In The News
What We Can Learn From Tim
Once getting over the initial shock
of hearing about the sudden, premature death of Tim
Russert of heart disease my next thought was too bad he
was overweight and didnít adequately address that risk.
He was medicated for high blood pressure but still had
an enlarged heart, likely a sign his blood pressure was
not optimally controlled. He certainly was given statins
long ago to manage cholesterol and LDL. His levels of
these were likely quite low. Yet he still became one of
the many who die each year from their first heart
attack, whose first symptom is sudden death.
First, I admit that
I have no direct or personal knowledge of his medical
condition. I am expressing a somewhat educated opinion.
Second, as sad as it is for his family and colleagues at
his sudden loss, it shouldnít be completely surprising.
While listening to
commentary the days following his death I heard comments
that his stress test was normal and he exercised. What
was rarely mentioned was his weight. I think this is a
perfect example of just how many of us donít perceive
excess fat, especially belly fat, as dangerous and
life-threatening. No amount of medications are a
guarantee to offset risk factors related to excess body
fat especially belly fat and its dangers.
We know that
increased belly fat is a component of
metabolic syndrome an
insulin resistance syndrome that leads to diabetes and
heart disease. Visceral fat around the mid-section and
deep into the abdomen is metabolically active producing
numerous harmful chemicals that increase inflammation in
the body. Inflammation is thought to be the main
cause of plaque formation in the arteries.
The latest info from
his physician quoted in the New York Times is that Mr.
Russert recently needed more aggressive blood pressure
management. Additionally, he had high triglycerides and
low HDL and an increased waist circumference--all
symptoms of the metabolic syndrome and important markers
for heart attack risk. There is no mention of an
evaluation for elevation of blood sugar and insulin
after eating. This allows a physician to diagnose
artery-damaging diabetes at an earlier stage and is
simply not done often enough.
If Mr. Russert was
attempting to lose weight he was likely advised the
usual: low calories, low saturated fat, high carbs the
very diet that will increase the abnormal metabolism he
suffered from. Yet the care he received is the standard
in the US. Since there are no good drugs that lower
triglycerides and increase HDL the way a low carb
lifestyle can, these factors are often not addressed
effectively. One reason is the phobia about dietary fat
and cholesterol and the concentration on lowering LDL
with drugs as the major risk. To read more info
explaining why low carb should be the treatment of
choice for metabolic syndrome click
Itís about much
more than cholesterol and LDL
cholesterol and LDL cholesterol with medications can
cause a false sense of security leading many to feel
that they have addressed their major risk factors for
heart disease. This prevents them from making the
lifestyle changes that can truly decrease their risks.
Unfortunately, many people arenít even fully evaluated
for other risk factors that can play an important role
in the development of cardiovascular disease.
There are many
factors that play a role in cardiovascular disease that
must be evaluated and addressed. They include:
sugar and insulin
Low HDL and high
Excess body fat
especially around the mid-section
small, dense LDL particle size
The process of
plaque formation takes many years to develop. When
unstable plaque in the artery wall ruptures into the
lumen of the artery a clot forms and causes death of the
heart muscle because of lack of blood supply carrying
oxygen and nutrients to the area. This happens suddenly.
A CT scan of the
chest can measure the calcium present in the coronary
arteries yet this test is often not done. According to
the New York Times Mr. Russert had the scan done in 1998
with a score of 210. It should be 0. There is no mention
of a repeat test to see if statin therapy had been
effective or if his disease was progressing.
Donít allow yourself
to be placed in the same position. Have your full risk
factors evaluated and take those that can be changed
seriously, embracing the idea of prevention and
lifestyle change before its too late.
Since Mr. Russert
was so committed to getting at the truth and educating
voters to have the facts necessary to make good
decisions, his death can be an opportunity to educate us
once more-- this time about heart disease and obesity.
Once again my
condolences to his family, colleagues and friends.
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