South Asians prone to heart disease

It may come as a shock to many people but South Asians, especially those who live in Western countries, have the highest risk of developing heart disease at a younger age as compared to other ethnic groups. Diet is an important lifestyle factor contributing to the increased risk of heart disease. The traditional South Asian diet generally consists of high fibre and healthy foods like fruits, vegetables, rice, beans, meat, legumes, fish and nuts; though it varies by region within Asia. Migration and acculturation are associated with changes in chronic disease patterns. The existing evidence points to unfavourable dietary change among South Asians after migration to Western countries and thus an elevated risk of coronary heart disease and diabetes type 2.

There are diverse South Asian groups living in the Netherlands ranging from Pakistanis to South Asian Surinamese (also called as Hindustanis in the Netherlands). In this article we will focus on diet and heart disease related risk factors among Pakistanis and South Asian Surinamese living in the Netherlands. There are 18,579 Pakistanis in the Netherlands, according to the country’s Central Bureau of Statistics. Of these 10,493 are males while 8,086 are females. The early Pakistani migrants can be called ‘fortune seekers’ who came to the Netherlands in the 1960s and early 1970s. The next wave of Pakistanis consisted of asylum seekers, imported brides or bridegrooms and the latest wave of migration consists of some highly skilled migrants.



An unpublished study regarding the food intake in relation to heart disease has shown that Pakistanis reported an increase in the consumption of convenience foods, fruits, soft drinks, dairy products and white meat and decrease in the intake of food items like high fat/fried foods, deserts/candy/sweets and red meat after migration to the Netherlands. An increased consumption of convenience foods and soft drinks increases the risk of development of diabetes and heart disease. Since the sample size for this study was not very large (154 participants) and it was also not very representative of the general Pakistani population, so we need to be careful while generalising the results of this study.

Pakistanis living in the Netherlands have higher prevalence of heart disease, diabetes and obesity as compared to the Amsterdam population. In addition, Pakistanis living in the Netherlands also consume fewer vegetables but more fruits as compared to the Amsterdam population. Fruits and vegetables have a protective effect against heart disease.

According to official data, there are 151,000 South Asian Surinamese and 22,000 Javanese Surinamese living in the Netherlands. South-Asian Surinamese originally migrated from countries such as India, Pakistan, Bangladesh, Sri Lanka and Nepal to Surinam and then to the Netherlands. The dietary intake among South Asian Surinamese living in the Netherlands indicates high intakes of rice and chicken and significantly lower intakes of red meat and vegetables and cookies and sweets. Second generation South Asian Surinamese and assimilated South-Asian Surinamese have more inclination towards Dutch foods as compared to their counterparts. There are also differences among different Surinamese groups regarding the prevalence of heart disease related risk factors and dietary intake. South-Asian Surinamese have significantly higher prevalence of obesity, heart disease and diabetes as compared with Javanese Surinamese.

There is a consistent trend for lower intake of vegetables and a higher intake of convenience foods, sugary drinks and intake of tea and coffee with sugar among South Asians after migration to the Western countries which could be the cause of high prevalence of heart disease related risk factors in this group. Preventive measures should be taken by the governments, policymakers, health scientists and the communities themselves to reduce this huge burden of non-communicable diseases.

Published in The Express Tribune, June 9^th, 2017.

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