According to the Heart Foundation, heart disease kills one Australian every 18 minutes. It’s been the leading cause of death in Australia for the last three years.
South Asians, however, are more susceptible to chronic diseases than the general Australian population. Numerous studies point to underlying genetic and physiological factors, including BMI and lipoprotein concentration levels.
But it’s not all genetic: our actions and mindset around areas such as diet, exercise, smoking and alcohol and health care (also known as our health behaviours) can exacerbate or reduce chronic disease.
Dr Mehwish Nisar, a PhD researcher at the University of Queensland, has found the South Asian community exhibit many negative health behaviours which increase their risk of chronic disease. These include favouring a sedentary lifestyle, using high amounts of oil and sodium in food and prioritising other facets of life, particularly education and work, over health.
Her findings show such health behaviours are linked to South Asian cultural beliefs, social circumstances, and economic situations.
“There are many things (South Asians) will face in a new country, but the main three things we can link are cost, culture and circumstances, my three C’s model,” she says.
“Cost relates to the price of healthy foods, the cost of facilities; culture is understanding our needs with facilities, doctors understanding cultural background and language; circumstances are about environment, the opportunity to exercise, both their own circumstances and those provided by the system.”
Frighteningly, the trend shows that heart disease is more severe and appearing earlier on in South Asians, with 50% of heart attacks happening before the age of 50. Dr Nisar notes how negative health behaviours can be passed intergenerationally.
“In school, kids might learn one thing, but ultimately, they have to come home, and if their parents don’t have the mindset or aren’t able to provide opportunities it’s a struggle for the kids,” she says.
Cultivating positive health behaviours is crucial to positive health outcomes within the South Asian community.
“Health behaviours are modifiable, you can change them with intervention,” she says. “If you have genetic susceptibility, negative health behaviours will aggravate it: you will get that disease earlier in life, and with more complications. This is not only a burden for the person, but the Australian healthcare system. Positive health behaviours will achieve several things, including delaying gene presentation.”
Dr Nisar notes that misinformation within the community is a key barrier to positive health behaviours.
“There are two types of misinformation; the myths that go from generation to generation, cultural misconceptions like how we don’t want to screen for disease because ‘if we’re digging for something, it will come’, or ‘if you are walking instead of driving, it is a sign of poverty’,” says Dr Nisar.
Dubious health advice shared via social media platforms such as WhatsApp can be equally harmful to follow. Dr Nisar urges the community to consult with a qualified GP or look at reputable websites instead.
“There is misinformation online; not everything on the internet is true or appropriate. For example, it’s giving an alternative to sugar, it might have other side effects, or if it suggests an exercise and you are not doing it properly, it will cause more injury. Please don’t follow everything that is on a video, it might just be made for views.”
Dr Nisar recommends introducing positive health behaviours through small changes, which will gradually help to shift mindset. Similarly, The Heart Foundation has templates for heart action plans to help manage risk and recover from heart conditions, and a three-step guide to detecting heart disease.
Small changes to reduce your risk of heart disease
- Eat fresh: include more fresh and raw fruits and vegetables, such as salads, as nutrients can often be cooked out of traditional foods.
- Minimise saturated and trans fats: try swapping butter, vegetable oil or ghee for rice bran oil, which is suitable for high temperature cooking.
- Reduce your salt intake: try adding flavour with alternatives such as herbs or lemon, and if you must use salt, pink is preferable to white.
- Go wholegrain: swap to wholegrain breads and cereals, whole wheat flour and brown rice and which have more nutrients.
- Get moving: Work your way up to the recommended 30 minutes of moderate exercise each day by involving friends and family and setting goals.
Institutional change is equally necessary according to Dr Nisar, to provide more cost effective and culturally sensitive physical activity and healthcare.
“There needs to be more clear and culturally relevant support; when [South Asians] go to the doctor, the doctor doesn’t always understand what’s manageable or culturally appropriate, which enhances negative health behaviours. It’s very important to provide facilities that are affordable and acceptable for their situation.”
However, Dr Nisar stresses the importance of individual action to mitigate chronic disease.
“We must realise we are disproportionately susceptible, and we have responsibility to maintain a healthy heart. (Positive health behaviours) don’t happen overnight, but the important thing is to start.”
The Heart Foundation’s Heart Week runs from 1-7 of May.