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Genes Affect Blood Pressure Risk
Lifestyle Factors Mix With Genes to Raise Risk of High Blood Pressure
By Jennifer Warner
WebMD Medical News Reviewed by Elizabeth Klodas, MD,FACC
June 16, 2009 -- Genes may help explain why some people are more or less susceptible to the negative effects of drinking, smoking , or lack of exercise on their blood pressure .
A new study shows lifestyle factors interact with genes to influence blood pressure levels and increase or decrease the risk of high blood pressure .
For example, people with a genetic predisposition to high blood pressure may benefit more than others by following a healthy lifestyle, such as not smoking, limiting alcohol use, and exercising regularly, because their genes magnify the negative effects of these factors.
"The three lifestyle characteristics are well-known risk factors for high blood pressure," says researcher Nora Franceschini, MD, assistant professor of epidemiology at the University of North Carolina in Chapel Hill, in a news release. "What's new is that we are showing that these behaviors interact with your genes to influence blood pressure levels. Drinking, smoking and exercise habits can be modified, which would, in turn, influence the risk of developing hypertension, even in people who are predisposed to the condition."
Lifestyle Affects Inherited Risk
The study, published in Circulation: Cardiovascular Genetics, analyzed genetic and medical data collected in the ongoing Strong Heart Family Study of American Indians. Using information from 3,665 participants ages 14 to 93, researchers looked at how inherited genetic patterns influenced high blood pressure risk among those with different lifestyles and education levels.
The results showed that about 15% of the variation in diastolic values (the bottom number in a blood pressure reading) was due to genes.
However, researchers also found an interaction between genetic and lifestyle factors on blood pressure, including:
• A link between cigarette use and gene interaction on diastolic blood pressure in comparing smokers and those who had never smoked.
• Evidence that blood pressure among drinkers is affected by different genes in former and never drinkers.
• Evidence that an individual's physical activity level influences the genetic effects on blood pressure.
"So your level of blood pressure is influenced by your genes, whether you are a smoker or not, are physically active or not, or drink alcohol or not," says Franceschini. "But those habits can still influence a person's susceptibility to the disease."
Researchers say the next step is to identify the particular genes that interact with each of the three lifestyle factors to increase the risk of high blood pressure.
WebMD
The Top 6 Exercise Excuses and How to Beat Them
You know you should be exercising . We've all heard that physically active people are healthier. They're less likely to develop heart disease , diabetes , and some cancer , they sleep better, and they feel happier and more energetic. Of course, a fit body looks better, too. But when it comes time to actually get out there and start moving, many of us have a long list of excuses not to exercise -- too little time, too little energy, or we simply don't like to work out.
How can you get past the excuses and get moving? Here are six top exercises excuses cited by fitness experts who spoke with WebMD -- along with tactics for overcoming them.
Exercise Excuse No. 1: "I Don't Have Time."
"How much television do you watch?" asks Walter Thompson, PhD, professor of kinesiology and health at Georgia State University
During your shows, use resistance bands, or walk in place. Or use Tivo so you can skip the commercials and see a one-hour show later in just 40 minutes, says James Hill, PhD, co-founder of the National Weight Control Registry: "That's 20 minutes right there." Better yet, turn off the TV and spend your newfound time working out.
If it's work that's sapping all your spare time, try exercising on the job. Close your office door and jump rope for 10 minutes, or walk in place, Thompson suggests.
Your exercise doesn't have to be a formal workout either. Try making small lifestyle changes that help you move more: take the stairs instead of the escalator, don't drive when you can walk, and get a pedometer and try to increase the number of steps you take throughout the day.
The U.S. Surgeon General recommends at least 150 minutes of aerobic activity per week, which may sound daunting, but actually works out to a little over 20 minutes each day. The good news is that three 10-minute exercise sessions work just about as well as one 30-minute one, and can be much easier to fit into your schedule.
People who exercise regularly "make it a habit," says Hill, who is director of the Center for Human Nutrition at the University of Colorado, Denver. "They haven't bought any more time during the day than anyone else. What we've done is prioritize it. We find time for things we value."
Exercise Excuse No. 2: "I'm Too Tired."
It may sound counterintuitive, but working out actually gives you more energy, says Marisa Brunett, a certified athletic trainer in Orlando, Fla, and spokeswoman for the National Athletic Trainers Association. Once you get moving, your fatigue will likely disappear.
"You're getting the endorphins [feel-good hormones in your body] to release,” says Brunett. "And you're getting the circulation going -- as opposed to coming home and crashing on the couch."
It may help to work out in the morning, before you get wiped out by a demanding workday, says kinesiologist Lynette Craft, PhD, assistant professor of preventive medicine at Northwestern University.
But if you're just not a morning person, don't worry. Brunett, who likes to work out in the middle or end of the day herself, recommends doing it whenever you feel best.
Exercise Excuse No. 3: "I Don't Get a Break From the Kids."
The answer is to multitask, experts say.
"Take the kids with you," says Hill. While they're swinging, you can walk around the playground or the backyard, or jump rope. Walk the kids to school instead of driving them. During their soccer games or practices, walk briskly around the field.
Use your family time for active pursuit, Brunett suggests. Go biking with your kids, put up a badminton net in the yard, sign up as a family for "fun runs," or just walk around the neighborhood with your children. When the weather's bad, try active video games like Dance Dance Revolution, Wii Sport, and Wii Fit.
And remember that your fitness is good for your kids as well as you. "When mom or dad is more fit, has more energy, the whole family benefits,” says psychologist Christina Recascino, PhD, a professor in the human factors department at Embry-Riddle Aeronautical University.
Exercise Excuse No. 4: "Exercise Is Boring."
"Exercise should be like sex," says sports physiologist Mike Bracko, EdD, FACSM, a certified strength and conditioning specialist and director of the Institute for Hockey Research in Calgary. "You should want it and feel good about it before you do it. And it should feel good while you're doing it."
So how do you get there? First, find an activity you love. Think outside the box: try inline skating, dancing, or gardening. Join a sports league. Or, if you love music, try ballroom dancing. "There's an exercise for everyone," says Recascino. "It doesn't have to be onerous or unpleasant."
If it makes exercise more enjoyable for you, it's OK to watch Oprah or read while you're on the exercise bike or treadmill -- just don't forget to pedal or run.
Working out with a group also helps many people. "Not everybody's cut out to put on their iPod and go on a six-mile run by themselves," says Peter Nierman, MD, assistant professor of psychiatry at the University of Chicago.
To find a group, look through local sports publications or on the web. Or simply recruit several friends.
And, every once in a while, try something totally new. “Mix it up so you don't get bored,” says Brunett.
Exercise Excuse No. 5: "I Just Don't Like to Move."
"There are people who really enjoy not moving," says exercise physiologist Gerard Endress, fitness director of the Duke Diet & Fitness Center. They prefer to knit, read books, or watch TV. "I work with those people on, 'Can you walk in the mall?'" he says.
If it's sweating you don't like, you can get a good workout without perspiring excessively, Endress says.
You can work out indoors, where it's air conditioned. You can swim so you won't notice any perspiration. Or, try a low-sweat activity like yoga .
If exercise hurts your joints, try starting by exercising in water, recommends Brunett. The stronger your muscles get, the more they can support your joints, and the less you'll hurt. If your physical limitations are more serious, check with your
local sports medicine or rehabilitation clinic, or find an athletic trainer who can help you figure out exercises that are still safe and easy to do
If you don't like to move because you feel too fat, start with an activity that's less public, like using an exercise video at home. Walk with nonjudgmental friends in your neighborhood while wearing clothes that provide enough coverage that you feel comfortable.
And remember that gyms today are different. "You don't have the Spandex gyms as much," says Endress. Women-only places like Curves may be more comfortable.
Exercise Excuse No. 6: "I Always End up Quitting."
Set small, attainable goals. Then you're more likely to feel like a success, not a failure, says Brunett. If you exercise for five minutes a day for a week, you'll feel good -- and more likely to want to try 10 minutes a day the next week.
It also helps to keep a log and post it somewhere public -- even on Facebook. Craft calls it a "wall of encouragement." Friends and family can then say, "Hey, you did 15 minutes yesterday. Great job," she says. A log also helps you see if you're starting to fall off the wagon (or the treadmill).
Having an exercise buddy keeps you accountable as well, says Boston psychologist Eric Endlich, PhD, who works with patients who need motivation to diet and exercise. When you back out of a scheduled workout, you're letting down your buddy as well as yourself.
And look toward the future. It's harder to start exercising than to stick with it once you've got your momentum going, says David Coppel, PhD, a sports psychologist in Kirkland, Wash.: "I bet you after two weeks of this, you'll feel really good."
WebMD
Sky-High Calories in Some Restaurant Meals
Restaurants Are Piling on Fat, Calories With Larger Portions, Group Says
By Elizabeth Lee
WebMD Medical News Reviewed by Louise Chang, MD
June 2, 2009 -- Restaurants are serving ever-larger portions of super-bad food to entice customers to start eating out again, according to a consumer watchdog group.
In a list of the most over-the-top, unhealthy restaurant foods, the Center for Science in the Public Interest singled out some dishes that provide more saturated fat or sodium than most people should eat in three days. The foods were also high in calories.
U.S. dietary guidelines call for healthy Americans to get less than 2,300 milligrams of sodium a day, about the amount in a teaspoon of table salt, to lower blood pressure and reduce risk of heart disease , stroke, heart failure , and kidney disease. But for the 70% of Americans who are middle-aged or older, African-American, or have high blood pressure , no more than 1,500 milligrams a day is recommended.
Federal nutrition guidelines also advise that less than 10% of daily calories come from saturated fat, about 20 grams for a 2,000-calorie diet. Eating lots of saturated fat can lead to increased risk of cardiovascular disease.
The group’s Xtreme Eating 2009 dishes, listed in the June issue of its Nutrition Action Healthletter, include:
Chili’s Big Mouth Bites with French fries (four mini bacon cheeseburgers with fried onion strings): 2,350 calories, 38 grams saturated fat, 3,940 milligrams sodium.
Olive Garden Tour of Italy, with lasagna, chicken parmigiana, and fettuccine alfredo: 1,450 calories, 33 grams saturated fat, 3,830 milligrams sodium.
The Cheesecake Factory Fried Macaroni and Cheese: 1,570 calories, 69 grams saturated fat, 1,860 milligrams sodium.
Chili’s Original Half Rack of Baby Back Ribs: An add-on for entrees, with 490 calories, 12 grams saturated fat, and 2,050 milligrams sodium.
Red Lobster Ultimate Fondue shrimp and crabmeat in a lobster cheese sauce served in a sourdough bread bowl: 1,490 calories, 40 grams saturated fat, 3,580 milligrams sodium.
Uno Chicago Grill’s Mega-Sized Deep Dish Sundae: 2,800 calories, 72 grams saturated fat.
The Cheesecake Factory’s Chicken and Biscuits: 2,500 calories.
Applebee’s Quesadilla Burgerwith fries: 1,820 calories, 46 grams saturated fat, 4,410 milligrams sodium.
The Cheesecake Factory Philly Style Flat Iron Steak with fries: 2,320 calories, 47 grams saturated fat, 5,340 milligrams sodium.
The examples are extreme, says Jayne Hurley, RD, chief nutritionist for the Center for Science in the Public Interest. But that’s the point.
“The problem is these oversized foods come with oversized calories, saturated fat, and sodium,” Hurley says. “It used to be you got a single entree, and now in some cases you’re getting three entrees on your plate.”
The typical restaurant entree, appetizer, and dessert contain about 1,000 calories apiece, Hurley says. The Center for Science in the Public Interest obtained the nutritional information in the report from restaurant web sites and menus.
“As a consumer-driven industry, we give our guests what they want,” says Shelia Weiss, RD, a nutrition consultant for the National Restaurant Association, an industry trade group. “Certainly there are indulgent items on menus, but there are more diet-conscious items on menus than ever before.”
Hurley believes diners don’t realize just how indulgent some items are. It’s a given that you’re splurging when you order Uno Chicago Grill’s Mega-Sized Deep Dish Sundae, a chocolate-chip cookie baked in a pizza pan and topped with ice cream, whipped cream, and chocolate sauce, she says.
“But how many people would guess there are 2,800 calories and 72 grams of saturated fat when that sundae hits the table?”
Weiss disputes CSPI’s contention that restaurants may be offering much larger portions to entice recession-weary customers into eating out again.
“If anything, restaurants are adjusting their portion sizes down as a measure of the economy,” Weiss says.
The Center for Science in the Public Interest is backing a federal menu labeling bill that would require calorie counts to be listed on the menus and menu boards of chain restaurants. The National Restaurant Association is supporting a measure that would allow nutritional information to be listed in other locations -- such as a brochure or poster -- when a customer orders.
Providing more information on fat, calories, and sodium in restaurant meals would help diners trying to protect their health, says Dawn Jackson Blatner, RD, a spokeswoman for the American Dietetic Association. Blatner, who provides nutrition counseling, says helping her clients learn what’s in restaurant meals is critical.
“People do not understand just how high in fat and calories these things can range,” Blatner says. “We’re talking about a day’s worth of calories in some cases. And, this is not the only meal that most people are going to be eating in a day. It’s no surprise that two out of three people are overweight in America.”
Want to avoid restaurant meals high in fat, calories, and sodium? Try these tips:
Check online for nutritional information before dining out. If your restaurant doesn’t disclose information, look for similar dishes at other restaurants that do provide that data.
Downsize the portion. Order a lunch portion or half-portion. Split a dish with a friend. Or take half home to eat later.
Try customizing. Ask if a food can be baked or grilled instead of fried. Substitute a vegetable for a side dish that may be high in calories and fat, such as a biscuit or mashed potatoes. If a food is laden with fatty additions, such as bacon, mayonnaise, and cheese, ask for it to be prepared without at least one of those high-fat foods