Hidden Epidemic: Heart Disease in America
Take One Step: A PBS Health Campaign
Hidden Epidemic: Heart Disease in America + Take One Step for a Healthy Heart with Larry King  

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Chapter 5 - Heart Disease & Obesity [3:31]

The role obesity plays. Know your waist-hip ratio. Good ideas for better eating. Why dental care matters.

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Transcript: Chapter 5 - Heart Disease & Obesity

The role obesity plays. Know your waist-hip ratio. Good ideas for better eating. Why dental care matters.

DR. STEVEN NISSEN: One that we're really struggling with now in America is the obesity epidemic. Each decade for the last five or six decades as a society we've gotten fatter. And people need to understand what that does, particularly fat that accumulates in the abdomen, that that fat in the abdomen--

DR. MICHAEL ROIZEN: That's the apple shape as opposed to the pear shape.

DR. STEVEN NISSEN: The apple shape as opposed to the pear shape, Dr. Roizen points out. That people who are shaped like an apple, who have fat in their abdomen, that fat actually puts out substances which cause inflammation to occur in the arteries, and that's one of the triggers for the plaque buildup in the arteries that causes heart disease.

And so if you've got a big waistline, you really want to pay attention to it. Don't think just because you're taking a statin drug to lower your cholesterol that you've taken care of the problem. If you've got abdominal obesity, that's another source driving this disease.

DR. MARIANNE LEGATO: Here's a tip for the informed patient. Ask your doctor to tell you your waist/hip ratio, the relationship between the inches of your waist vis-a-vis your hips. And if your waist/hip ratio is not ideal or below, you really need to pay attention to that apple shape.

LARRY KING: I know we all-- I changed my eating habits after heart attack, especially after the heart surgery. I cut out meat most of the time. I'll eat steak once a month. I went to fish and vegetables and steamed foods and the like. Are we what we eat?

DR. STEVEN NISSEN: You bet. You know, diet is very, very important. And it won't lower cholesterol levels in everybody, but it will lower them some for almost everyone.

LARRY KING:What steps can we take?

DR. STEVEN NISSEN: Well, I think clearly eating less saturated fat. That's meat fat, butter, milk fat, those sorts of products. And more poly- and mono-unsaturated fats. Vegetable oils. Nuts are very healthy. So this is called a Mediterranean diet. It's a diet high in healthy fats. And most experts believe the Mediterranean diet is the important diet.

LARRY KING: So nuts, which can be fatty, are also good?

DR. STEVE NISSEN: They are very good.

LARRY KING: Olive oil, which is fatty, is good?

DR. STEVEN NISSEN: Those are good fats. And it's important for people to understand the distinction between good fats and bad fats.

DR. MICHAEL ROIZEN: There are a lot of easy ways, small steps everyone can prevent heart disease, women and men. So walking 30 minutes a day decreases the heart attack rate by 40%. Amazing.

Do some easy things for your teeth. Flossing and preventing dental disease is a great way of preventing heart disease because one of the leading causes of heart disease is inflammation in your blood vessels. And for some reason, periodontal disease causes that. We don't know why. So you can prevent that with just flossing and seeing a dentist regularly.

Have an ounce of nuts a day. How tough is that?

And there's a whole raft of easy things that everyone should do that don't take any effort that don't have much risk and that have great benefits.

DR. PAULA JOHNSON: A very important point is we have a lot of healthy foods and we encourage our patients to eat those healthy foods such as nuts, but portion control is very important. So when you say an ounce of nuts, it's a small number. It's not eating a bag of a half a pound of nuts. It's a smaller portion.

DR. MICHAEL ROIZEN: Let me go and tell you what it is in nuts. So it's six walnuts twice a day or 12 almonds twice a day or 20 peanuts twice a day. It's not the whole bag; you're absolutely right.

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