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South Asians have the highest risk of heart disease of any ethnic group. The facts are sobering – 1 in 4 heart attacks occur before the age of 40.

In fact, South Asian men and women have a significantly higher likelihood of having a heart attack before age 50 that is more lethal compared to any other ethnic group.

Although cardiovascular disease remains the leading cause of death all over the world, why do South Asians carry an especially heavy burden of this disease?

Stanford’s South Asian Translational Heart Initiative – (SSATHI) is trying to find answers.

Helping South Asian Heart Health

At SSATHI we are helping South Asians – people from India, Pakistan, Bangladesh, Nepal, Bhutan, Maldives, and Sri Lanka – better understand what makes them predisposed to cardiovascular disease and providing culturally tailored, medical and lifestyle changes to help them lower their risk factors.

We are the first cardiology clinic dedicated to the detection and long-term management of heart disease risk among  South Asians.

Health Impact of the coronavirus pandemic

Since the shelter in place began on March 17, our clinic has seen many South Asian patients whose lifestyles have grown increasingly unhealthy.

These profound changes in lifestyle  include poor diet, reduced physical activity, increased alcohol consumption, weight gain and increasing levels of stress.

South Asians must be vigilant about staying heart healthy during social isolation.  At SSATHI, we are dedicated to increasing awareness about risks and lifestyle choices and offering advice on how to improve heart health.

 Dr. Rajesh Dash MD, PhD, Medical and Scientific Director of SSATHI

Partnering with SSATHI for Clinical Services

SSATHI’s team of clinicians – behavioral psychologists, dietitians, nurses, pre-diabetes specialist and cardiologists – offer comprehensive heart risk assessments, as well as medical and lifestyle interventions aimed at aggressive risk reduction.

As one example, the clinic offers the oral glucose tolerance testing that provides detailed insight into blood sugar and insulin regulation, and helps to identify patients at risk for pre-diabetes. This insight helps our providers tailor treatment by going beyond traditional markers such as hemoglobin a1c (Hba1c – three-month blood sugar mean).

Our pre-diabetes specialist Dr. Fahim Abassi,  has developed several tools to help providers and patients better understand blood sugar regulation and to develop personalized lifestyle recommendations.

The SSATHI clinic also offers virtual care so patients can access clinic services from the convenience of their homes and offices.

SSATHI Clinical Trials

In addition to clinical care, SSATHI has a robust research effort underway to uncover the underlying causes of South Asians’ increased risk for heart disease. Our clinical trials focus on genetic and hormonal risk factors behind heart disease, and a more recent trial on the effects of lifestyle intervention delivered by telemedicine has shown promising results. SSATHI is currently recruiting for a trial that studies the effect of plant sterol supplementation on LDL cholesterol levels. Trials like these helps explore alternative treatments beyond standard medication therapy.

Dangers of Covid19

Though our community has been making steady progress in managing their health, COVID-19 presents a whole new danger. People with co-morbidities such as high blood pressure, diabetes, and heart disease are at an increased risk of developing complications from COVID19. It is therefore more important than ever that we pay attention to our physical and mental health.

Recommendations to improve heart health during shelter in place

In addition to observing city and state mandates for masking and sheltering in place, and continuing proper hand washing, it is equally important to follow positive lifestyle behaviors.  Good nutrition, regular physical activity, consistent sleep schedule and instituting positive coping mechanisms to manage stress, will enhance our ability to deal with the pandemic.

NUTRITION

Sheltering in place has forced us to change the way we shop for groceries so dedicate a couple of pantry shelves to nutrient dense shelf stable foods. Channel your culinary curiosity towards creating more vegetable and lentil-based dishes and learn to cook with whole intact grains.

Avoid

  • Refined & processed starches/carbohydrates such as Maggi noodles, poha, sooji, instant mixes of idli,  or dhokla,

Choose

  • Whole grain alternatives like whole wheat noodles, steel cut oats,
  • Coarse cracked wheat or dahlia, quick cooking farro,
  • Barley, bulgur, quinoa, brown and red rice.

Must have

  • Fresh vegetables and fruits, organic low-fat dairy,
  • Plant-based protein sources like lentils and beans
  • Whole intact grains like quinoa, millet and brown rice.
  • Frozen vegetables

Snack Mindfully

  • Avoid using sugar and other refined and processed snacks as a crutch to get through your mid-afternoon slump.
  • Choose low fat organic yogurt and or fresh fruit as a refreshing wholesome snack instead.

Create a schedule to obtain groceries on a regular, biweekly basis and consider online delivery or in-store shopping with safety practices.

EXERCISE

Setting aside a few minutes – even as little as 20 minutes to go for a walk could make a big difference in your mood, energy levels and digestion. This could also be a great way to get some sun exposure and restoring your vitamin D levels while giving you an opportunity to clear your mind and getting some exercise.

SLEEP

It is particularly important to establish a consistent sleep schedule. Positive sleep habits include avoiding late night eating (eating after 10:00 pm), unwinding at least an hour before bed (even if it means going to bed later) and allowing sleep to unfold help support a good night sleep.

Getting up around the same time every day, getting light exposure shortly after waking up and blocking blue light on electronic devices 1 – 2 hours before bedtime are all valuable sleep strategies recommended by Stanford sleep specialists Dr. Rafael Pallayo and Dr. Rachael Manber.

REDUCING STRESS

As COVID can add a higher degree of stress and anxiety, SSATHI’s behavioral psychologist Dr. Valerie Hoover recommends practicing patience and compassion by lowering your expectations in areas of your life that you cannot control.

Instead, focus on parts of your life that you can control, whether it is health, finances, recreation or relationships. Separating work and non-work activities if you are working from home, creating daily routines such as showering and dressing up, further helps us deal with the lack of daily structure and disrupted routines.

We wish you all good health and optimism!

Vijaya Parameswaran MS, RD, CDE is a clinical researcher, dietitian and certified diabetes educator. She has developed a virtual lifestyle intervention program (NEST – Nutrition, Exercise, Sleep and Transcendence) at the SSATHI clinic. She is also the program manager for Stanford’s telemedicine program CardioClick.

Edited by Meera Kymal, contributing editor at India Currents

 

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