Oxygen

My paternal grandmother lived with us for the last decade of her life.  As kids, we thought she was old,  But, she was only in her early 60s at that time.  Well, back then it was a big deal if one lived until 60, and an even bigger deal if they completed 80.  So, yes, she was "old" in that context.

In the final third of that decade that she spent with us, grandmother started having breathing problems.  The heart and lung expert at the local hospital ran a few tests and zeroed in on the problem: An enlarged heart.

He concluded that it was not a new thing, but was perhaps congenital.  It was, therefore, up to the heart to keep working as long as it would before it stopped.

To relieve her of temporary breathing problems, we got her a portable oxygen tank at home.  If memory serves me well, that was rarely used.  But, it was there, nonetheless, in a corner in her bedroom.  I suppose it provided psychological comfort than anything else.

A couple of decades ago, a friend was diagnosed with lung cancer.  A middle-aged man who had never smoked in his life, nor had he spent time in the company of smokers.  In his final months, he too needed oxygen from an external device.

This was now in a new country and more than three decades after my grandmother's experience. Technology had vastly advanced.  A small machine in a corner of the house operated 24x7, and the long tubing delivered oxygen to wherever he was at home.  While the oxygen tank for grandmother was mostly for psychological support, this machine was literally keeping the friend alive and comfortable enough.

When healthy, we don't think about the breathing and oxygen.  It is only when things are not working well do we seem to understand, appreciate, and respect the things and people that make for a regular life.  How often do we pause to think about the phenomenal job that the heart and lungs and plasma and oxygen and ....?

COVID-19 compels us to separate out the fundamentals of life from all the fluff that otherwise preoccupies us.  The forced physical distancing is making us rethink the ways in which we have been distancing ourselves from friends, family, colleagues, neighbors, ... We are humbled by a virus that is invisible.  A virus that goes straight to the lungs, and makes it difficult to breathe.

If only we paused, even in the absence of any pandemic, to thank the cosmos for the miraculously normal lives that we are lucky to live!

Vegetarian ≠ Healthy. D'oh!

I have forever complained to anybody who would listen to me that it is incorrect to assume that being a vegetarian is synonymous with healthy eating.  My favorite is to point my finger at the huge mounds of rice on any plate, or the number of pooris.  Even worse, the fried snacks of a gazillion types. And the sweets, omg!  There is nothing healthy about all these.

In other words, there is vegetarian, and then there is healthy vegetarian.

Most of the people in, or from, the old country, that I interact with seem to be of the former kind.  Systematic research has already identified one aspect of such a life: Diabetes.  Despite all the research, people in the old country talk about the genetic reasons behind diabetes, when science shows otherwise.

There is also one other ailment that ties them together: Heart disease.

More than three years ago, I blogged about Masala, as in Mediators of Atherosclerosis in South Asians Living in America, which is a systematic study of 900 South Asians in the US. I quoted there from a NY Times story:

Heart disease is the leading cause of death in India, Pakistan and Bangladesh, and rates have risen over the past several decades. South Asian immigrants to the United States, like me, develop earlier and more malignant heart disease and have higher death rates than any other major ethnic group in this country. The reasons for this have not been determined. 

This Masala study was initiated because "traditional cardiac risk models, developed by studying mostly white Americans, don’t fully apply to ethnic communities. This is a knowledge gap that must be filled in the coming years."

A recent NY Times report informs me that the results have started to come in:

Heart risks tended to be greatest in South Asians, the Masala researchers found. In one recent study, in the Annals of Internal Medicine, they found that 44 percent of the normal weight South Asians they examined had two or more metabolic abnormalities, like high blood sugar, high triglycerides, hypertension or low HDL cholesterol, compared to just 21 percent of whites who were normal weight.
The Masala researchers also found that using the standard cutoff point to screen for diabetes, a B.M.I. of 25 or greater, would cause doctors to overlook up to a third of South Asians who have the disease. “Many of them may never get to that B.M.I. and they will have had diabetes for years,” Dr. Kanaya said.

Yep, a healthy looking South Asian who is mostly vegetarian could also be on the verge of a heart attack.

Most of the participants in the Masala study are first-generation immigrants, and the researchers found that their cultural practices also impact their disease rates. Cardiovascular risks tended to be highest in two groups: those who maintained very strong ties to traditional South Asian religious, cultural and dietary customs, and those who vigorously — embraced a Western lifestyle. Those with lower risk are what the researchers call bicultural, maintaining some aspects of traditional South Asian culture while also adopting some healthy Western habits.

Why the discrepancy between the two groups? Simple: mostly because of dietary behaviors.

But vegetarians who eat traditional South Asian foods like fried snacks, sweetened beverages and high-fat dairy products were found to have worse cardiovascular health than those who eat what the researchers call a “prudent” diet with more fruits, vegetables, nuts, beans and whole grains (and, for nonvegetarians, fish and chicken). People who eat a Western style diet with red and processed meat, alcohol, refined carbohydrates and few fruits and vegetables were also found to have more metabolic risk factors.

If only people listened to me and understood the importance of sanitas per escam!