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!

Masala for your heart

Back in graduate school, a friend who was Jewish joked that his family always scanned the news for Jewish names.  He laughed while acknowledging that he, too, did that.  I joined in the laughter because I found myself watching out for Indian-American names.  Yes, even when I was fresh off the boat.

More than two decades later, it seems like Indian-American names are popping up all over the place.  It used to be only in the academic circles, or in the research wings of those large multinational corporations.  Now, Indian-Americans are seemingly everywhere.  Even governors and stand-up comedians.  Thankfully, no gun-crazy Indian-American on a shooting spree!

The NY Times had a Sunday review essay on heart diseases, which was authored by Sandeep Jauhar, who has authored a few pieces for the Times, and has also been at other major media outlets.  An interesting background too--he decided to pursue the medical profession while he was a PhD student in physics at the University of California, Berkeley!  How do people become such brainiacs?

Anyway, back to the NY Times essay by Jauhar.  It is on heart diseases.  What is of interest is this:

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. 

One grandfather of mine--my mother's father--died from a cardiac event that, incidentally, was not his first either.  My grandmother--father's mother--died from an enlarged heart condition.  Whether or not that elevates my risk level is, well, we will find out within the next twenty-four years ;)

Jauhar writes about the Farmingham study that was initiated in 1948 with a key goal "to establish risk factors for coronary heart disease."  He quickly reviews there the research that went into identifying the risk factors that we now think is common sense--like high blood pressure, diabetes, smoking.  

But, those were about people who were of White European stock.  

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.

I need to remind myself that this was a guy who was on track to get his PhD in physics and after a career change, has been a cardiologist for years now!

So, why the "masala" in the title?  Did I have it there in order to provide a hint that the spices are killing South Asians?  Nope.

Fortunately, the National Institutes of Health have started such a study. Named Mediators of Atherosclerosis in South Asians Living in America, or Masala, it has enrolled about 900 South Asian men and women in two large metropolitan areas, the San Francisco Bay Area and Chicago.

I think that the researchers had decided a priori that the study would have a name that would also be a cultural reference, and then they came up with an acceptable scientific expansion of "Masala" ;)

Researchers are focusing on novel risk factors, including malignant forms of cholesterol (previous research has suggested that South Asians may have smaller and denser cholesterol particles that are more prone to causing hardening of the arteries), as well as other social, cultural and genetic determinants.

Hmmm ... for all I know, the tasty European butter that I prefer is transforming into artery-hardening cholesterol!  Oh yeah, there is a cardiologist in the family--he is not an Indian-American but is married to one though ;)  

NBC "Outsourced" comedy to India :)

A friend commented about the new NBC sitcom, Outsourced, which is set to debut in fall.  I told her that it is yet another instance of Indian-Americans being quite adept at merging with the American mainstream!
In the comedic world, it all started with Russell Peters:

If the NBC comedy Outsourced—the show being billed as "the Indian Office"—is successful when it premieres in September, the cast will be only the latest collection of Indian-American comedians to achieve fame on U.S. screens and stages. Aziz Ansari, Kal Penn, Mindy Kaling, and Danny Pudi—all have in recent years become successes in Hollywood, in the process redefining—again—the idea of what a typical American comic looks like.

But these young comics aren't the first Indian-Americans to find pop culture success. Russell Peters came before them, as the first Indian comedian to make it big in the Western world.

Reading all this "funny stuff" led me through a few links to this neat collection of US magazine covers with South Asian people/themes put together by SAJA

The Booker Prize longlist

One surprise: none of the authors' names suggest a South Asian origin, which is a rare occurrence these days in fiction in the English language that qualifies for this prize :) "The judges will now reread the longlist, name a shortlist of six on 7 September and reveal the winner on 12 October."

The Booker longlist in full (click the title to read a review):
Parrot and Olivier in America by Peter Carey (Faber and Faber)
Room by Emma Donoghue (Pan MacMillan - Picador)
The Betrayal by Helen Dunmore (Penguin - Fig Tree)
In a Strange Room by Damon Galgut (Grove Atlantic - Atlantic Books)
The Finkler Question by Howard Jacobson (Bloomsbury)
The Long Song by Andrea Levy (Headline Publishing Group – Headline Review)
C by Tom McCarthy (Random House - Jonathan Cape)
The Thousand Autumns of Jacob de Zoet by David Mitchell (Hodder & Stoughton - Sceptre)
February by Lisa Moore (Random House - Chatto & Windus)
Skippy Dies by Paul Murray (Penguin - Hamish Hamilton)
Trespass by Rose Tremain (Random House - Chatto & Windus)
The Slap by Christos Tsiolkas (Grove Atlantic - Tuskar Rock)
The Stars in the Bright Sky by Alan Warner (Random House - Jonathan Cape)

Indians top US spelling contests

BBC NEWS South Asia Indians top US spelling contests: "Over the years many children of South Asian origin have left their mark at the spelling event, but why do they dominate it?"

The Spelling Bee is a curiously American phenom. I have always suspected that the modern popularity of the event is because of immigrants who place a high value on learning, as opposed to, say, arts and sports. So, while some kids might show off their ballet moves, here are a few competing with words. Spellbound followed one such case, remember?

This is what Tunku Varadarajan suggested, back in 2005: "Success at letters is the sweetest sort of success, the achievement nonpareil.
For millennia, India was a land where the poorest scholar was held in higher esteem than the richest businessman. This approach to life proved disastrous for modern India. Jawaharlal Nehru, the country's first prime minister and a Brahmin to his manicured fingertips, had such contempt for business (and for profits) that his economic policies condemned his people to two generations of stagnation.
But Nehru would have approved of spelling bees. Indian pedagogy relies heavily on rote memorization--the result of a fusion of Victorian teaching methods imposed by the British and ancient Hindu practice, in which the guru (or teacher) imparted his learning to pupils via an oral tradition. (The Victorians, for their part, regarded correct spelling almost as a moral virtue, and certainly as a caste "signifier," to use a clumsy anthropological term.)