Heart Matters: Understanding Cholesterol, Obesity, and Longevity

According to the CDC, the leading risk factors for heart disease and stroke are:

• high blood pressure
• high low-density lipoprotein (LDL) cholesterol
• diabetes
• smoking 
• secondhand smoke exposure
• obesity
• unhealthy diet
• physical inactivity

Several other conditions like your family history can increase your risk for heart disease. These are called risk factors. About half of all Americans (47%) have at least 1 of 3 key risk factors for heart disease.

Some risk factors for heart disease cannot be controlled, such as your age or family history. But you can take steps to lower your risk by changing the factors you can control.

So let's look at these top two and what we can do about them

High blood pressure is a major risk factor for heart disease. Why?  Because the heart has to pump harder to get the blood to circulate around your body. When a pump, any pump has to work harder than it should, it’s going to burn out sooner. The pressure in your arteries is your blood pressure, and the higher it is, the harder the heart has to pump OVER that pressure to get the blood to flow. 

Cholesterol is a waxy, fat-like substance made by the liver or found in certain foods. Your liver makes enough for your body’s needs, but we often get more cholesterol from the processed foods we eat.

If we take in more cholesterol than the body can use, the extra cholesterol can build up in the walls of the arteries, (oops, there goes the blood pressure again!)  including those of the heart. This leads to the narrowing of the arteries and can decrease the blood flow to the heart, brain, kidneys, and other parts of the body. All tissues have to have blood flow to get their oxygen and stay alive.

There are two main types of blood cholesterol: LDL (low-density lipoprotein) cholesterol, which is considered to be “bad” cholesterol because it can cause plaque buildup in your arteries.  I told my patients to think that LDL stands for “Lousy, so we must keep it low”.

HDL (high-density lipoprotein) is cholesterol considered to be “good” cholesterol because higher levels provide some protection against heart disease. My patients would remember HDL as “Healthy, so we want it high”.

High blood cholesterol usually has no signs or symptoms. The only way to know whether you have high cholesterol is to get your cholesterol checked with a lab.

OK so here’s the best way to explain how this good and bad cholesterol works:

Let's say your arteries are like a road.  The blood (cars) run over it every second of every day.  So, these roads need repairing after a while.  They have cracks and potholes.  Here comes the bad cholesterol.  It’s great at fixing these potholes.  It’s like pouring concrete in these holes and cracks. But let's say your road workers don't smooth it out. What a mess.  Now you have bumps in the road instead of potholes. 

Bad cholesterol doesn’t stop there when you eat too much of it.  After all, it has to have somewhere to go.  So this bad cholesterol not only overfilled the potholes but now hangs out on the road, likes speed bumps.  Now your (arteries) roads look like a thousand speedbumps. Your poor blood is getting pushed and shoved around likes it's off-roading.

Well, good news!

Here comes the good cholesterol, HDL!  It’s similar to a roller or a putty knife.  It cleans off the excess bad cholesterol and smoothes the road back down again. Imagine a nicely paved smooth ride.  That’s what the blood vessels get with HDL, our healthy cholesterol. Woo hoo! By smoothing out the blood flow, our blood pressure may go back down and better yet, our hearts will love us!

But the problem is, our HDL tends to decrease as we age.  So how do we keep it high?  

Lifestyle changes are known to increase HDL, such as moving more, quitting smoking, or improving your diet,and have been shown to lower the risk of heart attacks, according to the Mayo Clinic.  However, medications that specifically increase HDL levels have failed to reduce the rate of heart attacks.

So, the best way is to not overload your vessels (roads) with too much bad cholesterol in the first place.  Remember, your liver makes enough and just the right amount.  Don’t add to it by eating the processed unhealthy American foods pushed on us in most ads. 

Which brings me to…

Obesity is excess body fat. Obesity is linked to higher “bad” cholesterol and triglyceride levels and to lower “good” cholesterol levels. Obesity can lead to high blood pressure and diabetes as well as heart disease. 

Why is obesity so bad for us?  Well, several reasons…

• Increased Risk of Chronic Diseases: Obesity is a major risk factor for various chronic conditions, including heart disease, stroke, type 2 diabetes, and certain types of cancer. Why? Because the body has to repair and renew more tissues which means overloading their metabolism and mistakes can happen, engines (I mean organs) can begin to fail. 
• Cardiovascular Health: Obesity is closely linked to high blood pressure, high cholesterol levels, and atherosclerosis (hardening of the arteries). We covered this but what happens when we start packing more weight?  Just like when a city expands to the suburbs, you’ve got to have the “roads” (arteries) to carry the people (blood) to those outer-lying areas.  This means the heart now has to pump harder for more coverage. Ugh!
• Type 2 Diabetes: Obesity is a leading cause of type 2 diabetes. Excess body fat, especially around the abdomen, can lead to insulin resistance, where the body's cells do not respond effectively to insulin, resulting in elevated blood sugar levels. Why are sugar levels so bad for us?  Have you ever eaten cotton candy?  It’s pure sugar blown through air. It’s sticky.  Now your arteries and veins are sticky and the blood doesn’t flow, it sticks like bubble gum on the bottom of your shoe.
• Joint Problems: The added weight from excess body fat can put stress on the joints, particularly in the knees and hips. This may lead to joint pain, osteoarthritis, and reduced mobility. And then there's our backs.  If we have a large breast, well, our core strength has to work extra hard.  If we have a large belly hanging over our underwear, well there goes the lower back. Back pain is no fun. 
• Respiratory Issues: Obesity is associated with respiratory problems, including sleep apnea, asthma, and reduced lung capacity. Sleep apnea, in particular, is more common in individuals with obesity and can lead to interrupted breathing during sleep. Let’s face it, your body needs oxygen for energy.  This energy in your cells and tissues allows them to live healthy happy lives. We all need oxygen. So, if we can’t breathe, we become tired and irritable.  Our heart, brain, and GI tract are no different. They get mad, too.
• Liver Disease: Non-alcoholic fatty liver disease (NAFLD) is more prevalent in individuals with obesity. It can progress to more severe conditions, such as non-alcoholic steatohepatitis (NASH) and cirrhosis. Can’t live without our liver. 
• Psychological and Social Impact: Obesity can have psychological and social consequences, including low self-esteem, depression, and discrimination. People with obesity may face stigmatization and challenges in various aspects of life. Some people feel great in their bodies.  Others love hearing how great we look!  “What did you do to look so good?” or “Have you lost weight?”
• Reduced Quality of Life: Here's the kicker – carrying extra weight might mean a shorter stay on this planet. People with obesity tend to have a bit of a reduced life expectancy compared to those keeping things balanced. Mobility issues, chronic pain, and the burden of managing associated health conditions can impact a person's daily life, especially our joy to get out, socialize, and be around others. 

Super-aging seniors and their families know all this.  They choose happy healthy lives no matter where they are right now.  

Come join us!