Being overweight (BMI > 25) or obese (BMI > 30) has long been associated with an increased risk of heart disease. The lowest mortality from cardiovascular disease (CVD) and all other causes combined was found in both men and women with a BMI of 19.0 to 21.9. The association between BMI and heart disease weakens with age, but overall risk and absolute risk both increase with age. Data from the long-running Framingham Study found about a 30% increase in the risk of CVD for a 10% increase in body weight.
Being overweight increases the risk of developing Type 2 diabetes, hypertension, higher levels of triglycerides (TG) and apo B, an increased preponderance of small dense LDL particles (a.k.a. phenotype B), higher levels of fibrinogen and plasma activator inhibitor-I, a more exaggerated postprandial lipemia and a lower HDL. All of these factors have been shown to increase the risk of heart disease. Weight loss has been shown to reduce all of these risk factors. Weight loss has also been shown to slow the progression of atherosclerosis in obese people close to that of lean controls in a four-year study. In this study, the control obese subjects (who lost no weight) experienced a nearly 3-fold faster progression of their atherosclerosis as measured by changes in the intima-media thickness than those who lost weight and kept it off.
It is not unusual for HDL to drop during active weight-loss. However, HDL usually recovers to higher than pre-diet levels if the lower body weight is maintained. Regular exercise should help raise HDL, lower TG and reduce insulin resistance. A goal of burning at least 300-400 kcal daily or 2000 kcal per week will not only promote weight loss but may improve many other heart disease risk factors seen in people with Syndrome X.
Very impressive improvement in blood lipids were seen when weight loss resulted from the ad libitum consumption of a diet made up largely of unrefined high-CHO foods. On this diet, there was a dramatic reduction in TC (-33%), LDL (-41%), and TG (-21%), but no effect on HDL after 3 months and an average weight loss of 16 lbs. More importantly a very-low fat, near vegetarian diet has been shown to regress atherosclerosis and dramatically improve blood flow to the heart muscle. The best approach for overweight people at high risk for heart disease is a very-low-fat, high-fiber diet composed largely of unrefined high-CHO foods coupled with regular aerobic exercise. (Excerpted from 21st Century Heart)
Dr. James J. Kenney, PhD, RD, FACN
Judy’s passion for cooking began with helping her grandmother make raisin oatmeal for breakfast. From there she earned her first food service job at 15, was accepted to the world-famous Culinary Institute of America at 18 (where she graduated second in her class), and went on to the Fachschule Richemont in Switzerland where she focused on pastry arts and baking. After a decade in food service for Hyatt Hotels, Judy launched Food and Health Communications to focus on flavor and health. She graduated with Summa Cum Laude distinction from Johnson and Wales University with a BS in Culinary Art, holds a master’s degree in Food Business from the Culinary Institute of America, 2 art certificates from UC Berkeley Extension, and runs a food photography studio where her love is creating fun recipes.
Judy received The Culinary Institute of America’s Pro Chef II certification, the American Culinary Federation Bronze Medal, Gold Medal, and ACF Chef of the Year. Her enthusiasm for eating nutritiously and deliciously leads her to constantly innovate and use the latest in nutritional science and Dietary Guidelines to guide her creativity, from putting new twists on fajitas to adapting Italian brownies to include ingredients like toasted nuts and cooked honey. Judy’s publishing company, Food and Health Communications, is dedicated to her vision that everyone can make food that tastes as good as it is for you.