The Plot Twist - Part 1
When lifestyle meets legacy
“I am in shock!”
“How can it be?”
“Arre yaar, kya karte ho aap?” (Oh man, what’s going on?)
“You have such a healthy lifestyle!”
These were some of the reactions of friends and family when they heard the news.
As my ex-classmate Nabanil (a neurosurgeon, sometimes with a flair for the dramatic) says, “Indian men should have the middle name diabetes or heart disease.” Not exactly the kind of legacy one hopes for!
According to Wikipedia, India has an estimated 212 million people with diabetes out of 828 million globally. One in four people (26%) in the world with diabetes is from India, making it the most affected country in the world. India leads national prevalence charts globally (about 20%) ; high-income countries trend around 8–14%, while some Pacific, Middle Eastern, and South Asian nations (e.g. Pakistan, Kuwait, French Polynesia) exceed 25% . Switzerland has a prevalence rate of 8%, which is the low end of the scale.
When it comes to heart disease, according to NFHS‑5 (2019–21), the rate of self-reported heart disease in Indian men aged 15–54 is 1,050 per 100,000(≈ 1.05%). In the 45+ age group, men have a 5.9% CVD (Coronary Valve Disease) prevalence (women have 4.6%) and over the past 40 years, urban CAD (Coronary Artery Disease) prevalence among men has quadrupled to 9–12%. There are multiple factors which contribute to CVD and CAD, lifestyle and genetics being the deadly duo.
India also has the highest prevalence of heart disease in the world at 11-12% in urban men. China is 9-10% and Pakistan 14%. USA & UK are in the 7-10% range, but early detection and treatment is more easily available.
Why all this Indian data? Because I was born and grew up in India before coming West.
The news is that at the age of 64, I was diagnosed with CVD and CAD. Damn, it never rains but it pours, eh?
Some of my friends and acquaintances over the years have heard me say that I am preparing for heart problems in my mid-60s since my father (and his older brother) left the world in the second half of their 60s with this problem. Deep down, I believed that I could outrun it.
As you can then imagine, I was not prepared for the news. Not prepared to believe that it was actually going to happen to me. All those runs, hikes, workouts, cycling, weight loss. All for nothing? Should I have stuck to samosas and stress?
How did this all come about? More in my next Substack. Stay tuned - and try to be in Zen mode rather than tense mode until then.
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Endnotes:
NFHS is the National Family Health Survey.
Heart Disease risk factors: Multiple modifiable risk factors such as smoking, hypertension, diabetes, dyslipidemia (abnormal levels of lipids in blood) and obesity which are poorly controlled.
I cannot not mention this: Air pollution and urban stress significantly increase risk—especially in major Indian cities.
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Dear Ashok, I am sorry to hear. Please take good care of yourself, I think you will live many more years and all will be fine
Sorry to hear all this Ashok. Its a bit of a shock since we just met and you looked good and fit. Yes, we have Indian bodies and our life expectancy is less than those of people born in these parts of the world. However, just because both my parents reached 80, it doesn't mean much. As you know Vicky was 35 when he passed away. I don't know when I'll go but I hope it is painless. I pray that you will live a hearty life for many more years to come. After all, medicine has improved too. And all your exercise will have counted for something.