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>O2 HEALTH > Am I overweight?
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by Dr. Damigo; PhD
In U.S and Europe, being overweight is the norm — but it’s not normal… two-thirds of all Americans need to lose weight
Excess body fat raises levels of LDL (“bad”) cholesterol and triglycerides while also lowering HDL (“good”) cholesterol levels. Obesity impairs the body’s responsiveness to insulin, raising blood sugar and insulin levels. But obesity does more than produce bad numbers: it also leads to bad health, increasing the risk of heart attack, stroke, hypertension, diabetes, gallstones, cancer, osteoarthritis, obstructive sleep apnea, fatty liver, and depression. All in all, obesity is a killer; in fact, obesity and lack of exercise are responsible for about 1,000 American deaths each day, and if present trends continue, they will soon overtake smoking as the leading preventable causes of death in the U.S.
Obesity affects men and women about equally. But you may be surprised to learn that men bear a particular burden, since obesity takes a special toll on male hormones, sexuality, and prostate health.
And if that’s not bad enough, it also increases the risk of male maladies, ranging from erectile dysfunction to BPH and prostate cancer.
A look in the mirror can give you a clue, but to find out if your weight puts you at risk for genitourinary disorders, you need a more precise assessment.
At present, the gold standard is the body mass index, or BMI. You can calculate your BMI by multiplying your weight in pounds by 703 and then dividing by your height in inches squared or by dividing your weight in kilograms by your height in meters squared. Or, if you’re like most of us, you can skip the math and use an online calculator (www.nhlbisupport.com/bmi).
The BMI gives a reasonable estimate of overall body fat. A BMI between 25 and 30 puts you in the overweight category, while a reading of 30 or more says you’re obese. But the BMI doesn’t tell you how your fat is distributed. Scientists know that while no excess body fat is good, abdominal fat is the most harmful variety. So to find out if you are at risk, simply measure your waist at your navel; for men, risk begins to rise at waist circumferences above 37.5 inches, and troubles mount over 40 inches.
It’s hard to shed excess pounds, but it is possible. There is no quick fix, but there is a slow fix: adjust your diet to take in fewer calories and ramp up your exercise to burn off more calories.
>O2 HEALTH > Obesity takes a toll on sexuality
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by Dr. Damigo; PhD
Erectile dysfunction
Although men with erectile dysfunction (ED) often blame testosterone, hormonal disorders account for only 3% of ED. But even with normal testosterone levels, men who are obese have an increased risk of ED. For example, a Harvard study found that a man with a 42-inch waist is twice as likely to develop the problem as a gent with a 32-inch waist. Brazilian research also linked abdominal obesity to ED, but only in men older than 60. And a California study reported that having a BMI of 28 (overweight but not obese) increased a man’s odds of developing ED by over 90%.
Establishing a link is one thing; finding a way to improve erectile function, another. But a Massachusetts study found that weight loss can indeed improve things for overweight men with ED. Similar results were reported by Italian scientists who randomly assigned 110 obese men with ED to a diet and exercise program or to simply continue their usual care. After two years, more than 30% of the men in the diet and exercise group had corrected their ED without medication, compared with less than 6% in the group that received their usual level of medical care. Men who lost the most weight enjoyed the greatest benefit.
Obesity takes a toll on sexuality, and it may also impair fertility. American research has linked obesity to low sperm counts and reduced sperm motility; German scientists reported similar findings in men between 20 and 30.
>O2 HEALTH > The Ups and Downs of Obesity and testosterone
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by Dr. Damigo; PhD
Testosterone is the major male hormone.
As such, it’s responsible for the deep voice, large muscles, and strong bones that characterize our gender, for development of the male reproductive organs, for sperm production and libido, and for the typical male pattern of beard growth.
After being converted to dihydrotestosterone, the hormone also spurs growth of the prostate, which is a much less welcome sign of manhood for older gents.
Testosterone levels surge at puberty and peak in early adulthood, and then after a few years of stability, the hormone begins a slow drift downward in early middle age. Because the drop in testosterone averages just 1% a year, most older men retain normal levels. But anything that accelerates the decline can nudge some men into testosterone deficiency.
Obesity lowers testosterone levels.
A study of 1,667 men ages 40 and above found that each one-point increase in BMI was associated with a 2% decrease in testosterone. IA further study of 1,862 men ages 30 and above found that waist circumference was an even stronger predictor of low testosterone levels than BMI. A four-inch increase in waist size increased a man’s odds of having a low testosterone level by 75%; for comparison, 10 years of aging increased the odds by only 36%. All in all, waist circumference was the strongest single predictor of developing symptoms of testosterone deficiency. And if you doubt these two American studies, just consider Australian research that found almost one in every seven obese men could benefit from testosterone replacement, a rate more than four times higher than in nonobese men.
>O2 HEALTH > Hypertension – Keeping blood pressure in a healthy range
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Reviewed by Dr. Damigo; PhD
One in three American adults has high blood pressure.
Known medically as hypertension, many people don’t even know they have it, because high blood pressure has no symptoms or warning signs. But when elevated blood pressure is accompanied by abnormal cholesterol and blood sugar levels, the damage to your arteries, kidneys, and heart accelerates exponentially. Fortunately, high blood pressure is easy to detect and treat. Sometimes people can keep blood pressure in a healthy range simply by making lifestyle changes, such as losing weight, increasing activity, and eating more healthfully.
Conquering your salt habit
Salt — sodium chloride — is essential for survival. Your body depends on sodium to transmit nerve impulses, contract muscle fibers, and, along with potassium, to balance fluid levels in all your cells. Because the human body is so good at conserving this vital mineral, you need only a tiny amount of sodium. Some tribes, like the South American Yanomamo Indians, consume a mere 200 mg, or about one-tenth of a teaspoon of salt—per day. Thousands of years ago, when humans roamed the earth gathering and hunting, sodium was scarce. But potassium — found naturally in many plant-based foods — was abundant. In fact, the so-called Paleolithic diet provided about 16 times more potassium than sodium.
Today, the average American diet contains about twice as much sodium as potassium, thanks to the preponderance of salt hidden in processed foods. This sodium-potassium imbalance, which is at odds with how humans evolved, is thought to be a major contributor to high blood pressure. Findings from the Trials of Hypertension Prevention study suggest that changing the balance between these two minerals can help the heart and arteries. Researchers measured the amounts of sodium and potassium excreted over the course of 24 hours by nearly 3,000 volunteers. (The amount excreted is a good stand-in for the amount consumed.) The higher the ratio of sodium to potassium, the greater the chance of having a heart attack or stroke, needing bypass surgery or angioplasty, or dying of cardiovascular disease over 10 to 15 years of follow-up, as described in the Archives of Internal Medicine.
To reverse the ratio, choose foods with a high proportion of potassium to sodium (see Table 6).
| Table 6: The power of potassium Most people eat too much sodium and not enough potassium. To counteract this trend, try eating more foods with a high potassium-to-sodium ratio. |
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| Food | Potassium-to-sodium ratio |
| Banana | 422 to 1 |
| Black beans, cooked without salt | 305 to 1 |
| Orange | 232 to 1 |
| Grapefruit juice | 126 to 1 |
| Peanuts, dry roasted, no salt | 93 to 1 |
| Peanuts, dry roasted, with salt | 0.8 to 1 |
| Avocado | 69 to 1 |
| Raisins | 68 to 1 |
| Baked potato, plain, with skin | 54 to 1 |
| Fast-food French fries | 2.5 to 1 |
| Peanut butter, without salt | 42 to 1 |
| Peanut butter, with salt | 1.4 to 1 |
| Brussels sprouts, steamed | 35 to 1 |
| Applesauce (jar), no salt | 31 to 1 |
| Applesauce (jar), with salt | 2.2 to 1 |
| Oatmeal, regular | 18 to 1 |
| Quaker’s Instant Oatmeal | 0.5 to 1 |
| Cantaloupe | 17 to 1 |
| Halibut, baked | 8 to 1 |
| Spinach, boiled | 7 to 1 |
| Salmon, baked | 6 to 1 |
| Salmon, canned | 0.8 to 1 |
| V8, low-sodium | 6 to 1 |
| V8, regular | 1 to 1 |
| Carrots, raw | 5 to 1 |
| Milk, 1% | 3 to 1 |
| Cheerios | 0.9 to 1 |
| Marinara sauce, prepared | 0.8 to 1 |
| Pork and beans, canned | 0.7 to 1 |
| Fast-food cheeseburger | 0.4 to 1 |
| French bread | 0.2 to 1 |
| Cornflakes | 0.1 to 1 |
Hypertension: Controlling the “silent killer”
This report details those changes, including a Special Section that features numerous ways to cut excess salt from your diet — a policy strongly recommended by new federal guidelines. This report also includes tips on how to use a home blood pressure monitor, as well as advice on choosing a drug treatment strategy based your age and any other existing medical issues you may have.
Prepared by the editors of Harvard Health Publications in consultation with Randall M. Zusman, M.D., Associate Professor of Medicine, Harvard Medical School and Director, Division of Hypertension, Massachusetts General Hospital. 48 pages. (2011)
Blood pressure basics
- Understanding the numbers
- What does blood pressure measure?
Types of hypertension
- Essential hypertension
- Isolated systolic hypertension
- Secondary hypertension
- White-coat hypertension
- Labile hypertension
- Resistant hypertension
- Malignant hypertension
- Hypertension during pregnancy
Are you at risk for hypertension?
- Risk factors you can’t change
- Controllable risk factors
- Sedentary lifestyle
How hypertension damages your health
- Stroke
- Coronary artery disease
- Atrial fibrillation
- Dementia
- Kidney disease
- Eye damage
Diagnosing hypertension
- Testing for hypertension
- Monitoring blood pressure at home
Lifestyle changes to lower your blood pressure
- Quit smoking
- Attain a healthy weight
- Follow a healthful diet
- Be active
- Stress less
SPECIAL BONUS SECTION: Conquering your salt habit
- Strategies for cutting back on salt
Medications for treating hypertension
- Classes of hypertension drugs
- The right drug for the right person
Resources
Glossary
>O2 HEALTH > How food becomes cholesterol
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Reviewed by Dr. Damigo; PhD
Why do people on cholesterol-lowering drugs still have heart attacks?
What role does cholesterol really play?
How can you lower your risk of heart disease and stroke?
What to Do About High Cholesterol answers these questions and explains why lowering your LDLs (the bad cholesterol) is even more important than previously thought.
From food to cholesterol
As you eat, your intestine absorbs fat from food. Intestinal enzymes rapidly dismantle the long, complex fat molecules into their component fatty acids, reassemble them into new triglyceride molecules, and package these—along with a small amount of cholesterol—into chylomicrons (see Figure 2). The amount of triglyceride-rich particles in the blood increases for several hours after a meal, as the intestine releases a barrage of chylomicrons filled with triglycerides. That is why you’re asked to fast before going in for a cholesterol test that measures the different lipids in your blood. If you don’t, the triglyceride amounts appear higher than usual, which skews the readings of the other lipids as well.
Figure 2: How food becomes cholesterol
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At the same time, dietary carbohydrates and proteins that are absorbed from the intestine pass to the liver, which converts them to triglyceride molecules, packages them with proteins called apolipoproteins and cholesterol, and releases the resulting VLDLs into the bloodstream. As chylomicrons and VLDLs course around the body, they temporarily stick to the walls of blood vessels in muscle tissue that needs energy or in fatty tissue (adipose tissue) that stores energy. Enzymes come along and remove most of their load of triglyceride molecules, which are then transported inside the muscle or fat cells. As triglyceride is drained from the chylomicron or VLDL particles, their protective protein coats are rearranged and reconfigured, essentially giving them a new address label that can be read by the liver or other tissues that take up lipoproteins.
What to do About High Cholesterol
The report includes a step-by-step method to determine your risk level for heart disease and specific guidelines on how to lower your risk.
Prepared by the editors of Harvard Health Publications in consultation with Mason Freeman, M.D., associate professor of medicine, Harvard Medical School and Chief of the Lipids Metabolism Unit at Massachusetts General Hospital. 48 pages. (2009)
- Cholesterol in the body
- HDLs, LDLs, and other lipid particles
- From food to cholesterol
- The cholesterol connection
- The role of diet
- The role of inflammation
- From cholesterol to heart attack or stroke
- What causes heart disease
- Risk factors for heart disease
- Metabolic syndrome
- Protective factors
- For women: Hormone therapy
- Weighing the risk factors
- Why treat cholesterol?
- Benefits of lowering your cholesterol
- What are the risks of treatment?
- Is treatment worth the trouble or the cost?
- Your cholesterol test
- When to test
- Taking the test
- Understanding your test results
- Physical examination and further tests
- Do you need treatment?
- Seven-step assessment
- How low can you go?
- Beginning treatment
- Pinpoint the cause
- Start your program
- Adopt a cholesterol-lowering diet
- Start an exercise program
- Drugs, herbs and other choices for lowering-cholesterol
- Statins (Reductase inhibitors)
- Ezetimibe (Zetia, Vytorin)
- Bile acid binders
- Fibric acid derivatives (fibrates)
- Niacin
- Drug combinations
- Selective estrogen receptor modulators (SERMs)
- Herbs, vitamins, and other substances that may lower cholesterol
- Treating other lipid problems
- What to do about low HDL
- How to treat high triglycerides
- Taking an individual approach
- Cholesterol in racial and ethnic groups
- Cholesterol in people who have heart disease
- Cholesterol in people who have diabetes
- Cholesterol in people with chronic kidney disease
- Cholesterol in women
- Cholesterol in the elderly
- Resources
- Glossary
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