Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A lifestyle that combines sensible eating with regular physical activity is the key to good health.
To be at their best, adults need to avoid gaining
weight, many need to lose weight and some are underweight. Being overweight or obese increases your risk for
high blood pressure,
heart disease,
stroke,
diabetes,
arthritis, and breathing problems. A healthy weight is key to a long, healthy life.
Evaluate Your Body
If you are an adult, find out your
BMI (click here for calculations).
Not all adults who have a BMI in the range labeled "healthy" are at their most
healthy weight. For example:
Some may have lots of fat and little muscle.
A BMI above the healthy range is less healthy for most people; but it may be fine if you have lots of muscle, a large body frame, and little fat.
The further your BMI is above the healthy range, the higher your weight-related risk. If your BMI is above the healthy range, you may benefit from weight loss, especially if you have other health risk factors.
BMIs slightly below the healthy range may still be healthy unless they result from illness.
An association between certain metabolic disorders and cardiovascular disease has been
known since the 1940s. In the 1980s this association became more clearly defined
and the term metabolic syndrome (also known as syndrome X or the dysmetabolic
syndrome) was coined to designate a cluster of metabolic risk
factors that come together in a single individual. In more current times, the
term metabolic syndrome is found throughout medical literature and in the lay
press as well. There are slight differences in the criteria of diagnosis -
depending on which authority is quoted. Regardless, the concept of a clustering
of risks factors leading to cardiovascular disease is well accepted.
The main features of metabolic syndrome include
insulin
resistance, hypertension (high blood pressure), cholesterol abnormalities, and
an increased risk for clotting. Patients are most often overweight or obese.
Insulin resistance refers to the diminished ability of cells to respond to
the action of insulin in promoting the transport of the sugar glucose, from blood into muscles
and other tissues. Because of the central role that insulin resistance plays in
the metabolic syndrome, a separate article is devoted to insulin resistance.
How is metabolic syndrome defined?
The definition of metabolic syndrome depends on which
group of experts is doing the defining. Based on the guidelines from the 2001
National Cholesterol Education Program Adult Treatment Panel (ATP III), any three of the following
traits in the same individual meet the criteria for the metabolic syndrome:
Abdominal obesity: a
waist circumference over 102 cm (40 in) in men and over 88 cm (35 inches) in
women.
The World Health Organization (WHO) has slightly different criteria for the
metabolic syndrome:
High insulin levels, an elevated fasting blood glucose or an elevated post
meal glucose alone with at least 2 of the following criteria:
Abdominal obesity as defined by a waist to hip ratio of greater than
0.9, a body mass index of at least 30 kg/m2 or a waist measurement over
37 inches.
Cholesterol panel showing
a triglyceride level of at least 150 mg/dl or an HDL cholesterol lower than 35
mg/dl.
Blood pressure of 140/90 or above (or on treatment for high blood
pressure).
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Polycystic ovarian syndrome (PCOS), also known by the name Stein-Leventhal syndrome, is a hormonal problem that causes women to have a variety of symptoms including irregular or no menstrual periods, acne, obesity, and excess hair growth. Treatment of PCOS depends partially on the woman's stage of life and the symptoms of PCOS.
Nonalcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis (NASH), to cirrhosis (irreversible, advanced scarring of the liver). All of the stages of NAFLD have in common the accumulation of fat (fatty infiltration) in the liver cells (hepatocytes).
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use. Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
Cushing's syndrome, sometimes referred to as hypercortisolism, is a hormonal disorder caused by prolonged exposure to high levels of the hormone cortisol. Symptoms may include obesity, thinning arms and legs, a rounded face, and increased fat around the neck. Some causes of Cushing's syndrome is from taking glucocorticoid hormones such as prednisone for inflammatory diseases. Treatment for Cushing's syndrome depends on the cause.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Diffuse idiopathic skeletal hyperostosis (DISH or Forestier's disease) is a form of degenerative arthritis. It is characterized by calcification along the sides of the vertebrae of the spine. Symptoms include stiffness and pain in the upper and lower back. Anti-inflammatory medications are used to treat DISH.
A diabetic diet, or diabetes diet helps keep blood glucose levels in the target range for patients. Exercise and medication may also help stabilize blood glucose levels. Keeping track of when you take your diabetic medicine, keeping track of food choices, eating the proper amount of fruits, vegetables, carbohydrates, and fats will also help maintain proper blood glucose levels.
The risks for developing type 2 diabetes include family history, ethnicity, birth weight, metabolic syndrome, and obesity. Warning signs pointing to an increased risk for developing type 2 diabetes include irregular menstruation, impaired fasting glucose, inflammatory markers, and other risks. Gestational diabetes is also a risk factor for developing type 2 diabetes later in life. Prevention of type 2 diabetes can be achieved through a healthy diet (Mediterranean diet), exercise, weight control, not smoking, and medication.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Menopause is defined as the state of an absence of menstrual periods for 12 months. The
menopausal transition starts with varying
menstrual cycle length
and ends with the final menstrual period. Perimenopause means "the time around menopause"
and is often used to refer to the menopausal transitional period. It is not officially a medical term, but is sometimes used to
explain certain aspects of the menopause transition in lay terms. Postmenopause
is the entire
period of time that comes after the last menstrual period.
Menopause is the time in a woman's life when the function of the ovaries
ceases. The ovary (female gonad), is one of a pair of reproductive glands in
women. They are located in the pelvis, one on each side of the uterus. Each
ovary is about the size and shape of an almond. The ovaries produce eggs (ova) and female
hormones such as estrogen. During each
monthly menstrual cycle, an egg is released f...
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