February is heart health month. If you are like many, the determination of a New Year’s resolution to lose weight and be healthier may already be starting to wane. The following should give your resolve to lose or maintain a healthy weight an extra nudge, and provide a different perspective on heart health.
Many lifestyle factors influence heart health. In addition to regular exercise, a diet rich in fruits and vegetables, omega-3 fatty acids from fish and nuts, antioxidants like vitamins C and E, minerals like calcium and magnesium, CoEnzyme Q10, plant phytonutrients, and dietary fiber are all essential for a healthy heart.
Some factors that have a negative impact on heart health include:
- Excessive alcohol intake
- Unmanaged stress
- Nutrient poor diets
By far the most important factor negatively affecting heart health is excess body weight.
Previously, it was thought that fat was inert. But, being overweight or obese is not just a cosmetic problem. Now scientists understand that fat, especially intra-abdominal fat (belly fat), has a significant impact on metabolism, and greatly raises the risk for other health problems.
A recent meta-analysis involving 300,000 people showed that being overweight (BMI 25-29.9) boosted the risk of cardiovascular disease by 32%, and obesity (BMI > 30) increased the risk by 81%. Specifically, atherosclerosis, or hardening of the arteries, is present 10 times more often in obese people compared to normal weight individuals. Sudden cardiac death in obese adults can be as much as 40 times higher than for non-obese adults. None of this should really come as a surprise to most of us.
How does weight affect heart disease?
The heart is a muscle that functions as a pump to circulate blood through the arteries and veins of the body. Blood carries oxygen and nutrients to all tissues of the body, except the corneas of the eyes. To do this, each day an average heart pumps approximately 2,000 gallons of blood through 60,000 miles of vessels in the circulatory system of a normal weight adult.
To help illustrate how the heart and vascular system work to supply nutrients to every tissue of the body, I will use the analogy of a large garden.
Picture a huge garden. On an American Football field it stretches from a goal line to the 27 yard line, and from sideline to sideline. In order to cover every inch of it you have an extensive configuration of soaking hoses, one small electric pump the size of a small cantaloupe, and a water source that contains the nutrients and fertilizer needed for optimal growth of the garden plants. Each day, enough nutrient rich-water (2,000 gallons) is pumped through the system to cover this entire area ¼ inch deep. This is essentially what the heart is doing day after day, year after year. As long as the pump is maintained and the system stays clean, the water and nutrients will be efficiently supplied to every inch and the entire garden will flourish.
The first consequence of increased body weight on the heart is the increased blood volume (increased garden size). New tissue needs blood supply, so the vascular system expands to accommodate it. This also means the heart must work harder to pump blood through the new network, which may reduce oxygenation and nutrient replenishment in other tissues. For such rapid expansion, there must be a very active production of blood vessels to deliver oxygen, and in fact, every single fat cell is surrounded by capillaries. It is estimated that each additional pound of fat requires a mile of new blood vessels.
In our analogy, for each additional yard of garden, more hoses, nutrients and water are required, but the expanded garden is still nourished by the same small pump.
Overeating and obesity lead to elevated levels of free fatty acids and triglycerides in the blood stream and tissues, and contribute to diminished insulin sensitivity, atherosclerosis, and high blood pressure. Insulin insensitivity compromises the ability of the nutrients to get into the tissues to provide nourishment and energy.
Too much of the wrong nutrients getting into the vessels cause a waxy substance called plaque to build up inside the arteries. This begins to narrow and may eventually block the arteries. In order to compensate for the decreased flow, blood pressure increases. As the walls of the arteries try to defend themselves against the increased force of blood, they become stiffer, thicker, and narrower. This vicious cycle can lead to heart attack, stroke, and many other complications.
In our analogy, if oil, dirt and grease are pumped through the hoses in the garden, hoses and holes will begin to get clogged, reducing the water and nutrients to parts of the garden. Parts of the garden not getting sufficient nutrients and water will begin to die. Trying to compensate and pump more fluid through the hoses will only serve to clog it worse, and weak spots in the hoses can even crack or break.
Obesity can also damage the heart itself. The increased volume of blood requires the heart to pump a greater volume of blood with each heartbeat, putting extra strain on the heart. Additionally, the heart is an electrical organ that requires a series of electrical impulses that regulate heart muscle contractions. Obesity can disrupt this natural pacemaker and cause abnormal heart rhythms called arrhythmias. If severe, this can cause the heart to stop beating (cardiac arrest).
So, not only can the increased workload put strain on the electrical pump, but dirt, grease and grime can damage it enough that eventually the pump will stop working completely.
The good news is, there are simple steps we can take to re-establish a healthy cardiovascular system (garden).
First of all, losing weight will reduce the size of the garden. During weight loss, the body breaks down and reabsorbs the unneeded blood vessels from previous tissue. In addition to reducing the amount of dirt and grime going into the system, healthy nutrients (vitamins, phytonutrients, antioxidants, fiber) can help unclog, repair, strengthen and protect the entire system. Maintaining the health of the pump and system through regular exercise and cleaning will help ensure the pump works effectively, uninterrupted year after year as you reap the maximum benefit from every square inch of your garden.
If a smaller pant size or lower number on the scale are not motivation enough, remember that for every pound of fat lost you are getting rid of a mile or more of blood vessels, reducing the load on your heart, and enabling a higher quality of nutritional support to your whole body.
Arch Intern Med. 2007;167(16):1720-1728. http://archinte.jamanetwork.com/article.aspx?articleid=413025
Kannel WB, Plehn JF, Cupples LA. Cardiac failure and sudden death in the Framingham Study. Am Heart J. 1988;115:869–875.
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