Can You Outrun Bad Genes for Heart Disease?
You can’t outrun a bad diet. So says the wisdom of the internet. But a new study published yesterday in Circulation suggests that maybe you can outrun bad genes for heart disease. Emmi Tikkanen and colleagues found that fitness, strength, and physical activity might erase some – but not all – of the risk for heart disease, even for people who inherit high genetic risks.
A Robust Risk Reduction
Let’s be clear. This is an observational study of a very large cohort – 502,635 people – followed for six years. The researchers found a robust inverse relationship of fitness and physical activity with people developing cardiovascular disease. Even among people in the highest genetic risk group, those with high fitness had half the risk of coronary disease.
Though the study can’t prove cause and effect by itself, the findings are robust and very consistent with a much larger body of research. And it provides fresh insight that the benefits of fitness hold up even for people who inherit a high risk of heart disease.
Speaking for the American Heart Association, Cardiologist Suzanne Steinbaum praised the study:
This is a great study. Exercise really is the best medicine.
So often, I hear people say, “Well, heart disease is in my family, so I’m going to get it.” But even if you have a genetic predisposition, exercise can change your outcome. It’s still in your hands.
We certainly agree with her enthusiasm. Just so long as you don’t take that “best medicine” concept too far. Even with a great fitness routine, don’t stop taking your meds without consulting your doctor first.
Click here for the study and here for further perspective.
Running, photograph © Phil Hilfiker / flickr
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April 10, 2018
April 10, 2018 at 10:57 am, David Stone said:
“But even if you have a genetic predisposition, exercise can change your outcome. It’s still in your hands.”
Yes indeed, and so is losing weight. But developing a permanent habit of staying fit and active is not much easier (if easier at all!) than developing a permanent habit of eating only enough Cals to reach and maintain a healthy weight. And as we all know, couch-potato-hood and excess weight tend to occur together.
April 10, 2018 at 11:02 am, Ted said:
Thanks, David
Fun facts:
Heritability of Coronary Artery Disease – 50%
Heritability of Obesity – 70%
https://www.snpedia.com/index.php/Heritability
April 10, 2018 at 1:11 pm, John DiTraglia said:
Exercise is dangerous, painful and expensive but to my mind it’s way easier than hunger. Just an opinion. But the exercise epidemic is evidence, I think, for that opinion being more widespread than weight loss.
April 11, 2018 at 12:10 am, David Stone said:
Ted, I appreciate the Fun Facts, but there’s another difference: excess body fat is 100% controllable by modifying behavior; not so for artery disease.
April 11, 2018 at 4:13 am, Ted said:
I wish you were right, David. But clinical studies prove you wrong.
Much can be done to prevent or control CAD. Good outcomes are reliable and more frequent than not.
For obesity, diet and exercise doesn’t work to reverse the problem for most people. Pharmacotherapy doesn’t work for everyone. Surgery is pretty effective, but not universally so. And it’s daunting. 100% controllable? Not obesity. Not by a long shot. At least, not yet.
April 11, 2018 at 2:02 pm, David Stone said:
Ted, I suppose I was making a sort of theoretical point. I’m well aware of the clinical studies and the discouraging failure rate of “diet and exercise”. My point was only that when people do lose down to a healthy weight, it’s accomplished by behavioral means–eating fewer Cals and usually, being more physically active. Even Orlistat, which can be easily defeated, needs a behavioral assist to effect a clinically significant loss of weight. If a fabulous appetite-killing drug (with minimal side-effects) is ever invented, it will work (we hope) by modifying behavior, just as bariatric surgery works by modifying behavior.
On the other hand, statins and various other drugs that affect risk-associated lipids to reduce risk of artery disease don’t rely on behavioral change; but of course there are plenty of behavioral changes that also reduce risk. I walked/jogged a mile early this morning and I’m about to walk/jog another one. Best to you.
April 11, 2018 at 2:59 pm, Ted said:
Thanks for your very thoughtful reply, David. Behavior is indeed an important component of obesity. Physiology is equally important. Sometimes it’s far more important.