Obesity and Cardiovascular Disease

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Medically reviewed by: Robert Philibert MD PhD

Impact of Obesity

On the rise for decades, obesity is prevalent now more than ever. Obesity affects both adults and children, and is associated with other conditions such as cardiovascular disease, diabetes, and hypertension. In those with cardiovascular disease, obesity increases the likelihood of other cardiac complications. The Obesity Medicine Association defines obesity as a chronic, relapsing, neurobehavioral disease. An increase in body fat promotes adipose tissue dysfunction, resulting in metabolic adverse effects throughout the body. While obesity can be a result of different factors, there are some key contributors. Risk factors for obesity include:

  • Genetics: There have been more than 140 chromosomal regions identified that relate to obesity. Many of these genes implicated in obesity have key roles in the central nervous system.
  • Epigenetics: Epigenetic changes, which are non-coding modifications to DNA that affect gene expression, are associated with obesity.  Many of these changes cosegregate in families which highlights the important role of good family health and diet for all family members.
  • Behavioral functions and environmental factors: These include factors such as disrupted sleep schedules, stress, infections, and physical inactivity.


How does obesity cause cardiovascular disease?

Obesity contributes to heart disease in many ways. Obesity promotes inflammation, driving adipogenesis. Adipogenesis is the formation of adipocytes (fat cells) from stem cells. As adipose tissue accumulates, there are often corresponding alterations in factors that promote risk for heart disease.  For example, with greater adiposity, serum triglyceride and cholesterol levels may increase. Along with this, obesity can start a vicious cycle with  increasing blood pressure levels. Obese individuals require more oxygen input and nutrients, resulting in a need for increased pressure to move blood around. These factors increase cardiac workload, fatiguing the patient, while also increasing risk for diabetes, yet another risk factor of heart disease. Increases in body fat result in atherosclerosis, atrial enlargement, and ventricular enlargement.  Therefore, it is important to address obesity early in its course, before it can lead to a cascading set of complications leading to heart disease.

Maintaining a Healthy Lifestyle

Weight loss is key to maintaining a healthy weight, especially for individuals with comorbidities. Understanding how excessive weight gain is detrimental to body functions is a step to making healthier decisions. Active and mindful living can help reduce some of the risk factors associated with obesity:

  • Stay physically active! Go for a short stroll, run, or do your favorite exercise for at least 45 minutes a day a few times a week.
    • Staying active promotes a healthier heart, improves circulation and lowers cholesterol/sugar levels.
  • Reduce stress. Try out some breathing exercises, meditation, yoga or listen to relaxing music.
  • Talk with your doctor about creating a balanced nutritious diet plan that works best for you. Having a consistent diet or meal plan may help in the long run.
  • Know the foods and beverages that you are consuming! Make sure they aren’t high in “hidden” fats and sugars. Be wary of products that contain “empty calories.”

 

References:

  1. https://www.ahajournals.org/doi/10.1161/circulationaha.106.171016
  2. https://www.acc.org/latest-in-cardiology/articles/2018/07/06/12/42/cover-story-obesity-and-cardiovascular-disease-risk
  3. https://pubmed.ncbi.nlm.nih.gov/16627822/
  4. https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2019/march/obesity-and-heart-disease
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