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WHY Heart Attacks are common in Sri Lanka

Saturday, July 3
By Dr. D P Atukorale
(July 0, !olom"o, Sri Lanka #uardian$ %yocardial &n'arction ((eart attack$ is t(e "i))est killer
in Sri Lankan and more and more youn) Sri Lankans (t(ose "elo* 0 years$ are )ettin) (eart
attacks "ecause t(ey do not li+e *it( nature, eat "ad 'ood and eat at t(e *ron) time in t(e ni)(t.
&t is not sur,risin) t(at Sri Lankans are )ettin) (eart attacks a"out ten to t*enty years "e'ore
,eo,le in t(e West. -(is is due to a num"er o' reasons.
A ma.ority o' Sri Lankans ,ass o'' t(e )ood 'ood suc( as c(ea, +e)eta"les, )reens, nuts and
red rice to t(e ser+ants and eat so/called )ood 'ood suc( as ,olis(ed rice, e))s, "utter, c(eese,
mutton, ,ork and "ee'. -(ey eat 'ast 'ood and a si)ni'icant num"er o' t(em, es,ecially t(ose
li+in) in t(e ur"an areas eat .unk 'ood. -(ey end u, dinin) at e0,ensi+e restaurants, *(ose 'are
is not t(e "est 'or a (ealt(y (eart.
Dee, 1ryin) Wit( 2e)eta"le 3ils
&t is common kno*led)e t(at most o' t(e (otels and restaurants use +e)eta"le oils 'or 'ryin). As
a result, t(e amount o' trans/'ats in +e)eta"le oils is increased. -rans/'ats increase your "ad
(LDL$ c(olesterol, decrease your )ood (HDL$ c(olesterol and increase your serum tri)lycerides.
Hi)( LDL c(olesterol, lo* HDL c(olesterol and ele+ated serum tri)lycerides are coronary risk
'actors and dee, 'ryin) *it( +e)eta"le oils result lo* HDL and (i)( serum tri)lycerides.
Lo* HDL ()ood$ !(olesterol Amon) Asians
Sri Lankans and ot(er Asians are ,rone to (a+e lo* HDL c(olesterol, unlike ,eo,le in t(e West
and e0cessi+e use o' +e)eta"le oils and dee, 'ryin) makin) use o' +e)eta"le oils makes t(is
lo* HDL c(olesterol *orse and some o' my ,atients *(o use +e)eta"le oils (a+e dan)erously
lo* ("elo* 0m)4$ HDL c(olesterol.
5,idemic 3' 3"esity &n -(e Youn)
We Sri Lankans consume too muc( o' aerated *ater, s*eet drinks and too muc( o' (i)( calorie
'ood suc( as ice cream, ,uddin)s, *atala,,an, yo)(urt etc. We eat too muc( o' rice at ni)(t
and t(ere is an e,idemic o' o+er*ei)(t and o"esity amon) teena)ers and youn) Sri Lankans.
3"esity is a coronary risk 'actor and o"ese ,ersons (a+e (i)( LDL c(olesterol, lo* HDL
c(olesterol and (i)( tri)lycerides.
Dia"etes %ellitus
5atin) too muc( o' su)ar and ot(er s*eets is one o' t(e causes o' dia"etes and uncontrolled
dia"etic ,atients (a+e (i)( serum tri)lycerides and lo* HDL. Dia"etes mellitus is a common risk
'actor 'or (eart attacks and ele+ated LDL ("ad$ c(olesterol is not uncommon amon)
uncontrolled dia"etics.
5atin) Dinner Late At 6i)(t
5atin) a late dinner is "ad 'or your (eart. &n t(e ur"an areas o' Sri Lanka , a si)ni'icant num"er
o' ,eo,le ate )ettin) used to (a+in) a late dinner.
Lack 3' 50ercise
Lack o' e0ercise is anot(er *ell kno*n risk 'actor 'or (eart attacks. HDL ()ood$ c(olesterol is
lo* in a (i)( ,ro,ortion o' ,eo,le *(o do not e0ercise re)ularly. HDL is normal in ,eo,le *(o
e0ercise re)ularly.
W(en & *as studyin) in t(e si0t( standard at t(e #o+ernment Junior Sc(ool 5l,itiya, in 788, &
used to *alk t*o miles daily in t(e mornin) to 9!atc(9 t(e sc(ool "us. & can remem"er once *e
students *ent on strike a)ainst t(e ,ri+ate "us o*ners *(o increased student:s "us 'are and *e
*alked ; miles a day (7; miles u, and 7; miles do*n$ 'or t*o consecuti+e days. -(e ,ri+ate
"us o*ners "rou)(t do*n t(e "us 'are and *e *on t(e strike. & do not t(ink any o' t(e ,resent
day students *ill e+er *alk e+en one mile a day to sc(ool. 5+en to tra+el a distance o' t*o "us
(alts, most Sri Lankans in t(e ur"an areas use a "us or a t(ree/*(eeler.
-o sum u,, lack o' e0ercise, lo* HDL c(olesterol, (i)( LDL c(olesterol, (i)( serum
tri)lycerides, eatin) too muc( o' su)ar and ot(er (i)( calorie diets, includin) 'ast 'ood and .unk
'ood and eatin) a lar)e dinner late at ni)(t are some o' t(e common causes o' (eart attacks in
Sri Lankans.
-(anks to t(e ,resent )o+ernment, smokin) is rare amon) Sri Lankans no*. W(en Dr.
Walloo,,illai and & carried out a researc( ,ro.ect to 'ind out t(e common causes o' (eart attacks
amon) youn) Sri Lankans in 78<, it *as 'ound t(at t(e commonest cause o' (eart attacks
amon) t(ose ,atients "elo* 0 years *as (ea+y smokin).
%ost o' t(e (eart attacks amon) Sri Lankans can "e ,re+ented i' *e li+e *it( nature, eat )ood
'ood, take re)ular e0ercises and take dinner early. 3t(er coronary risk 'actors suc( as (i)(
"lood ,ressure, dia"etes, o"esity and a"normal "lood li,ids ('ats$, can "e controlled *it( t(e
(el, o' correct medication and t(e correct diet.
P Sa+e a -ree.Please consider t(e en+ironment "e'ore ,rintin) t(is

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An introduction to (eart disease and t(e risk 'actors t(at can cause it.
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