Why Asian Indians are more prone to developing coronary artery disease than other groups?

By Navin Nanda, M.D.

Professor of Medicine and Director, Heart Station/Echocardiography Laboratories, University of Alabama at Birmingham, Birmingham, Alabama. Although Dr. Navin Nanda is internationally famous as an expert and innovator in echocardiography, he has also done pioneering studies in coronary artery disease in Asian Indians right from the time he was a Medical Resident at Seth G.S. Medical College and King Edward Memorial Hospital in Mumbai, India.  He is the Founding President of the American Association of Cardiologists of Indian Origin and Past President of the American Association of Physicians of Indian Origin.  He is currently the President of the International Society of Cardiovascular Ultrasound.

* Two facts stand out:
1) The incidence of coronary artery disease in Asian Indians is 2 to 5 times higher at all ages than Whites, African-Americans, Hispanics and other Asians.
2) It is 5 to 10 times higher in those younger than 40 years.  This is not new.  For example, my MD thesis from Bombay University prepared 44 years ago in 1966 was on heart attacks in patients under the age of 40 years.

* There are a host of risk factors implicated in the development of coronary artery disease in all groups.  These include high blood pressure, diabetes mellitus, high blood cholesterol level,  (increased “bad” or LDL cholesterol and decreased “good” or HDL cholesterol), obesity (especially abdominal), high blood triglyceride level from high saturated fat diet, sedentary life style, smoking, family history of coronary artery disease, procoagulant state (increased risk of clot formation), pollution, stressful life, to name some of them.

Many of the above factors are similar to other racial groups.  However, others are more prevalent in Asian Indians.  One which stands out more than others is diabetes.  This is much more common in Asian Indians, has reached epidemic proportions in India and the country has the world’s largest diabetic population.  Again, this is not new.  For example, in 1967 we published a study from India in the New England Journal of Medicine that documented the relation of heart attacks to high blood sugar levels and showed that heart attacks triggered the development of diabetes in some of these patients.  A common thread in most of the studies conducted in Asian Indians living in India as well as other parts of the world such as Africa, United Kingdom and West Indies is the presence of overt or latent (hidden) diabetes and insulin resistance.  There is mounting evidence that Asian Indians may have a genetic predisposition to diabetes and coronary artery disease. 

A recent survey of Asian Indians conducted at the Swami Narayan Temple in Atlanta, Georgia, showed similar findings.  Asian Indians also typically have higher levels of “bad” cholesterol and lower levels of “good” or protective cholesterol.  In the young (under the age of 40) Asian Indians we studied in the sixties, we found they were thin and not overweight but had high cholesterol levels, a substantial number were smokers and showed effects of pollution (“arcus senilis” or white circles in the cornea of their eyes). 

Studies in Birmingham, Alabama itself have shown that Asian Indians living here have higher prevalence of smaller and denser lipoprotein (fat) particles in their blood as compared to white Americans.  These particles are considered an important risk factor for the development of coronary artery disease.  Asian Indians living in Birmingham have also been found to have increased platelet activation and fibrinogen in their blood as compared to whites.  Both of these factors make the blood more prone to clotting and clot formation in coronary arteries result in heart attacks.

Conclusion:  Higher prevalence of several risk factors most likely account for the increased incidence of coronary artery disease and heart attacks in Asian Indians.

Posted by ks on 03/01/10 at 12:15 AM
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Can Cutting Down On Carbohydrates (Carbs) Helps With Weight Loss?

By PJ Prakash, Ph.D.
Dr. PJ Prakash holds a Ph.D. in Human Nutrition from the University of Rhode Island and a Post-Doctorate in Human Nutritional Biochemistry from the Tufts Medical School, Boston. He previously worked as a nutrition scientist at the USDA Human Nutrition Research Center on Aging at Tufts University, Boston where he published several research papers in prestigious nutrition journals. Currently, he is a nutrition consultant and personal weight loss coach (healthysouthasians.com) and also a freelance writer in the field of human nutrition.

The number of people with unwanted body weight has reached to an unprecedented rate among the western population, with about 65% people overweight and about 33% clinically obese. Extra body weight has been correlated with numerous nutritional disorders, such as, high blood pressure, diabetes, and heart related problems. Studies indicate that reducing the body weight may help to lower the risk of these related health problems.

In this era of high protein and/or low-carb foods, there seems to be a great deal of confusion among the consumers as to what would be the ideal diet for losing and maintaining weight. The consumers are often influenced by the food industry marketing campaigns branding their low-carb although processed foods. The popular diet plans in the market have also contributed confusion among the consumers when it comes to including carbohydrates in the diet. The consumers are often faced with a challenge in their selection of carbohydrate foods where they either don’t know what to consume and what to avoid or are perplexed with whether or not to consume carbohydrate foods at all. The lack of knowledge on the consumers’ side in terms of selection of healthy foods often leads their buying decisions to be influenced by these marketing nudges.

So can cutting down on carbohydrate intake help to lose weight? This is rather a controversial topic. This article sheds some light on this aspect and educates the readers on the selection of good carbohydrate foods and avoid bad carbohydrate foods.

Carbohydrates (carbs) have been providing energy to the human body since the beginning of the evolution. In other words, our human bodies have adapted to consume carbohydrate foods for thousands or more years. Therefore, avoiding carbohydrates from our diet would not be wise. However, a precaution needs to be taken for the selection of good carbs over the bad carbs.

The bad carbs are mainly derived from processed foods and sweet snacks and desserts, such as, candies, cookies, chips, doughnuts, brownies, danish, etc. Their sugar content is very high. Some of these foods may also be high in fat, salt and overall calories. These bad carb foods, in addition to being high in calories, are burned quickly by the body and make you hungry again. Unfortunately, the foods available in the western world are abundant in bad carbs. It has also to do somewhat with the western culture. For example, Thanksgiving and Christmas dinners would not be complete without pies and cakes, the spirit of the month of Christmas is incomplete if homemade cookies are missing, and taking candies out of Halloween and Ester is like taking a fish out of water. So over the time, people in the western world have gotten accustomed to consuming foods high in bad carbs. A big part of this trend is contributed by the processed food industry, which is also transcending into other parts of the world.

The sources of good carbs are whole grains like rice, wheat, oat, barley, whole grain cereals, whole grain breads, fruits, vegetables, etc. The good carb foods are generally low in sugar, fat and salt – the three main enemies of good health. The good carb foods like fruits contain a complex form of sugar that is not so readily absorbed in the human body and thereby keeps your blood sugar levels low. The good carb foods are also in general high in fiber that reduces the absorption of fat in the body. Therefore, replacing the carbohydrate portion of your daily diet with these good carbs would be a step towards better health.

The main sources for calories for human body are carbohydrates, proteins and fats. In general, less than 30% of total calories consumed per day should be provided by fat, and proteins and carbohydrates may each contribute about 30-40% of your daily calorie intake. Since 1 gram of carbohydrate provides 4 calories, it come out to be roughly 100-150 grams carbohydrates/day for most men and 75-125 grams carbohydrates/day for most women, on an average 1,500-2,000 calories/day diet. These carbohydrates should be good carbs as mentioned above.

Now the question is how to avoid eating bad carbs? There is a very simple answer – DON’T BUY THEM. Read the list of bad carb foods listed above and then go through your refrigerator and kitchen cabinets and look for the matches. Un-list all these and other similar bad carb foods from your grocery-shopping list when you go to the supermarket next time. Also, add the good carb foods listed above and others similar in your grocery-shopping list. Develop a mindset of avoiding bad carb foods, and the foods that are high in fat, sugar and salt.

Below are the general guidelines for weight regulation and optimum health:

1. Cut down on overall salt, sugar and fat intake.

2. Substitute the intake of bad carbs with good carbs; animal proteins with plant protein foods; saturated oils with vegetable oils.

3. Increase the intake of water and fiber.

4. Consume 7-9 servings of fruits and vegetables a day.

4. 20 minutes of aerobic exercise, at least 3 times a week.

5. Consistency of all above.

Posted by ks on 03/01/10 at 12:14 AM
Health • Right Food • Permalink

How Revving Up Your Heart Rate, Even A Bit, Pays Off

From NPR.org

Posted by ks on 02/04/10 at 06:56 AM
Health • Health Links • Permalink

Osteoporosis

By Prameela Goli, M.D; F.A.C.R.

Practicing Rheumatologist in Birmingham, AL, Specializing in Treatment of Arthritis, with Special Interest in Osteoporosis, Rheumatoid Arthritis, and Lupus. Phone: (205) 877-2552

ABOUT OSTEOPOROSIS

Osteoporosis is a condition in which bones have lost minerals, especially calcium, making them weaker, brittle, and susceptible to fractures (broken bones).  Any bone in the body can be affected by osteoporosis, but the most common places where fractures occur are the back (spine), hips, and wrists.  Each year osteoporosis causes an estimated 1.5 million fractures.  Fractures may also reduce a person’s ability to lead an active life.  It is estimated that 1 out of every 2 women over the age of 50 will be affected by osteoporosis in her remaining lifetime.

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Posted by ks on 01/07/10 at 05:47 AM
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Cancer Treatment And Nutrition Choices

By Manisha U. Vaidya, MS, RD, LD

Mrs. Vaidya is a Registered Dietitian (RD) with the UAB hospital.  She coordinates nutritional assessment, re-assessment, diet education and plan of care for Bone Marrow Transplant, Hematology-Oncology and Geriatric unit patients. She is responsible for follow up with food preferences, patient care, calorie counts and diet education for cancer patients. Mrs. Vaidya can be reached at .

Smart nutrition choices before, during, and after treatment of cancer will fuel the body and help manage common treatment side effects.

All the ladies out there! There is lot of awareness about diet for diabetes, hypertension (blood pressure), heart disease and in general weight loss.  However, it is not very common that we talk about diet or type of food one should eat while undergoing chemotherapy, radiation or bone marrow transplant.

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Posted by ks on 01/07/10 at 05:46 AM
Health • Right Food • Permalink

The Open Secret Of Weight Loss: Calories In & Calories Out

By PJ Prakash, Ph.D.

Dr. PJ Prakash holds a Ph.D. in Human Nutrition from the University of Rhode Island (U.S.A.) and a Post-Doctorate in Human Nutritional Biochemistry from the Tufts Medical School, Boston (U.S.A.). He previously worked as a nutrition scientist at the USDA Human Nutrition Research Center on Aging at Tufts University, Boston where he published several research papers in prestigious nutrition journals. Currently, he is a nutrition consultant and personal weight loss coach ( http://www.healthysouthasians.com) and also a freelance writer in the field of human nutrition.

Extra body weight is being perceived as an epidemic in the United States. The latest data from the National Center for Health Statistics show that 30 percent of U.S. adults 20 years of age and older - over 60 million people - are obese. About 60-65 percent people in the U.S. alone are overweight. This increase is not limited to adults. The percentage of young people who are overweight has more than tripled since 1980. Among children and teens aged 6-19 years, 16 percent (over 9 million young people) are considered overweight.

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Posted by ks on 10/30/09 at 06:58 PM
Health • MD Perspective • Permalink

Your Child - Nutrition and Health

By Suman Madan, MS, RD, LD
Sr. Nutrition Consultant, Northern Health Center, Birmingham, AL

Suman Madan is a Licensed, Registered Dietician and has been practicing in Public Health for over 25 years. At Jefferson County Dept. of Health, she coordinates activities for Women, Infants and Children (WIC) program and provide nutrition education for North Birmingham Communities. WIC is a federally funded Supplemental Nutrition Program. For more information on Alabama WIC, please go to www.adph.org/wic. Suman Madan is available to answer any questions regarding WIC program benefits for the eligible families at .