♪ ♪ ♪ ♪ OBESITY AND TOBACCO SMOKING ARE THE LEADING RISK FACTORS FOR HEART DISEASE.

BUT DID YOU KNOW THAT THERE ARE SOME OTHER LESS OBVIOUS CULL CULPRITS OUT THERE.

STAY WITH US AS WE TALK WITH RESEARCHER Dr. DANIEL CONKLIN ABOUT AIRBORNE TOXINS AND HEART DISEASE NEXT ON "KENTUCKY HEALTH."

>> KENTUCKY HEALTH IS FUNDED IN PART BY A GRANT FOR A HEALTHY FOUNDATION FOR A HEALTHY KENTUCKY.

>> HEART DISEASE IS THE NUMBER ONE CAUSE OF DEATH IN THE UNITED STATES.

ACCORDING TO Dr. KEITH CHURCHWELL, PRESIDENT OF THE AMERICAN HEART ASSOCIATION, EVERY DAY IN THE UNITED STATES 2500 PEOPLE OR ONE PERSON EVERY 34 SECONDS, DIES FROM CARDIOVASCULAR DISEASE.

IN FACT, MORE PEOPLE DIE FROM CARDIOVASCULAR DISEASE AND STROKES, WHICH IS THE NUMBER FIVE CAUSE OF DEATH, THAN FROM ALL CANCERS, WHICH IS THE NUMBER TWO CAUSE OF DEATH AND ACCIDENTS, WHICH IS THE NUMBER THREE CAUSE OF DEATH COMBINED.

RISK FACTORS FOR CARDIOVASCULAR DISEASE THAT MOST OF YOU WILL RECOGNIZE INCLUDE TOBACCO SMOKING, HYPERCHOLESTEROL, DIABETES, OBESITY AND HYPERTENSION.

FORTUNATELY, TOBACCO SMOKING RATES AND THE NUMBER OF PEOPLE WITH ELEVATED CHOLESTEROL LEVELS HAVE BEEN DECLINING.

UNFORTUNATELY, AS REPORTED BY THE AMERICAN HEART ASSOCIATION, NEARLY 47% OF U.S.

ADULTS HAVE HIGH BLOOD PRESSURE.

72% HAVE UNHEALTHY WEIGHTS AND 57% HAVE TYPE 2 DIABETES OR PREDIABETIC.

IN ADDITION TO THE ALARMING NUMBER OF PEOPLE WITH RISK FACTORS FOR CARDIOVASCULAR DISEASE, THERE ARE MORE PEOPLE AFFECTED BY NEWLY RECOGNIZED AND LESS OBVIOUS CAUSES.

I REFER TO THE AIRBORNE TOXINS THAT WE BREATHE DURING OUR DAILY LIVES IN A SEPARATE GROUP THAT WE VOLUNTARILY INHALE.

TO IDENTIFY AND DISCUSS HOW THESE TOX YIPS AFFECT OUR CARDIOVASCULAR SYSTEM WE HAVE AS OUR GUEST TODAY Dr. DANIEL CONKLIN.

DR. CONKLIN EARNED HIS Ph.D.

IN CARDIOVASCULAR PHYSIOLOGY AT THE UNIVERSITY OF NOTRE DAME AND COMPLETED A POST DOCTORAL FELLOWSHIP AT THE NATIONAL INSTITUTES OF ENVIRONMENTAL HEALTH SCIENCE AND TECHNOLOGY TRAINING PROGRAM AT THE UNIVERSITY OF TEXAS MEDICAL BRANCH.

HE IS THE EDITOR OF CARDIOVASCULAR TOXICOLOGY AND IS A PROFESSOR OF MEDICINE AT THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE AND DIRECTOR OF THE EXPOSURE AND PHENOTYPING CORE.

Dr. CONKLIN, DAN, THANK YOU FOR BEING WITH US TODAY.

>> THANK YOU, Dr. TUCKSON FOR INVITING ME.

>> PLEASE CALL ME WAYNE.

OTHERWISE WE ARE GOING TO SPEND A LOT OF TIME WITH THIS DOCTOR STUFF AND THAT'S NOT REALLY NECESSARY.

>> WILL DO.

>> SO OKAY WE KNOW ABOUT THESE BIG RISK FACTORS, DIABETES, HYPERTENSION, AND THAT SORT OF THING.

BUT TELL ME A LITTLE BIT MORE ABOUT THESE NEWER THINGS THAT YOU ARE LOOKING AT.

WHAT ARE SOME OF THE CHEMICALS THAT ARE OUT THERE THAT WE SHOULD BE SOMEWHAT KERNED ABOUT?

-- CONCERNED ABOUT?

>> YOU LAY OUT, THESE ARE THE MAJOR RISK FACTORS.

PART OF THE STORY THAT WE ARE TRYING TO ADDRESS IS HOW DID WE GET THERE?

HOW DID WE GET TO SO MUCH OBESITY?

HOW DID WE GET TO SO MUCH HYPERTENSION?

THESE CLEARLY ARE MAJOR RISK FACTORS.

AND WE THINK WHAT WE BREATHE IN IS CONTRIBUTING TO THE MECHANISMS THAT UNDERLIE THOSE DISEASES.

SO NOT NECESSARILY THAT THEY DO DIFFERENT THINGS, BUT THEY ACTUALLY ACCELERATE THE RISK FACTORS THAT ARE UNDERLYING OR PRESENT IN SO MANY OF US.

AND THIS INCLUDES TWO MAJOR CLASSES OF INHALED COMPOUNDS, PARTICULATE MATTER, WHICH MANY PEOPLE KNOW ABOUT, BECAUSE THIS IS ONE OF THE E.P.A.

'S CRITERIA POLLUTANTS-- >> ENVIRONMENTAL PROTECTION AGENCY.

>> YES, E.P.A.

AND SO SO ALL MAJOR STRI CITIES HAVE TO MONITOR FOR HOW MUCH PARTICULATE MATTER IS IN THE AIR AND THIS GOES INTO THE AIR QUALITY INDEX ALERTS THAT WE GET EVERY DAY WHEN IT'S A BAD CARE DAY BUT THERE IS ALSO THE GASES THAT WE BREATHE IN AND WE CAN PUT OZONE IN THAT CATEGORY.

WHEN OZONE IS BAD, PEOPLE KNOW ABOUT IT.

YOU FEEL IT, YOUR EYES CAN BURN AND YOU PUT OZONE AND PARTICULATE MATTER TOGETHER, THAT'S A BAD MIX.

AND SO OTHER GASES THAT ARE LESS KNOWN, AS YOU MENTIONED, ARE WAS WE CALL VOLATILE ORGANIC COMPOUNDS OR V.O.C.s AND THIS MAY INCLUDE ACROLINE FORMALDEHYDE, AS ZONE,-- ACETONE.

IT SEEMS LIKE A MIXTURE OF THINGS THAT ARE PRESENT IN OUR HOME, WHEN WE COOK OR WE HAVE AN OPEN FIRE, BUT ALSO COME OUT OF THE BACKS OF OUR VEHICLES.

SO EXHAUST CONTAINS ALL OF THESE V.O.C.s.

>> NOW YOU MENTION A LOT OF GASES THAT ARE OUT THERE.

I WOULD NORMALLY ASSUME THAT THE GASES AND THINGS THAT WE ARE INHALING WOULD DAMAGE OUR LUNGS AND WE WOULD SEE THE PROBLEM MORE WITH OUR LUNGS AND I'M LESS THINKING ABOUT THE HEART.

HOW DOES THAT OCCUR?

>> THAT IS A GREAT QUESTION AND IF YOU LOOK AT YOUR LIST ARE CAUSES OF DEATH, WHILE CHRONIC OBSTRUCTIVE PULMONARY DISEASE IS IN THE TOP 10, IT'S CERTAINLY NOWHERE NEAR CARDIOVASCULAR DISEASE.

SO IS THERE A MISMATCH BETWEEN OUR POLLUTED ENVIRONMENT AND THE DISEASES WE THINK THEY SHOULD CAUSE?

ONE OF THE IMPORTANT ASPECTS OF OUR PULMONARY SYSTEM IS THAT IT WANTS TO DETECT NASTY THINGS THAT WE ARE BREATHING BEFORE THEY GET INTO THE LUNGS.

SO YOU ACTUALLY WANT TO PREVENT BREEDING DEEPLY THOSE COMPOUNDS.

AND AS I MENTIONED WITH HIGH LEVELS OF PARTICULATE MATTER AND OZONE, PEOPLE NOTICE THAT THEY ARE TRIGGERED TO THEIR EYES WILL WATER THEY WILL COUGH.

SOME TRIGGER ASTHMATIC EVENTS, WHICH IS REALLY HIGHER IN THE AIR WAYS, CAUSING A CONSTRICTION PART EVER THAT IS REFLEXLY DRIVEN TO PREVENT YOUR LUNGS GETTING EXPOSED TO THESE THINGS.

SO IF REFLEXES ARE BEING TRIGGERED BY IRRITANTS IN THE AIR, THAT MEANS THE NERVOUS SYSTEM IS BEING ACTIVATED AND THE NERVOUS SYSTEM GOES THROUGHOUT YOUR BODY.

AND WE NOW BELIEVE WE HAVE PROVIDED SOME EVIDENCE IN OUR ANIMAL EXPOSURE MODELS THAT EXPOSURE TO THESE INDIVIDUAL GASES, TRIGGER THESE REFLEXES THAT INFLUENCE CARDIOVASCULAR HEALTH IN A NEGATIVE WAY.

SO WE THINK JUST THAT THAT REFLECTION EXPOSURE-- AT REFLEX EXPOSURE CONTRIBUTES IN PART TO INJURY IN THE CARDIOVASCULAR SYSTEM AND MAY HELP TO EXPLAIN THE DISPARITY BETWEEN LUNG DISEASES AND CARDIOVASCULAR DISEASE.

>> BEFORE YOU EXPLAIN TO ME WHAT IS GOING ON AT THE CARDIOVASCULAR SYSTEM THEN, BY THESE CHEMICALS, HOW THAT MECHANISM LOOKS, WHAT DO YOU TELL THE PERSON-- BECAUSE WHEN WE TALK ABOUT, OKAY, WE WANT TO YOU MAINTAIN YOUR GOOD CARDIAC HEALTH SO GET OUT THERE AND EXERCISE.

IN OTHER WORDS, BREATHE DEEPLY.

SO WE ARE REALLY DOING OURSELVES IN IT SOUNDS LIKE OR DOES IT DEPEND WHERE YOU BREATHE DEEPLY?

>> THAT'S A REALLY IMPORTANT CONSIDERATION.

CERTAINLY THE RESEARCH IS KIND OF EARLY TO FULLY BALANCE BETWEEN THE BENEFITS OF EXERCISE, WHICH CLEARLY STRENGTHEN ALMOST ALL OF OUR SYSTEMS, OUR ORGAN SYSTEM, INCLUDING THE CARDIOVASCULAR AND THE PULMONARY BECAUSE THEY WORK TOGETHER.

VERSUS BREATHING IN MORE OF THE THINGS THAT ARE IN YOUR ENVIRONMENT.

WHICH IS CLEARLY BAD TO DO.

I THINK THE RESEARCH IS NOT CLEAR, BUT THE RECOMMENDATIONS ARE THAT YOU NOT EXERCISE OUTSIDE ON BAD AIR DAYS.

SO CHECK THE AIR QUALITY INDEX.

IF IT SAYS THIS IS BAD FOR SUSCEPTIBLE INDIVIDUALS, CERTAINLY IF YOU ARE AT RISK FOR ASTHMA AND YOU KNOW YOU HAVE PROBLEMS WHEN THE AIR QUALITY IS BAD, DON'T PUT EXERCISE IN THAT ENVIRONMENT.

EXERCISE INDOORS WE USED TO SIT BACK AND TELL PEOPLE, WELL, YOU ARE EATING TOO MUCH.

YOU NEED TO CUT BACK ON EATING.

WELL WE FOUND OUT THERE IS PROBABLY MORE TO IT THAN THAT.

THERE ARE VARIOUS ENDOCRINE SYSTEMS THAT ARE OUT OF SYNC PUT THERE ARE CERTAIN CHEMICALS THAT WE KNOW ABOUT THAT BLOCK INSULIN, THAT CAUSE INSULIN RESISTANCE AND MAYBE DECREASE INSULIN PRODUCTION GIVING RISE TO DIABETIC PICTURE.

HOW DOES THE OBESITY FACTOR FACTOR INTO HEART DISEASE.

TELL ME ABOUT THIS IF YOU CAN.

>> I THINK I'LL START WITH AN ANALOGY... >> OKAY.

>> REGARDING CARDIOVASCULAR DISEASE.

WE KNOW THAT HAVING HIGH LIPID LEVELS IN YOUR BLOOD INCREASE YOUR RISK FOR GETTING ATH ROW SCLEROSIS, THE STARTING POINT FOR CLOGGING YOUR BLOOD VESSELS.

YOU NEED TO HAVE HIGH LIPIDS THERE TO DEVELOP VASCULAR DISEASE IN TERMS OF ATHROSCLEROSIS BUT WE HAVE FOUND THAT WHAT TICKS THAT PROCESS OUT IS INFLAMMATION.

SO LIPIDS ARE NECESSARY BUT NOT WHAT SEEM TO BE THE DRIVER FOR CARDIOVASCULAR DISEASE, ESPECIALLY IN ATHROSCLEROSIS.

SO WE THINK THERE IS A PARALLEL HERE WITH HOW DOES OBESITY INCREASE YOUR RISK IT'S PROBABLY NOT ADDING FAT.

WE KNOW WHERE THE FATth, MAKES A DIFFERENCE TO YOUR CARDIOVASCULAR RISK AND THAT'S WHY THINGS LIKE BODY MASS INDEX ARE NO LONGER CONSIDERED A VERY GOOD METRIC FOR CALCULATING RISK.

PEOPLE CAN HAVE A I.B.M.

THAT IS UNHEALTHY BUT THEY'RE FAT FIT.

SO DIGGING IN TO WHERE DOES THE FAT DEPOSIT AND IF THE FAT IS INPLAIMED, THIS SEEMS TO PROMOTE CARDIOVASCULAR DISEASE MUCH MORE READILY.

WE THINK SOME OF THESE GASES THAT YOU BREATHE IN ACTUALLY STIMULATE FAT INFLAMMATION.

AND WE HAVE SHOWN THAT BOTH WITH PARTICULATE MATTER AS WELL AS WITH GASES LIKE ACROLINE AND BENZINE FOR THAT MATTER IS ANOTHER ONE.

>> IS THERE A PARTICULAR MECHANISM THAT THIS OCCURS?

>> THIS IS A CHALLENGE TO DIG DOWN INTO THE MECHANISMS BY WHICH THIS INFLAMMATION IS ACTIVATED.

PARTLY, MY RESEARCH SAYS THAT THIS IRRITANT RESPONSE IN THE UPPER AIR WAYS AND ESPECIALLY IN OUR NOSE, MAY BE LINKED WITH SYSTEMIC INSULIN RESISTANCE AND CHANGING THE WAY... >> YOU MENTIONED A POINT, ALL FAT AIN'T THE SAME-- ALL FAT AIN'T THE SAME.

I'M GOING TO PUT IT THAT WAY.

HOPE MY THIRD GRADE TEACHER WON'T GET MAD AT ME.

NOW, HAVING SAID THAT, AND YOU SAID DIFFERENT LOCATIONS OF THE FAT ARE WORSE THAN OTHERS.

>> RIGHT.

>> AND YOU USE THE TERM FAT FIT.

YOU THREW OUT THREE THINGS AND HAVE YOU TO TELL-- BEFORE-- I GOT TO TELL YOU, THE REASON I'M CONCERNED CLEARLY ONE SIZE DOES NOT CONTRIBUTE TO THE CHARACTER OF THE INDIVIDUAL.

BUT STILL, WE KNOW THAT OVERWEIGHT AND OBESITY CONTRIBUTE TO THE PROBLEM.

BUT NOW YOU ARE SAYING, AND YOU SAID HOLD ON SO TELL ME, WHERE IS THE FAT THAT ISN'T SO BAD OR AS BAD AS WHAT WE THINK IT SHOULD BE.

>> WELL, CLEARLY THE LAST 20 YEARS HAS REVEALED THAT VISCERAL ADIPOSE AROUND OUR ORGANS IS MUCH MORE PROBLEMATIC THAN FAT STORED SUBCUTANEOUSLY.

>> REALLY?

>> SO THAT'S THE FIRST THING THAT KIND OF CHANGES BECAUSE BMI ONLY TELLS YOU ABOUT THE RELATIONSHIP BETWEEN FAT AND YOUR SIZE.

AND THAT DOES NOT WORK FOR EVERYBODY SO ADVISE RAL IS DIFFERENT STORAGE THAN SUBCUTANEOUS FAT.

AND GO BACK TO MY ANALOGY.

IF YOU HAVE EXCESS PAT, THAT OPENS THE PATHWAY THOUGH FOR THAT FAT TO BECOME INFLAMED SO HAVING LESS FAT FROM THE DEPOSITION BEING IN THE WRONG PLACE.

SO YOU WANT TO WATCH WHAT YOU EAT.

I'M NOT TRYING TO SAY DON'T WORRY ABOUT THAT.

BUT IT IS CLEAR THAT THERE ARE DIFFERENT PHENOTYPES IN TERMS OF FAT DEPOSITION AND SOME PEOPLE ARE NOT AS AT HIGH OF A CRFER DISEASE RISK-- CARDIOVASCULAR DISEASE RISK THAN OTHERS.

I'M PARTICULARLY INTERESTED IN THE FAT THAT GETS DEPOSITED AROUND BLOOD VESSELS BECAUSE THAT IS A VISCERAL FAT, AND THAT FAT, WHEN IT GETS INFLAMED, ACTUALLY CAUSES THE BLOOD VESSEL TO GO INTO A DYSFUNCTIONAL STATE >> SO WHAT GUIDES THE DIFFERENCE WHERE THE FAT IS DEPOSITED?

IS IT, AGAIN, IS IT SOMETHING THAT-- IT'S NOT THE FOOD THAT WE ARE TAKING IN, NOT THE LEVEL OF ACTIVITY.

YOU ARE SAYING IT MIGHT BE DRIVEN BY CHEMICALS OR IS IT GENETIC?

>> IT COULD BE DRIVEN BY ENVIRONMENTAL SOURCES OF AGENTS THAT WE CALL OBESE-OGENS.

THEY MAY BE PREFERENTIALLY SITTING ADIPOS SE SOMEWHERE WHERE IT NORMALLY DOESN'T GO OR THEY'RE AFFECTING THE DEPOSITS TO INFLAME THEM SO BOTH THINGS COULD BE TRUE.

BUT MORE RESEARCH HAS TO BE DONE ON WHAT GETS ADIPOSE TO GO WHERE.

I THINK THAT IS AN INTRIGUING THING.

THE ONE THING WE DO KNOW UPSTREAM OF THAT IS INSULIN RESISTANCE TENDS TO PROMOTE MORE ADIPOSE DEPOSITION.

SO INSULIN RESISTANCE CAN COME ABOUT FROM HAVING TOO HIGH OF CALORIE INTAKE, OVERWORKING THE PANCREAS SO THAT, YOU KNOW, THERE IS INSULIN EXHAUSTION IN THAT REGARD.

BUT WE HAVE FOUND IN HEALTHY ANIMALS, THAT EXPOSURE TO THESE AIR PLUNT ANTS,-- POLLUTANTS, PARTICULATE MATTER AS WELL AS ACRILNE BOTH CAUSE VASCULAR RESISTANCE.

>> BREAK THAT DOWN.

ARE YOU SUGGESTING THAT WHEREAS INSULIN IS ACTIVE IN OUR CELLS THROUGHOUT OUR BODY, SELECTIVELY SOME ORGAN SYSTEM CELLS ARE NOT RESPONSIVE.

IS THAT WHAT YOU ARE SAYING?

>> YES, RIGHT.

AND IN FACT THIS WAS SOME REALLY ELEGANT RESEARCH IN THE MID 2000S THAT SHOWED WHEN YOU FEED AN ANIMAL HIGH FAT DIET, THAT THE ORGANS BECOME INSULIN RESISTANT IN A SEQUENCE AND THE FIRST ORGAN THAT BECOMES INSULIN RESISTANCE IS THE VASCULAR.

INSULIN DOESN'T WORK ON ALL CELLS EQUALLY.

BUT PART OF THE REASON THE VASCULAR STORY IS IMPORTANT IS THAT INSULIN, IN THE VASCULARTURE ALLOWS GLUCOSE TO MOVE INTO THE ORGAN.

SO SAY YOUR SCHEDULE SKELETAL MUSCLE.

SO IF YOU ARE EXERCISING, YOU WANT THAT BLOOD GLUCOSE TO GO FROM THE BLOOD INTO THE CELLS WHERE IT CAN BE UTILIZED.

>> RIGHT.

>> IF THE VASCULARTURE BECOMES INSULIN RESISTANT, IT BLOCKS THE EFFICIENCY OF THAT TRANSFER.

SO WHAT HAPPENS TO EXTRA BLOOD GLUCOSE?

IT GETS DEPOSITED AS FAT.

>> INTERESTING.

I WANT TO CHANGE GEARS JUST A BIT BECAUSE WE KNOW SMOKING IS A PROBLEM IN AND AMONGST ITSELF.

BUT MANY OF US OUT HERE WHO ARE WATCHING, HAVE TRIED TO GET OFF OF CIGARETTES AND ONE OF THE THINGS THAT PEOPLE ARE USING ARE E-CIGARETTES.

SOME PEOPLE PREFERENTIALLY ARE USING THESE THINGS AS THEIR BIT.

BUT WHAT IS GOING ON WITH E-CIGARETTES?

IS THIS THE PANACEA TO KEEP PEOPLE FROM SMOKING OR WE OPENED UP ANOTHER SOURCE OF PROBLEMS FOR PEOPLE DOWN THE ROAD?

>> YEAH, THE RESEARCH RIGHT NOW IS-- >> IT TOOK A LONG TIME TO THINK ABOUT THAT ONE.

>> THE RESEARCH IS SUGGESTING THIS IS A PAN DOOR PANDORA BOXES THAT WE HAVE OPENED.

I THINK THERE IS A NUMBER OF PUBLIC HEALTH RELATED ORGANIZATIONS THAT WOULD LOVE TO BELIEVE THAT E-CIGARETTES ARE GOING TO IMPROVE HEALTH.

YOU BROUGHT UP THE ONE THING OF SWITCHING FROM TOBACCO CIGARETTES TO ELECTRONIC CIGARETTES.

>> YES.

>> IT HASN'T TURNED OUT TO BE QUITE AS EFFECTIVE AS IT WAS ORIGINALLY MARKETED FOR THAT PROCESS.

BUT I ACTUALLY WANT TO STEP BACK TO INTEGRATE OUR DISCUSSION ABOUT OBESITY.

AND HERE BRING IN SMOKING BECAUSE YOU KNOW SMOKING, FOR A LONG TIME IN MANY PEOPLE, PROVIDES AN APPETITE SUPPRESS ANT.

NICOTINE IS KNOWN TO HAVE THIS KIND OF ANOREXIC EFFECT.

IF YOU SUPPRESS YOUR APPETITE, YOU REDUCE THE AMOUNT OF INTAKE AND YOU STAY THIN.

AVOIDING OBESITY THROUGH SMOKING IS NOT A GOOD TRADE-OFF BECAUSE YOU ARE STILL GETTING EXPOSED TO ALL OF THESE TOXINS, NOT ONLY THAT CAUSE CANCER, BUT ALSO HIGHER RATES OF HEART DISEASE, WHICH IS KIND OF THE PROOF IN THE PUDDING THAT THESE THINGS, ON THEIR OWN, THESE TOXINS, ON THEIR OWN, CAN TRIGGER SCRF DISEASE-- CARDIOVASCULAR DISEASE THROUGH POSSIBLY INFLAM ACHES OR CHANGING OTHER MECHANISMS.

PEOPLE DON'T WANT TO GO OFF CIGARETTES BECAUSE WHEN THEY DO, THEY EAT MORE AND GAIN MORE WEIGHT SO IT'S VERY TOUGH TO QUIT WHEN YOU ARE BATTLING THESE TWO THINGS AND THAT IS I THINK I HEARD OF A PHRASE TOBESITY WHICH IS TOBACCO OBESITY WHEN YOU TRY TO GO OFF CIGARETTES AND GAIN WEIGHT.

THAT YO'-YO'ING IS NOT CONSIDERED HEALTHY FOR OUR BODY.

YOI ONE OF THE THOUGHTS IS DOES E-CIGARETTES PROVIDE THAT NICOTINE IS THAT WILL MAINTAIN BODY WEIGHT, BUT WITH FEWER OF THE COMPOUNDS THAT WE KNOW ARE PROBLEMATIC FOR CANCER, CARCINOGENS THAT ARE FOUND IN TOBACCO SMOKE; BUT ALSO THESE OTHER TOXINS, PARTICULATE MATTER AS WELL IS THE GASES.

>> SURE.

SO I WORK ON THIS AREA WHERE WE ARE TRYING TO EVALUATE WHETHER OR NOT THESE PRODUCTS PRODUCE SIMILAR LEVELS OF TOXINS BUT ALSO WHAT IS THE EFFECT ON THE ORGANISM WHEN YOU EXPOSE THEM TO THESE COMPLEX AEROSOLS AS WELL AS THE INDIVIDUAL GASES.

>> WE'VE TALKED A BIT ABOUT WEIGHT IN THIS RELATIONSHIP.

BUT THERE ARE THIN PEOPLE WHO HAVE HEART DISEASE, ALSO.

SAME MECHANISMS GOING ON?

WE JUST DON'T SEE THE FAT SIDE OF IT?

AND I SAY FAT, I MEAN THE ACTUAL STRUCTURE OF FAT, NOT SAYING SOMEBODY IS FAT.

>> RIGHT.

I THINK THAT THE INFLAMMATION SIDE OF IT, THAT MECHANISM IS STILL GOING TO OCCUR.

IF YOU HAVE ADIPOSE, THAT'S ANOTHER WAY THAT THE INFLAMMATION CAN NEGATIVELY IMPACT YOUR CARDIOVASCULAR, BUT IT DOESN'T REQUIRE IT.

STROKE AND HEART ATTACKS CAN OCCUR IN SMOKERS EVEN WHEN THEY HAVE VERY LITTLE ADIPSOE.

THOSE MECHANISMS SEEM TO STILL BE RELATED TO THIS IRRITANT QUALITY OF THESE COMPOUNDS BECAUSE IT CAN TRIGGER THE NERVOUS SYSTEM.

AND SOMETIMES A HEART ATTACK IS BECAUSE WE GET STRESSED OUT AND THE LEVEL OF OUR STRESS HORMONES GO UP AND OUR VASCULARTURE CAN CONTRACT TOO MUCH, CAUSING A VASO SPASM WHICH DEPRIVES THE HEART OR IN THE BRAIN, A STROKE, WHERE, YOU KNOW, CONSEQUENCES ARE DIRE.

>> DO YOU SEE CLUSTERING OF HEART PROBLEMS IN AREAS WHERE WE HAVE HIGHER EXPOSURE TO SOME OF THESE TOXIC MATERIALS?

>> YEAH, I THINK THAT'S A GREAT QUESTION AND CERTAINLY OVER THE PAST 25-- 30 YEARS, THE DEVELOPMENT OF THE AREA OF RESEARCH CALLED ENVIRONMENTAL CARDIOLOGY-- >> ENVIRONMENTAL CARDIOLOGY.

>> IS BASED ON THE EPIDEMIOLOGY THAT SAID THE MOST POLLUTED CITIES IN THE UNITED STATES HAVE THE HIGHEST MORTALITY AND THAT MORTALITY WAS PRIMARILY DUE TO CARDIOVASCULAR DISEASE.

>> REALLY?

>> AND REALLY THE DEVELOPMENT OF E.P.A.

'S CRITERIA POLLUTANTS IS PARTLY BASED ON ENVIRONMENTAL CARDIOLOGY THAT WHERE YOU LIVE, HOW CLOSE YOU ARE TO THE POLLUTION, THE WORSE YOUR RISK IS.

IT HAS BEEN KNOWN FOR SOMETIME.

>> THE FLIP SIDE OF THAT IS WHAT ABOUT WHAT YOU EAT WHEN WE ARE EXPOSED THE TO PROCESSED FOODS OPPOSED TO THE NATIVE FORM.

IS THAT A CONTRIBUTING FACTOR THEN?

>> CERTAINLY ANYTHING YOU TAKE INTO YOUR BODY IS POTENTIALLY A AN ISSUE AND PROCESSED FOOD, NOT AN AREA THAT I FOCUS ON, BUT I THINK THE EMERGING EVIDENCE IS THAT YOU CAN STIMULATE AN INFLAMMATORY RESPONSE WITH THESE COMPOUNDS THAT ARE FOUND IN PROCESSED FOOD.

THERE IS ALSO THIS CYCLE THAT THEY SEEM TO PROMOTE MORE INTAKE.

SO THEY KIND OF HAVE AN APPETITE FEED FORWARD, PARDON THE PUN, OF RELATIONSHIP WHICH, AGAIN, GOES BACK TO THIS KIND OF TOO MANY CALORIES.

BUT I THINK THERE IS A LOT OF QUESTIONS ABOUT THE MECHANISMS BY WHICH THE COMPOUNDS ACTUALLY STIMULATE THAT.

>> IN THE LAST COUPLE OF SECONDS WE HAVE AVAILABLE, WHERE SHOULD I GO AND WHAT SHOULD I DO IF I WANT TO MAINTAIN GOOD HEART HEALTH?

WHRER WHERE AM I GOING TO LIVE AND WHAT AM I GOING TO EAT?

>> YEAH, AS YOU STARTED OUT THE PROGRAM, I THINK AWARENESS OF YOUR ENVIRONMENT BELIEVING THAT EACH DAY IS NOT THE SAME AND CHECKING THE AIR QUALITY INDEX, WHETHER I SHOULD GO EXERCISE OUTSIDE OR, YOU KNOW, ONE OF MY FAVORITE THINGS TO PROMOTE IS TAKING THE STAIRS.

I THINK IT IS SAID THAT INSIDE RELATIVELY SAFE, DON'T TRY TO RUN UPSTAIRS, BUT-- >> DO I NEED TO CARRY MY OXYGEN TANK WITH ME SO I HAVE MY OWN AIR?

>> DEPENDING ON-- >> WE CARRY OUR OWN WATER BOTTLES.

DO I NOW TAKE MY OWN AIR WITH ME?

>> YOU MIGHT WANT TO WEAR A MASK, DEPENDING ON THE, YOU KNOW, ON THE LOCATION.

>> YOU ARE A LITTLE NON-COMMITAL ON THAT ONE.

I WANT TO THANK YOU VERY MUCH.

YOU MADE A DIFFICULT SUBJECT A LOT MORE DIGESTIBLE FOR ME AND HOPEFULLY FOR EVERYBODY ELSE.

THANK YOU FOR BEING WITH US TODAY.

THERE ARE MANY THINGS THAT WE CAN DO TO MITIGATE OUR RISK FOR CARDIOVASCULAR DISEASE SUCH AS DECREASING TOBACCO USE, MODIFYING OUR DIETS AND EXERCISING.

HOPEFULLY AS WE IDENTIFY AND GAIN GREATER UNDERSTANDING OF AIRBORNE TOXINS WE MAY SOON BE ABLE TO BLOCK THEIR EFFECTS, TOO.

IF YOU WISH TO WATCH THIS SHOW AGAIN OR WATCH AN ARCHIVED VERSION OF PAST SHOWS PLEASE GO TO ket.org/HEALTH F. YOU HAVE A QUESTION OR COMMENT ABOUT THIS OR OTHER SHOWS, WE CAN BE REACHED AT KY HEALTH@ket.org.

I LOOK FORWARD TO SEEING YOU ON THE NEXT "KENTUCKY HEALTH."

PLEASE GET OUT THERE AND EXERCISE, PAY ATTENTION TO THE AIR QUALITY, WATCH WHAT YOU ARE EATING AND YES, THE BMI MAY NOT BE GOOD, WATCH HOW MUCH WEIGHT YOU HAVE AND EXERCISE.

WE LOOK FORWARD TO SEEING YOU AGAIN NEXT WEEK ON "KENTUCKY HEALTH."

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.