Young, Vegetarian, Non-Smoking Indians Are Struggling With Heart Disease

This article personally resonates with me as a South Asian-American who has a father with heart disease. There are multiple reasons for this. 1) A very high carb diet that isn't suited to sedentary lifestyles. Not just traditional foods, but also "Western" foods like excessive bread and pasta. 2) An unusually high value placed on doctors and pharmaceuticals. Many think it's normal to be on a cocktail of drugs. For example, it's been shown that women who have never had a heart attack have increased mortality with statin use, yet it's common for South Asians to get on statins in their 30s, at the slightest news of elevated total cholesterol. 3) Most South Asian vegetarians are actually "grain-atarians", lots of rice & pasta, very little actual vegetables. 4) Mixing Western dietary advice with old world cooking. For example, replacing ghee with vegetable oil. Most still think that vegetable oil is healthier than ghee or coconut oil. 5) Most are uninformed about exercise.

In my experience, as some of the commenters stated on the post, it is really lack of understanding of healthy lifestyle.

I see it in my circle of friends all the time; walking is cardio, oily vegetarian food is healthy, not eating sweets/dessert after a meal is rude, and force feeding guests is just cultural. And ridiculous amount of bread or rice is consumed with every meal.

Perhaps there is some genetic factors but I think it is very obvious that our lifestyle is major factor in increasing our risk of heart dieseases.

Great article but somewhat misleading title.

Young, Vegetarian... so these are qualities that take away traditional CVD risks. Add "still" to the title & it becomes much more clear.

Indians consuming a traditional diet get ridiculous amounts of SUGAR & FRIED FOODS. Add to this the fact that many so called "Vegetarians" are vegetarians by virtue of NOT consuming meat rather than Eating vegetables. So, - Young, inactive "grainitarians" with high-sugar & oily-food diets at high risk of heart disease & diabetes - sounds about right.

There are a lot of people here commenting on Indian dietary habits, and there's a lot of misinformation, leading to a lot of misconceptions. In no particular order, let's clear some up:

1. There's no such thing as an "Indian" diet. The cuisines throughout India, Bangladesh, Pakistan, Sri Lanka, and Nepal are incredibly varied, and bear little resemblance to each other.

2. Most Indian cuisines are all but unavailable outside India, particularly in the UK and US. Most Indian restaurants in the US bear little resemblance to the style of food that is eaten in the home. In other words, Indian food available in the UK and US does not reflect daily Indian diets within India.

3. Indian people living abroad may eat very differently, because many of the ingredients are too expensive or simply unavailable outside their home region.

4. Not all Indian cuisines are carbohydrate-heavy.

5. Not all Indian cuisines contain a lot of rice.

6. Not all Indian cuisines fry food.

7. Not all Indian cuisines are vegetarian. Vegetarianism does not dominate Indian cuisine, and it certainly does not dominate Bangladeshi and Pakistani cuisine.

8. What counts as "vegetarian" in India is very different from what people in the US think of as vegetarian. For example, eggs are considered non-vegetarian.

Finally, I should add that all of this, combined with the fact that this is so common both across South Asia and in the diaspora in the US suggests (to me) that genetics are a heavy factor.

You can easily make vegan short bread or pie crust. A can of pop is vegan, as is a bag of chips.

To get the health benefits from being a vegan or vegetarian, you actually have to eat the green, leafy stuff. And the unprocessed tubers, legumes, nuts/seeds and so on.

If your idea of vegetarian is daily serving of deep-fried samosa stuffed with mashed potato and peas, better think again.

The article does not answer the question it poses. The answer is likely that Indians eat an enormous amount of carbohydrates and very little protein. Every single meal is accompanied by as much bread or rice as all of the other foods combined.

Indians have a high level of lactose intolerance, and many dislike eggs as well. Nuts are considered a luxury item and aren't eaten regularly. This leaves few opportunities to compensate with other protein sources.

Carbs in diet. The diet of most Indians has more carbs than most other diets.

It is extremely difficult to get healthy amounts of good nutrients with a vegetarian diet. Most vegetarians I know eat way too many starches, beans, and oils. They do not eat enough nuts, leafy vegetables, etc.

The fact that prevalence of heart disease is nearly invariant between Indians in India and Indians in the US suggests high heritability and raises the specter of a genetic effect.

If it were purely cultural, one would expect Indians in the US to differ from Indians in India. In particular, over successive generations, the risk should approach that of the US as a whole. Since that is not seen (based on the data within this post), factors unrelated to culture / food / etc should be strongly considered as culprits, again, namely genetics.

Hmm, I seem to meet 3/5 criteria on that article. Signed up with the screening center at El Camino. Thanks for posting this link.

I'd be interested in any information where these young, vegetarian, non-smoking Indians started eating a high fat, high protein, low carb diet and what effect it has on blood levels. Or alternatively, an actual vegetarian diet removing anything processed like bread or pasta.

The article says these people are genetically inclined to this state which may in fact be true. But a "vegetarian" diet isn't necessarily heavily based on vegetables. I'm assuming the science is looking into this but as a not so young, definitely not vegetarian white guy, when I went from a diet based on bread to a diet based on meat and vegetables with a lot of exercise on the side, I saw my blood levels drastically improve.

It's PUFA consumption. They're using corn and soy oil and peanut oil with everything rather than their traditional ghee. They're probably also eating less dairy overall.

When I posted it, I had complete title like the author had it viz with Heart Disease, CAD and Diabetes. Someone edited it to shorten it. I can't tell who/when/why, and I can't edit it again.

Title in HN is misleading. Original title refers to coronary artery disease and heart attack, which does not cover all heard diseases. Coronary artery disease is not a big problem now if you have finance to do angioplasty.

considering the smog in Indian urban areas effectively everybody is smoking by western standards.

this isn't even mentioned - but instead goes on about nutritional theories.