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 May 13, 2005
Obesity: Bad For Men, Women and Kids
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By Amanda Gardner, HealthDay Reporter

MONDAY, April 18 (HealthDay News) -- Obesity increases the risk of heart disease, and it doesn't matter whether you're a man or a woman.

The latest research confirming earlier studies says that women with "apple"-shaped figures are at higher risk for cardiovascular death while obese men -- even if they are aerobically fit -- are at increased risk for coronary disease.

Those are just two messages appearing in the American Heart Association's journal Circulation, which this week places its focus on the perils of obesity.

"Throughout the world, obesity has become an epidemic," Dr. Robert Eckel, AHA president-elect and professor of medicine at the University of Colorado Health Sciences Center in Denver told reporters Monday at a special news conference. "Obesity does relate to more cardiovascular disease development," he said.

Research shows that individuals who are obese are more likely to have a number of cardiovascular-related disorders, including hypertension, blood clots and congestive heart failure -- not to mention cancer, degenerative joint disease and gallbladder disease.

Experts are increasingly realizing that the key to keeping weight off lies in childhood. But, according to a statement appearing in the journal, the prevalence of overweight children and adolescents has almost quadrupled from less than 5 percent in the 1980s to about 16 percent today. In some populations, such as African-American girls and Hispanics, that prevalence may be even higher.

Actual cardiovascular problems in this population won't arise for years or even decades, experts say. "If we have a group of children who are becoming more overweight, they are at the beginning of this pipeline that results in disease further down the road," explained Dr. Stephen R. Daniels, lead author of the statement and professor of pediatrics and environmental health at Cincinnati Children's Hospital Medical Center in Ohio.

That's not to say many of these kids will not have health problems when they are young. Many already suffer from elevated blood pressure, obstructive sleep apnea and type 2 diabetes.

Regardless of when problems begin, prevention needs to start immediately. "It's clear that if we want to start preventive efforts, we should start earlier," Daniels said. Perhaps even soon after birth, since studies suggest breastfeeding during this period can reduce the chances of a child becoming overweight later on.

"The message from the scientific statement is that prevention should begin in childhood and must include a variety of agencies, and this includes schools, the food industry, the entertainment industry, and the built environment," Daniels said. Children need to be encouraged early on to engage in physical activity, he said.

Another study found that almost two-thirds (62 percent) of teenagers who were both heavy and insulin-resistant had two or more risk factors for cardiovascular disease, compared with only 8 percent of teens without these two risk factors. Insulin resistance is a precursor to diabetes.

Obesity and insulin resistance don't always go hand-in-hand, however. According to the researchers, some thin teens were insulin-resistant while a few heavy teens were healthily insulin-sensitive. The authors found that thin, insulin-sensitive teens had the healthiest profile, followed by thin, insulin-resistant teens and heavy, insulin-sensitive teens. Heavy, insulin-resistant teens had the worst health profile and the highest risk.

"Insulin resistance seems to be independent to a certain degree from obesity, although they are related," said Dr. Alan R. Sinaiko, lead author of the study and professor of pediatrics and nephrology at the University of Minnesota Medical School in Minneapolis.

In other findings, a Danish study suggests a certain body shape predisposes women to cardiovascular risk.

Among postmenopausal women, those with a large waist circumference plus elevated levels of a blood fat called triglycerides faced a fivefold increased risk of fatal cardiovascular events compared with women who did not have these characteristics, the researchers found.

Waist circumference and high triglyceride levels are two of the five traits included in the definition of metabolic syndrome, which puts people at higher risk for heart problems.

The authors of this study wanted to see if certain of the five characteristics were more important than others and if certain types of obesity were more dangerous in women.

Accoring to Dr. Laszlo Tanko, lead author of the study and senior research physician at the Center for Clinical and Basic Research in Ballerup, Denmark, "87.5 percent of women whose cardiovascular death seemed to be a consequence of metabolic syndrome had a simultaneous diagnosis of enlarged waist and elevated triglycerides."

Women with these risk factors tended to have an "apple" shape, rather than "pear-shaped" obesity, meaning they had more upper body fat relative to lower body fat. They had a waist circumference of at least 35.2 inches and a triglyceride level of at least 128 milligrams per decliliter.

In a third study, researchers in Colorado found excess body fat associated with cardiovascular risk factors -- even if the person was aerobically fit.

"We found that found that fatness most strongly and more consistently predicted cardiovascular risk factors than aerobic fitness," said Phillip Gates, senior author of the study and a research associate in the department of integrative physiology at the University of Colorado at Boulder.

The message here: It's not enough to be aerobically fit -- overweight and obese individuals need to decrease their weight as well.

"Exercise should not be seen as an alternative to weight management but as a partner to weight management," Gates said.

More information

For more on obesity and heart disease, visit the American Heart Association (www.americanheart.org).

SOURCES: April 18, 2005 news conference with Robert H. Eckel, M.D., president-elect, American Heart Association and professor, medicine, University of Colorado Health Sciences Center, Denver; Stephen R. Daniels, M.D., Ph.D., professor, pediatrics and environmental health, Cincinnati Children's Hospital Medical Center; Laszlo Tanko, M.D., Ph.D., senior research physician, Center for Clinical and Basic Research, Ballerup, Denmark; Alan R. Sinaiko, M.D., professor of pediatrics and nephrology, University of Minnesota Medical School, Minneapolis; Phillip Gates, Ph.D., research associate, department of integrative physiology, University of Colorado at Boulder; April, 19, 2005, Circulation

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