Africa
- Heart disease rates are more than two times higher among Asian Indians than among blacks in most African countries studied.1-3 Heart disease was the major cause of death (43% of all deaths) in Asian Indians in Kampala, Uganda in 1959.4
- Data from the U.K, Trinidad, Uganda, and South Africa suggests very low rates of heart disease in blacks despite a high prevalence of high blood pressure and stroke.4-7
- The difference in heart disease between Asian Indians and blacks may be at least partly due to the substantial differences in quality and quantity of the fat consumed. Asian Indians consume 40% of the daily energy from fat compared to 15% in Africans.4
- The major source of dietary fat in Africans is peanut oil which is low in saturated fat (14%).8 This may explain the low LDL and high HDL among blacks.
- For Asian Indians, cotton seed and ghee were the major sources of fat. Cotton seed oil is high in saturated fat (27%) although lower than in palm oil (50%) and coconut oil (92%).8 (see Cooking Oils)
- Ghee is obtained by heating butter and is not only rich in saturated fat but also oxidized lipids, fat, and cholesterol oxide and contributes to significant dyslipidemia.4
- Worse yet, most Indians believe it to be a healthful fat consumed by their forefathers for millenniums. Therefore, its consumption is unlikely to be reduced in the near future unless extensive re-education is successful.
Sources
1. Steinberg WJ, Balfe DL, Kustner HG. Decline in the ischaemic heart disease mortality rates of South Africans, 1968-1985. S Afr Med J. 1988;74(11):547-550.
2. Seedat YK. Coronary artery disease in South African Indians. Mumbai: CSI; 1998.
3. Beckles G L, Miller GJ, Kirkwood BR, Alexis SD, Carson DC, Byam NT. High total and cardiovascular disease mortality in adults of Indian descent in Trinidad, unexplained by major coronary risk factors. Lancet. Jun 7 1986;1(8493):1298-1301.
4. Shaper AG, Jones K. Serum cholesterol, diet, and coronary heart disease in Africans and Asians in Uganda. Lancet. 1959;2:534 – 537.
5. Enas EA, Yusuf S, Mehta J. Meeting of the International Working Group on Coronary Artery Disease in South Asians. 24 March 1996, Orlando, Florida, USA. Indian heart journal. Nov-Dec 1996;48(6):727-732.
6. Wild SH, McKeigue P. Cross sectional analysis of mortality by country of birth in England and Wales, 1970-92. Bmj. 1997;314(7082):705-710.
7. Balarajan R. Ethnic differences in mortality from ischaemic heart disease and cerebrovascular disease in England and Wales. Bmj. Mar 9 1991;302(6776):560-564.
8. Enas EA. Cooking oils, cholesterol and CAD: facts and myths. Indian heart journal. Jul-Aug 1996;48(4):423-427.