As a Family Physician and Lipidologist (cholesterol specialist), I have seen many patients who are confused about heart disease risk, and the factors that contribute to other diseases as well. 

We know that approximately 1 million people suffer from a heart attack each year in the United States.  One third of those people don’t survive the attack, and nearly half of those people never have chest pain or any cardiac event such as bypass surgery or angioplasty prior to suffering their heart attack.  Their only warning sign was the heart attack itself. 

The same risk factors for heart disease are also the risk factors for stroke (and often diabetes and even cancer).

In our office, we use a 5-factor process to evaluate patients’ risk factors for these diseases.  If they meet or exceed three out of five then we diagnose them with The Metabolic Syndrome;  these patients are at “higher risk.”  These specific risk factors are:

1. Waist Circumference: Males with a waist size  greater than 40 inches, or Females with a waist size greater than 35 inches.   This is NOT the belt size, but an actual measurement of the widest part of the waist around the belly.

2. Triglycerides: Triglyceride levels over 150.

3. HDL (Good Cholesterol): For males, less than 40, and females less than 50.

4. Blood Pressure: Systolic Levels (top number) over 130, OR Diastolic (bottom number) over 100.

5. Blood Sugar: A fasting blood sugar at or over 100.  (Although less than 100 is acceptable, 87 or less is a much more acceptable goal).

Fat in the belly is the key indicator for all of these factors. Losing “belly fat” weight could have the single largest impact on reducing the risk of disease.  Although regular exercise and a healthy diet is important, it is even more important to be at your ideal weight.    Two-thirds of Americans are considered “overweight” with a body mass index (BMI) of over 25, and 1/3 of all Americans are considered “obese” with a BMI of over 30.  The problem is prevalent in our culture, but can be reversed.

So what can you do to determine if you are at risk for heart disease, diabetes, stroke and cancer?

You probably have a good sense of whether or not you have a family history of these diseases.  Measuring your waist circumference is easy, and you may have already had a recent cholesterol screening, and blood pressure test, but a thorough physical from your doctor would be a great idea for the new year.  Some physician offices might evaluate the five key factors we mentioned, but some may not.  Many routine physicals include blood pressure, height and weight, but be sure to ask for a cholesterol screening, fasting blood sugar test, and measurements of your waist and body mass index (BMI) at a minimum.

Once patients have been evaluated, we consult with them about their lifestyle, and the most effective way to help them improve these key health factors.  Losing weight is the most common and effective strategy.  In our office, we offer physician-supervised weight loss programs.  Some patients require medication, changes in diet, exercise, stress reduction, or a combination of these strategies.

This new year, make it your resolution to lose weight for your health (especially belly fat) and make an appointment with your doctor for a thorough physical for the right health strategies in 2007.