HealthTalk
Doctor ’ s notes
Dr Rik Heymans is a general practitioner in Nerja and writes on developments in the world of medicine
Obesity and Heart Disease
An analysis of more than half a million people in Europe with 12 years of follow-up showed that , compared with normalweight individuals , overweight and obese patients had a higher risk for heart attacks , regardless of their metabolic health ( lipids , glucose , and blood pressure ). The study also found that metabolically unhealthy persons ( high cholesterol , uncontrolled diabetes , sleep apnea ) are at a higher risk for heart disease regardless of their body weight . So , lean patients with risk factors still have an increased risk for heart disease .
This is robust evidence against the notion of healthy obesity ( meaning an overweight person but with normal cholesterol and / or sugar values ), supporting the idea that maintaining a normal body weight is a key step toward maintaining a healthy heart . So , here is a good intention to adapt for the New Year ; I am afraid to say that in all likelihood applies to all of us here in the Western World … A sobering statistic is that between 2000 and 2014 , the amount of obese people increased by 44.9 % in the US .
Non-alcoholic Fatty Liver Disease
Another complication of the obesity epidemic is that the burden of non-alcoholic fatty liver disease ( NAFLD ) is increasing greatly , and the resulting need for liver transplants is likely to outstrip the supply of donors , researchers report .
NAFLD includes non-alcoholic fatty liver ( NAFL ) and nonalcoholic steatohepatitis ( NASH ), which is an increasingly common cause of end-stage liver disease and is the second most common cause of hepatocellular carcinoma ( HCC ) requiring liver transplantation . It means basically that the liver stores too much fat ; fat which doesn ’ t come from alcohol , but from an excessively rich diet . With the anticipated increase in the obese population ( to more than 92 million adults by 2025 ), the number of NASH-related waiting list additions is also expected to increase by 55.4 %.
In the medical community , there is a sense that fatty liver will be an enormous problem in the United States , and we will be facing in the future if obesity trends in the US continue to be on the trajectory they have been - with Europe trailing not far behind unfortunately .
Climate change and health
This is a story from recent history that we believe President Trump urgently needs to hear . In 1985 , a huge and growing hole in the planet ’ s ozone layer was identified . Ozone in the stratosphere blocks some of the sun ’ s ultraviolet radiation from reaching the Earth ’ s surface , thus protecting its biosphere ( which includes humans ) from DNA damage that would otherwise occur . The hole was caused by the action of chlorofluorocarbons ( CFCs ) used in refrigeration and as aerosol propellants .
Margaret Thatcher is admired by many on both sides of the Atlantic , including President Trump as a strong politician , a person with clear beliefs on which she acted without ever doubting them . A scientist by background , Thatcher appreciated the magnitude of the threat immediately , throwing her weight behind international efforts to address this . Working with Ronald Reagan , within two years the 1987 Montreal Protocol was signed to phase out the production and use of CFCs . Despite this , because CFCs persist in the atmosphere for more than a century , the ozone layer will not recover completely until 2060 . A failure of leadership at that time would have been catastrophic .
A similar challenge faces us now . The evidence that climate change is happening , driven by human activities which increase atmospheric greenhouse gases , is overwhelming . Increased temperatures and disruption of ecosystems by climate change impact directly on health and on lung health in particular . Mosquito-borne diseases may worsen ( as their distribution , breeding and feeding patterns change : a perfect example is the dreaded Tiger mosquito ), crop failure ( from flooding , heat waves and extreme weather events ) will drive starvation and cases of bacterial diarrhoea and exposure to toxic algal blooms will increase .
Climate change can increase exposure to pollen and mould allergens . Raised temperatures increase concentrations of ground-level ozone and small particles in the air . This impacts both the development and the severity of asthma , rhinosinusitis , COPD and respiratory tract infections . Smoke from forest fires related to heat waves impacts lung health .
The effects of climate change are more likely to be felt by those with pre-existing cardiopulmonary disease especially . It is clear that the cost of limiting climate change now is far less than the cost of addressing the consequences in the future . An entrepreneurial state should provide leadership and frameworks for green investment in infrastructure and energy generation and thus avoid the world going down this dead end street . But this requires leadership and vision , which appear to be lacking in the governments which decide our fate .
One slight ray of hope : it appears that China is rapidly going green , investing in renewable energies - mainly because they don ’ t want to depend on the Middle East Oil . This at least will help a great deal .
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© Dr RIK HEYMANS c / Angustias 24 , Nerja .
Tel : 95 252 6775