Health Numbers: Waist Circumference, LDL, HDL, Triglycerides, Fasting Blood Sugar, Blood Pressure
The American Medical Association no recognizes obesity as a disease. The focus on obesity goes way beyond appearance. We know that when waist circumference goes up, the cost of providing health care goes up as well. When waist circumference goes above 35″ for women and 40″ for men, there are metabolic and hormonal changes that increase systemic inflammation, weaken the immune system, and increase the risk of developing diabetes, heart disease and cancer. At a healthy weight, our bodies are like a symphony with metabolism and other physiologic activities happening efficiently and responsively. But when waist circumference becomes unhealthy, the body becomes less efficient and less responsive setting up for a cascade of events that lead to heart disease, diabetes and cancer, especially when coupled with family history. Knowing your health numbers – your waist circumference, lipids, fasting blood sugar and blood pressure, can give you an indication of how your body is performing and what is your health risk.
It’s more than just total cholesterol. Know what your LDL or “bad” cholesterol is. This cholesterol is what creates plaque and hardening of the arteries. Eating a diet high in saturated and trans fats does to your arteries what pouring bacon fat down your kitchen sink does to your drain. Eventually you get narrowing and clogging leading to poor nourishment below the clog and increased work load for the heart as it is forced to pump harder to get blood and nutrients to all parts of the body. Ideally LDL should be below 100, for those with heart disease or diabetes the goal is to get it to below 70. The HDL or “good” cholesterol is the happy garbage truck that takes the LDL back to the liver where it is eliminated from the body. It protects the heart and the arteries. It should be greater than 40 and really greater than 60 to be protective. Elevated triglycerides occur when too many calories are eaten than what the body needs at one time. The extra fat is stored as triglycerides in fat cells and can be used for energy between meals. But when people regularly eat too many calories – particularly those with high carbohydrate and fat, then this leads to chronically high triglyceride levels and hardening of the arteries or atherosclerosis. The American Heart Association recommends a triglyceride level below 100 for optimal heart health.
Fasting Blood Sugar
Type 2 diabetes has a story; it does not just appear suddenly. If somebody has a family history of type 2 diabetes then we know they have a stronger likelihood of developing it as well. When family history is combined with obesity, inactivity and a diet with excessive refined carbohydrates and unhealthy fats, we know the “perfect storm” is created leading to type 2 diabetes. We can tell that this is developing by looking at fasting blood sugars over time. Gradually the blood sugars will go from 70’s, to 80’s then 90’s and then over 100. If someone has a fasting blood sugar 100 or greater on 2 occasions then they have prediabetes, a preventable precursor to diabetes. This can also be tested using a lab test called HbA1c that looks at an average of blood sugars over a 2-3 month period. A result of 5.7 or greater indicates prediabetes. A result of 6.5 or greater indicates diabetes.
A healthy blood pressure protects the heart muscle as well as the walls of our arteries. The top number or systolic number represents the pressure your heart has to pump against inside your arteries. The higher the number, the harder your heart has to pump. Over time this can lead to thickening and weakening of the heart muscle. The bottom number or diastolic number represents the pressure between beats of the heart. This number is important because this is when the heart itself gets its nutrients. Consistent numbers greater than 120/80 indicate some concern and need for intervention in order to avoid long term damage to the heart and arteries.
Your Life Is In Your Hands
I tell my clients that we can not choose the cards we are dealt – meaning we can’t change our family health history – but we can affect how those cards are played. Knowing your numbers is like knowing all the strengths and weaknesses of your hand, not just working with wild cards. This can motivate you to gradually change unhealthy habits and to protect your health. Unfortunately we do not feel whether blood pressure, lipids or blood sugars are elevated. We only know when we have them checked, understand their significance and play our cards wisely.