In the October 25 issue of Circulation, the American Heart Association published a scientific statement aimed at helping doctors manage obese patients who have heart disease. The statement discusses the state of knowledge on the relationship of obesity to heart disease, and reviews the treatment of obesity.
The statement holds few surprises. The mainstays of weight loss, the AHA says, are diet and exercise.
Regarding exercise, the AHA stresses a high volume of regular physical activity, and notes that it is the total amount of physical activity - rather than the intensity of that activity - that is important.
The only surprise real surprise in the AHA's report is its acknowledgement of recent evidence that low-carb diets have been more successful than low-fat diets, in several randomized trials, in achieving weight loss. Further, the statement notes, low-carb diets seem to be more effective in raising HDL cholesterol levels than low-fat diets. The fact that the AHA mentions low-carb diets in a modestly favorable tone is a major departure from 30 years of low-fat-only tradition.
Weight loss surgery is also mentioned. It is suggested for patients who have extreme obesity and who are unable to lose weight with more conventional approaches.
Overall, the AHA's statement may serve to remind doctors that obesity is a major risk factor for heart disease, and that, while there is no magic weight loss bullet, doctors owe it to their patients to encourage them to lose weight.
