cardiovascular disease Archives

A Rant About Diet and Responsibility

Published on June 1, 2021

8.6K views

The American diet is atrocious and largely responsible for the growing epidemics of diabetes, cardiovascular disease, and obesity, not just in America, but worldwide. The highly processed, high calorie, high fructose corn syrup and hydrogenated fat, and high chemical additive products that line grocery stores are products of American ingenuity; products that we have exported internationally, and sadly, products that are responsible for the declining metabolic health worldwide. This is a fact that many of us are reticent to accept. We are poisoning ourselves and everyone else around us by the products we make and consume.

A recent study found that fully 80% of metabolic disease can be attributed to lifestyle, e.g. poor diet and a lack exercise. Eighty percent. That is a staggering finding especially when one considers that 476 million people worldwide have diabetes, most of them Type 2 (T2). This represents a 129% increase since 1990, when the number stood 211.2 million. During the same time frame, the rates of cardiovascular disease have increased from 271 million to 523 million. Underlying a significant percentage of these conditions is the obesity epidemic, with 13% of the world’s population considered obese and 39% considered overweight and heading towards obesity.

In the US, the situation is quite dire, only 12-20% of the population, depending upon the criteria utilized, are considered metabolically healthy. Clearly, our approach to metabolic health is not working and yet, much of the focus in health research remains centered on either identifying that one medication or combination of medications that resolve all of our bad choices or an overly simplistic approach to health represented by balancing the calories in/calories out equation. As evidenced by the exploding numbers of metabolic disease, neither of these perspectives seems particularly useful.

While both personal choice and calories play a role in these epidemics, the problem is much broader. The food ecosystem has been decimated and in its place, we have non-nutritive chemical-toxicant food-like products that were designed to be highly addictive. When consumed, these products fundamentally change the metabolism of the individual who consumes them, and not for the better. Every bite of a chemically processed food is one step closer to metabolic disease. Beyond that however, the choice to allow industry to create, utilize, and ultimately dump these chemicals into food, other products, and into the environment, rests on us as well. Those are choices too; choices that affect the metabolic health of communities, and more broadly, the world.

We tend to think of industry and the pollution they create as amorphous, self-propelling and promoting agents of doom, forgetting of course, that each and every one of these organizations is made of people; people like you and me who make decisions to produce and promote these chemical poisons; people who choose to put poisons in foods under the auspices of the pathetically weak and ineffective GRAS guidelines. People make these choices. We do not get forever chemicals that fundamentally disrupt all aspects of metabolism without people who chose to create them, others who chose to use them in common products (and deny any and all risk), and all of us who relish in the novelty of these products. We do not get 80,000 synthetic chemical entities currently on the market without people putting them there. We do not get 1.8 billion pounds of glyphosate used every year, enough for every person on the planet to consume 4lbs annually without people that made choices to produce, use, and not regulate this chemical. We are the problem. We made these choices. We are the ones who are destroying our health and the health of others by the choices we make.

So when we look at the skyrocketing numbers of diabetes, cardiovascular disease, and obesity, it is not enough to say ‘eat better and eat less’. We need to clean house, top to bottom. We need to stop producing the garbage food that pollutes our bodies and the environment. We need to take responsibility for all of the choices that lead us to the point where only 12-20% of the population can be considered metabolically healthy.

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Dietary Guidelines Increase Death – Why Open Data Matter

by Chandler Marrs, PhD

Published on February 18, 2013

5.8K views

At Hormones Matter we’re huge proponents of open data. We believe data matter and should be open and available to all – not cloistered behind a corporate paywall. Without access to critical data, neither physicians nor patients or researchers can make educated decisions about health. When data from clinical trials are not published, and even when they are published, but physicians and researchers are denied access to the research by paywalls, people die, accidents and injuries happen.

The open data movement has garnered some powerful supporters. The leading British Medical Journal (BMJ) has launched an open data campaign, motivated largely in response to the pharmaceutical industry’s long-standing history of publishing only those clinical trials that positively reflect their products. Neither raw data nor contrary clinical trials data are accessible. Physicians make clinical decisions based on published research. If only the positive findings are published, then their decisions are obviously skewed in favor of specific medications, products or procedures. This skewed presentation of favorable research trickles down into every aspect of healthcare. It costs money and more importantly, it costs lives.

Even something as simple as dietary guidelines for healthy living are affected by publication bias. Case and point, as part of their open data campaign, BMJ gained access to the Sydney Diet Heart Study – a randomized controlled trial conducted from 1966 to 1973 that led to dietary guidelines for men with cardiovascular disease (as is commonly the case, women were not studied) .

As a result of the published data from the Sydney Study, physicians and heart associations around the world recommended the use of dietary vegetable oils instead of saturated fats. The primary component of vegetable oils are omega-6 polyunsaturated vegetable fats (PUFAs) specifically, omega-6 linoleic acid.

It turns out, that when all data from the study were re-analyzed, this wasn’t such a good recommendation. In fact, men who followed the recommended dietary guidelines and ate more vegetable oils, margarines instead of other dietary fats had a much higher risk of death from all causes, including cardiovascular disease and coronary heart disease, compared the group who continued with their previous diets.

The American Heart Association and just about every other major medical association recommends the more dangerous diet.

However, alternative medicine and natural health organizations have been reporting on the dangers of too much omega-6 for decades. And certainly, anyone with an understanding of basic biochemistry can look past the trials data and surmise that something is off. A quick dive into the pharmacokinetics and dynamics of foods high in omega-6’s and the cocktail of other artificial ingredients should give anyone pause – even without access to the trial data.

Nevertheless, the need for open data has reached a critical point. As the open data movement gains steam, more and more studies like this will contradict long held beliefs. Let’s hope this open data becomes a reality sooner rather than later.

Are We Really that Fat and Does it Matter?

by Chandler Marrs, PhD

Published on August 13, 2012

6.5K views

Body mass index (BMI), the dreaded math calculation used for decades to tell us whether we are merely fat or morbidly obese, suggests that over 41 million or 35% of us are in the latter category. As bad as that may seem, it’s about to get a whole lot worse. Researchers from New York University found that BMI underestimates the obesity numbers, especially for women.

In a study published on PLoS ONE, a peer reviewed open access journal, researchers suggest that when more accurate measures of adiposity (fat) are used, at least 74 million Americans (64%) should be deemed obese. Whoa.

BMI and Women’s Health

It appears that BMI (weight in pounds/(height in inches)²×703) while a quick and easy indicator of obesity, ignores several important factors that tend to underestimate obesity levels in the female population. Most importantly, BMI doesn’t account for the relationship between lean body mass and fat mass. Sarcopenic obesity, the loss of lean mass or muscle combined with the increase of fat mass, plagues women more frequently than men, especially as we age. As we age and lose more lean mass, BMI measures of obesity become less and less accurate. According to the research, BMI underestimates the obesity levels in women by 40% across all age groups, but for the older age groups, >60 years, the number approaches 60-70% error. This is striking, not only because of the high mis-classification rate in women (remember medical decisions are made based upon BMI assumptions) but also, because BMI potentially underestimates the number of women who should be considered obese. Or does it?

While I agree that many of us are not as slim as we should be, I wonder if we might not need new measures of health and fitness. I am thinking of the female athletes in the Olympics – not the gymnasts or divers (although even as petite as those athletes are, their weight, because of muscle mass, to height ratio could be skewed by BMI standards), but the female weight lifters, boxers, wrestlers, judokos, and even the water polo players. Many of these women would be considered overweight by current BMI standards, and yet, they are at the pinnacle of health and fitness. What does that say of the BMI standards when those at the height of health and fitness can be considered fat while those at edge of illness, who are noticeably overweight are considered normal weight because of skewed lean to fat mass ratios?

The Paradox of Obesity: Why BMI Doesn’t Predict Health

And here we have the paradox of obesity (and the problem with BMI); obesity doesn’t correlate with mortality. Indeed, with many conditions and under many circumstances-stroke, cardiovascular disease, hemodialysis, cancer and others, being overweight increases survival. Maybe it’s not the fat, or even the lean muscle to fat ratio, but the fitness level that should be measured. Research shows that individuals who are metabolically healthy regardless of weight, have no increased risk of mortality from cardiovascular disease than their normal weight counterparts.

Resting Heart Rate Better than BMI

It is well known that athletes, no matter their BMI, have lower resting heart rates than couch potatoes. Perhaps resting heart rate might be a better indicator of overall health. Indeed, several studies have demonstrated that a low resting heart rate may be a better indicator of cardiovascular and metabolic health in women than BMI. So, before we go starving ourselves to reach some physical notion of health (and beauty) based upon a faulty metric, embrace your inner athlete and exercise.

To the researchers who bemoan the growing obesity epidemic and associated health costs, it’s time to move beyond what we look like as a matter of predicting health and move toward how our bodies function. Resting heart rate may be one solution, biomarkers may be another, but BMI is not an effective metric for evaluating women’s health.