Genetics or Benign Neglect ? Facts About Heart Disease in Indians

By Narinder K. Saini M.D.

We are supposed to be the leader and educator of the western world regarding yoga and meditation techniques. This part of our rich culture was unfortunately thrown away by us because this was old and did not fit into our modern lifestyle. We forgot the traditional way of living because we were too consumed buy the glitter of instant relief and were oversold by the outcome of western medicine. Our social structure changed; we chose to become more isolated and lacked the support system which was so helpful to us as part of the healing medicine in our day-to-day living.

In spite of the unique fact that 50 percent of Indians are life long Vegetarians, we now have the highest incidence of coronary artery disease in the world. Presently in India about 25 million (estimated) people are suffering from heart disease. In England, Asian men and women are 40 percent more likely to die of heart disease compared to the local population. In the USA, Indians are 4 times more likely to die of heart disease compared to the American counterparts and 10 times more likely to die of this disease compared to the Japanese.

The meta-analysis of the studies done from England, South Africa, Singapore, Malaysia, Fiji, West Indies and more recently in USA, shows a universal high incidence of heart disease among Indians

Just in the last decade, India may be the only country in the world now where young kids (in 30’s and 40’s) are having heart attacks. The recent statistics show that one out of ten heart attacks happen before the age of 40. Dr. Natoobhai Shah, a senior cardiologist from Bombay at the Asian Pacific Congress, presented that one out of three heart attack admissions in the hospital were young Indians. Incidence of Heart Disease in India now ranks Number 4 compared to Number 14 about at decade ago; T.B. still ranks to be Number 1 followed by communicable diseases and malnutrition. With this rate it will not be far away when heart disease will rank Number 1. This is alarming. Government of India, Indian Medical Association and other Indian associations must declare war on this disease otherwise we will lose all those brilliant young entrepreneurs who are building the nation. There should be a cohesive well thought policy developed like the American Heart Association in the USA to combat this war.

Today we are dealing with many diseases of choice, not of chance. We all know that heart disease is a disease of affluence.

It has become fashionable in India now to talk about bypass surgery, angioplasty and all other invasive things that the western medical system has to offer. The awareness of prevention (exercise, low fat diet and stress management) is now increasing in USA but ironically our country, which has given to the world the art of relaxation, has increasingly abandoned the practice of a healthy life style. Autopsies performed after World Was II, starvation and other studies had confirmed that the arteries of these subjects were clean of any fatty deposits and people didn’t die of heart disease but malnutrition and infectious diseases.

Do we have to die from heart disease? Do people have to fall prey to heart disease in the first place? If your parents or grandparents had heart disease, are you doomed to have it too? Is a genetic factor alone enough to include your name in the statistics column? The answer to all of the above question is maybe not.

Our ancestors fully understood the science of healing by comprehensive understanding of mind and body since 4000 B.C. Ayurveda, is one of the oldest healing systems known to the world (3000 B.C.) Charaka and Susruta were the two famous practitioners of health on record. Susruta was considered the “father of surgery”. The ancient surgeons also conducted amputations, set broken bones and removed foreign bodies. “Atreya” taught about the composition of the body and how to keep the body in the state of equilibrium by correcting the origin of the disease rather than merely treating and relieving the symptoms.

Thousand of years of evolutionary genetic makeup has created and perfected our body to store more fat for emergencies (Syndrome X) and will actually take thousands of years to change and to accept this new western high stress, high fatty diet and low exercise lifestyle. We survived by a sensible healthy living, supporting the bodily system by proper food, herbs, exercise and stress management. This system developed by elders for taking care of our health was called Ayurveda which meant providing greater harmony, peace and longevity to the human body.

The present way of living included instant gratification, pushing and abusing our body to the limit, without proper exercise, stress management and nourishment. But, the problem is that we are changing our way of life too dramatically. These changes which have happened in the last 50 years is at odds with our genetic makeup, resulting in this modern plague of heart disease, cancers and other chronic diseases.

As our body is genetically trained to conserve calories into fat for the rainy day. This unhealthy fat became responsible for the unwanted weight gain.

We changed our diet from Ghee and mustard base oil to the refined oil based diet, thinking that refined oil which is nice and clear does not smell bad is better for our health. As a matter of fact, this was exactly what we were told, without really knowing that this change of oil base is actually a killer for us. Business, including nutritionists and doctors advertised and sold us that “Ghee” which is full of saturated fat is bad and refined oil is better for us. Actually we now know that trans fatty acid, which is found in the refined oil in the form of margarine, is worse than ghee.

Along with the dietary changes, stress and lack of exercise, the incidence of heart attack, cancer and other chronic problems started to increase tremendously.

Our genes could not keep up with these fast lifestyle changes, resulting in storing extra fat for the rainy day from the excessive calories being consumed daily — forgetting that there are no more rainy days anymore.

To help survive the erratic nutritional demand of our body, we had genetically developed a system to store fact for all the needs of our body. Now, you may be thinking shy fat, shy not protein or carbohydrate? The answer is simple … fat molecules can store more calories compared to protein and carbohydrates: Fat stores nine calories and carbohydrates and protein store only four. So for the protein to store and use these calories, it has to do double the amount of work that fat will do. See how smart our body is! This genetic trait is called “Syndrome X” or excessive food calories that you consume would be converted into fat called fluffy fat.

Because of these lifestyle changes (westernization), we don’t exercise that much anymore: we don’t eat right: more western and unhealthy food is consumed by us: and finally the daily stress in our life has increased tremendously.

When this fluffy fat is not utilized, then it stores itself as an extra tire on the tummy resulting in increased triglyceride and lower HDL and thereby increasing the chances for heart disease. Although this type of genetic trait, which I have called “Syndrome-S” can be detrimental when it is misused, was essential for our survival.

I am completely convinced that isolations, hostility, low HDL, high LPa, insulin resistance and small dense LDL (Syndrome X) is a major risk factor for heart disease in Indians. Although blood tests can detect most of our risk factors, in my view the most important cause of the disease, which cannot be measured quantitatively, is “unmanageable stress.”

Wealth and materialistic way of life has exposed us to unhealthy eating habits of so-called rich food full of fat and the luxury of not exercising. The most important message from my experience is that the core problem of heart disease or as a matter of fact any chronic disease is stress management. Stress by itself is not the problem; it becomes a problem when it is not managed properly. There is nobody living in this world that does not have stress. Actually, stress is one of the most abused words in the English language.

By stress, I mean that if you are isolated, resistant to change, have hostility, are impulsive, get stressed out easily and have a “Type-A” personality, then that is the stress which is a risk factor that I am talking about. All other things like eating disorders, weight problems, hypertension, and diabetes are actually one way or the other linked to this psychological personality.

Is nobody living in this world that doesn’t have stress. Actually, stress is one of the most abused words in the English language. The reason I am saying that stress management is the core of our problems comes from my personal experience, literature study and most important what I have learned from my patients. Statistically, in Cardiac Rehabilitation, I have found that in six out of ten (60%) patients who joined the program, the real cause of the disease was not abnormal cholesterol but unmanageable and toxic stress which includes “Type A” personalities, impulsiveness, hostility and resistance to change. This behavior was, in part, responsible for the rest of the risk factors, like obesity, uncontrollable Diabetes and hypertension which in turn became responsible for the causation of the disease. If you try to unfold the problem then you will realize that if their nature of impulsiveness, hostility and “Type-A” personality can be addressed, then their eating habits, exercise and other risk factors can be improved. This is the core of my message. Dean Ornish, MD, Robert Eliott, MD, Larry Dossey, MD, Herbert Benson, MD and so many physicians, scientists and researchers in USA, Europe and India have realized the power of yoga and meditation in treating not only heart disease but also cancer and other chronic diseases. I strongly believe that this is simple, cheap and effective treatment for any chronic illness.