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Hearts at risk: a little fat'll do ya in

Men's Fitness, Jan, 2003

Is a modest beer gut as dangerous as the overfull-frontal variety?

Extreme obesity has long been associated with cardiovascular disease and heart failure, but it's been unclear whether overweight and lesser degrees of obesity also pose a hazard. The answer, according to a study published in the New England Journal of Medicine, is an incremental yes.

You don't have to shovel in stuffed-crust pizza and jelly doughnuts to ratchet up your risk factor. After adjusting for age, smoking status, alcohol consumption, hypertension and diabetes, the study found a 5 percent jump in the chance of heart failure for men per each increment of 1 in the body mass index.

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"Excess body weight is strongly and independently associated with a greater risk of heart failure," reports the National Institutes of Health. "This risk, which increases continuously with rising degrees of body weight, is 34 percent higher for overweight individuals and 104 percent higher for obese persons."

The government defines "overweight" as a body mass index of 25 to 29.9 and "obese" as a BMI of 30 or more. (A BMI calculator is available at www.cdc.gov, which notes that the results can be skewed for bodybuilders.)

Approximately 61 percent of the population is considered overweight or obese. The research, supported by the National Heart, Lung, and Blood Institute as part of the ongoing Framingham Heart Study, followed more than 5,000 subjects for nearly 15 years.

"Obesity has reached epidemic proportions in the United States, and it's increasing," says NHLBI Director Claude Lenfant, M.D. "While the death rate from heart disease has decreased, the death rate from heart failure has not declined. This study suggests that obesity is an important risk factor for heart failure. Promoting optimal body weight may help reduce the burden of heart failure we're seeing."

FAILURE SAFE

Nearly 5 million Americans suffer from heart failure, according to the National Institutes of Health, but the term is misleading. The heart doesn't actually fail; it simply loses some force and can't pump enough oxygen-rich blood through the body. The condition often goes unrecognized because the symptoms--shortness of breath during exercise or rest, excessive fatigue, swollen ankles or legs, frequent urination, and weight gain from fluid retention--are easily attributed to other problems or just to aging.

Heart failure can be managed with medication: diuretics, to remove excess fluid (coupled with potassium supplements to keep muscles working properly); ACE inhibitors, to dilate blood vessels; digitalis, to shore up the heart's pumping power; and beta blockers, to assist ventricular function. A physician-monitored exercise program is recommended to strengthen the heart, control weight and reduce blood pressure.

Hearts at risk: a little fat'll do ya in

Men's Fitness, Jan, 2003

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