Diet & Weight Loss Archive

Many Americans have fatty liver disease, a condition that can lead to serious liver problems.

If you're not a big drinker, you may not give much thought to the health of your liver. But there might be reason to be concerned. An estimated 64 million Americans have an often-symptomless liver condition called nonalcoholic fatty liver disease (NAFLD), which may put them at risk not only for serious liver disease, but for heart disease as well.

Many people — including doctors — didn't pay much attention to NAFLD until the 1980s, but life insurance companies have had this issue on their radar for years, says Dr. Michelle Lai, an assistant professor of medicine at Harvard Medical School. They knew that an abnormal liver blood test could reflect a lower life expectancy, and they set the premium higher or decline to insure people with the condition, she says.

New guidelines provide advice on the role of drugs, weight loss, and procedures to cope with this common heart rhythm disorder.

The classic symptom of atrial fibrillation — a fluttering or thumping sensation in the chest — can leave you breathless, dizzy, and tired. Caused by electrical misfires in the heart's upper chambers (atria), this condition affects an estimated one in 11 people ages 65 and older.

While the symptoms of atrial fibrillation (often called afib) can be unsettling, the real danger is a heightened risk of serious strokes (see "How afib can lead to a stroke"). As many as 30% of strokes from afib prove fatal, notes Dr. Christian Ruff, a cardiologist at Harvard-affiliated Brigham and Women's Hospital.

Ask the doctors

Q. I don't need to lose weight, so I don't exercise very often, but I maintain a healthy diet. Could my lack of exercise lead to health problems?

A. Exercise is essential for good health — even if you're not overweight. This point is illustrated by a recent study, published March 1 in The American Journal of Cardiology. It found that 30% of normal-weight people who were sedentary had the same risk of heart attack and stroke as people who were overweight. In short, just being at a healthy weight didn't necessarily ensure that someone was in good health. In addition to having a higher risk of serious cardiovascular events, some inactive but normal weight people were also more likely to have labored breathing during exercise and a larger-than-recommended waist circumference, compared with normal-weight adults who exercised regularly.

Managing emotionally driven weight gain requires planning ahead.

How much and when you eat isn't driven just by hunger, which you likely already know if you've ever found yourself hunched over a bowl of ice cream after having a particularly stressful day. Stress can set off a cascade of physical reactions in your body that may not only drive you to eat more and make you crave less nutritious, fattening comfort foods, but also help you pack on extra pounds much more easily.

"Stress drives up levels of a hormone called cortisol in the blood," says Dr. Fatima Cody Stanford, an instructor in medicine at Harvard Medical School. Cortisol is a hormone produced by the adrenal gland that helps to regulate your metabolism. It also plays a role in blood sugar management and memory. When levels of cortisol rise, it can promote inflammation and may spur the body to start stockpiling fat around the midsection. "Stress might also disrupt sleep and drive people to seek out food when they wouldn't normally — such as in the middle of the night," says Dr. Stanford.

A high intake of sugar is linked to an increased risk of obesity, type 2 diabetes, cardiovascular disease, and certain cancers. But whether some sugars are healthier (or worse) than others remains a question of interest to many.

Are you doing everything you can to keep your heart healthy?

After decades of steady decline, the number of deaths from cardiovascular disease (CVD) has risen over the past few years, according to the American Heart Association.

The good news is that an estimated 80% of all CVD cases — heart disease, heart attack, heart failure, and stroke — can be prevented. The key is to control high blood pressure and high cholesterol and to maintain healthy habits, such as exercising regularly, eating a plant-based diet, getting enough sleep, and not smoking.

Eat breakfast? Skip breakfast? Newer research fails to link eating breakfast with eating less or weight loss. So, will skipping breakfast shave off weight?

News briefs

Many people think the only reason for regular exercise is that it helps you maintain a healthy weight. Not true. A sedentary lifestyle can cancel the potential heart benefits of weight control, according to a study published online Dec. 4, 2018, by the American Journal of Cardiology. Researchers looked at five years' worth of health survey responses and weight calculations from thousands of overweight and normal-weight people ages 40 to 79 who'd never had heart disease. Scientists noted the participants' amount of abdominal fat, waist size, and self-reported amounts of physical activity, then calculated everyone's cardiovascular disease risk. The results: 30% of sedentary people with a normal weight had about the same risk for a heart attack or stroke as people who were overweight. Sedentary adults whose weight was normal also had higher levels of belly fat, shortness of breath upon exertion, and an unhealthy waist circumference compared with normal-weight adults who exercised regularly. However, people with a normal weight who exercised at least 150 minutes per week were 58% less likely to have a heart attack than those in the study who were overweight.

 Image: Halfpoint/iStock

These trendy programs may encourage healthier eating and even weight loss. But consider the cost and sustainability.

For people who don't have the time, energy, or interest to plan and prepare their own meals, a subscription meal delivery service may be an appealing option. A growing number of companies will deliver partly (or even fully) prepped meals right to your door. Many cater to a variety of dietary preferences, including vegetarian and gluten-free. Some are geared toward people seeking to lose weight or who have diabetes, and at least one provides low-sodium meals.

If you're concerned about preventing or treating heart disease, what should you consider before trying one of these plans? That depends on your particular situation, says Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital.

Excess fat around your midsection is especially dangerous for your heart.

For decades, experts have warned that a big belly is more harmful to your heart than extra padding in your hips and thighs. A growing number of Americans now sport this unhealthy "apple-shaped" profile, according to the latest statistics from the CDC.

The average waist circumference for men is now 40.2 inches, up from the 39 inches recorded in the last survey, which was done in 1999–2000. Women's waist measurements also rose — from an average of 36.3 to 38.6 inches. That means that a majority of Americans now have belly sizes that put them at high risk (see "Gut check: How to measure your midsection").