In The News What We Can Learn From Tim Russert’s Death 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 didn’t 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 shouldn’t 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 don’t 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 here. It’s about much more than cholesterol and LDL Simply lowering 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 aren’t 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: Abnormal blood sugar and insulin Smoking Low HDL and high triglycerides High blood pressure Excess body fat especially around the mid-section Inflammation Metabolic syndrome High fibrinogen levels High homocysteine levels Predominately small, dense LDL particle size Periodontal disease Couch potato lifestyle Chronic stress Sleep apnea Nutrient deficiency Elevated lipoprotein a 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. Don’t 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.      The information presented on this site is in no way intended as medical advice or as a substitute for medical treatment. This information should be used in conjunction with the guidance and care of your physician. Consult your physician before beginning this program as you would any weight-loss or weight-maintenance program.  Those of you on diuretics or diabetes medication should proceed only under a doctor’s supervision as changing your diet usually requires a change in medication dosages. As with any plan, the weight-loss phases of this program should not be used by patients on dialysis or by pregnant or nursing women. As with any weight-loss plan, we recommend anyone under the age of 18 follow the program under the guidance of their physician.