Chaim is 46 years old and goes to see his doctor for his yearly physical examination. After checking him thoroughly and doing standard blood work, he finds that Chaim has blood pressure of 144/92 and his cholesterol, particularly his LDL (the bad stuff), is borderline high. The physician prescribes drugs to lower his blood pressure and begins 10mg of a statin drug to control his cholesterol levels, thus dealing with two risk factors for heart disease and stroke through drug intervention. But this is far from the full picture.
We have all heard about the risk factors for heart disease and coronary artery disease. There are about 20 altogether. Every hour of every day, we are all aging; we can’t turn back the chronological clock or change our family history. And if we were born with a low birth weight, there isn’t much we can do about that either.
But we can do something about most risk factors, and not necessarily with drug intervention. A smoker can stop smoking. A compulsive eater can regain control of his food patterns.
Yet there are many misconceptions when it comes to risk factors, and often, those things that really matter the most are not necessarily diagnosed through a blood test. Consequently, the underlying issue is that we have don’t always have accurate information as to what those risk factors actually are.
Dr. Michael Mogodam of the George Washington University School of Medicine and Associate Professor of Medicine at Georgetown University Medical School has studied the effects of the different risk factors extensively. Let’s look at his top four risk factors.
#1: The first and foremost risk factor is diabetes. Twenty-two million Americans have diabetes and another 20 million have insulin resistance and pre-diabetes. Aside from the many other complications of diabetes, we know that 80% of diabetics will eventually die of cardiovascular complications. Yet, this is a risk factor that can be prevented, dealt with, and even reversed. By eating properly (you should see a registered dietician and learn what constitutes proper eating for a diabetic), eating small amounts more often and beginning a formal and balanced exercise program, you can, in the majority of cases, control your diabetes. You may need medication as well until you can gain control. Staying generally active in addition to your planned exercise is also important.
#2: Being obese – particularly abdominal obesity. The Body Mass Index (BMI) is the most widely used gauge for measuring obesity. A reading of 30 or above would indicate obesity. Because the BMI has some inaccuracies built into it, a better way to determine your risk is to measure your waist-to-hip ratio as abdominal obesity is more of a risk factor than overall weight.
Take your waist circumference and divide it by your hip circumference. Look for a reading less than 0.9 for men and 0.75 for ladies. Higher readings indicate heart risk.
Tangible steps you can take to reverse this situation: 5 serving of vegetables, 3 servings of fruit per day and exercising 30 minutes per day are a great way to get started. Cut your overall calories but don’t eliminate entire food groups. Include monounsaturated fats in your diet such as nuts and olive oil. Proceed slowly and methodically with your weight loss, as rapid weight loss will almost always result in a rapid return of the weight.
#3: A sedentary lifestyle. Our lives are different today than they were 40 and 50 years ago. The workplace is now a sedentary setting in which most of us sit by a computer all day, after using cars or public transportation to get there (and everywhere), and riding the elevators to deliver us straight to our destination.
According to the Center for Disease Control and Prevention, sedentary lifestyle accounts for more than 250,000 deaths annually – more that the total deaths from colon, breast, and prostate cancers combined.
One 8-year study of 3,120 healthy women showed that being physically fit had an age-adjusted 900% advantage in the death rate from cardiovascular disease than sedentary women. The nurses’ study showed that those who engaged in moderate exercise had a 54% lower combined risk of heart attack and stroke.
No one has to be sedentary. Start with some simple walking and build up from there.
#4: Diet. Food need not be the enemy. And we don’t have to entirely eliminate foods we like. However, we know that including an abundance of fruits and vegetables and using whole grains will help keep all the western diseases away and will add years to your life.
Typical western diets have too many trans fats and saturated fats, lack vitamin D, don’t include enough sources of Omega-3 and have inadequate fiber and healthy fats.
Keeping the daily caloric intake to the amounts we need for maintaining a normal and healthy weight is also essential.
So there you have the first four risk factors.* Remember Chaim and his high cholesterol and high blood pressure? Those are in the top 20, but not the top four. Physicians are great at prescribing medication for these conditions, but are they prescribing active living and exercise, normal, healthy eating and even stress management?
Most likely, if you get serious and do the work to mitigate risk factors one through four, you will end up solving most of the other ones, too.
* If you would like to learn more about these risk factors, email me at alan@loseit.co.il and I will gladly send you the complete list.
Alan Freishtat is an A.C.E. certified personal trainer and a lifestyle fitness coach with over 16 years of professional experience. He is the co-director of the Jerusalem-based weight loss and stress reduction center Lose It! He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il.
