Urbanized South Asians' susceptibility to coronary heart disease: The high-heat food preparation hypothesis

Kakde, Smitha; B, Raj; Bhardwaj, Swati; Misra, Anoop

doi:10.1016/j.nut.2016.07.006

Cited by 20 publications

(11 citation statements)

References 79 publications

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“…Our observations for the South Asian group are consistent with those from prior reports in both the Asian subcontinent, as well as in other Western countries of destination, where South Asians consistently showed a very high prevalence of metabolic abnormalities, especially diabetes, and of premature and aggressive CHD 5 8 14–17. A number of potential underlying mechanisms have been proposed, including genetic predisposing factors, cultural and lifestyle determinants such as low levels of physical activity or diets rich in highly atherogenic fat, and metabolic factors such as abdominal adiposity, insulin resistance, high-density lipoprotein cholesterol abnormalities or high levels of Lp[a], among others 5 8 14–21…”

Section: Discussionsupporting

confidence: 91%

Cardiovascular risk factors and disease among non-European immigrants living in Catalonia

Cainzos‐Achirica

Vela

Clèries

et al. 2019

Heart

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ObjectiveTo describe the prevalence and incidence of cardiovascular risk factors, established cardiovascular disease (CVD) and cardiovascular medication use, among immigrant individuals of diverse national origins living in Catalonia (Spain), a region receiving large groups of immigrants from all around the world, and with universal access to healthcare.MethodsWe conducted a population-based analysis including >6 million adult individuals living in Catalonia, using the local administrative healthcare databases. Immigrants were classified in 6 World Bank geographic areas: Latin America/Caribbean, North Africa/Middle East, sub-Saharan Africa, East Asia and South Asia. Prevalence calculations were set as of 31 December 2017.ResultsImmigrant groups were younger than the local population; despite this, the prevalence of CVD risk factors and of established CVD was very high in some immigrant subgroups compared with local individuals. South Asians had the highest prevalence of diabetes, and of hyperlipidemia among adults aged <55 years; hypertension was highly prevalent among sub-Saharan Africans, and obesity was most common among women of African and South Asian ancestry. In this context, South Asians had the highest prevalence of coronary heart disease across all groups, and of heart failure among women. Heart failure was also highly prevalent in African women.ConclusionsThe high prevalence of risk factors and established CVD among South Asians and sub-Saharan Africans stresses the need for tailored, aggressive health promotion interventions. These are likely to be beneficial in Catalonia, and in countries receiving similar migratory fluxes, as well as in their countries of origin.

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Section: Discussionsupporting

confidence: 91%

Cardiovascular risk factors and disease among non-European immigrants living in Catalonia

Cainzos‐Achirica

Vela

Clèries

et al. 2019

Heart

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“…Increasing influence from social media regarding “fad” or “alternative diets” and preferences for specific nutrients (eg, high carbohydrate diets in Asian countries, a traditional fondness for dietary sugar and oils high in saturated and trans fats in India) and religious fasting (see below) may hinder the management of diabetes (Table ). The approach to drug or insulin management is usually as per international guidelines, but should be further dictated by the phenotype of patients in developing countries .…”

Section: Managementmentioning

confidence: 99%

Diabetes in developing countries

Misra

Gopalan

Jayawardena

et al. 2019

Journal of Diabetes

Self Cite

197

129

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Highlights• Diabetes in developing countries is increasing and often undiagnosed. In South Asians, diabetes and related metabolic abnormalities develop at a younger age and at a lower body mass index and waist circumference than in Whites. • Overall glycemic control and management of diabetes is suboptimal, driven by multiple factors (eg, unawareness, cost of drugs and insulin etc.), and the load of complications is high. • To stem this epidemic, strong actions for prevention and management are required using innovative and low-cost approaches. AbstractThere has been a rapid escalation of type 2 diabetes (T2D) in developing countries, with varied prevalence according to rural vs urban habitat and degree of urbanization. Some ethnic groups (eg, South Asians, other Asians, and Africans), develop diabetes a decade earlier and at a lower body mass index than Whites, have prominent abdominal obesity, and accelerated the conversion from prediabetes to diabetes. The burden of complications, both macro-and microvascular, is substantial, but also varies according to populations. The syndemics of diabetes with HIV or tuberculosis are prevalent in many developing countries and predispose to each other. Screening for diabetes in large populations living in diverse habitats may not be cost-effective, but targeted high-risk screening may have a place. The cost of diagnostic tests and scarcity of health manpower pose substantial hurdles in the diagnosis and monitoring of patients. Efforts for prevention remain rudimentary in most developing countries. The quality of care is largely poor; hence, a substantial number of patients do not achieve treatment goals. This is further amplified by a delay in seeking treatment, "fatalistic attitudes", high cost and non-availability of drugs and insulins. To counter these numerous challenges, a renewed political commitment and mandate for health promotion and disease prevention are urgently needed. Several low-cost innovative approaches have been trialed with encouraging outcomes, including training and deployment of non-medical allied health professionals and the use of mobile phones and telemedicine to deliver simple health messages for the prevention and management of T2D.

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“…[ 134 135 ] Repeated heating/frying or reusing of oils at high temperature, which is a common practice in India should be avoided as it, induces chemical changes that increases the amounts of harmful TFAs, which greatly elevate the risk of CV complications in T2DM patients. [ 136 137 ] …”

Section: R Ationale and E Videncementioning

confidence: 99%

RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020

Chawla

Madhu

Makkar

et al. 2020

Indian J Endocr Metab

111

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Urbanized South Asians' susceptibility to coronary heart disease: The high-heat food preparation hypothesis

Abstract: We hypothesize that South Asians' susceptibility to CHD is partly attributable to high-heat treated foods producing high NFCs. Research to accrue direct evidence is proposed.

Cited by 20 publications

References 79 publications

Cardiovascular risk factors and disease among non-European immigrants living in Catalonia

Cardiovascular risk factors and disease among non-European immigrants living in Catalonia

Diabetes in developing countries

RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020

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