Teens Think They’ll Live Forever, Which May Explain Their Food Choices

Teens just can’t catch a break in the health department.

Last week we learned, if nothing changes, today's obese kids will have heart attacks much earlier than their parents. http://bit.ly/9R3647 It’s because of the epidemic of obesity seen in children and adolescents today. As a result, if we are not successful and the obesity problem remains or – heaven help us – gets worse, our kids today will start having heart attacks by the time they hit their 30s and 40s.

Also, last week, we learned that excess stress during adolescence may be setting young people up for more mood disorders as adults. http://bit.ly/azJOrI If there is one thing more universal among young people today than obesity, it’s stress. So, that’s just great news! And we learned that kids with hypertension have more learning disabilities. http://bit.ly/cKX6PP Since obesity is tightly tied to the development of high blood pressure – well, you can see the problem.

Is There Any Good News?

Here at the American Heart Association meeting, investigators reported that maintaining a healthy lifestyle from young adulthood to middle age plays a huge role in achieving a low cardiovascular disease risk profile in middle age.

In other words, the solution to the more-heart-attacks-sooner problem of tomorrow is helping young people make more heart healthy choices today.

Here’s the data: Researchers studied the long-term follow-up of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Researchers wanted to know whether adopting a healthy lifestyle from young adulthood to middle age can lead to a low cardiovascular disease risk profile in middle age – we already know that your risk factors in middle age play a big role in how healthy or unhealthy your cardiovascular system is years later.

CARDIA included 2,498 black and white participants 18 to 30 years old in 1985 at baseline. Compared to their peers, a healthy lifestyle was one that included:
• Not being overweight or obese
• Having no or only moderate alcohol intake
• Eating a diet with more potassium, calcium and fiber
• A lower intake of saturated fat
• Being more physically active
• And never smoking cigarettes.

After 20 years, more than 60% percent of people with all five healthy lifestyle factors from young adulthood to middle age showed a much lower risk profile compared to the less than 6% of people with none of the healthy lifestyle factors.

In this study, risk profile was based on common factors that influence your heart health: blood cholesterol, blood pressure, smoking, diabetes and history of heart attack. That means, for young people who had healthier lifestyles, they were less likely to later have major risk factors like high blood pressure, high cholesterol, etc.

We know that middle-aged adults with fewer cardiovascular disease risk factors have a longer life expectancy, dramatically lower rates of heart disease, better quality of life, and lower health care costs as they age. The same would appear to true of young people, too.

More good news: overall, even in this age of obesity, the majority of young adults have a low cardiovascular risk profile; they don’t have hypertension, they don’t have high cholesterol levels, etc. The majority! Only about 7% of American middle-aged men and women satisfy the low cardiovascular disease risk profile.

So, young people are starting out way ahead of their parents – but they’ll lose that advantage quickly if they don’t change some of their lifestyle habits.

Bottom line: More emphasis should be devoted to encouraging healthy lifestyles among young adults.

Not sure how to talk to kids about food? Last week I noted the fine line between obesity and eating disorders. At the time, I recommended this post, from Psychology Today, on talking to kids about eating, food, and weight. http://bit.ly/9mPKby

Forget You Even Know the Word Exercise: Choose to Move

Had another great conversation with a world-class medical investigator today, whose specialty is diabetes. Once more, the topic turned to the impossibility of getting middle-aged and older adults to exercise.

Maybe the real problem is the word itself. Exercise brings forth images of weightlifting, jogging, calisthenics. (Cripes, a shudder just went down my spine: I hated PE when I was a kid!)

The American Heart Association has the right idea and they call it: Choose to Move.

Here at the AHA meeting, investigators reported on this national Web-based intervention program. The 3,796 women in the organization’s national 12-week Choose To Move program were provided weekly activity guides and requested to complete surveys on activity, quality of life and readiness for activity.

Researchers evaluated 892 women who completed the program. Participants improved their activity from a median 240 to 343 kcal/week. What does that mean? Glad you asked. In daily conversation, the word calorie is used instead of the more precise scientific term kilocalorie. When a fitness chart says you burn about 100 calories for every mile you jog, it means 100 kilocalories.

So, we burn calories when we are active (notice I did not say the E word) and all these women did was increase the number of calories burned in a week by a little over 100 calories – and their body mass index improved from 29.3 to 28.9 kg/m2 after 12 weeks. Also, they were scored on how much energy they had and their overall well-being; both improved with such a small increase in activity.

Forget jogging; depending on your weight, 100 calories would be about what you would burn in a 20-minute walk. That is do-able for just about anyone!

For more than 2 years now, I walk 2.2 miles with my youngest son (he’s 16) every night. Eric and I are both in much better shape.

There is an old saying, “Use it or lose it.” Don’t think about the E word. Exercise is something we did in school and we either loved it or hated it. Sadly, that became our mental image of exercise and now we think we have no time or energy for that. Or we just think we would look ridiculous in our old gym suits. The trick is to realize that all you need is a different point of view: move it or lose it.

NOTE: The American Heart Association has a FREE 12-week online nutrition and fitness program. Go to http://bit.ly/9dNfAu

The Eyelids Have It: Your Eyelids May Predict Risk of Heart Attack, Death

Think of me as a medical version of Lewis Black: When a medical story falls through the cracks, I’m there to catch it. Here’s a story from the American Heart Association meeting in Chicago that should have gotten some attention:

Cholesterol deposits on eyelids, which has the jaw-breaking name of “xanthelasmata,” (say that 3 times fast) predict your risk for heart attack, artery disease and early death.

The Danish team reporting the data say that because half of the people with the deposits have normal blood cholesterol levels, the eyelid lesions may be an important independent marker of underlying artery disease.

Here’s what the study showed:

Copenhagen researchers established the presence or absence of xanthelasmata at baseline in 12,939 people. Of these, 1,903 developed heart attacks, 3,761 developed ischemic heart disease and 8,663 died during up to 33 years of follow-up. Cumulative incidence of ischemic heart disease and heart attack as a function of age increased in those with xanthelasmata, and the proportion surviving decreased.

Xanthelasmata predicted 51% increased risk of heart attack and 40% increased risk of ischemic heart disease. Those with xanthelasmata also had a 17% increased risk of death after adjustments for well-known cardiovascular risk factors including blood cholesterol levels.

OK, here’s the hard science for those who enjoy it: The results suggest that other factors besides cholesterol levels — including capillary leakage, characteristics of macrophages or intercellular matrix components — “may predispose certain individuals to both xanthelasmata and to atherosclerotic disease and early death,” researchers said.

“In societies where other cardiovascular disease risk factors can’t be readily measured, presence of xanthelasmata may be a useful predictor of underlying atherosclerotic disease,” researchers said.

One editorial note: This flies against some earlier data. In 2008, investigators reported no link between xanthelasmata and cardiovascular disease risk. (Read the story here: http://bit.ly/9I1LVU) Granted, it was a much smaller study, so the work from the Danish investigators may be more reliable because of its sheer size.