February is considered the month dedicated to love, right? So, its only natural that this month is recognized as American Heart Month. Heart. Love. Get it? Since this has been designated as a time to increase heart health awareness, I'm going to add to the conversation.
I was once someone under the age of 33, weighing 273 lbs, had relatively normal blood pressure, fasted blood sugar levels were in a healthy range, and cholesterol levels were also within decent ranges. I felt as if I was pretty healthy. I look back on those days now and realize I was at risk and headed down the path of heart disease. Being overweight or obese IS a problem.
“It’s just a little extra weight, but my numbers are good.” - Me
Obesity (and Overweight)
I’m sure you’re familiar with the term obesity, in case you aren’t it means excessive body fat. Obesity is a result of consuming more energy than is burned (eating more than you are active), your environment, and illnesses such as PCOS.
One can determine if they are obese by measuring body fat based on weight and height. This is your Body Mass Index (BMI). A BMI of 25-29 is considered overweight and necessary changes should be made to get in a healthier range. A BMI of 30-39 is considered obese and greater than 39 is considered severe obesity.
“I’ve got a cute face, chubby waist...”- Missy Elliott
Your waist can also be used as a tool to measure obesity. A waist circumference greater than 102 centimeters or 50 inches in men and greater than 88 centimeters or 35 inches in women increases your health risks. Which means, if you are overweight or obese and have a large waist circumference, you are at an even higher risk for developing heart disease. You saw it above, my waist circumference was once 43 inches.
“I’m not fat, I’m thick!”
Obese individuals require more blood to supply oxygen throughout the body. Increased fatty tissue in the body (over weight and obesity) causes an increase in vascular resistance and in turn causes the heart to work harder to pump blood throughout the body. Vascular resistance is the resistance that the heart has to overcome to push blood through the circulatory system. This eventually leads to hypertension, also known as high blood pressure. Hypertension is often referred to as the silent killer because it often has no symptoms.
As weight is gained, sensitivity of tissues to the effects of insulin diminishes. This is know as insulin resistance. Our body’s response is for pancreatic beta cells to produce more insulin to compensate for insulin resistance. Once pancreatic beta cells can no longer produce enough insulin and blood sugar levels continue to increase, type 2 diabetes is the result. Being overweight or obese is one of the best predictors of type 2 diabetes. "Thank God! Thank God! I'm getting thicker!" -Lizzo
Obesity can also lead to body pain and difficulty functioning, gallbladder disease, heartburn, osteoarthritis, sleep apnea, and cancer. Then there’s this…
Your weight can change your cholesterol levels. Obesity can cause a spike in “bad” or LDL cholesterol and lower HDL. It can also increase triglycerides. As your weight increases so does the “bad” cholesterol and triglycerides. Aging also causes increases in LDL and triglycerides. As we age, we gain weight too. Which means, if you’re obese and your cholesterol numbers are “good” now, obesity and aging will have adverse effects on your cholesterol in the near future. Those adverse effects?
Heart and Cardiovascular Disease
About the size of a fist, the heart is a muscular organ that pumps blood throughout the body. This is done through arteries and veins, collectively known as the cardiovascular system.
Heart and cardiovascular disease refers to various heart conditions and conditions that affect the blood vessels that supply the heart with blood. The most common is coronary artery disease (CAD), which is a narrowing of the walls or blockage of the coronary arteries that supply blood to the heart.
Other conditions include:
Cardiac arrest- the heart stops beating.
Heart attack- blood supply to part of the heart stops causing that section of the muscle to begin to die.
Congestive heart failure- fluid builds up around the heart affecting its pumping power.
Angina- severe chest pain caused by inadequate blood supply to the heart.
Atherosclerosis- the clogging or hardening of arteries. Arteries carry oxygen-rich blood to your heart and other parts of your body. Atherosclerosis causes CAD.
Heart disease is the leading cause of death in the United States. 1 in every 4 deaths is from heart disease. Three major risk factors include high blood pressure, high blood cholesterol, or smoking. Other medical conditions and lifestyles that increase the risk of heart and cardiovascular disease includes:
overweight and obesity
excessive alcohol use.
Deaths from heart disease are higher in African Americans than any other ethnic group and white Americans. It also develops at a younger age in African Americans. And who is at the top of the list for the highest occurrence? African American women. Yes, African American women account for the most cases of heart disease in America. The most common conditions that increase an African American’s risk of heart disease are high blood pressure, obesity, and diabetes.
“But, I feel fine at this weight. I just need to lose this stomach.”
So no, if you are overweight or obese but your numbers are good, you are not ok. Use the weight gain as a sign to take action. Waiting until there is an actual diagnosis is the worse thing that you can do for yourself.
Of course I wouldn’t dump all of that on you without telling you how to take action. Combating Obesity
In order to combat obesity you have to understand its causes. Of the three causes of obesity I listed above (behavior, environment, and illnesses), two we have a bit of control over. So, I’ll discuss those.
Your Behavior Has an Effect on Your Weight
Our behavior includes our activity or the lack there of, our relationship with food, and how we respond to stress. There are a total of 24 hours in a day and 5 to 7 of those hours we are supposed to be sleeping. Are you actually getting sleep? Because lack of sleep can lead to obesity. What are you doing with the rest of your time? Is any of it dedicated to an activity that gets you moving? Not just standing on your feet.
Be Active and Relax
Yes, I said it! Your behavior has a direct effect on your weight. If you have a desk job, you spend majority of your time not burning calories and you probably snack to get you through the day. Step away from your desk every hour to get additional steps. If you aren't able to do that, walk around your building or parking lot during your breaks. Take the stairs instead of the elevator. Park away from buildings instead of finding that “hot spot” in the front. If you feel like your knees or ankles won’t allow you to do much walking, challenge yourself to do more than you did the day before. Start out small, even if its just 5 minutes the first day. Push for 7 minutes the next day and so on. Whatever you do, be consistent with it.
Oh, and swap out those desk snacks for healthier options.
Get sleep. When we lack sleep we tend to grab food and drinks loaded in sugar to give us a burst of energy. I’m pretty sure this is why Starbucks, Dunkin Donuts, and Krispy Kreme are doing so well. But, this cycle will cause weight gain, especially in the midsection. Also, read good books and consider taking a yoga class. Both reading and yoga are relaxing activities that reduce stress.
Pay attention to your daily caloric intake. Know what your Basal Metabolic Rate (BMR) is in order to learn your daily caloric needs. Here's a link to do so. Having this information will give you an idea of how many calories you should eat daily. You want to burn more calories than you eat and your BMR gives you an idea of how many calories your body burns naturally.
Mindfulness and Balance
“Get your salad, no dessert!”- Kanye West
Practice mindfulness when eating. Only eat when you’re hungry and make healthier eating choices. Practice not snacking often and cut out sugary desserts and processed foods.
Also, practice mindfulness by taking time out of your day to meditate and find peace. Stress causes your body to produce cortisol, leading to stress eating and cravings for sweets, causing weight gain. For more tips on managing stress, click here.
“Shawty thick, she say, ‘I don’t miss no meals’.” -K. Camp
Consider fasting. Fasting is a practice that teaches discipline, patience, and self-control. It also teaches you to have a different relationship with food. Upon completion of a fast you should see that you’ve been over doing it with your normal way of eating and it actually doesn’t take as much for survival and nourishment. Fasting will also teach you to listen to hunger cues from your body.
Honestly, you can learn a lot about yourself and your bad habits with food by fasting. Importantly, fasting helps with weight loss and weight control.
The Effects Your Environment Have on Your Weight
Your environment has a major effect on your weight. The lack of sidewalks, parks and gyms decreases the likelihood of someone being active. Dining options in the community, as well as distance of local grocery stores effect your diet and in turn your weight.
“Everybody in my family is big boned.”
The people in your home and your circles also have an effect on your weight. We pick up the habits of those around us. Ever hung out late with friends and at the end of the night y’all grabbed a bite to eat? If you were home in the bed sleep would you be eating? That’s an influence on you.
The same with how you prepare your meals. That was passed down to you from an influence in your family.
This is what family history is largely based on. When doctors want to get an understanding of your health and ask about family history and illnesses they aren’t totally thinking it’s in your genes. Genes are considered. However, they are also formulating that since its in your family’s history it’s possible you’ve picked up those habits that will lead you to the illness as well.
You can’t change your genes, but you can change your environment and those around you by introducing new behaviors. If you don’t have access to parks and gyms in your neighborhood, opt to drive a little further. This can have benefits that will improve your family history. Trips to the local grocery store to prepare meals at home can also do the same. Your family may see your changes and begin to make their own changes. If you have children, begin teaching them healthy habits that they can carry with them into adulthood. Make It Make Sense
Let's travel back in time right quick. Pretend it's March 2016 and I'm a patient in for a Biometric Screening.
Patient is a 31 y/o African American woman with a family history of high blood pressure, high cholesterol, and diabetes. Pause. Let's count the risks as we go. African American woman. BING! There's one. Family history of high BP, high cholesterol, and diabetes. BING times 3. And we haven't looked at her stats yet. She drinks excessively and no physical activity, as well. That's another BING and BING!
Her blood pressure is a little elevated but seems close to normal. Normal being 120/80 or less. I'm going to BING this because the top number IS elevated. Total cholesterol (all blood work done in a fasted stated) is 127. Less than 200 is desirable. So this is good. Patients HDL levels are acceptable. Could be better. 60mg/dL or more is ideal. I'll give this a BING because this is something she needs to pay attention to. Because it's in an acceptable range, she'll probably overlook it. Her LDL levels are desirable. Less than 100mg/dL. Triglycerides are within normal range; anything less than 150mg/dL. Her glucose levels are desirable under 100mg/dL. It's a little close to pre-diabetes (100-125mg/dL) so, I'll BING it. She'll also overlook this because its within a normal range.
Moving on from her blood work to her measurements. Patient has severe obesity. BING! Her BMI is greater than 39 and her waist is greater than 35 inches. There's a BING for her waist. As she ages her cholesterol levels will worsen on its own. Consider her lack of activity, diet, and weight. Unless she makes changes, she's well on her way to heart disease.
I had to step away from my computer to process that. I'm not even there any more but the thought that that's where I was headed terrified me. What if I didn't decide to make changes? We can be so delusional sometimes and this just made me realize how much I was. Whew, ok. It's not just about looks when it comes to weight. It's about life or death.
Excessive weight puts you at risk for several health related issues. However, your body gives you signs when the weight becomes too much. The body aches and knee pain are cues. Being tired all of the time is too. It's hard to see it as such because it's confused with tiredness from being up all day. If you don't get ahead of the weight gain and get it under control you put yourself at risk for heart or cardiovascular disease and a host of other illnesses.
With this being the last day of American Heart Month (AND Black History Month) take some time out today to develop your goals and a plan to work on your health in March. Matter of fact, do this monthly to help you stay on it. You don't have to make drastic changes at once. Start out slow and set weekly challenges for yourself to help you reach your monthly goals. Rome wasn't built in a day and we all eat one bite at a time. Think of ways to help improve your environment (even if it means to change those around you).