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Visceral obesity: 21st century cholesterol?

Atherosclerosis is the process by which your arteries (blood vessels that carry important organs that feed food, such as the heart, brain, kidneys) accumulate cholesterol. This leads to a very complex process by which these blood vessels thicken and harden (similar to rust inside the water pipe), which impairs the flow of blood through the narrowed arteries.

This is just a rough picture, but when the atherosclerosis is advanced, the lumen (inner space) of the blood vessels decreases considerably, leading to complete occlusion of the artery or pulling of the inner layers of the artery that will release the substances that lead to the formation of thrombus.

In both cases, the organ perfused from the clogged arteries will not be able to properly feed. If it is a heart, it will talk about angina at rest or effort, or even an infarct that will require an emergency medical intervention.

If the clogged or damaged artery feeds the brain, this can lead to a stroke. It is understandable that atherosclerosis is a phenomenon with serious consequences that has been the subject of research anywhere in the world.

It starts from birth

In addition, it has been shown that atherosclerosis develops from birth (autopsies in small children who have accidentally died but reveal its presence) and several factors accelerate its development, such as, among other things, smoking, hypertension, diabetes and known cholesterol.

In this respect, the research identified a poor cholesterol-transporter of cholesterol-LDL cholesterol-with high levels that predict an increased risk of cardiovascular disease. That's why your family doctor pays attention to the levels of cholesterol (especially LDL-cholesterol).

Moreover, since the arrival of a group of drugs, statins, doctors now have an effective treatment for lowering LDL-cholesterol in patients who have already had a cardiovascular event or are at a high risk. Although sometimes we suspect in their prescription sometimes the abuse, the arrival of these drugs that strongly lower LDL-cholesterol is the success of pharmaceutical research.

However, after a more detailed analysis of clinical trials, the phenomenon proved to be obvious to the researchers: even in patients whose levels of LDL-cholesterol are significantly lowered by statins, a subgroup of treated patients is always considered to be at a higher risk than other groups.

Indeed, this shows abdominal obesity (high waist) and is characterized by the constellation of additional abnormalities that increase the risk of cardiovascular and type 2 diabetes.

This group of abnormalities was called by US experts metabolic syndrome. More than 30 years ago, our laboratory suggested that visceral obesity (excess accumulated fat in the abdomen) is by far the most common form of metabolic syndrome in the population.

We then showed that the doctor can detect his presence by paying attention to the volume of the waist and other form of fat in the blood, triglycerides, which are produced in excessive amounts by the liver that literally becomes filling if you are visceral obesity.

In order to emphasize the importance of these concepts in medical practice, the International Department of Cardiopathic Risk, which I have run at Laval University for more than 10 years, organized a meeting in Prague in April 2017, including international experts in the Society. The International Society of Atherosclerosis has developed an international consensus on visceral obesity as the main risk factor for atherosclerosis and cardiovascular disease.

After more than two years of discussion and discussion, we are very proud to report the fruits of our joint work in the prestigious English medical journal The Lancet Diabetes & Endocrinology. This recognition reflects the importance attributed to visceral obesity by international experts in atherosclerosis and cardiovascular disease. (1)

How many University Institute for Cardiology and Pulmology in Quebec and Laval University came in 30 years! This consensus of international experts again emphasizes the need to place this knowledge in the service of Quebecers!

When is the national campaign to explain to Quebeckers that we need to be cautious with this internal fat that is much more dangerous to health than we do not have healthy weight?

When will we equip them to prevent his development or allow them to be solved? When will we tell them that losing weight is not always the right goal and it is never too late to adopt the habits of a healthy lifestyle? We have a science to share! Let's collectively devote ourselves to the means for it!

1. The major international medical association is joining forces with the International Department of Cardiometabolic Risk University Laval in a position paper published on July 10 in the prestigious English magazine Lancet Diabetes & Endocrinology, which recognizes visceral obesity as the major risk factor for atherosclerosis and cardiovascular disease.

See the study here:

* Jean-Pierre Després is a professor at the Kinesiology Department of the Medical University of Laval University. He is also the scientific director of the Center for Research on Primary Health Care and Services at Laval University, CIUSSS-Capitale-Nationale, and Director of Science and Innovation at Alliance Santé Québec.

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