By Charles and Elie Traube
Heart disease is the number-one cause of death in the United States.
While data on the incidence of heart disease in the frum community does not currently exist, there is no question that our cholesterol-rich, kugel-laden diets and sedentary lifestyle put us at a greater risk of developing heart disease or suffering a heart attack.
In our Brooklyn cardiology practice, close to 50 percent of our patients are Orthodox. In fact, one of our patients actually served as the inspiration for this article.
At age fifty, the patient weighed over 350 pounds, ate huge amounts of unhealthy foods, didn’t exercise and rarely saw a doctor. Then one day he developed chest pain, which traveled down his left arm; he had an acute heart attack and subsequently required bypass surgery.
I remember him telling me prior to his bypass, “How could I have let this happen? What have I done to myself and my family?” After the bypass surgery, he changed his whole way of life. He lost over 150 pounds, began to exercise on a regular basis and changed his eating habits—not by adopting the latest diet fad, but by adhering to a heart-healthy diet. He now plays tennis three times a week and has never been healthier. Hopefully, this article will encourage people to live a healthier life, before they need surgery.
The heart is the main pumping organ and the most important muscle in the body. Unfortunately, many people have a predisposition to developing fatty plaque, which can block one’s arteries and cause a heart attack. The good news is that heart disease is frequently preventable and sometimes reversible. True, we cannot change certain risk factors, such as age, sex or family history, but we can take certain proactive steps to avoid the disease.
Smoking may be the most significant risk factor for developing heart disease. Chemicals such as carbon monoxide and nicotine in tobacco often lead to narrowing of the arteries and heart attacks. No amount of smoking is safe, and second-hand smoke should also be avoided. Unfortunately, smoking is prevalent in many boys’ yeshivot. It is especially sad to pass by a yeshivah and see teens smoking outside, in full view of their rebbeim. I am truly puzzled by the lackadaisical attitude many Orthodox Jews have toward smoking when it is clear that smoking causes death. At the same time, I want to point out that even if one smoked as a young yeshivah bochur, all is not lost. As soon as one stops smoking, the risk of heart disease declines rapidly.
Lower your cholesterol.
Do you know your cholesterol number? Do you know how much money you have in your bank account? Just as one knows his account balance, he should know his cholesterol level. Remember, high levels of “bad cholesterol” (LDL) increase the risk of heart disease. High levels of “good cholesterol” (HDL) protect against heart disease.
Approximately 80 to 85 percent of a person’s cholesterol consists of what the body produces and only 15 to 20 percent comes from what we eat. Therefore, many people may have high cholesterol through no fault of their own.
In recent years, statin drugs have revolutionized the treatment of high cholesterol. They are able to block the action of a chemical in the liver that is necessary for making cholesterol. (As a general rule, statins are safe, but they do have certain side effects.)
Nevertheless, when it comes to watching one’s cholesterol, diet should not be overlooked. Is it really necessary to eat kugel every Shabbat at the shul kiddush? Is kishke a worthwhile staple at the Shabbat meal? If you are at risk for heart disease, rethinking your diet is not just a good thing to do; it is an absolute necessity.
High blood pressure.
Hypertension, or high blood pressure, is a blood pressure above 140/90. A physician has numerous medications at his disposal to lower an elevated blood pressure. However, it is best to first attempt to lower blood pressure through lifestyle changes, such as decreasing salt intake, losing weight and exercising.
A major risk factor for heart disease is diabetes. Nearly 10 percent of the American population suffers from diabetes, including more than 25 percent of seniors.
Obesity, of course, is one of the main culprits responsible for the rise in diabetes in American society; and, with all the emphasis placed on food in frum life, it should come as no surprise that obesity and diabetes are common in Orthodox circles. We have holidays every few months where we serve elaborate meals laden with carbohydrates and other fatty foods (e.g., blintzes, latkes, et cetera). Think about what we eat weekly at our Shabbat tables!
We rarely hear about the Torah’s mandate of “Venishmartem me’od lenafshoseichem” in the Shabbat derashah; why is health not a rabbinic concern?
A great way to overhaul one’s eating habits is to stick to the “Mediterranean diet,” which consists mostly of fruits and vegetables, olive oil, red wine, nuts and good fats such as those found in fish. Studies have shown that such a diet lowers the risk of cardiovascular disease. (Please note that cholent and flanken are not part of this diet regimen!)
Exercising regularly can also prevent heart disease, lower blood pressure and improve cholesterol levels. One should exercise for thirty minutes, three to four times per week. Unfortunately, the frum community in general does not emphasize exercise enough. Certainly the obligation to learn Torah in one’s spare time is critical, but maintaining good health—especially when one is sitting all day in front of either a Gemara or a computer screen—is also a Torah imperative. Moreover, in many right-wing yeshivot, sports are regarded as bittul zeman and gym classes are virtually nonexistent. As parents and grandparents, we should demand that yeshivot make physical activity more of a priority. This is especially necessary as our kids become hooked on technology. Instead of rollerblading or shooting hoops, they spend hours fixated on screens with only their fingers getting exercise.
We’ve heard plenty of rabbis at the bimah speak about the importance of including more Torah study in one’s daily and weekly schedule, which is, of course, fair and reasonable. However, shouldn’t our religious leaders also discuss maintaining a healthy lifestyle—specifically, the importance of exercise and moderation of food intake? I rarely hear about the Torah’s mandate of “Venishmartem me’od lenafshoseichem” in the Shabbat derashah; why is health not a rabbinic concern?
As cardiologists, we have witnessed far too many painful stories; too many patients who refuse to exercise self-control, who refuse to make their own health a priority and end up succumbing to devastating diseases. Heart disease doesn’t have to happen. You—the patient—can play a more active role in the prevention and protection of your body. With a little knowledge, a good physician and some self-control, we can all strive to remove heart disease from its current distinction as being the number-one killer in the US today
Drs. Charles and Elie Traube, a father and son, share a cardiology practice with Dr. Sidney Plawes, Dr. Arthur Marush and Dr. Denise Dogonay in Brooklyn, New York.