Fried vegetables, dairy products, sweets in regularIndian diet increase risks, says renowned cardiologist Dr.Enas

Does being a vegetarian reduce your risk of heart disease? Not if you’re an Indian, asserts Enas A. Enas, renowned cardiologist and founder Coronary Artery Disease among Asian Indians Research Foundation (CADI).

Though red meat consumption has been traditionally associated with increased risk of heart disease, even vegetarian Indians are at risk for heart disease.

“There is no low risk Indians, only high-risk and very high risk Indians,” said Dr. Enas, who has done extensive research on heart disease in Indians, at a meeting with city cardiologists and physicians.

This is because certain risk factors are pronounced in Indians, including abnormal obesity, consanguineous marriages, metabolic syndrome and what Dr. Enas calls as ‘contaminated vegetarianism’.

Citing WHO statistics, the cardiologist said there were 6,300 Indians diagnosed with heart disease every day with at least 40 per cent under the age of 40.

There are differences between an Indian vegetarian and a Western vegetarian because there are three errors in the Indian vegetarian diet - high in fat (excessive consumption of dairy products); fried food (even vegetables are fried) and rich in sweets ( Indian sweets are high in sugar and soaked in syrup). This is compounded by the fact that only rice or roti is considered food in India while vegetables and fruits are always taken ‘on the side’.

Most Indian breads are prepared with vanaspati, which is a source of fats, which increases LDL cholesterol or bad cholesterol. The food pyramid could be abandoned for a ‘plate’ classification of diet with 30 per cent vegetables, 20 per cent fruits, 30 per cent grains and 20 per cent proteins.

Target risks

Such dietary changes with focus on reducing LDL cholesterol level were one of the combative strategies suggested to prevent heart disease. “Today’s risk factors are tomorrow’s diseases,” believes Dr. Enas. Agreeing with him, M.Chenniappan, senior cardiologist says, “Estimation of risk is integral part of preventing coronary heart disease. We often neglect the subtle changes till a patient ends up with a massive myocardial infarction (heat attack). We need to concentrate on risk factors to prevent heart disease.”

How has the US done it

Though diabetes and obesity has doubled or tripled in the US, the country has managed to bring down the number of deaths due to heart disease.

Also there are less people dying below 40 because of heart disease. Government intervention in the form of subsidy cut for dairy products and increased subsidy for fruits and vegetables has also helped, said Dr. Enas. While similar government intervention is desirable in India, doctors too have a role to play in patient education.

Revised guidelines by modifying risk calculations are required for preventing coronary artery disease for Asian Indians, as opposed to common guidelines. These guidelines also include modified dyslipidemia management or cholesterol control.

Treating coronary artery disease surgically with bypass or angioplasty can be avoided in most cases by treating the disease medically, provided treatment starts early.

Doctors need not wait for a cardiac catastrophe to prescribe preventive medicines. Risk estimation can reduce financial burden of hospitalisation and surgery.

Though aspirin is ideal to prevent heart attacks in persons who have already had a heart attack, it is replaced by statins that are emerging as the foundation of preventive cardiology or preventing first-time heart attack.

  • Fried vegetables, dairy products and sweets in regular Indian diet increase risks

  • Estimating risks important to prevent heart disease

  • strategies to reduce risk of heart attack

    Stop cigarette smoking

    Reduce body weight - achieve BMI below 23 and waistline circumference < 90 cm for men and < 80 cm for women

    Daily physical activity with at least 30 minutes of daily walking

    Healthy diet rich in fruits, vegetables and whole grains

    Lower systolic blood pressure by 10 mm/hg

    Reduce LDL cholesterol.