All my friends have been raving about the recent Spanish study, which concluded that the “Mediterranean diet”, rich in extra virgin olive oil, fish, vegetables and nuts can cut the risk of developing heart disease by about 30% in the study population, consisting of 7447 men and women aged 65-80, who had all the ill omens that precede heart disease such as elevated blood pressure and blood cholesterol. Matthew Herper, at my favorite blog has more insight into this and other similar studies.
I immediately thought of whether the outcome of the study would have been the same had the enrollees been, say South Asians. Apart from being one myself, I have been watching with horror as my healthy, active, vegetarian extended family, succumbed to Type II diabetes, hypertension, hyper cholesterolemia and heart attacks at unbelievably young ages. Our diet is very low in saturated fat, absolutely free of processed food, high in fiber and comprises “good” fat. And as I was looking for more hard facts, to prove that this is not a one- family curse, I stumbled upon the South Asian Heart Center in the El Camino Hospital, CA. The facts are really hard to swallow there- that coronary heart disease strikes South Asians at a four- fold higher rate compared to other populations and it also strikes them younger by 33%. In spite of the South Asian population being only 3% in the San Francisco bay area, South Asians make up a full 5% of those admitted for coronary heart disease at the El Camino hospital, which led to the establishment of the South Asian Heart center there, to cater to their needs. This was found in two studies done on expatriate South Asian populations, here in the US and in Britain. And this, despite the South Asian population, being generally free of risky habits like smoking, sedentary life style and unhealthy diet.
So what is the problem with South Asians? There seem to be inherently high levels of homocysteine, lipoprotein a, and fibrinogen in the blood, accompanied with low HDL thereby tilting the “good” to “bad” cholesterol balance. Also accompanying is a tendency towards early insulin- resistance. These findings may have genetic causes.
I think the next Mediterranean diet efficacy study must be done on South Asians; it will be interesting to study the incidence of early heart disease. Better still, maybe we can come up with a spicy, heart- healthy Mediterranean diet for the South Asian palate- getting the best of both worlds. The alarmingly early and high incidence of diabetes and heart disease in South Asians also makes them an ideal population to develop precision medicine. With predictable life styles, diets and bio- markers, South Asians will benefit greatly from such studies and targeted diagnostics and treatment.