Jewish World Review June 14, 2002 / 4 Tamuz, 5762

Young Men, Obesity & Heart Disease

By Robert A. Wascher, M.D., F.A.C.S. | During the Vietnam War, autopsies performed on young men who died in battle revealed that coronary artery disease begins to occur shortly after adolescence. Today, an epidemic of obesity has afflicted both young and old in our land of plentiful and fat-ladened food, and the ubiquitous presence of effort-reducing devices.

A study in the current issue of the journal Circulation provides further insight into the impact of obesity in young men on cardiac health. In this study, autopsies were performed on 3,000 men and women, aged 15 to 34, who died primarily from trauma.

The arteries of the heart and kidneys were evaluated for changes due to atherosclerotic plaques and high blood pressure, respectively. The blood was assessed for cholesterol levels, byproducts of tobacco smoke and sugar levels. Finally, the deceased young men and women were evaluated for obesity using standard assessments.

The study's authors found that obesity in young men was significantly associated with narrowing of the coronary arteries, elevated blood cholesterol levels, high blood pressure, and diabetes or pre-diabetes. Among the young women studied, only minimal coronary artery narrowing was identified, and then primarily in the obese women with large abdominal fat pads.

This study dramatically confirms previous research suggesting that men are generally at greater risk of developing heart disease, and particularly in the presence of risk factors such as obesity and smoking. Moreover, this study provides compelling evidence that the adverse health effects associated with obesity can be identified in very young men who are obese. For the first time in history, more than 50% of Americans, both young and old, are overweight. While it has often been said that it is never too late to adopt a healthy lifestyle, it might also now be said that it is never too early, particularly for men.


Speaking of adopting a healthy lifestyle as early as possible in one's life, this week's Lancet features a study of 32,200 Scottish children, aged 39 to 42 months, that assessed the impact of breastfeeding on weight gain. The study attempted to control for variables such as socioeconomic status, weight at birth and gender between the children that were breastfed as babies and those that were fed by bottle. The researchers found that breastfed babies were 30% less likely to be obese than babies who took a bottle instead of the breast. While this study did not control for all conceivable variables between the two groups of babies, it does strongly suggest that breastfeeding-or some factor(s) associated with breastfeeding-appears to reduce the incidence of obesity in babies.


Irritable Bowel Syndrome (IBS) is a poorly understood syndrome that generally manifests as crampy abdominal pain and sudden bouts of diarrhea. Occasionally, intermittent constipation alternates with diarrhea. IBS more commonly affects women, and has been variously attributed to nervous disorders, autoimmune disease and infection.

However, the symptoms of IBS overlap with many other gastrointestinal problems, making the diagnosis of IBS somewhat tricky. A study in the journal Gastroenterology evaluated the use of an inflatable balloon placed in the rectum of patients with IBS and other non-IBS gastrointestinal ailments. The study found that patients with IBS have a much lower threshold of discomfort than patients with other GI diseases when the balloon was distended within the rectum. They conclude that this test, unpleasant as it sounds, may be an especially accurate means of discriminating IBS from other gastrointestinal disease syndromes with similar symptoms.


I have rather frequently discussed the apparent association between COX-2 enzyme inhibiting drugs, such as Celebrex and Vioxx, and a reduced risk of colorectal cancer and other cancers. The journal Gastroenterology has also just published a study that assessed 145 esophageal tumors for COX-2 enzyme activity. The study found that patients with elevated expression of the COX-2 enzyme in their esophageal tumors had a significantly worse 5-year survival rate (35%) than patients with low COX-2 expression (72%). These findings further support a possible role for COX-2 enzyme expression in the formation and progression of at least some types of cancer, and the potential use of COX-2 enzyme inhibitors to prevent certain cancers in patients who are at increased risk of developing these diseases.


Clinical Cancer Research: Herceptin is a recently approved drug that blocks a breast cancer growth factor known as HER2/neu. This growth factor is present in about 30% of breast cancers, and these cancers are often more aggressive than those that do not over-express the HER2/neu protein. Herceptin is an antibody that blocks a single site on this growth factor, and has been shown to increase survival in patients with HER2/neu-positive breast cancer. New research shows that antibodies directed against multiple sites on the HER2/neu protein appear to be even more effective at killing breast cancer cells (in cell cultures) than Herceptin.

Clinical Evidence: An exhaustive review of the world's medical literature regarding the measles-mumps-rubella vaccine (MMR) has concluded that there is no evidence that the vaccine causes autism or inflammatory bowel disease. On the other hand, MMR appears to be extremely effective in preventing the three viral diseases that it is supposed to protect against. In terms of public health benefit, MMR provides exceptional protection against measles and rubella, which are capable of causing significant illness, and even death. Previous studies linking MMR to autism and inflammatory bowel disease were found to be poorly performed and statistically non-significant.

Archives of Medicine: Helicobacter pylori (H. pylori), a stomach bacterium linked to ulcer formation and stomach cancer, may play a role in certain forms of glaucoma. Glaucoma is a disease that can threaten vision due to elevated fluid pressure within the eye. Forty-one glaucoma patients and 30 age-matched patients without glaucoma were tested for H. pylori with biopsies of the lining of the stomach. The study found that 88% of the glaucoma patients had H. pylori infections of the stomach, as compared to 47% of the non-glaucoma patients. Following treatment with antibiotics, 83% of the H. pylori infections were eradicated. Two years after the treatment was completed, the glaucoma patients in whom the antibiotics were effective actually experienced a reduction in their intraocular pressures, and an improvement in their vision.

JWR contributor Dr. Robert A. Wascher is a senior research fellow in molecular & surgical oncology at the John Wayne Cancer Institute in Santa Monica, CA. Comment by clicking here.


06/07/02: New coronary artery stent reduces risk of restenosis; possible cause of Parkinson's Disease identified; more

05/31/02: New biological insights into obesity & weight loss; broccoli kills cancer-causing stomach bug; anti-inflammatory drugs and the risk of heart attack

05/24/02: Molecular detection of tumor cells in the blood & prognosis; Cox-2 & breast/lung cancers; BRCA2 gene mutations & the risk of breast cancer; breast density & the risk of breast cancer

05/19/02: Moderate alcohol intake and blood sugar levels; more good news for tea drinkers; blood potassium levels & the risk of cardiovascular disease; ethnic differences in diabetic complications

05/10/02: Tea drinkers and the risk of death following heart attack; duration of breastfeeding & adult intelligence; abdominal aortic aneurysms: surgery or observation?

05/03/02: Risk of adverse drug reactions from newly released medications; preoperative beta-blockers may reduce heart bypass deaths; shape-shifting plastics may alter surgical practice; weight loss supplement may cause liver damage
04/26/02: Angry young men & risk of premature cardiovascular disease; stay-at-home dads & risk of cardiovascular disease; more on the effects of statins; dairy consumption and the risk of pre-diabetes; smallpox vaccine: good to the last drop?
04/19/02: Change your sex by drinking water?; Anti-inflammatory RXs may reduce growth of breast cancer cells; radiation treatment reduces repeat narrowing of bypass grafts
04/05/02: Fish & Omega-3 fatty acid consumption and cardiac health; news briefs
04/05/02: Can coffee reduce your risk of tooth decay?; exercise & blood pressure; a single high-fat meal reduces coronary artery function
04/01/02: Pre-diabetes: a newly defined category of health risk; teen television viewing and subsequent aggressive behavior; the benefits of strength training in the elderly; more ...
03/22/02: Bacteria, antibiotics & heart disease; mammograms: the debate continues; calcium & the risk of colon cancer ... and more
03/15/02: Mammography debate continues; statins & fracture risk; physical fitness & the risk of death; other intriguing findings
03/08/02: Blows to the chest & sudden cardiac death; air quality & the risk of lung cancer; tomatoes and your prostate
03/01/02: Diet & the risk of ovarian cancer; lifetime risk of developing high blood pressure; Osteoporosis prevention with a once-a-year injection?
02/26/02: The continuing controversy regarding screening mammography
02/22/02: Lowering body temperature after heart attack improves outcome; A silver lining for the chronically sleep-deprived?
02/15/02: Hormone replacement therapy & the risk of breast cancer; use it or lose it: Alzheimer's disease & cognitive stimulation; stress, divorce & death; child daycare, infections & parental guilt
02/08/02: Possible breakthrough in early cancer diagnosis; mammography: the controversy continues; CPR techniques revisited
02/01/02: Antibiotics in livestock feed & human disease; genetic detection of early colon cancer in the stool; genetic analysis of breast cancers may help decide treatment
01/25/02: Drug increases lifespan (if you're a fly...); workplace attitudes and smoking cessation; effects of inadequate sleep on surgeons
01/18/02: Lifelong effects of premature birth; smokers under the knife; aspirin and cardiovascular health
01/11/02: Estrogen levels in the blood & breast cancer risk; Heart attack: sex and survival; dangerous lettuce invaders
01/09/02: Cancer & aging: Two sides of the same coin?
01/04/02: Vitamin a & the risk of hip fracture in postmenopausal women; ovarian cancer risk and oral contraceptives
12/28/01: Magnetic Resonance Imaging (MRI) detects coronary artery disease; new development in obesity research; adverse childhood experiences & the risk of suicide attempts
12/21/01: Vaccination of children controls hepatitis a in the community; a possible cure for sickle cell disease; leptin and the risk of heart attacks
12/14/01: Chernobyl and the Risk of Thyroid Cancer in hildren; children & obesity; gastroesophageal reflux disease update
12/07/01: Update on school shootings; new implantable heart-assist device approved for further evaluation; prevention of fungal infections in pre-term babies
11/30/01: Flu vaccination in asthmatics; low-tar cigarettes are not less harmful; beans and your heart
11/21/01: Modified smallpox vaccine may reduce risk of cervical cancer; New approach to breast cancer diagnosis; New non-invasive prenatal diagnostic test for down's syndrome
11/16/01: Cholesterol-lowering drugs reduce risk of heart attack; supplemental radiation therapy reduces risk of breast cancer recurrence; brains of women may answer age-old questions
11/09/01: Bio-warfare (redux); my gray matter is bigger than yours; mad elk disease?
11/02/01: Making sense of bio-warfare
10/26/01: The impact of mammography on deaths due to breast cancer; diet & exercise may slow cancer cell growth; antidepressants and the risk of heart disease
10/19/01: New insights into autism; the wiley appendix
10/12/01: More bad news about obesity links to other diseases…Hey dad, can I borrow the car keys?
10/05/01: California leads nation in reduction of tobacco-related disease; exercise as an antidepressant?
09/25/01: Advances in the detection of breast cancer; primary care physician awareness of peripheral arterial disease; arsenic in the water
09/17/01: In perspective
09/12/01: Genes may hold secret to long life; men and women: cognitive function in the elderly; physical activity, obesity and the risk of pancreatic cancer
09/05/01: English milk cows prefer Beethoven and Simon & Garfunkel over Bananarama; new prostate cancer prevention study: looking for a few good men; exercise & diet can help prevent diabetes
08/28/01: Arthritis drugs may be linked with increased risk of heart disease; errors in blood clotting tests can be fatal; infant soy formula not associated with reproductive side effects

© 2002, Dr. Robert A. Wascher