Women in Kerala are at very high risk of developing coronary artery diseases because apart from all lifestyle factors, physical inactivity has cost them the biological protection of estrogen.
Results from various studies indicate that not only are the women in Kerala growing obese, they are also suffering from related complications like elevated lipids and blood sugar levels, hypertension which put them at high risk of coronary events.
As per the data of the Acute Coronary Syndrome Registry in the State, the ratio of men and women admitted to the coronary ICUs in 1967 with heart attacks was 24 : 1. In 1990, this ratio came down to 9 : 1,and significantly, the age group of women had also come down.
“Shockingly, the ratio has now further come down to 4 : 1, which means that more and more women are now succumbing to heart attacks in the State. In the West, the use of tobacco and alcohol are cited as risk factors for women developing heart diseases. But in Kerala, the single-most reason for this state of affairs is the absolute lack of physical activity among womenfolk,” says S. Sivasankaran, Professor of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences.
The high incidence of breast cancer and gestational diabetes among women in Kerala is another indication that all in not well with the fairer sex.
The increasing incidence of breast cancer, world over, has been linked to an unhealthy diet and lack of physical exercise. No wonder then, that from an incidence of eight per one lakh population in 1985, the breast cancer incidence in Kerala has now soared to 32 per one lakh population in 2010. About 25 per cent of these women are under 35 years of age.
Gestational diabetes (diabetes that is detected during pregnancy) has grown four fold in the last ten years. But it is only in recent times that the multi-generational effect of this condition has hogged the attention of researchers and doctors, says MKC Nair, Professor of Paediatrics and the Director of Child Development Centre here.
Obesity results in gestational diabetes. In-utero (inside womb), the high blood sugar is passed on to the foetus, and the baby born is larger than normal size. Maternal diabetes can have adverse consequences for the baby into its adulthood. An overweight baby girl grows into an overweight or obese adult, who is at risk of becoming a diabetic by 30 years, increasing the risk for cardiovascular diseases. She again would become a diabetic mother and the vicious cycle just goes on, Dr. Sivasankaran explains.
The prevalence of Type 2 diabetes in women in the less than 30 years age group in Kerala is three per cent, according to a 2010 study done by K. R. Thankappan et al, at the Achutha Menon Centre for Health Science Studies.
Adolescent health, especially that of girls, is where the Government as well as health policy-makers should focus, Dr. Nair says.
An estimated 50 per cent girls/women between 15 to 35 years in the State have elevated lipid levels (cholesterol, tryglycerides) and low HDL, which is another risk factor for heart diseases.
In 2010, a study conducted among 18,000 school children at the Amrita Institute of Medical Sciences, Kochi had reported high blood pressure among girls just into puberty.
“There is an epidemic of polycystic ovarian syndrome as well as thyroid diseases among our adolescent girls, which is inextricably linked to the physical inactivity- obesity- elevated lipids – insulin resistance chain,” Dr. Nair points out.
Vitamin D deficiency is another dimension of physical inactivity, which again could precipitate cardiovascular events.
“Unless we focus on the health of adolescent girls, we are jeopardising the health of our future generations. Adolescence is the time for us to focus on their nutrition and ensure that they do not lack physical activity. Unfortunately, in our society, very little importance is attached to physical activity, sports and games for girls,” says Dr. Sivasankaran says.