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The Healthy Heart Handbook for Women

Major Risk Factors for Heart Disease

Overweight and Obesity
A healthy weight is important for a long, vigorous life. Yet overweight and obesity (extreme overweight) have reached epidemic levels in the United States. About 62 percent of all American women age 20 and older are overweight—about 33 percent of them are obese (extremely overweight). The more overweight a woman is, the higher her risk for heart disease. Overweight also increases the risks for stroke, congestive heart failure, gallbladder disease, arthritis, and breathing problems, as well as for breast, colon, and other cancers.

Overweight in children is also swiftly increasing. Among young people 6 to 19 years old, more than 16 percent are overweight, compared to just 4 percent a few decades ago. This is a disturbing trend because overweight teens have a greatly increased risk of dying from heart disease in adulthood. Even our youngest citizens are at risk. About 10 percent of preschoolers weigh more than is healthy for them.

Our national waistline is expanding for two simple reasons—we are eating more and moving less. Today, Americans consume about 200 to 300 more calories per day than they did in the1970s. Moreover, as we spend more time in front of computers, video games, TV, and other electronic pastimes, we have fewer hours available for physical activity. There is growing evidence of a link between "couch potato" behavior and an increased risk of obesity and many chronic diseases.

It is hard to overstate the dangers of an unhealthy weight. If you are overweight, you are more likely to develop heart disease even if you have no other risk factors. Overweight and obesity also increase the risks for diabetes, high blood pressure, high blood cholesterol, stroke, congestive heart failure, gallbladder disease, arthritis, breathing problems, and gout, as well as for cancers of the breast and colon.

Each year, an estimated 300,000 U.S. adults die of diseases related to obesity. The bottom line is that maintaining a healthy weight is an extremely important part of heart disease prevention. It can help to protect your health—and may even save your life.

Should You Choose To Lose?
Do you need to lose weight to reduce your risk of heart disease? You can find out by taking three simple steps.

Step 1: Get your number. Take a look at the BMI chart. You'll notice that your weight in relation to your height gives you a number called a "body mass index" (BMI). A BMI of 18.5to 24.9 indicates a normal weight. A person with a BMI from25 to 29.9 is overweight, while someone with a BMI of 30 or higher is obese. Those in the "overweight" or "obese" categories have a higher risk of heart disease—and the higher the BMI, the greater the risk.

Step 2: Take out a tape measure. For women, a waist measurement of more than 35 inches increases the risk of heart disease as well as the risks of high blood pressure, diabetes, and other serious health conditions. To measure your waist correctly, stand and place a tape measure around your middle, just above your hip bones. Measure your waist just after you breathe out.

Step 3: Review your risk. The final step in determining your need to lose weight is to find out your other risk factors for heart disease. It is important to know whether you have any of the following: high blood pressure, high LDL cholesterol, low HDL cholesterol, high triglycerides, high blood glucose (blood sugar), physical inactivity, smoking, or a family history of early heart disease. Being age 55 or older or having gone through menopause also increases risk. If you have a condition known as metabolic syndrome, your risk of heart disease is particularly high. If you aren't sure whether you have some of these risk factors, ask your doctor.

Once you have taken these three steps, you can use the information to decide whether you need to take off pounds. Although you should talk with your doctor about whether you should lose weight, keep these guidelines in mind:

If you are overweight AND have two or more other risk factors, or if you are obese, you should lose weight.
If you are overweight, have a waist measurement of more than 35 inches, AND have two or more other risk factors, you should lose weight.
If you are overweight, but do not have a high waist measurement and have fewer than two other risk factors, you should avoid further weight gain.

Are You At a Healthy Weight?

Body Mass Index
Here is a chart for men and women that gives the BMI for various heights and weights.^*

BODY MASS INDEX
	21	22	23	24	25	26	27	28	29	30	31
4'10"	100	105	110	115	119	124	129	134	138	143	148
5'0"	107	112	118	123	128	133	138	143	148	153	158
5'1"	111	116	122	127	132	137	143	148	153	158	164
5'3"	118	124	130	135	141	146	152	158	163	169	175
5'5"	126	132	138	144	150	156	162	168	174	180	186
5'7"	134	140	146	153	159	166	172	178	185	191	198
5'9"	142	149	155	162	169	176	182	189	196	203	209
5'11"	150	157	165	172	179	186	193	200	208	215	222
6'1"	159	166	174	182	189	197	204	212	219	227	235
6'3"	168	176	184	192	200	208	216	224	232	240	248

^* Weight is measured with underwear but no shoes.

What Does Your BMI Mean?

Normal weight: BMI = 18.5-24.9. Good for you! Try not to gain weight.

Overweight: BMI = 25-29.9. Do not gain any weight, especially if your waist measurement is high. You need to lose weight if you have two or more risk factors for heart disease and are overweight, or have a high waist measurement.

Obese: BMI = 30 or greater. You need to lose weight. Lose weight slowly—about 1/2to 2 pounds a week. See your doctor or a nutritionist if you need help.

Source: "Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report," National Heart, Lung, and Blood Institute, in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, NIH Publication 98-4083, June 1998.

Small Changes Make a Big Difference
If you need to lose weight, here is some good news: a small weight loss—just 5 to 10 percent of your current weight—will help to lower your risks of heart disease and other serious medical disorders. The best way to take off pounds is to do so gradually, by getting more physical activity and following a heart healthy eating plan that is lower in calories and fat. (High-fat foods contain more calories than the same amount of other foods, so they can make it hard for you to avoid excess calories. But be careful—"low fat" doesn't always mean low in calories. Sometimes extra sugars are added to low-fat desserts, for example.) For some women at very high risk, medication also may be necessary.

To develop a weight-loss or weight-maintenance program that works best for you, consult with your doctor, a registered dietitian, or a qualified nutritionist. For ideas on how to lose weight safely and keep it off, see "Aim for a Healthy Weight".

Table of Contents

Next: Physical Inactivity

Last Updated: February 29, 2012