A Bit Of A Twist

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Have you given a thought to Valentine’s Day yet?  I suspect for most people it’s a last minute scramble for dinner reservations or roses.  The Valentine cards and candy in stores have been staring us in the face since Christmas Eve.  But most of us have had a few other things on our minds, things like floods, flu, holiday bills, and taxes.  Hearts and flowers aren’t top priorities for most folks unless they work for Hallmark or Russell Stover.

This year there’s a bit of a twist.  February 14th is Valentine’s Day and Ash Wednesday.  It’s most unusual.  As soon as I noticed this anomaly on the calendar, I realized several things would happen.  Some people would turn it into a theological controversy over which observance should take precedence.  I’ve always been perplexed by the propensity of some people to promote “either-or” thinking.  Sure enough, several prominent clerics have issued stern statements about the obligation of their members to fast and forego any Valentine treats.  That’s their call.

Some people will slog through the day unaware of either observance.  They don’t worry about philosophical or theological dilemmas, and, for the most part, they’re not terribly romantic or thoughtful to begin with.  No big deal.

I have a different take on this.  As a 63-year-old woman, I’ve had my share of lovely Valentine surprises and a few bitter disappointments.  That’s life.  As a geriatrician, I know how many sick, lonely, elderly people are ignored on Valentine’s Day.  That’s sad.  As a lifelong Catholic, I understand that Ash Wednesday is all about spiritual priorities and discipline.  We’re not supposed to be self-indulgent morning, noon, and night.  That’s prudent.

Here’s the good part:  Valentine’s Day and Ash Wednesday don’t have to be at odds with each another.  There is no need for “either-or” thinking.  St. Valentine was a real man, a priest who brought great kindness and love to persecuted people in third century Rome.  He was martyred for his devotion in 270 A.D.  Ash Wednesday is a major reminder that life is short.  The only thing we’ll take with us at the end is the love and compassion we have shown to others.

We all have patients, colleagues, neighbors, and even passing strangers in our lives who will be neglected on February 14th unless we remember them.  Valentine’s Day and Ash Wednesday.  Curious.  There’s never a need to “fast” from being thoughtful.

Obesity and Heart Disease

Posted on Posted in Continuing Education, Homestudy, Nutrition

thick-373064_640By Dr. Mary O’Brien MD

Longitudinal studies clearly indicate that obesity predicts coronary atherosclerosis in men and in women. Hypertension, a leading cause of atherosclerosis, is approximately three times more common in obese individuals than in those who are of normal weight or less than normal weight.

Body mass index (BMI) is one of the most effective ways to measure obesity. Some studies show that a BMI that is between 25 and 30 confers as much as a 70 percent increased risk of coronary heart disease.

However, a high BMI may not entirely predict heart disease risk. In women, a BMI near 30 may still not be of major concern when the increase in fat tissue is distributed over the hips and not the abdomen.  Accumulating evidence indicates that an increased waist circumference, or waist-to-hip ratio (WHR), predicts complications and mortality from obesity.

Weight-reduction seems to be effective in reducing risks of coronary heart disease (CHD) and congestive heart failure (CHF), potentially preventing heart disease in obese patients. Evidence indicates that, for obese patients, a reduction of only five percent to 10 percent of body weight improves lipid profiles, insulin sensitivity, and endothelial function.  Such a reduction also reduces thrombosis and inflammatory markers.

Maintaining a BMI of less than 25 throughout adult life is a good strategy to reduce the risk of heart disease. For most patients with a BMI between 25 and 30, lifestyle changes in diet and exercise are appropriate.

Restricting consumption of fat to less than 30 percent of total calories should be recommended, because low-fat diets also promote weight reduction. Physical training programs can reduce body mass and help bring about gradual weight loss.

Medical therapy may be necessary in patients with a BMI higher than 30. However, the safety of long-term use of anti-obesity medications has not been established. When the BMI falls within the range of 35 to 40 (or above), bariatric surgery may be an option. Unfortunately, less than five percent of patients are able to maintain their reduced weight four years after surgery. Thus, the prevention of obesity with diet and regular physical activity appears to be the most dependable way to maintain cardiovascular health.

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