Matters of the Heart
On Heart Disease (dedicated to my mom, as she did ask the question)
My mom replied to the email that I had sent her from the middle of a scientific lecture. "Your sister was 7 pounds, and your oldest brother was 8 lbs-something. Your other brother was 9 pounds 12 oz, and then you were 9 lbs 2oz. It should be on your birth certificate. What does that have to with your heart?"
To answer that question, I want to relate 2 parables, a night in a bar, and some recent scientific findings.
The first is the Parable of the Flowers. Both dandelions and orchids are flowers, and do all the things that flowers do. However, the dandelion can put its taproot down just about anywhere and grow. Near desert, forest meadow, veggie garden, cracks in sidewalk - it doesn't care. The orchid, on the other hand, requires the right temperature, the right soil composition, just enough water and sunlight, or else it is a sad looking plant. If it does get these, boy does it bloom. Some folks can be compared to these types. The dandelion folks will dig in where ever they find themselves. The orchid people won't thrive unless they are in a narrower range of conditions.
The lecture was trying to explain how we can tell who the orchids are, in the context of heart disease, and with a pint of McMinnimen's oatmeal stout in one hand. I volunteer at an event called Science Pup, which basically takes a scientist, puts them on stage with a microphone in one hand and a beer in the other, and has them present for an hour before letting the patrons of the establishment ask questions. It's the local instance of the international phenomenon of Cafe de Scientifique, where, as I understand it, the scientist to audience ratio tends to hover at 1:50. McMinnemen's Bagdad, where we hold many of the events, is a pub theater, and holds about 600 people. We regularly fill to capacity. Apparently we're commonly putting a good show.
Heart disease is getting more and more common - 1 in 4 deaths in the US are related to it. Some graphs and maps our speaker, Dr Kent Thornburg from OHSU, showed where the trends were going. Much of the country's heart disease victims are centered around areas of generational poverty. It's the recovery from the civil war economy, not the southern cooking that gives the southeast it's larger share of heart disease - the traditional foods are quite similar in Louisiana and France, yet the French have a extremely low rate of disease. France has not had the same multigenerational stresses.
Another parable: your heart health can be compared to a building's engineering. How does a building stay standing up? Well, it's foundation give a stable platform. The. walls lean against each other, and support the weight of a roof. If its over a certain height, rebar inside the walls provide stiffening. Any one of these objects can fail, and need repair, but if the foundation is cracked and the rebar rusts and the walls begin to crumble, sooner or later you don't have a building, but a pile of rubble. We need several layers of reinforcement to ensure in times of high wind, or earthquakes, the building won't fall due to the unaccustomed strain.<
Similarly, the human heart can take a lot of stresses, but can be overtaxed for the amount of reinforcement it has. Commercials have made folks aware of heart healthy Cheerios and the like, but why is this an issue to some folks, and not others? How can we predict how much stress your heart can take?
The researchers have honed in on your birthweight as an indicator, and the cause, believe it or not, is linked to your grandmother's nutritional health.
Here's the cycle. At conception, you are the result of your father's sperm, which is created during his puberty, and your mother's eggs, which were created when her mother was carrying her. If gramma was in an era of tough times, and did not get great nutrition, those eggs are stressed - no rebar in our building walls. Then when mom conceives, if she's not eating healthy food and supplying nutrition to the babe, we loose a little foundation. You can most easily see this generational echo in the baby's birth weight.
Note that this denotes the genetic predilection for heart disease, but the cards you are dealt as a gamate are not the entire story. The first 1000 days of nutrition (from conception to 2 years old) has a lot to do with it, as does the epigenetics - a stressed environment leads to a twitchy child growing into an adult with hypertension. Obesity from sedentary lifestyles and modern convenience foods may bring on diabetes. Smoking and drinking are other factors that may shake the walls of the heart.
But as a 9lb baby, I probably won the lottery as it goes for probability of heart disease. I seem to be a dandelion. My honey, assisting at the same lecture and texting his mother for the same data, weighed in at 6lbs, and so has a higher probability of heart disease - indeed, he's on cholesterol medications, and is being encouraged to change his diet, since he and I exercise a great deal, don't smoke, and aren't excessively heavy. He's an orchid, and will need more ideal conditions to continue to thrive.
Food being a factor he can still tweak the diet for better health - Dr Thornburg said he had never met with a nutritionist that would disagree with the basic heart healthy diet. Leafy greens and fruits, fiber and whole grains, and fish & low fat proteins - in appropriate portion sizes, these are the buttresses for supporting your heart, regardless of your birthweight foundation. So we're eating more beans and steel-cut oatmeal - we're already big fans of salads - to support the structure the household orchid needs. I may not require it, but it'll certainly not hurt!
So what was your birthweight, and how's your heart?