Ask The Doctors Women's Edition: April 2014
Q. My doctor recently told me to lose weight to help with my heart health. How much weight do I need to lose to actually gain cardiovascular benefits?
A. More than 60 percent of U.S. adult women are overweight, according to 2007 estimates from the National Center for Health Statistics of the U.S. Centers for Disease Control and Prevention. Additionally, more than a third of overweight adult women are obese. It’s known that being moderately overweight or obese increases your risk of cardiovascular disease.
While it seems that you would have to lose a lot of weight to benefit, new research shows that overweight and obese women who lost a modest amount of weight and kept it off for two years saw improvement in almost every measure of cardiometabolic health.
A study published in the Journal of the American Heart Association shows that after 24 months of a diet intervention, LDL cholesterol, C-reactive protein (CRP) insulin and triglycerides (TD) were reduced in women who lost just less than 10 percent of their body weight.
You can determine if you’re at a healthy weight for your height by calculating your body mass index (BMI). Your BMI is a measure of body fat based on height and weight that applies to adult men and women. The BMI categories for adults are as follows:
Underweight = less than 18.5
Normal weight = 18.5-24.9
Overweight = 25-29.9
Obese = BMI of 30 or greater
To calculate your BMI, visit the National Heart, Lung and Blood Institute’s web site at http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm.
Q. I recently underwent an electron beam computed tomography (EBCT), which showed calcium in my heart. Is there a relationship between calcium and heart disease?
A. An electron beam computed tomography (EBCT) is a type of coronary calcium test that looks for specks of calcium in the walls of the coronary (heart) arteries. Specks of calcium are often deposited in the walls of the coronary artery where atherosclerosis or “hardening of the arteries” has developed, and are known as calcifications. An early sign of coronary heart disease, the amount of calcium seen on X-rays correlates with the amount of atherosclerosis in the coronary arteries.
Research has shown that a high calcium score has been associated with worse cardiovascular outcomes. A coronary artery calcium score was most helpful for people considered to be at intermediate risk of a heart disease — defined as those with a 3 to 10 percent chance of developing heart disease over the next five years — according to a study published in the Journal of the American Medical Association.
However, it’s important to understand that calcium intake in your diet does not cause calcium build-up in the arteries, so you should not limit your intake of calcium because of this concern. Additionally, while a calcification is a risk factor for heart disease, it does not necessarily correlate with stenosis, or narrowing of the heart arteries, which indicates specific areas of the heart that might be involved in a heart attack.
Coronary artery calcium scanning is not generally recommended as a screening test.
Q. I’m on a strict diet to manage my heart condition and have heard that I should avoid eggs. Can I include any eggs in my diet, and if so, how many per week?
A. Eggs are an excellent source of protein, but are high in cholesterol. One way to include eggs in your diet and avoid the cholesterol is by eating egg whites, or through cholesterol-free egg substitutes, which are made of egg whites. However, for regular or “real” eggs, you should consider the recommended daily limits on cholesterol in your food: If you are healthy, limit your dietary cholesterol to less than 300 mg a day.
If you have cardiovascular disease, diabetes or a high low-density lipoprotein (LDL, or “bad”) cholesterol level, dietary cholesterol should be limited to less than 200 mg a day.
Keep in mind that one large egg has about 186 mg of cholesterol—all of which is provided by the yolk. If you decide to eat an egg on a given day, it’s important to limit other sources of cholesterol for the rest of that day. Instead, consider substituting servings of vegetables for servings of meat, or avoid high-fat dairy products for that day.