Counting calories is key to combating obesity, which is as life-threatening as smoking.

“Exercise is a pretty cruddy way to lose weight,” Elkhart cardiologist Dr. Donald Westerhausen Jr. said Feb. 5 at Southwestern Michigan College. “It’s a good way to maintain weight. To lose weight, you’ve got to watch calories” — hard work made easier with smartphone apps such as MyFitnessPal.

“We’re not going to get people to lose weight like bikini models. You need realistic goals like losing five to 10 percent of your body weight in six months. Dietitians will tell you if you cut 500 calories a day, you can burn a pound a week. It takes six weeks to break a habit, but a year related to your diet so your body can adjust hormonally to that new weight. That’s why people yo-yo. It’s difficult to sustain without strategies and reinforcement.”

“Cardiovascular disease is self-inflicted for the most part, so we can prevent it if we want,” Dr. Westerhausen told the Academic Speaker Series in the theatre of the Dale A. Lyons Building on the Dowagiac campus.

“(In 2012) heart disease surpassed infectious disease as the leading cause of death in the world. It’s been the leading cause of death in civilized countries for decades. Eat food your grandmother would recognize,” he said. “She would look at our diets and not know what we’re eating. Save money spent on supplements such as Vitamin C or Vitamin E and spend it on education.”

Recommended exertion is 150 minutes per week of moderate-intensity aerobic activity in at least 10-minute increments to maintain muscle mass, with balance and flexibility training twice a week.

When arteries harden in coronary artery disease (CAD), narrowed vessels reduce flow to the heart until inflammation ruptures plaque build-up.

Risk increases with age, smoking, high blood cholesterol, diabetes, high blood pressure and is more common in men and those with close relatives with CAD.

“Cardiology does an incredible job keeping people alive,” he said. “Every decade for the past three, we’ve decreased the death rate from cardiovascular disease, but we haven’t decreased its burden. Almost as many people have it as had it before, they’re just living longer with a better quality of life.”

Cardiovascular disease killed 925,333 people in 1999, or 38.7 percent of deaths, versus 753,799 (30.5 percent) in 2010.

“But, even with that decrease, one of three people in the United States dies of heart disease. That’s 2,200 a day, a death every 39 seconds. Adults 20 and older, a third have hypertension. Adults 18 and older, one in five smoke. Eight percent will be diabetic, a third are pre-diabetic, a third are obese, a third are overweight, a third don’t exercise. Almost half have too-high cholesterol.”

“Seventy-five percent of women over 65 have hypertension, 65 percent of men. Diabetes, a third over 65, with another third pre-diabetic. Obesity, three out of four people over 65. It wasn’t that way 100 years ago” before salty processed foods.

Eating a Mediterranean diet rich in fish, nuts, whole grains, vegetables and fruits can lower your risk of cardiovascular disease, Harvard School of Public Health reported.

A study of 780 male firefighters found participants who closely adhered showed a 35-percent decreased risk of metabolic syndrome, which includes risk factors such as high blood pressure, high triglyceride levels, a large waistline, low HDL (good) cholesterol levels and high blood sugar.

Firefighters are known to have more prevalence of obesity and risk factors for cardiovascular disease.

Research showed the group with the greatest adherence to a Mediterranean diet had a 43-percent lower weight gain risk, versus the group with the least adherence.

“Everyone eats too much salt,” he said. “Recommended intake is 1,500 milligrams a day. A tablespoon is 2,300 milligrams. Most consume 3,500 or more because of  sodium in any processed food. Salt restriction lowers blood pressure without medication. The lower your blood pressure, the fewer strokes and heart attacks.”

Studies show BMI, or body mass index, related to mortality.

Normal falls between 20 and 25.

“Every five-point increase means a 30-percent death rate increase,” he said. “Waist circumference is incredibly important. The spare tire you get as you age is like an adrenal gland secreting chemicals that are bad for you. For females, the magic number is 35 inches, 40 inches for males.