Obesity and Coronary Heart Disease - Causes, Relationships and Recommendations - Essay Example

Obesity and Coronary Heart Disease: Causes, Relationships and Recommendations Obesity is one of the most prevalent conditions in the modernized, industrialized world. As people take up permanent positions in front of the computer and the couch, this condition only continues to worsen while the problems caused by obesity continue to be downplayed. Generally speaking, obesity refers to anyone who carries more body fat on their frame than is considered healthy for a person of their particular height and bone structure. Officially, obesity refers to people who are 40 to 100 pounds over their recommended weight while those who are more than 100 pounds over their recommended weight are considered morbidly obese. Obesity dramatically lowers a person’s life expectancy through a variety of possible complications, not the least of which is coronary heart disease. According to a study by the Veterans Administration, a morbidly obese person aged 25 to 34 is twelve times more likely to die during that time of their life than an individual of average weight (Drenick, 1980: 444). Some statistics link obesity to at least 300,000 U.S. citizens each year. Obese people also suffer increased incidence of other illness, such as diabetes, develop problems in their bones, joints and back and experience the psychological problems brought about by public humiliation of not being able to keep up with the crowd. “The direct costs associated with obesity represent 5.7 percent of the national health expenditure within the United States. The indirect costs attributable to obesity are $47.6 billion and are comparable to the economic costs of cigarette smoking” (Wolf, 1998: 97). The purpose of the present research is to examine the causes of obesity and coronary heart disease, how they are related to each other and what can be done to reduce the possibilities of developing these conditions. There are a number of causes of obesity. People whose parents are overweight and who live in poverty or are otherwise restricted by a lower income have a greater likelihood of also being overweight. This is caused not only by heredity and genetics, but also by family culture as the individual learns poor eating habits and by the available food supply, which tends to be less nutritious and have greater fat content. Despite claims to the contrary, heredity can significantly influence obesity tendencies. People who are genetically predisposed to obesity actually do have greater difficulty trying to lose weight and then maintaining a more healthy body mass. Several studies have been conducted that illustrate that approximately 50 percent of those children who are overweight also have overweight parents. Heredity will also determine whether a person carries their extra weight on their stomach or on their hips and thighs. Finally, heredity has an effect on a person’s natural metabolism and hormonal balances. Metabolism is the process by which the body burns up energy. Hormonal balances factor in the process of controlling weight. “Recent studies show that levels of ghrelin, a peptide hormone known to regulate appetite, and other peptides in the stomach, play a role in triggering hunger and producing a feeling of fullness” (“Overview of Obesity”, 2007). People with lower levels of ghrelin or other hormones may have more difficulty determining when they are full and thus have a tendency to overeat. Other medical factors that may contribute to overweight include endocrine ailments, certain medications and specific illnesses. However, there are also a great number of environmental factors that can contribute to obesity. Overeating, eating fatty foods and inactivity are widely assumed to contribute to obesity, but so does socio-economic position. Numerous studies have been conducted that demonstrate there is a connection between low income and obesity rates. This is particularly true for women, who are six times more likely to be obese than women of middle or upper level economic levels (“Overview of Obesity”, 2007). These studies also reveal that minority women are more likely to be obese than white women. Reported statistics indicate that more than 75 percent of black women over the age of 20 are considered overweight with many of these likely to cross into obese within their lifetime. Of course, lifestyle options such as sitting on the couch and regularly overeating will also contribute significantly to weight gain. “Eating a diet in which a high percentage of calories come from sugary, high-fat, refined foods promotes weight gain” (“Overview of Obesity”, 2007). Unfortunately, fast food and snack food are typically the most readily available and affordable food products for lower income people, who tend to make this a regular portion of their diet. This, combined with inactivity, is a prime recipe for consistent weight gain. The degree to which inactivity plays a role in obesity can perhaps best be illustrated by investigating the case of children, for whom inactivity is the prime cause of obesity. Many children today spend a great deal of their time at their school desk or at home in front of the television, computer or video game console. “Over nine million children between the ages of six and 19 are overweight” (“Overview of Obesity”, 2007). Tracing the effects of obesity on children reveals many of the same psychological elements that are at work upon the obese adult. Obesity in a child will affect the way that child feels about himself, determines the kinds of relationships he will have with his peers and can severely undermine his self-confidence while limiting his possibilities in his academic or future career. According to author Sylvia Rimm (2004), who has made a complete study of the issue, overweight children are introduced into a vicious cycle that continues to work to build up their weight well into their adulthood. The child who is slightly overweight upon going to school, for genetic or other reasons, is soon ridiculed by peers or finds they are unable to keep up with their friends activities. This creates emotional turmoil that is typically solved by indulging in eating for comfort and gaining more weight. As the cycle continues, these children begin measuring themselves against other children their weight and finding themselves lacking, a belief that is often reinforced by adults as well as less becomes expected of them. Understanding they are not expected to perform as well as other children causes the overweight child to expect less of himself while also reinforcing the idea of returning to food as comfort and contributing to weight gain. The cycle repeats over and over into adulthood, quickly causing these overweight children to become obese adults. Obese adults must deal with all of these psychological issues from childhood on top of a typically low income position and the stress of survival, which further burdens the body with health-related concerns. Perhaps more important than the psychological dangers of obesity, the physical dangers are positively life-threatening. Obesity has been definitively linked to at least 30 different dangerous health conditions. Painful but not necessarily deadly, one of the most common of these ailments is arthritis of the knees, back, hips and hands. On the more deadly front, obese women and men are approximately 50 percent more likely to develop breast cancer than their lighter counterparts as well (“Health Effects”, 2002). The obese are also much more likely to develop other forms of cancer as well. These include endometrial, gastric, esophageal and colorectal cancers. Long-term suffering can be increased by the development of Type 2 diabetes. As many as 90 percent of people with type 2 diabetes are either overweight or obese (“Health Effects”, 2002). While most people associate liver disease such as acute hepatitis or cirrhosis with alcoholism, obesity is the second leading cause of these ailments and is also known to cause gallbladder disease and pancreatitis. “The obese are three times more likely to develop gall stones and are more susceptible to infection and pneumonia than people within the recommended weight range” (“Health Effects”, 2002). Women can also experience a great deal more difficulty with pregnancy and childbirth as a result of being obese. All of these health dangers are very real and very frightening, but perhaps the greatest cause for fear is the effects obesity has on the heart. Obesity increases the levels of cholesterol being carried in the bloodstream, which is significant because this cholesterol has a tendency to clog the arteries of the heart. Increased body fat also places external strain on these blood vessels and they become constricted, making it more difficult for blood to flow through them and reducing the body’s ability to transport blood to vital organs, such as the heart. This causes those who are obese to suffer with breathing problems, experience sleepiness at all hours and struggle against general fatigue. Over long term, obesity can significantly increase the chances of an individual suffering a stroke or developing hypertension. “More than 75 percent of people with hypertension are obese” (“Health Effects”, 2002). Recent studies have shown a closer link between obesity and coronary heart disease. According to one study, obesity can independently predict coronary atherosclerosis (Eckel, 1997). This means that every obese person must be immediately concerned with heart health if they wish to avoid suffering a heart attack. Coronary heart disease refers to a condition in which an individual’s coronary arteries are narrowed or blocked. When this occurs, oxygen-rich blood is unable to effectively reach the heart muscle. Two possible physical reactions to this condition are angina and heart attack. Angina is the term used to refer to a condition in which some blood is reaching the heart but the flow is strongly restricted. “Angina may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw or back” (Coronary Artery Disease, 2008). This is a slowly progressing condition that ultimately acts to restrict blood flow to the heart, thus the supply of oxygen to the brain and body. Heart diseases can be congenital (born with the disease) (“Heart Disease”, 2005), yet they are more often the result of lifestyle choices and physical condition. Heart disease causes the deaths of nearly one million people in the U.S. every year, accounting for more than 40 percent of total fatalities and is the primary cause of death worldwide among both women and men (“Heart Disease Overview”, 2007). This condition requires immediate attention and intervention strategies in order to prevent heart attack or other permanent damage. However, since heart disease is a slowly progressive illness, the onset may not be noticeable until a heart attack occurs. Heart attacks occur when blood flow to the heart becomes completely blocked. In this situation, oxygen-rich blood cannot make it all the way into the heart and the muscle, deprived of oxygen, begins to die. When this happens, an acute pressure of the chest is accompanied by a severe shortness of breath and pain in other areas of the upper body which could involve both or either arm, back, head, neck or stomach. Other symptoms could include feelings of light-headedness, becoming nauseous and/or sweating profusely for no other apparent reason (“Heart Disease FAQs”, 2007). Unless the individual is treated quickly, the heart stops and death follows. Long term heart disease can also weaken the heart muscle to the point where it is no longer capable of performing its job even when blood is able to reach the heart. One condition that develops in this case is termed heart failure. Heart failure occurs when the muscle becomes so weak that it is no longer able to effectively pump blood through the body. This condition can also be exacerbated by the heart attempting to push blood through a system in which the main conduits are compressed and restricted by external pressures, such as when arteries and veins are squeezed under multiple layers of body fat. Another condition that can occur in the event that the heart muscle itself is damaged by coronary artery disease is arrhythmia. “Arrhythmias are problems with the speed or rhythm of your heartbeat” (Coronary Artery Disease, 2008). In this case, the body is not given new blood according to a predictable rhythm which can cause a great deal of trouble and again, possible death. The common factor in all of these conditions is the presence of plaque build-up within the coronary artery. “Plaque is made up of fat, cholesterol, calcium and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis” (Coronary Artery Disease, 2008). Not only can these build-ups of plaque create blockage as they slowly narrow the internal circumference of the artery, but they can begin to come together and form blood clots. Blood clots can eventually become great enough to completely clog an artery suddenly and without the assistance of other blockage. They can also travel to other portions of the body and cause other unhealthy conditions should they become lodged in areas such as the brain. Just as in the case of obesity, there are a number of contributing causes for heart disease and many of them can be prevented or effectively controlled. Some of these cannot be controlled. These include age, family history and other health conditions. Not all older people will experience heart disease, but there is an increased risk of heart disease as a person grows older. “Genetic or lifestyle factors cause plaque to build in your arteries as you age. By the time you’re middle-aged or older, enough plaque has built up to cause signs or symptoms” (Coronary Artery Disease, 2008). Women generally experience greater tendencies for heart disease after age 55 while men usually experience it at a younger age, usually around 45. A history of heart disease in the family is also a significant and uncontrollable risk factor. According to the National Heart and Lung Disease Institute (Coronary Artery Disease, 2008), men who have male relatives that experienced heart disease before the age of 55 and women who have female relatives diagnosed with heart disease before the age of 65 are at greater risk of developing heart disease themselves. Finally, other health conditions, such as sleep apnea, high blood pressure, obesity or even tooth decay, can lead to greater risk of heart disease as the heart exists under a continuously stressed condition. Some of these may be controllable while others may not. Most risk factors for heart disease are controllable. There are at least nine controllable factors that are the basis for almost all instances of heart disease. The moderate use of alcohol (one drink per day) actually reduces the risk for heart disease, by 12 percent for men and an amazing 60 percent for women. However, drinking too much promotes heart disease by placing undue stress on the heart in attempting to clear the bloodstream. The inability to successfully manage the stresses of everyday life which includes bouts with depression and behavioral disorders triples the risk for heart disease. Those that smoke contract heart disease at three times the rate of those who do not. “Cigarette smoke damages the artery wall, paving the way for inflammation and cholesterol build-up. It narrows arteries. It also activates platelets, sticky cells that cling together and promote clotting” (Sternberg, 2006). Diet and exercise issues also have a great deal of impact on heart disease. A person’s diet can decrease their risk of heart disease. Foods that have a low fat content, grains, vegetables, fruits and other highly nutritious fare play a large role in lowering cholesterol, preventing obesity and contribute to a significantly lower risk for heart disease while foods high in fat content and low in nutritional content contribute to the development of obesity. Obesity, particularly of the abdomen, more than doubles the risk for heart disease. A large ‘tummy’ causes hormonal issues which produces high blood pressure, high cholesterol and diabetes, all of which puts the individual at greater risk. Having diabetes or abnormally high cholesterol quadruples the risk for heart disease. High blood pressure triples the risk. Exercise and proper diet lowers cholesterol, improves blood sugar content and allows blood vessels to expand reducing high blood pressure (Sternberg, 2006). These seven factors cause plaque to form restricting arteries. Clots form and when they break away, they clog the remaining passageway in the artery which causes a heart attack. Understanding the risk factors for coronary heart disease and understanding the additional problems associated with the condition of obesity reveals the high degree to which obesity and coronary heart disease are linked. Obesity, by its very nature, has the effect of raising a person’s blood cholesterol and triglyceride levels within the blood stream. The types of foods that are eaten by people who are obese tend to be higher in fat content and lower in nutritional content, having the effect of lower HDL, or ‘good’, cholesterol. This form of cholesterol can lower the risk of heart disease as it reduces the amount of LDL or ‘bad’ cholesterol in the blood stream. Studies have linked HDL with decreased risk of heart disease and stroke. Because of the additional physical stresses placed on the body due to the excess weight, obesity also has a tendency to raise blood pressure, another risk factor of heart disease. Finally, people who are obese have an increased tendency for diabetes. Diabetes, as an illness, increases the effects of other risk factors already present in the body for heart disease as the body becomes increasingly less able to cope with the myriad pressures being loaded on the heart. As people continue to gain weight, they continue to place stress – physically, emotionally and spiritually – on the body which increasingly has an effect on the heart. As the causes of obesity and heart disease are examined, it can be discerned that the problems of obesity paint a straight line to the problems of heart disease, making it almost inevitable that people who are obese will have heart problems. Since obesity affects an increasing number of Americans every year, this is a significant health issue that must be addressed as health care centers become overwhelmed attempting to cope with the problems associated not just with obesity, but also with the very real and very life-threatening problems of heart disease. As the American culture is exported to other parts of the world, obesity is becoming a problem in these areas as well. If a person is not born with heart disease or a predisposition for obesity, both of these conditions can be regulated by adjusting lifestyle choices. Avoiding the smoking habit and taking part in a reasonable exercise regiment decreases the risk of contracting heart disease by about 25 percent. If these habits are combined with eating healthy foods and maintaining a desirable weight the odds of contracting heart disease are decreased even further. “Consistently eating a diet rich in fruits, vegetables, whole grains and low-fat dairy products can help protect your heart. Low-fat sources of protein and certain types of fish also can reduce your risk of heart disease” (Mayo Clinic Staff, 2007). As people grow older, they find it harder to maintain their desired weight. It is important for the older person to schedule regular exercise and to consciously maintain a healthy lifestyle to avoid heart disease. There are a number of medical treatments available today that can assist people with overcoming overweight, obesity and heart disease. For the overweight person, there are medications that help regulate hormonal imbalances and surgical procedures that help reduce weight or suppress appetite and make true exercise possible. However, these procedures also require a change in lifestyle habits that includes healthy eating and regular exercise. Many medications and treatments are available that will enhance the flow of blood within the arteries after artery disease has started. Two procedures to treat heart disease that do not require open-heart surgery are angioplasty and using a pacemaker. Angioplasty expands the artery by dilating it with a balloon which is attached to a catheter inserted into the artery. Pacemakers, or electrophysiological devices, replace the heart’s rhythmic electrical pulses and maintains a proper heart rate. Open-heart surgery generally alludes to the replacement of an artery with a large blood vessel of that same patient (“Health Encyclopedia”, 2001). Following these treatments as well, the patient is required to make some significant lifestyle changes that include a healthy diet and regular appropriate exercise if they truly wish to prolong their life. Works Cited “Coronary Artery Disease.” (June 2008). Diseases and Conditions Index. National Heart Lung and Blood Institute. October 10, 2008 Drenick, E.J., et al. (1980). “Excessive Mortality and Causes of Death in Morbidly Obese Men.” Journal of the American Medical Association. Vol. 243, pp. 443-445. Eckel, Robert H. (1997). “A Statement for Healthcare Professionals from the Nutrition Committee, American Heart Association.” Circulation. Vol. 96, pp. 3248-3250. “Health Encyclopedia - Diseases and Conditions Heart Disease.” (2001). USA Today. October 10, 2008 “Heart Disease.” (January 19, 2005). Medical Encyclopedia. American Medical Network. October 10, 2008 “Heart Disease FAQs.” (February 9, 2007). Center for Disease Control and Prevention. Washington D.C.: U.S. Department of Health and Human Services. October 10, 2008 “Heart Disease Overview.” (2007). Health InfoChannel. Health Communities. October 10, 2008 < http://www.healthinfochannel.com/heartdisease/> Mayo Clinic Staff. (January 15, 2007). “Heart disease prevention: 5 strategies keep your heart healthy.” Heart Disease. Mayo Clinic. October 10, 2008 “Overview of Obesity.” Cardiovascular Diseases. (January 22, 2007). University of Virginia Health System. October 10, 2008 Rimm, Sylvia. (2004). Rescuing the Emotional Lives of Overweight Children. New York: St Martin’s Press. Sternberg, Steve. (January 8, 2006). “Nine factors that affect your heart’s health.” USA Today. October 10, 2008 Wolf, A.M. & Colditz, G.A. (1998). “Current Estimates of the Economic Costs of Obesity in the United States.” Obesity Research. Vol. 6, pp. 97-106. Read More