related to better heart health were green leafy vegetables.

The truth about wine

The most studied benefit to date of drinking red wine is the lowering of heart disease. Studies on polyphenols in wine and the various compounds are shown to prevent heart disease.

Some studies say one glass of wine daily is recommended. Others suggest two. Doctors say stick to one or two glasses a day. If you have high blood pressure, doctors recommend a glass of wine ever other day because alcohol is a factor in hypertension. You can get some of the same health benefits of wine from grape juice.

Depression may be bad for your heart

New research is adding to evidence of a link between depression and problems like heart attack and stroke. A study of post-menopausal women finds depression increases the chances of death from cardiovascular disease, even when there is no history of cardiovascular illness. Women without diagnosed depression, but with depressive symptoms like feeling sad, being tired, and having trouble sleeping were 1 1/2 times more likely to die of a cardiovascular illness compared with women who had no depressive symptoms.
Women with depressive symptoms were 12-percent more likely to have high blood pressure and 60 percent more likely than non-depressed women to have a history of cardiovascular illness. Though they don't understand the metabolic connection, researchers say this adds to evidence that depression is an independent risk factor for cardiovascular illness. Several studies in the past have found a higher rate of depression among patients with cardiovascular disease.

Research taken from the Albert Einstein School of Medicine.

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