An uncle of mine is in his late sixties when he had his first heart attack. He was immediately taken to the hospital and an emergency Angiogram was done. The doctors discovered significant narrowing in two of the arteries supplying the heart. Immediate angioplasty- dilating of the block and stenting was done. He was discharged after three days. Now he is back to normal and has resumed all his normal activities.
He had led a very careful life. He never smoked and drank in strict moderation. He was quite careful about what he ate and kept his weight within normal limits. He walked briskly for an hour a day. He had regular check-ups and tests. He was fanatic about keeping his blood sugar under control as he had mild diabetes.
‘What was the point of being so careful with your life, if after all that you get a bloody heart attack?’ One of his friends commented. ‘Wasted most of his life without enjoying himself’
“Yes, that is right.’ Another of his friends agreed with him. ‘I have smoked throughout my life and ate whatever I wanted. Never had to stay in a hospital ever. It is all fate I tell you. Trying to change fate is not going to work. That is what all the wise people say.’
I talked to my uncle later when he was back to work. He told me about his father who died at the age of forty five.
“He had chest pain and was in the hospital when he was about forty, as I remember” Said my uncle.
“He was a heavy smoker and was very fat. Never cared about how he lived. After coming back from the hospital, he was a sick man. Always breathless. But after that he listened to the doctor and was very careful.”
“What did the doctor tell him? Did he stop smoking?”
“The doctor did not stress on that. I don’t think that time they were aware of all that. So he continued to smoke. He was advised to take rest and was asked to take good food.”
“Lots of milk, butter and eggs. He also advised lots of liver, fried in oil. Entire goats were bought just to make rasayanam with the meat. He also told us to add ghee to whatever he ate. The doctor told us that was the only way to build up his health. Inspite of all this, my father deteriorated and started having severe chest pains. Breathlessness worsened, and he became bed ridden towards the end of his life.”
“The doctor was a good family friend. He came for the funeral and helped us a lot. He was a nice man. He consoled us saying that sometimes you just can’t do anything about fate. “
In the 1940s and 1950s, doctors and public health experts in the USA noted that people were dying of heart attacks and heart failure- coronary artery disease. The incidence was increasing. It was reaching epidemic proportions. The National Heart, Lung and Blood Institute decided to study it. The study was started in 1948 in the town of Framingham, Massachusetts. It became the famous ‘Framingham Heart study’. It was the first step in identifying a new enemy- chronic lifestyle disease.
A total of 5209 people were enrolled in this well-designed longitudinal cohort study. All the factors thought to be relevant were recorded. These people consented to yearly physical examination, blood and other tests. The diseases and deaths were recorded. The second generation of these participants were enrolled in 1971. This is an ongoing study and the third generation was added in 2002.
It was a massive and fruitful effort, and spanned three generations of participants. It has, till now, generated more than 1000 medical papers. The term ‘risk factor’ was first used in this study. The findings have been confirmed by literally hundreds of other studies.
Before the results of this study came trickling in, there was no concept that any of these diseases could be prevented. The clogging of arteries, called atherosclerosis that causes heart attacks and ischemic stroke was thought to be a normal accompaniment of ageing. Hypertension and increased blood cholesterol also were considered normal as people aged.
This study, and later, literally thousands of other studies and supporting data has given faces to our main enemies now. They were quite hazy a mere half a century ago.
Coronary artery disease of the heart is a major cause of death and disability. It is brought on by atherosclerosis- a narrowing of the arteries due to development of ‘atheromatous plaques’ in the walls of the arteries.
Ischemic stroke is a related illness with the same cause- narrowing due to atherosclerosis in the arteries supplying the brain.
Diabetes is a lifestyle disease leading to disability and death.
Some cancers, like colon, breast and prostate, has some relationship to dietary habits. Some other common cancers, like cervix, lung, head and neck etc that are directly related to unsafe sex, cigarette smoking, tobacco chewing and alcohol.
There are certain other diseases that are silent or not particularly distressing in the early stages. But later, they cause or accelerate the onset of other diseases like heart disease, stroke etc. These diseases can be considered directly lifestyle related.
Hypertension- an increase in arterial pressure. This is a silent killer. Accelerates atherosclerosis and is a main risk factor for coronary artery disease and stroke.
Disorders of blood lipids. Lipids means fats. They include increased cholesterol, LDL, triglycerides and a decrease in HDL.
Diabetes- this has to be included in both. It is a major disease in itself, and a main risk factor for many other diseases. It accelerates atherosclerosis.
Obesity. A dangerous increase in body weight. This directly correlates with all the other diseases. It also has a direct contributing effect to other risk factors, like hypertension, diabetes and hypercholesterolemia.
Just imagine- A physician (including Naturopths and Traditional practitioners) – had no idea about most of these, just fifty to sixty years ago! Hard to believe, isn’t it?