Are we heading towards cardiometabolic syndrome endemicity?

Surat (Gujarat) [India], July 1: With the evolution of human beings over billions of years, our ancestral genes eventually adapted to surviving on minimum food and putting in maximum activity to procure small amounts of food. This changed around 100 years back when the industrial revolution started. Since then, the maladaptation of our genes began, which might be the backbone of the etiology of the endemicity of cardiometabolic syndrome.

Nowadays, our younger generation is suffering from heart attacks, high blood pressure, diabetes, high cholesterol, and even sudden cardiac deaths of so-called “healthy young individuals”.

So let’s introspect. As I mentioned earlier, our genes were adapted to minimum food and maximum activity for billions of years, when suddenly, we got exposed to an abundance of food with the least physical activity. This could have led to confusion in our genetic makeup, subsequently leading to maladaptation, whose cumulative effects over the past 100 years could be a major behind the ever-increasing trend in cardiometabolic diseases.

We are aware that there is a multifactorial etiology for cardiometabolic endemicity apart from bad genes, which includes insulin resistance in the form of diabetes,  high body fat percentage, high cholesterol, high blood pressure, physical inactivity, smoking and other forms of tobacco, high intake of saturated fat, refined carbohydrates, high intake of processed food, and so on.

Are we missing something in the list mentioned above?

Yes. We missed most of the important physiological need of our body to recover- Sleep.

We are suffering from lack of sleep and mental stress which is equally responsible for bad cardiovascular health.

A minimum of 8 hours of sound sleep is necessary, apart from a healthy diet and regular exercise for healthy heart and healthy mind.

Also, have you heard about “gut microbial diversity?” Our intestines have trillions of microbial, which are essential for good health and are indirectly associated with a healthy heart too. Mother nature has blessed us with this abundance of“ gut microbial diversity”, but we are rapidly losing many healthy gut microbial families, which might lead to bad gut health. Probable reasons for the lack of gut microbial diversity are processed food, food with artificial sweeteners, junk food, excessively refined carbohydrate, fried food, and many more environmental factors.

Now let’s discuss a bit about the circadian rhythm of the body. Our body was adapted to digest food and release certain healthy hormones according to the time of the day related to sunrise and sunset since time immemorial. For example, we get a high insulin spike if we eat simple carbohydrates or sugar at night which over time leads to insulin resistance, eventually giving rise to high chances of diabetes and an unhealthy heart.

So if we think out of the box, we should go back to the lifestyle of our grandparents. They used to eat before sunset and sleep early; they used to do heavy physical activity, and they used to eat staple food which was fresh and available at their local place. They had never heard of pizzas, burgers or ice-creams. They were eating less as compared to the physical activity they were doing. And i want to stress this because, as a cardiologist, I feel really bad when I need to do angioplasties of young people who suffer from heart attacks and diabetes.

Now, let’s come to the most highly discussed disease of recent times, Covid, and its effect on the heart. I feel that Covid, like a warning bell, has unmasked as well as accelerated the cumulative unhealthy cardiovascular health at a mass level. It has detrimental effects on our endothelium, which is the innermost layer of the arteries which supply blood to the heart muscle. But the negative effect of Covid on our endothelium is reversible and temporary if people would have adapted a healthier lifestyle like that of our forefathers as a rehabilitation programme. Rather we started becoming more unhealthy in the post covid era as a boomerang kind of behaviour.

So to summarize, what should we do now to have a healthy heart??

Check your risk factors for heart disease. Do you have any family history of heart disease? Are you diabetic? Are you a smoker? Do you have high blood pressure or high cholesterol? Are you living a sedentary or unhealthy lifestyle for many years? Then check your heart periodically even if there are no evident symptoms. And keep an eye out for the indicators of heart disease.

Any symptoms which worsen on exercise or exertion, or activity might be related to a bad heart, whether it is chest pain or breathlessness or fatigue or palpitation.

My dictum for heart disease is “ Any unusual symptoms from ear lobule to umbilicus which increase on walking or exercise, might be related to heart disease, go and get your heart checked in such cases.”

Dr. Sanjay Vaghani


Interventional Cardiologist



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