Heart disease poses a significant threat to South Asian communities, with early onset and severe cases leading to alarming mortality rates, yet awareness and preventative measures remain critically low.
Heart disease is the leading cause of death among South Asians worldwide, with early onset and severe cases disproportionately affecting these communities. Despite accounting for approximately 25% of the global population, South Asians carry a staggering 60% of the world’s heart disease burden. The incidence of heart disease in South Asian countries, particularly India and Bangladesh, is alarmingly higher than in Caucasian populations, with cases occurring at least a decade earlier.
Statistics reveal that 50% of heart attacks among South Asians occur in individuals under the age of 50. This trend raises urgent questions about the genetic predispositions and lifestyle factors that contribute to such high rates of heart disease in these communities.
Genetic factors play a significant role in the heightened risk of heart disease among South Asians. Many individuals are born with a genetic predisposition that makes them more susceptible to developing heart conditions. For instance, South Asians are particularly prone to visceral fat accumulation, which is linked to chronic diseases such as diabetes and hypertension. This phenomenon, often referred to as apple-shaped obesity, is detrimental from a cardio-metabolic perspective.
Additionally, a specific type of lipoprotein known as LP little A (Lp(a)) is found in disproportionately high levels among South Asians, with studies indicating that over 25% of individuals in this demographic exhibit elevated levels, marking it as an independent risk factor for heart disease.
Dietary habits also contribute to the increased risk of heart disease. The traditional Indian vegetarian diet, often perceived as heart-healthy, can pose similar risks to non-vegetarian diets due to several structural issues. High carbohydrate content is prevalent, with 60% to 80% of the diet consisting of high-carb sources like white rice and refined flour (maida). Furthermore, the common practice of deep-frying foods introduces trans fats, which inflame heart arteries. For example, a single jalebi can contain up to 17% trans fat, significantly exceeding the recommended daily limit.
Moreover, the Indian diet often lacks sufficient protein, particularly from vegetarian sources, which hinders muscle building and contributes to increased fat mass. Traditional cooking methods frequently utilize oils high in saturated fat, such as ghee and coconut oil, further elevating the risk of heart disease.
Lifestyle factors exacerbate the situation. South Asians exhibit some of the lowest exercise rates globally, and stress, sleep deprivation, and smoking—collectively referred to as the “three S’s”—are significant risk factors. Notably, psychosocial stress has been linked to chromosomal changes that can lead to heart attacks in young individuals aged 20 to 35, even in the absence of other risk factors.
Heart disease is not solely a “man’s disease.” The death rate from heart disease among women is ten times higher than that from breast cancer. Conditions such as gestational diabetes, obesity, and high cholesterol can strip away the protective benefits of estrogen, resulting in heart disease rates for women that are comparable to those of men, even before menopause. After menopause, which can begin as early as age 40 to 50, women’s heart disease rates can match those of men, often accompanied by increased LDL cholesterol levels and weight gain concentrated around the abdomen.
Despite these alarming statistics, preventative measures can significantly mitigate the risk of heart disease. Following a healthy lifestyle can reduce the risk to levels comparable to those born with a low genetic risk. Early screening and diagnostic recommendations are crucial for South Asians, who should begin specific screenings around age 35 to 40. Target LDL cholesterol levels should be maintained below 100, and tests for coronary artery calcium (CAC) and LP(a) are recommended due to their high prevalence in this community.
Dietary changes are essential for reducing heart disease risk. Replacing high-risk traditional cooking habits with healthier alternatives can make a significant difference. For instance, using cooking oils that remain liquid at room temperature, such as canola or olive oil, is advisable. Limiting the intake of saturated fats from ghee, coconut oil, and butter is also crucial. Increasing protein intake to a minimum of 50 grams daily, and ideally between 70 to 100 grams, can help build muscle mass and reduce visceral fat. Substituting high-glycemic carbohydrates like white rice with healthier options such as brown rice or quinoa is also recommended.
Incorporating regular exercise into daily routines is vital. South Asians should strive to maintain a Body Mass Index (BMI) of less than 23 and engage in aerobic exercise, complemented by strength training, particularly for those over 60. Simple activities, such as walking after meals, can contribute to overall health. Stress management techniques, including daily meditation and ensuring adequate sleep, are also beneficial.
Women, in particular, must prioritize their heart health. Preventing gestational diabetes is crucial, as it is believed to be a precursor to heart disease risk. For women experiencing early menopause, hormone replacement therapy (HRT) may be recommended for a period of 5 to 10 years, provided they consult with their healthcare provider and undergo necessary screenings.
Meera Kymal, Managing Editor of India Currents, recently spoke with Dr. Nirmal Joshi and Dr. Renu Joshi, who provided insights into the disproportionate impact of heart disease on South Asians. Their documentary, “The Brown Heart,” explores heart disease trends within South Asian populations and aims to raise awareness to drive change in how these communities approach heart health.
Source: Original article