A prime example of how media will take a study and leave out key points in order to scare people. Gotta love it.
All over, the news outlets are talking about how people should maybe lay off the calcium because there may be too much risk for a cardiovascular incident versus osteoporosis prevention. What they conveniently forget to mention is that the calcium used did not contain any vitamin D, which is pretty much standard faire in the US. Vitamin D is renowned for lowering cardiovascular risk.. perhaps this study highlights that now more than ever? I can say fairly confidently that people are waking up to the need of vitamin D and post-WLS folks are some of the most educated in that realm. WTG WLSers!
Additionally, it should be noted that the problem is with fluctuating serum calcium levels — something that doesn’t happen as often with post-WLS patients as our absorption does not work the same way. Food for thought: how many post-ops, people who routinely take 1500-2000mg of calcium citrate a day (or should be..) are dropping like flies with heart disease? Not many.
Am I worried? No.
Wow. That’s sobering.
And we know what the number one cause for heart disease is, right?
(Don’t make me slap you silly. Cause I will.)
From MSNBC.com:
Heart disease to kill 400,000 in U.S. in 2010
Experts: Progress against cutting cholesterol stalled by rising obesity rates
LONDON – Decades of progress in the United States on cutting cholesterol, blood pressure and smoking are being stalled by rising obesity rates, and heart disease will kill around 400,000 Americans this year, experts said on Monday.
A study by British scientists found that around half of those deaths could be averted if people ate healthier food and quit smoking, and experts warned there was no room for complacency when it came to heart health risks.
Simon Capewell of the University of Liverpool said recent weight trends were “alarming,” with 1.5 billion adults worldwide expected to be overweight by 2015.
“Although (heart disease) death rates have been falling in the United States for four decades, they are now leveling off in young men and women,” he wrote in a study in the World Health Organization’s weekly journal.
“Recent declines in total blood cholesterol have been modest, blood pressure is now rising among women and obesity and diabetes are rising steeply in both sexes.”
The researchers calculated the number of deaths based on lifestyle trends, taking the year 2000 as a base.
They found that almost 200,000 lives could be saved if certain heart risk factors were cut, even modestly, in particular, Capewell said, “if people ate healthier food and stopped smoking.”
Two-thirds of U.S. adults and nearly one in three children are overweight or obese — a condition that increases their risk for diabetes, heart disease and other chronic illnesses.
U.S. health officials last week introduced first lady Michelle Obama as their latest weapon in a fresh campaign against the increasingly-costly weight burden.
But Shanthi Mendis, an expert on chronic disease prevention at the Geneva-based WHO, noted that the United States was not alone in facing an obesity epidemic, and said lifestyle choices now directly affected the health of many of the world’s people.
“Worldwide, nearly one billion adults are overweight and, if no action is taken, this figure will surpass 1.5 billion by 2015,” she said in the study.
“By avoiding tobacco, eating a healthy diet and engaging in regular physical activity, people can dramatically reduce their risk of developing heart disease, stroke or diabetes.”
Not a good day, news-wise.
From Medscape:
Obesity on All Measures Linked to Increased Ischemic Stroke Risk
January 22, 2010 — No matter how it is measured, obesity is a significant risk factor for ischemic stroke, not only in men and women but also in both blacks and whites, a new study has found.
The study, which used all 3 measures of obesity — body mass index (BMI), waist circumference, and waist to hip ratio (WHR) — was among the first to look at the association between obesity and stroke risk in blacks and whites.
“This was the first study that shows consistently that obesity increases risk of stroke in both blacks and whites,” said lead author Hiroshi Yatsuya, MD, PhD, visiting associate professor in the Division of Epidemiology & Community Health at the School of Public Health, University of Minnesota, Minneapolis.
The study reinforces the message that controlling obesity, which may help prevent hypertension and diabetes, may reduce the risk for stroke, he said.
The study was published online January 21 and will appear in the March issue of Stroke.
Obesity Measurements
The analysis included 13,549 participants (5930 men and 7619 women and 3694 blacks and 9855 whites) aged 46 to 64 years from the Atherosclerosis Risk in Communities (ARIC) Study who were recruited from 4 US communities and followed up from 1987 to 2005.
Participants were interviewed over the telephone and completed several clinic visits.
To determine obesity, researchers used BMI, that is, weight in kilograms divided by height in meters squared, waist circumference alone, and WHR, the ratio of waist circumference taken at umbilical level to hip measurement taken at maximum buttock circumference.
Table. Mean Obesity Measures at Baseline by Race and Sex
Group BMI Waist Circumference Waist to Hip Ratio Black women 30.8 100.3 0.90 Black men 27.6 96.7 0.94 White women 26.6 93.0 0.89 White men 27.4 99.5 0.97 BMI = body mass index
During follow-up, there were 598 ischemic strokes. Researchers confirmed the incidence of stroke through hospital discharge records and imaging information. Blacks had a 2 to 3 times higher incidence of ischemic stroke compared with whites in each obesity group.
The researchers calculated stroke incidence according to different quintiles of obesity, using all 3 obesity measures. For BMI, they found that the stroke incidence per 1000 person-years ranged from 1.2 for white women in the lowest category to 8.0 for black men in the highest category.
Linear Relationship Between Stroke and Obesity
For other obesity measurements, the stroke incidence rate had a similar range. Using waist circumference, the rates ranged from a low of 1.1 per 1000 person-years for white women in the lowest quintile to 8.2 in black men in the highest quintile. Using WHR, the lowest rate was 1.1 for white women in the lowest category, and the highest was 8.2 for black women in the top category.
No matter what obesity measure was used, the results showed about twice the stroke risk among patients in the highest category compared with those in the lowest. For example, for BMI, the risk for patients in the highest category was 1.4 to 2.1 times higher than those in the lowest BMI category (varying modestly by race and sex).
Dr. Yatsuya noted that the correlation between increasing stroke incidence and increasing degree of obesity was apparent in both races and sexes.
However, said Dr. Yatsuya, much of the association between stroke and obesity in this study could be explained by diabetes and hypertension, both of which are well-established risk factors for stroke.
“Either blood pressure or diabetes mellitus alone could have eliminated significant associations between obesity measure quintiles and ischemic stroke incidence,” the study authors point out.
Given the strong association between obesity and hypertension and other risk factors, including diabetes, they conclude that “obesity would be an important target for prevention of ischemic stroke.”
Best Measure?
There is still a debate in the scientific community about which measure of obesity is most accurate. According to Dr. Yatsuya, BMI might be the easiest to obtain because a clinician just needs to know height and weight. Getting an accurate waist circumference and WHR may be challenging in obese patients, he said.
Using proportion attributable fraction values — the proportion that might be prevented by eliminating a risk factor — the researchers estimated that 18% to 20% of ischemic stroke may be accounted for by a BMI of 28 or more.
Stroke is the third leading cause of death and the leading cause of serious long-term disability in the United States.
Reinforces Obesity Importance
Reached for a comment, Ralph L. Sacco, MS, MD, professor and chair of neurology at the University of Miami in Florida and a member of the American Academy of Neurology, said the study is a “well-done, large, prospective study” that reinforces the importance of obesity as a risk factor not just for heart attack but also for stroke.
One of Dr. Sacco’s own studies, using data from the Northern Manhattan Stroke Study and published in 2003, showed an elevated stroke risk for both blacks and whites using WHR but not BMI (Suk SH, et al. Stroke 2003;34:1586-1592).
“This [new] study is much larger and has much more statistical power and was able to show BMI, as well as waist circumference and waist-to-hip ratio, all great markers for obesity, increased risk in both blacks and whites,” he notes.
Another report from the Northern Manhattan Cohort Study by Dr. Sacco and colleagues, published last year in the Journal of the American College of Cardiology, showed that an elevated waist circumference in both men and women and across whites, blacks, and Hispanics increased the risk not only for stroke but also for myocardial infarction and vascular death (Sacco RL, et al. J Am Coll Cardiol. 2009;54:2303-2311).
All this research is important because obesity is becoming “an alarming trend,” with Americans being less physically active and following unhealthy diets, said Dr. Sacco. “We’re concerned about a higher proportion of the US population that will be obese and at higher risk for high blood pressure, diabetes, and now definitely stroke.”
Dr. Sacco also noted that in this new study, the stroke risk drops after controlling for other factors. “To us, this just means that some of the effect that obesity has is through high blood pressure, diabetes, and other vascular risk factors.”
The ARIC Study was funded by the National Heart, Lung, and Blood Institute. The authors have disclosed no relevant financial relationships.
Stroke. Published online January 21, 2010.
Via CNN.com
About time people are getting the message. Vitamin D has been linked to everything from lowering cancer risk, stroke, heart disease, hypertension, auto-immune disorders, diabetes, and depression.
A few notables..
In the first study, May and her colleagues measured blood levels of vitamin D in 8,680 people age 50 or older who had been diagnosed with heart disease, stroke, or another type of cardiovascular disease. vitamin D levels above 30 nanograms per milliliter of blood (ng/mL) were considered normal, levels between 15 and 30 ng/mL were low, and those 15 ng/mL and below were deemed very low.
Among those with very low levels of vitamin D, 32 percent were depressed, as were 25 percent of the people with low levels, and 21 percent of those with normal levels. This trend was seen even among individuals with no history of depression.
…
In the second study, which looked at 27,686 people age 50 or older with no history of cardiovascular disease, May and her colleagues found that, compared to individuals with normal levels of the vitamin, people with very low levels of vitamin D were 77 percent more likely to die, 45 percent more likely to develop heart disease, and 78 percent more likely to have a stroke during the study, which lasted for more than a year. They also had double the risk of heart failure.
…
Holick advocates raising the daily limit to 10,000 IU. Many researchers agree and have suggested that the toxic level of vitamin D is closer to 10,000 IU/day.
Keep in mind that 10,000 IU / day number is for normies.. not for those with designer guts.
