The new silent killer


THE silent killer of the 1970s, high blood pressure, is now replaced by metabolic syndrome, a cluster of three or more risk factors like abdominal obesity, high blood pressure, high triglycerides, abnormal lipids, and insulin resistance (pre-diabetes type 2).

The expanding waistlines of Americans (and Filipinos as well) in the past several decades have been alarming, not only from the cosmetic/physical point of view but, more importantly, from their adverse impact on health, morbidity and mortality. It is now obvious that “love handles” can be deadly.

The researchers from Charles E. Schmidt College of Medicine at Florida Atlantic University, in an article posted this year in the Journal of Cardiovascular Pharmacology and Therapeutics, stated that “being overweight and obesity contribute to metabolic syndrome, which affects 1 in 3 adults and about 40 percent of adults aged 40 and older…that the risk factors are more than just the sum of their parts.”

Obesity is indeed surpassing tobacco as the preeminent preventable cause of early morbidity and premature deaths in the United States and globally.

The rule of thumb is that optimizing health requires and includes a waistline of less than 40 in men and less than 35 in women, and a healthy lifestyle: diet, exercise, abstinence from tobacco, disciplined alcohol intake, and stress management.

The authors of the study explain “that the visceral fat component of abdominal obesity leads not only to insulin resistance but also to the release of non-esterified free fatty acids from adipose tissues or body fat…the lipids then accumulate in other sites such as the liver and muscles, further predisposing individuals to insulin resistance and dyslipidemia-abnormal amounts of lipids…and adipose tissue may produce various adipokines that may separately impact insulin resistance and cardiovascular disease risk factors.”

Persons with metabolic syndrome are generally without symptoms and are severely underdiagnosed and untreated, but have a 10-year risk of a first heart attack, according to the Framingham Risk score of 16 to 18 percent, which puts them in a higher risk category similar to those who already had a previous heart attack.

Various clinical studies have shown that even with a normal Body Mass Index (BMI), individuals with expanding waistlines from visceral fats could still have metabolic syndrome. Those who consume soft drinks of any kind, cola, diet or regular, caffeinated or not, have a higher risk for the development of metabolic syndrome, especially children. Indeed, soft drinks are toxic to our body and to our DNA.

As I have highlighted in the book, “Let’s Stop ‘Killing’ Our Children,” healthy lifestyle and disease prevention, in order to be fully effective, must start in the womb, and dieting and discipline must begin in the crib to protect the children’s DNA. This preemptive and proactive strategy at the cellular/molecular level will exempt them from having the so-called “expected and normal diseases of aging,” like arthritis, high blood pressure, diabetes T2, heart diseases, stroke, Alzheimer’s, and even cancer. Indeed, these are preventable.

The pandemic of obesity, which begins in childhood, has been increasing in the past century, and the current generation of children and adolescents (who eat more calories and unhealthy foods and who exercise less) will reach middle age with higher morbidity and mortality from metabolic, cardiovascular diseases, stroke, and cancer, which may even be worse than their parents’ in spite of the great advances in medical science and technology.

While colon cancer rates have been going down among the elderly (55 and older) since the 1980s, they are increasing among those in their 20s and 30s. This was the recent alarming finding of a U.S. cancer registry, which reviewed nearly half a million color-rectal cancers diagnosed between 1974 and 2013, published in the Journal of the National Cancer Institute and in the March 1, 2017 issue of the New England Journal of Medicine.

The research shows that for colon cancers, a rate increase of 2.4 percent annually was noted for those in their 20s and 1.0 percent among those in their 30s. For rectal cancers, the yearly increase was even higher, 3.2 percent. In general, the study also found that there was an increase in the rate among adults in their 40s and early 50s, but not as bad.

This report revealed an alarming retrogression in our battle against colorectal cancers: “that young adults’ colorectal cancer risk is now similar to that of adults born around 1890.”

The investigators pointed out that high obesity rates during the past several decades “may play a role in this generation. Obesity increases the risk for all types of cancers and cardiovascular diseases, like high blood pressure, heart attack, stroke, and diabetes.”

Our lifestyles, which includes what and how much food we eat, whether we exercise or not, and all our self-indulgences/abuses, contribute a lot to our state of health. Metabolic syndrome, especially obesity, and red meat and processed meat consumption, all increase the risk for cancer. Neglecting regular medical/dental check-ups and recommended tests also increase our health risk.

The National Institutes of Health reports “approximately 2/3 of adults between 20 and older are overweight or obese with BMI greater than 25, and nearly 1/3 have BMIs greater than 30…less than 1/3 of them are at a healthy weight with BMI of 18.5 to 24.9.”

The estimated cost of obesity in the United States is around $190.2 billion a year, almost 21 percent of medical spending, not including the personal expenses of the individuals and the toll on human misery and human life.

Shedding off at least five pounds of our excess weight through disciplined caloric counting and walking exercise for about 20 minutes a day will reduce our risk for metabolic syndrome and cancer by more than 33 percent. This is a practical and wise strategy we can painlessly do — for free!

Glaringly obvious are the evidence-based roles and impact of diet, exercise, tobacco, and alcohol on our individual health and longevity. They can’t be any clearer.

To a great extent, our health and our lives are in our hands and what to do with them is our choice.

***

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: scalpelpen@gmail.com

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