What am I referring to? Cancer? Heart attacks? AIDS? Ebola Virus? No, no, no, and NO. Obesity—that’s what our most serious epidemic is . . . right now and for the foreseeable future. As the article about childhood obesity makes clear in our News & Events section, obesity (that’s the step beyond just being overweight) carries dangers greater than mere social disapproval.
The biggest issue with obesity is insulin resistance. Insulin is secreted by the pancreas in response to the ingestion of glucose (sugar) and helps the body absorb the glucose into muscle, liver and fat cells. Increased adipose tissue (the medical term for “fat”) makes these tissues more resistant to insulin. This leads to two things: increasing blood levels of glucose, the hallmark of diabetes, and increasing secretion of insulin to try to overcome the resistance.
Unfortunately, the insulin-resistant state, itself, creates adverse effects on the cardiovascular system, including worsening of lipids (cholesterol and other fats that clog the arteries) and increasing inflammation. The article cited above reminded me of a shocking story recently in which a very obese four-year old child had developed type 2 diabetes. When I was in medical school in the 1980s, “type 2 diabetes” was synonymous with “adult-onset diabetes.” It was unheard of for a child to develop type 2 diabetes. For small children to develop this type of diabetes, they have to have profoundinsulin resistance and that only occurs with severe obesity.
So, the epidemic of obesity is very concerning to cardiologists. It means that younger and younger people will develop diabetes and coronary heart disease and start to reverse the trends in controlling coronary heart disease that we have achieved over the last several decades.
Yes, obesity is a very real and serious epidemic. We all must work hard to fight this epidemic by eating healthily, avoiding high-carbohydrate meals— particularly high glycemic index foods—and exercising regularly. If you need some help with your diet, make an appointment a dietician.
-Greg Koshkarian, MD, FACC