Determined To Succeed

Last night I had the hell scared out of me.

I had the occasion to do some catch-up with a friend of mine over dinner last night. It was a cool and casual dinner, and a few delicious happy hour pineapple martinis and mini-burger and egg roll appetizers were consumed. It was great, that is until my friend told me about a friend of theirs who had recently had a stroke, two of them, in fact…

…and he is only 38.

That news hit me like a ton of bricks. A guy who is ONE YEAR YOUNGER THAN I AM has had two strokes and is now dealing with the realities of recuperation and recovery from them, and he’s only 38.

“A year younger than me,” I thought to myself, ““My God, that guy could have easily been me by now.”

While the evening continued on for at least an hour past that piece of news it never left me. It sat next to me the rest of the night. It made me put down the appetizers and the martinis. It sobered me up and followed me home when the catch-up was over. As I lay in bed I thanked God, my lucky stars, guardian angel, mom, fate, destiny, karma and everyone and everything else I could that I was alive and well enough to be able to do the things I do these days. It is not news to you guys that I firmly believe my quality of life would have suffered severely if I didn’t lose weight and had remained 400 pounds. I had high blood pressure that would have kept going. I had arthritis that would have gotten worse with age. I had sleep apnea causing me to stop breathing during sleep. I might even be dead.

When I got up this morning I was still very troubled by the news I’d heard. I was also curious about obesity and the roll it plays in strokes.

For those of you lucky enough to never have known what a stroke is, a stroke occurs when there’s a problem with the amount of blood in your brain. The cause of the main type of stroke — ischemic stroke — is too little blood in the brain. The cause of the other type of stroke — hemorrhagic stroke — is too much blood within the skull.

About 80 percent of strokes are ischemic strokes. They occur when the arteries to your brain are narrowed or blocked, causing severely reduced blood flow (ischemia). This deprives your brain cells of oxygen and nutrients, and cells may begin to die within minutes. The most common ischemic strokes are:

• Thrombotic stroke. This type of stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot usually forms in areas damaged by atherosclerosis — a disease in which the arteries are clogged by fatty deposits (plaques).
• Embolic stroke. An embolic stroke occurs when a blood clot or other particle forms in a blood vessel away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus. It’s often caused by irregular beating in the heart’s two upper chambers (atrial fibrillation). This abnormal heart rhythm can lead to poor blood flow and the formation of a blood clot.

“Hemorrhage” is the medical word for bleeding. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Hemorrhages can result from a number of conditions that affect your blood vessels, including uncontrolled high blood pressure (hypertension) and weak spots in your blood vessel walls (aneurysms). A less common cause of hemorrhage is the rupture of an arteriovenous malformation (AVM) — an abnormal tangle of thin-walled blood vessels, present at birth. There are two types of hemorrhagic stroke:

• Intracerebral hemorrhage. In this type of stroke, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging cells. Brain cells beyond the leak are deprived of blood and are also damaged. High blood pressure is the most common cause of this type of hemorrhagic stroke. Over time, high blood pressure can cause small arteries inside your brain to become brittle and susceptible to cracking and rupture.
• Subarachnoid hemorrhage. In this type of stroke, bleeding starts in a large artery on or near the surface of the brain and spills into the space between the surfaces of your brain and your skull. This type of hemorrhage is often signaled by a sudden, severe “thunderclap” headache. This type of stroke is commonly caused by the rupture of an aneurysm, which can develop with age or be genetically inherited. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow to parts of your brain.

A transient ischemic attack (TIA, or ministroke) is a brief episode of symptoms similar to those you’d have in a stroke. The cause of a transient ischemic attack is a temporary decrease in blood supply to part of your brain. Most attacks last just a few minutes. However, in contrast to a stroke which involves a more prolonged lack of blood supply and causes some permanent damage to your brain tissue, a TIA doesn’t leave lasting effects to your brain. Still, if you’ve had a TIA, it means there’s likely a blocked or narrowed artery leading to your brain, putting you at a greater risk of a full-blown stroke that could cause more permanent damage. If you’re having a TIA, get emergency medical treatment and make sure your regular physician knows about it.

Why am I telling you guys this heavy stuff today? Because I want to scare the hell out of you, too. Why? The higher a person’s degree of obesity, the higher their risk of stroke — regardless of race, gender and how obesity is measured, according to a recent study published in Stroke: Journal of the American Heart Association who said the higher a person’s degree of obesity, the higher their risk of stroke – regardless of sex or race.

However, stroke is more likely among obese blacks than obese whites. Hiroshi Yatsuya, M.D., Ph.D., study lead author and visiting associate professor at the University of Minnesota in Minneapolis and colleagues followed 13,549 middle-aged black and white men and women in four U.S. communities from 1987 through 2005. Participants started the study free of cancer and cardiovascular disease.

During the follow-up period of about 19 years, 598 ischemic strokes occurred. The researchers calculated incidence rate — the number of new cases per 1,000 people per year — according to groups representing different degrees of obesity, using each obesity measure.

They found that incidence rates differed substantially between whites and blacks. For example, the stroke rate in the lowest BMI category was 1.2 per 1,000 person-years for white women and 4.3 per 1,000 person-years for black women. The rate in the highest BMI category was 2.2 for white men and 8.0 for black men.

“Black women had about three times higher incidence of stroke than white women in the lowest as well as in the highest BMI categories,” Yatsuya said. “But the correlation between increasing stroke incidence and increasing degree of obesity was apparent in both races and genders.”
“Since individuals with higher degrees of obesity tended to have higher blood pressure levels or higher diabetes prevalence, we further examined the relationship between the degree of obesity and ischemic stroke incidence by statistically adjusting for difference in blood pressure of diabetes status attributed to the degree of obesity,” Yatsuya said. “That significantly weakened the associations, suggesting these major risk factors explain much of the obesity-stroke association.”

My friends, strokes remain among the top five leading causes of death. The Archives of Internal Medicine published a study showing that people who are overweight by 20% or less carry a 50% increased probability of suffering a stroke. The study also explained that being more than 20 percent overweight carried a risk that was twice as high. Because of these statistics, it’s important to know how weight and strokes are related. The tell-tale effect is that extra weight affects arteries by narrowing them. With narrowed arteries, it becomes easier for blood clots to form, which could cause a stroke later on. The narrowing of the arteries can be compounded by hypertension, low exercise level and a diet that contains a lot of cholesterol. Unfortunately, some (but certainly not all) overweight people don’t exercise regularly and eat high-cholesterol diets, which increases their stroke risk dramatically. On the flip side, healthy eating habits and exercise can decrease your risk of a stroke later on.

As I sit here and type I am looking out of the stop sign-shaped window next to my desk. I am looking at the blue sky above (which has, at most, a very few whispy clouds floating through it) and I feel as though I’ve woken up from a nightmare. Losing weight has had a dramatic effect on my life to say the least. However, I realize I have been concentrating on the effects you mostly see and feel, not necessarily on the effects you DON’T see: like how much I’ve prolonged my life and like how much I’ve dramatically reduced the chances of strokes, heart attacks and diabetes all by losing the weight I did. Sometimes good can happen when you cannot see it and these positive effects are there the more you see your numbers come down on the scale.

Having the hell scared out of you may add grey hairs to your head, but sometimes being scared is a good way to avoid being scared to death. Know what I mean?

Good Sunday morning, my friends (yaaaaaaawwwwwwnnnnnn). And how are we today?

Life has a funny way of doing things sometimes. Remember how I had to go to the dentist, not once but twice, to get my tooth “fixed?” Well…I am headed back a third time tomorrow morning because it just feels – how should I put it – wrong. It feels achy, in a strained, empty sort of way, not in a direct pain sort of way. So, just as a precaution I am going in first thing in the morning.

The last time I was there and getting things “fixed” they didn’t say to me “well, Bill. For the next 48-hours you shouldn’t have this or that,” which is what I guy like me needs. I need some simple, clear instructions about what to eat and not. It is driving me nuts, this tooth-o-mine. As I was out and about yesterday I pondered this and, almost instinctively, reached for a plain Hershey bar in the Wawa. As I did that I caught myself, gave me the tisk-tisk and walked away. But I started thinking about chocolate. Does it really cause cavities? Is it really all that bad for you?

The answer is yes…and no.

Like with all things in the scientific, health-related worlds there are conflicting data. Ugh. I like my chocolate (he says whining).

On the “go-ahead-and-eat-chocolate” side, Dr. Rutai Hui of the Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing and his colleagues did analysis of eight different studies and showed that eating chocolate might bring down cholesterol levels in some people, lower blood pressure and that chocolate eaters were less likely to suffer a stroke or heart attack over the next 10 years.

That’s because they were freaking happy, that’s why (just kidding).

Dr. Hui looked at how cocoa affected blood fats, or lipids, and found eight trials including 215 people. When the studies were analyzed together, the team found eating cocoa cut levels of LDL, or bad cholesterol, by about 6 mg/dL and reduced total cholesterol by the same amount. Analysis also showed that only those who ate small amounts of cocoa — containing 260 milligrams or less of polyphenols — experienced cholesterol lowering effects. People who consumed more showed no effect (polyphenols are antioxidants found typically in fruits, vegetables, chocolate and red wine. A 1.25 ounce bar of milk chocolate contains about 300 milligrams of polyphenols). The team also found that healthy people didn’t get any cholesterol benefits from cocoa, but people with risk factors for heart disease and diabetes, saw their LDL cholesterol and total cholesterol drop by about 8 mg/dL each.

There’s even research that shows chocolate can protect against tooth decay.

Huh?

A study carried out by researchers at Osaka University in Japan found that parts of the cocoa bean, the main ingredient of chocolate, thwart mouth bacteria and tooth decay. They discovered that the cocoa bean husk – the outer part of the bean which usually goes to waste in chocolate production – has an anti-bacterial effect on the mouth and can fight effectively against dental plaque and other damaging agents.

See, now there’s a medical reason to have my plain Hershey bar (just kidding again).

Foods that contain fermentable carbohydrates (FCs) are the nasty cavity-causing culprit. Although FCs are found in chocolate, the cocoa butter in chocolate coats the teeth, making it less likely to cause tooth decay. Chocolate may be high in sugar, but it melts quickly in your mouth, leaving little time for bacteria to attack your teeth and cause cavities. Plus, if you brush regularly, you won’t have a problem!

On the “O.k.-step-away-from-the-chocolate” side…

Pure cocoa has positive effects on blood pressure and cholesterol and also prevents heart disease. However, processed chocolate is what the majority of people are eating, and it contains added sugar, milk fats, saturated fats and corn syrup. These ingredients actually promote heart disease, weight gain, high blood pressure and high cholesterol.

Also, even dark chocolate is packed with calories. Its fat content may not cause cardiovascular disease, but eating it in large quantities can result in weight gain. (WHY ARE THERE ALWAYS CALORIES? IN THE NEW WORLD ORDER I AM ABOLISHING ALL CALORIES).

The refined sugar in processed chocolate can be detrimental to your teeth when eaten often without regular and proper teeth brushing. Sugar plays a harmful role in tooth decay by providing the bacteria in your mouth with energy. The bacteria begin to multiply faster, and plaque begins to grow in size and thickness on your teeth. Bacteria can also use sugar as a type of glue to cling to your teeth, making it difficult to get rid of with just a toothbrush.

Sugar can also cause and aggravate gum disease. Milk chocolate, along with other sweets, should be consumed only in moderate amounts. It is especially important to monitor the amount of sweets eaten by children to prevent bad habits (including childhood obesity), and tooth and gum problems later on.

So there it is. The good and bad of having a chocolate sweet tooth. I know it’s a bit long-winded, especially for a Sunday morning, but it does make for some interesting reading. I know there is no substitute for good chocolate but fruits provide the same health advantages of dark chocolate without the calories and saturated fats. They also contain natural sugar for those who crave sweets. If you must have chocolate (like yours truly), buy it in the smallest serving sizes possible (like those bite-size Halloween portions). This prevents you from eating up all of your calories for the day but satisfies your cravings.

And what have we learned? Eating some chocolate is O.K. Check. Especially if it’s dark chocolate. Check. Even better if it’s straight cocoa (although I have no idea how that would taste). Check, check. Brush teeth regularly. Double Dog Dare Check. Visit dentist regularly…

Yeah. No kidding…

Sorry this was so late today but I was in a quandry.

I’m going to sound like an old fogie (is that even how it’s spelled?) but I don’t know how to relate to kids these days. Well, I do and I don’t. Last week you heard me talking about a website and technology conference I attended in New York and, while there, I got a wonderful idea to try to help kids who might have weight loss issues through information and resources on my website.

However, the more I delved into the “what” of it all (like what kind of content to have, etc.) I realized I don’t exactly know how to reach kids these days. When I was a fat kid it was the late 70s/early 80s. There were no such things as the following:

• Cell Phones (which kids seem to have younger and younger these days so no texting, mobile internet, etc.)
• iPods (hell, I thought I was king of the world with my first Sony Walkman personal radio)
• Personal Computers (I had a small electronic typewriter that got me through school – a typewriter!)
• Internet (and with it the extension of ways to get and absorb news and information)
• E-Mail (back then we actually wrote letters to each other and sent them in the mail, or snail mail as it’s called today, or passed notes)
• Cable TV (there wasn’t even a fourth Fox network back then. Just independent TV stations and the big three – CBS, NBC and ABC)
• Facebook and Twitter (progress back then was called a “party line,” expensive phone calls people could make to join 20 others to chat on the phone hosted by someone whose only job it was to keep you talking to get you to pay more per minute)

Amazing, isn’t it? Over the last 25-30 years technology has really improved. However, it has made the job of reaching people, especially kids, such a hard thing to do. The only way I can describe it is as practicing “lucky science.” Science because you have to do it so surgically since you can’t reach really large numbers of people using very few media anymore, and lucky because you never know what will resonate with people and take off like wild fire (as Twitter has the power to put information all over the world in a matter of minutes).

So how do I reach kids these days and let them know my simple story? That I was once a chubby kid, who was made fun of in school, and who had the same social problems they do these days because I was obese? How do I let them know I know how they feel when you can’t find age-appropriate clothes that fit, or have to find clothes less attractive or popular because they just aren’t in your size? How do I let kids know it’s normal to feel sad and depressed because you’re made fun of and are different, but also let them know it’s OK to talk about it and try to do something about it?

Jeez! I do sound like an old fogie FER SURE! LIKE TOTALLY! I sound like I’m waving my cane at some hot-rodders burning rubber down the street yelling at them as I wave my cane calling them “young whippersnappers.” But I’m not old (at least not yet) and I do very much remember what it’s like to be the fat kid. Plain and simple – it hurts. It hurts and at a time that is really solidifying who you’re going to become as an adult there are these pressures from family (in some cases), society-at-large, media (particularly fashion magazines geared towards teens) and friends to be this perfect being. And sometimes we are just not and we do not need anyone pointing out our flaws!

I guess it would be simple enough to tell kids this. In fact, it might make it easier for them to believe me when I tell them my personal fat kid story. I just know that America does have a childhood obesity epidemic on its hands, driven by lack of food education, support and economics. Well, I am going to do my best to help in any way I can. Not because I am saying all kids need to be thin or anything. But because it is all about health. Things like asthma and breathing problems (which I’ve had). High blood pressure (which I’ve had). And you could go on with juvenile diabetes, joint pain, etc. That is why I want to reach out. Because if I could go back in time and talk to me I would tell me it’s OK and to not eat so much McDonalds or ribs or fried foods. I’d also tell me the dangers of eating that much and how much I weighed at my heaviest and what problems it caused me. I’d tell me I understand what it’s like not having money to buy better foods and not have the proper resources to prepare them. I’d offer to help.

This is a crazy, mixed up and fast-paced world in which we live these days. But no matter what, kids need our help. And no matter how we reach them and tackle this problem of childhood obesity, we are helping them to become the same old fogies we are today. And I’d rather be an old fogie waving my cane around at young hot-rodders than dead in my 40s from a heart attack brought on by obesity.