Moving and Eating To Protect Your Heart

One of the great pleasures of Chicago is summer. We’re outdoors and moving around, whether jogging, swimming, biking, walking the dog, slamming a volleyball, or tossing a Frisbee. And because we’re all wearing fewer clothes, we can tell in a single furtive glance if we’re happy with our weight.

“Oh, well,” you think, “I might have a few extra pounds but at least I’m active.” Being overweight myself, I’ve frequently fallen prey to the myth that it’s okay to carry a few extra pounds as long as I’m active. I’d fling my avoirdupois onto my bike or elliptical, throw myself into a crack-of-dawn five mile power walk, or vow a level of activity that would shame Sisyphus pushing his boulder.

Now comes some research that shows just how we’ve been fooled by this notion. No matter how active I’ve been, being overweight remains a health risk.

An analysis of more than half a million people in Europe with 12 years of follow-up showed that compared with healthy-weight individuals, the overweight and obese had a higher risk for heart attacks regardless of their activity levels. The risks were further increased by well-known factors like high blood pressure, lipid abnormalities, and diabetes, but pure-and-simple overweight had risks, too.

It was undeniably a huge study, gathering data on those half million people for a dozen years. During that time, 7,637 people had heart attacks. And while many had familiar risks that could cause heart disease, when researchers filtered out those risks they discovered no shortage of heart attack sufferers whose risk factors included nothing more than being overweight or obese. In addition, activity level was no guarantee of protection. Conclusion: There’s no such thing as a healthy, risk-free overweight or obese person.

UK cardiologist Aseem Malhotra, MD, might have the most elegant phrasing of this idea with his “You can’t outrun a bad diet.”

For the study, researchers used body mass index (BMI) tables to classify people as normal, overweight, or obese. You can calculate yours here. Any BMI over 25 is considered a potential risk. There are limits to the accuracy of BMI, making waist measurement a potentially more reliable gauge. Your risk goes up with a waist size more than 35 inches for women and 40 inches for men.

Eating healthfully
So whether you’re inside at a health club or outside running along the lake you must also eat healthfully. And speaking of healthy eating, now that Amazon has promised to drop the Whole Foods/whole-paycheck pricing (so far I’m unimpressed) and excellent organic foods are available at virtually any large grocery store, a reasonable question is “What exactly is healthy eating?”

The easiest way is to avoid additives like the plague they are. If you eat an apple, that’s it. If you cut it up, add some cinnamon, and put it into a NutriBullet, you’ve got some tasty cinnamon applesauce. On the other hand, if you buy Mott’s “Natural” Cinnamon Applesauce, you get apples, high fructose corn syrup, water, cinnamon, ascorbic acid, and so-called natural flavor.

We think unhealthy means processed foods, but this isn’t always the case. Medscape Editor-At-Large George Lundberg, MD, reminds us that processed food is any food that has been altered from its natural state in some way, either for safety reasons or for convenience. Cooking, freezing, canning, drying, and pasteurizing are examples—many quite healthy. Thus, processed food is not the demon. You must look more particularly at what’s been added.

A whole lot of stuff is regularly added to processed food. Don’t trust the marketing hype on the front of the box. Read the ingredients list.

From labels in Dr. Lundberg’s pantry: Multigrain Wheat Thins lists 22 ingredients, including sugar, molasses, salt, and canola oil. All-Bran lists nine, including salt and sugar. Creamy peanut butter lists 15, including sugar, salt, corn syrup, and hydrogenated vegetable oil (aka trans fats). Ranch dressing lists 18, including sugar, salt, and canola oil. In many processed foods, you’re swimming in sugar, salt, oil, and additives.

Things to avoid
Always read the label on any food you’re considering (better yet, eat mainly foods that don’t have labels). What should you try to stay away from?

• Any ingredients whose meaning you don’t understand.
• High-fructose corn syrup and all sugar derivatives (there are more than 30 different ways sugar is listed on labels).
• Partially hydrogenated vegetable oils.
• Trans fatty acids (trans fats).
• Nondairy coffee creamer.

We’re also becoming more aware of the importance of the gut microbiome, that five-pound blend of bacteria living in our intestines. It seems that the wrong balance of bacteria can enhance your body’s ability to get more calories per mouthful than you want or need.

Also, we’ve discovered that in our misguided desire for low-fat foods, food manufacturers are adding some thing called emulsifiers, which help break up fat molecules. We’re taught oil and water don’t mix, but when you add any of a dozen utterly unpronounceable emulsifiers they do.

In recent lab animal studies, adding emulsifiers changed the cells lining the animals’ intestines as well as their gut microbiome, sometimes even inducing mild pre-diabetes. Actual obesity did not occur. However, it’s been well established that if you’ve got too much gut bacteria classified as firmicutes you are predisposed to gain more weight per mouthful than someone with an excess of bacteroidetes.

The takeaways

1. Moving your body is undeniably healthful, but if you exercise and are overweight or obese, you’re not as protected from heart disease as you might think.
2. Getting your weight into a normal BMI/waist-circumference range is your best bet. If you need help, schedule a visit with one of our nutritionists, Marla Feingold or Seanna Tully.
3. Common sense tells you that the type and amount of food you eat is very much a factor with regard to your weight. Start by replacing all your 11-inch plates with 9-inch plates. Bring no serving dishes to the dining room table (they make second helpings too easy). Eat exactly half of whatever you’re served at most restaurants and don’t eat out regularly.
4. Food additives are probably a lot more dangerous than we think. Read every food label carefully, keeping in mind there’s a good reason there’s no food label on celery, an apple, spinach, or a salmon filet. Canned wild salmon may be processed, but often contains only fish and salt, a good example of a healthful processed food.
5. Real whole foods are vegetables, fruit, and responsibly-raised meat, eggs, and dairy. Beans and legumes too. Get into the habit of preparing them every day for most of your meals. You can find these foods at Jewel, Aldi, Mariano’s, the farmers markets, and your neighborhood grocery without refinancing your condo or ravaging your IRA.

Be well,
David Edelberg, MD