By Emily Landgraf
On June 18, 2010, the number one killer in the United States affected my life and the lives of my family and friends forever.
That Friday seemed like any other until I got home from depositing my week’s paycheck from the grocery store where I spend my summers. My father told me that his best friend, William Wolk, appeared to have had a massive heart attack and was in the emergency room at Abington Hospital.
I walked the six or so blocks to the emergency room with my dad. I watched as our family friends anxiously waited to hear news — any news. I watched my father break down completely when he heard that his best friend was gone.
Ultimately, it wasn’t a heart attack that killed Wolk. A blood clot which had broken away from one of his arteries had simply gotten too close to that all-important organ and his heart had simply frozen to keep it out, killing him in the process.
Millions of Americans like Wolk are affected with heart disease every year. According to the Centers for Disease Control (CDC) 204 people out of every 100,000 Americans died of heart disease in 2007.
“[The death rate from heart disease] is ridiculously high,” said Dr. James Riggs, an immunologist who works for the National Institutes of Health and teaches biology courses at Rider University. “”It’s really a reflection of diet and lack of physical activity.”
While heart disease kills many Americans every year, millions of others are forced to live with the disease and modify their life styles accordingly, often after a heart attack.
Keith Warncke’s father is one of the lucky ones. Keith’s father had a heart attack when Keith was in the fifth grade and has since changed much about his lifestyle.
“It was really scary when my dad had his heart attack,” Warncke said. “I was only 11, so it was kind of confusing, but I knew it was really bad. Since his heart attack, he’s really changed a lot about the way he eats. He tries hard to stay away from foods really heavy in saturated fats and sodium and he walks a couple times a week to keep himself in better shape.”
As of 2007, there were 26.8 million Americans living with heart disease making up roughly 12 percent of the population. More women than men have heart disease, and whites and African Americans are the groups with the highest risk for heart disease.
Heart disease will cost the United States $316.4 billion, according to the CDC. The number of people affected keeps rising. The question has really become why does heart disease continue to kill millions worldwide when everyone is now so aware of the risks?
A person’s ethnic background is a factor when it comes to cardiovascular diseases. Caucasians lead the way with 27.5 percent of cardiovascular deaths in the United States. African Americans follow with just under 26 percent. It is important to note that because African Americans are more likely to develop hypertension, or high blood pressure, they are more likely to develop heart disease.
Asians and Pacific islanders make up about 25 percent of heart disease related deaths. Hispanics make up just over 20 percent, while American Indians make up fewer than 20 percent of deaths caused by the disease. American Indians may have a diet higher in fish to thank for a lower rate of cardiovascular deaths.
Heart disease is the single leading cause of death for both men and women in the United States, but there are some important differences that should be noted, according to Riggs.
Women tend to experience heart disease later in life than do men because the disease often occurs post-menopause. They also usually have a worse outlook when they are diagnosed with the disease.
Women generally experience symptoms of heart disease that men do not, Riggs said. These are called atypical symptoms and they include headaches, shortness of breath and fatigue, among other things.
According to Riggs, the growth of women with heart disease can be attributed to the fact that fewer women were being diagnosed with cardiovascular problems in years past, “a huge medical mistake that reflected a bit of white male medical bias.”
Location, location, location
The CDC has maps that easily allow anyone to find where the most deaths because of heart disease occur. In 2006, Mississippi had the highest rate of deaths while Minnesota had the lowest. The South was awash with deep red, a dubious sign. Riggs believes that the culture of fried food that is popular down in Dixie is to blame.
Urban areas were generally easier to find on the map, as they too tended to be darker shades of red. Riggs believes that because there are more people in cities, there are more people diagnosed with heart disease in those areas. He also believes that the environment that many urban children grow up leaves them more susceptible to cardiovascular problems in the future.
“The double whammy is if you have lots of fast food around you, and you’re not exercising,” he said. “That’s the problem in an urban environment. A lot of kids aren’t getting out on playgrounds and good eating habits aren’t being developed.”
Evolution, genetics and the environment
The desire for fatty, calorie-laden foods can be traced back to our ancestors, Riggs said.
According to Riggs, before the human race became agriculture-based, it was made up of nomads who gathered any food they came across. These primitive humans never knew when their next meal would be, so they loaded up on calorically dense food whenever they found it.
“Humans used to come across an animal carcass and eat the bone marrow because it was full of calories and nutrients they rarely got,” Riggs said. “No one could have predicted how quickly the human race would move from scavenging to farming to having enormous amounts of food at our disposal. The problem is, we haven’t evolved away from that instinct to consume foods rich in calories and fat. We’re still hard wired to desire that kind of food.”
Riggs also stated that while genetics certainly can play a role in which people are most susceptible to heart disease, ultimately environment matters most.
The Apo lipoprotein E (APOE) gene, one of the genes that can be associated with heart disease, is a class of Apo lipoprotein, or proteins, which bind to lipids. This protein is essential to the regulation of triglyceride-rich lipoprotein constituents, that is, saturated fats and cholesterol.
“There are multiple genes that are associated with heart disease, but this APOE-4, one variation of the gene that plays a role in how you carry around cholesterol, has really been shown to be a risk factor,” Riggs said.
According to Riggs the people who most often express this defective gene are the people of New Guinea. However, these people do not develop heart disease at a rate even close to that seen in the United States.
“It’s because of the diet aspect,” Riggs said. “They have that risk factor, but they don’t develop heart disease at the same alarming rate as we do. It just shows how important your environment is.”
Fast Food Fallout
The evolutionary urge to ingest foods high in calories and saturated fats can easily be satisfied in the United States through fast food restaurants. These pre-packaged meals, which soccer moms all over the country appreciate, are loaded with calories, saturated fats and sodium. A McDonald’s cheeseburger with low fat milk and French fries contains 640 calories, 26 grams of fat, 74 grams of carbohydrates and 25 grams of protein, according to the nutritional information on McDonald’s website.
McDonald’s isn’t just for the tykes in the United States, though much of the company’s advertising is geared toward children. The Big Mac, the chain’s most popular burger, contains 540 calories — 260 of which come from fat — 29 grams of fat, 45 grams of carbohydrates and 25 grams of protein. After adding the 400 calories from a large order of French fries and the 310 calories from a large Coca-Cola Classic, patrons are looking at 1,250 calories in one meal — nearly 65 percent of the recommended 2,000 calorie per day diet.
According to Riggs, the food offered at establishments like McDonald’s contributes not only to heart disease, but to other chronic health problems like type 2 Diabetes, obesity and colorectal cancer, the second deadliest cancer in the United States.
“Fast food is cheap, not just fast, and has the combination of fat and the sweet and salty tastes that people crave,” Riggs said. “Their portion sizes have grown ridiculously with their competition amongst each other.”
While many argue that individuals need to take responsibility for personal choices, others believe that advertising for fast food restaurants like McDonald’s is simply too much. McDonald’s spends well over $2 billion dollars a year on advertising, according to McSpotlight.org, a watchdog website.
Riggs, who admitted to partaking of the calorie-ridden meals places like McDonald’s offer as a teen, is now far more conscious of what he puts into his body as well as his children’s bodies.
“As a parent, I have grown to despise their marketing campaigns where they target kids with Happy Meals, toys, and play structures,” he said.
Various databases on the CDC’s website, http://www.cdc.gov/heartdisease/facts.htm
(Databases can be found in the References section at the bottom of the page)
“The Issues: Advertising.” McSpotlight. Tucow’s Inc., 12 Jan. 2005. Web. 2 Dec.
“McDonald’s USA Nutrition Facts for Popular Menu Items.” Jan. 2007. File last
modified on Jan. 2007. PDF file.