As you’ve no doubt noticed, press articles about African-American health problems in recent years take it as a given that any and all disparities in health must be due to System Racism, not to genes or anything blacks could do for themselves to improve. But here’s a useful article from the Washington Post by a South Asian about the high rate of coronary troubles among South Asians that attributes them to “a mix of genetic, cultural and lifestyle influences” rather than to Evil White People.
Which perspective is more useful for improving health?
By Vignesh Ramachandran
November 15, 2020 at 9:00 a.m. PST
… South Asian Americans — people with roots in Nepal, India, Pakistan, Sri Lanka, Bangladesh, Bhutan and the Maldives — have a disproportionately higher risk of heart disease and other cardiovascular ailments. Worldwide, South Asians account for 60 percent of all heart disease cases, even though — at 2 billion people — they make up only a quarter of the planet’s population.
In the United States, more attention is being focused on these risks for Americans of South Asian descent, a growing population of about 5.4 million. Health-care professionals attribute the problem to a mix of genetic, cultural and lifestyle influences — but researchers are advocating for more resources to fully understand it. …
A 2018 study for the American Heart Association found South Asian Americans are more likely to die of coronary heart disease than other Asian Americans and non-Hispanic White Americans. The study pointed to their high incidences of diabetes and prediabetes as risk factors, as well as high waist-to-hip ratios. People of South Asian descent have a higher tendency to gain visceral fat in the abdomen, which is associated with insulin resistance. They also were found to be less physically active than other ethnic groups in the United States.
… They stress that high blood pressure and diabetes are common in the community, even for people at normal weights. That’s why, said Alka Kanaya, MASALA’s principal investigator and a professor of medicine at UCSF, South Asians cannot rely on traditional body mass index metrics, because BMI numbers considered normal could provide false reassurance to those who might still be at risk.
Kanaya recommends cardiac CT scans, which she said help identify high-risk patients, those who need to make more aggressive lifestyle changes and those who may need preventive medication.
Another risk factor, this one cultural, is diet. Some South Asian Americans are vegetarians, although it’s often a grain-heavy diet reliant on rice and flatbread. The AHA study found risks in such diets, which are high in refined carbohydrates and saturated fat. “We have to understand the cultural nuances [with] an Indian vegetarian diet,” said Ronesh Sinha, author of “The South Asian Health Solution” and an internal medicine physician.
“That means something totally different than . . . a Westerner who’s going to be consuming a lot of plant-based protein and tofu, eating lots of salads and things that typical South Asians don’t,” he said.
But getting South Asians to change their eating habits can be challenging, because their culture expresses hospitality and love through food, said Arnab Mukherjea, an associate professor of health sciences at California State University at East Bay. “One of the things South Asians tend to take a lot of pride in is transmitting cultural values and norms knowledge to the next generation,” Mukherjea said. …
Kevin Shah, a University of Utah cardiologist who co-wrote the AHA study, said people with diabetes, hypertension and obesity are also at higher risk of covid-19 complications, so they should now especially work to improve their cardiovascular health and fitness.
Kaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
It’s almost as if Knowledge Is Good…