Why Heart Attacks are common in Sri Lanka

By Dr. D P Atukorale

(July 04, Colombo, Sri Lanka Guardian) Myocardial Infarction (heart attack) is the biggest killer in Sri Lankan and more and more young Sri Lankans (those below 40 years) are getting heart attacks because they do not live with nature, eat bad food and eat at the wrong time in the night. It is not surprising that Sri Lankans are getting heart attacks about ten to twenty years before people in the West. This is due to a number of reasons.

A majority of Sri Lankans pass off the good food such as cheap vegetables, greens, nuts and red rice to the servants and eat so-called good food such as polished rice, eggs, butter, cheese, mutton, pork and beef. They eat fast food and a significant number of them, especially those living in the urban areas eat junk food. They end up dining at expensive restaurants, whose fare is not the best for a healthy heart.

Deep Frying With Vegetable Oils

It is common knowledge that most of the hotels and restaurants use vegetable oils for frying. As a result, the amount of trans-fats in vegetable oils is increased. Trans-fats increase your bad (LDL) cholesterol, decrease your good (HDL) cholesterol and increase your serum triglycerides.

High LDL cholesterol, low HDL cholesterol and elevated serum triglycerides are coronary risk factors and deep frying with vegetable oils result low HDL and high serum triglycerides.

Low HDL (good) Cholesterol Among Asians

Sri Lankans and other Asians are prone to have low HDL cholesterol, unlike people in the West and excessive use of vegetable oils and deep frying making use of vegetable oils makes this low HDL cholesterol worse and some of my patients who use vegetable oils have dangerously low (below 40mg%) HDL cholesterol.

Epidemic Of Obesity In The Young

We Sri Lankans consume too much of aerated water, sweet drinks and too much of high calorie food such as ice cream, puddings, watalappan, yoghurt etc. We eat too much of rice at night and there is an epidemic of overweight and obesity among teenagers and young Sri Lankans. Obesity is a coronary risk factor and obese persons have high LDL cholesterol, low HDL cholesterol and high triglycerides.

Diabetes Mellitus

Eating too much of sugar and other sweets is one of the causes of diabetes and uncontrolled diabetic patients have high serum triglycerides and low HDL. Diabetes mellitus is a common risk factor for heart attacks and elevated LDL (bad) cholesterol is not uncommon among uncontrolled diabetics.

Eating Dinner Late At Night

Eating a late dinner is bad for your heart. In the urban areas of Sri Lanka, a significant number of people ate getting used to having a late dinner.

Lack Of Exercise

Lack of exercise is another well known risk factor for heart attacks. HDL (good) cholesterol is low in a high proportion of people who do not exercise regularly. HDL is normal in people who exercise regularly.

When I was studying in the sixth standard at the Government Junior School Elpitiya, in 1949, I used to walk two miles daily in the morning to "Catch" the school bus. I can remember once we students went on strike against the private bus owners who increased student’s bus fare and we walked 24 miles a day (12 miles up and 12 miles down) for two consecutive days. The private bus owners brought down the bus fare and we won the strike. I do not think any of the present day students will ever walk even one mile a day to school. Even to travel a distance of two bus halts, most Sri Lankans in the urban areas use a bus or a three-wheeler.

To sum up, lack of exercise, low HDL cholesterol, high LDL cholesterol, high serum triglycerides, eating too much of sugar and other high calorie diets, including fast food and junk food and eating a large dinner late at night are some of the common causes of heart attacks in Sri Lankans.

Thanks to the present government, smoking is rare among Sri Lankans now. When Dr. Wallooppillai and I carried out a research project to find out the common causes of heart attacks among young Sri Lankans in 1974, it was found that the commonest cause of heart attacks among those patients below 40 years was heavy smoking. Most of the heart attacks among Sri Lankans can be prevented if we live with nature, eat good food, take regular exercises and take dinner early. Other coronary risk factors such as high blood pressure, diabetes, obesity and abnormal blood lipids (fats), can be controlled with the help of correct medication and the correct diet.

-Sri Lanka Guardian