Physician Scientist - American Association of Physicians of Indian ...

SPECIAL ARTICLE
AAPI Journal • June 2009
Larger Your Waistline Shorter Is Your Life Span! Indian
Diaspora In The U.S. and Cardio-Metabolic Syndrome
Continued from page 24
With regard to the increase in
cardiovascular risk associated with
metabolic syndrome, the whole far
exceeds the sum of its parts. For
instance, the 4-year risk of incident
myocardial infarction (MI) among
men ages 40-65 in the Prospective
Cardiovascular Münster (PROCAM)
study was increased 2.5 times in the
presence of either type 2 diabetes or
hypertension; 8 times in the
presence of both factors; and 19
times in the presence of both factors
plus an abnormal lipid profile.
Both the proinflammatory and
prothrombotic states of metabolic
syndrome derive largely from the
secretory activity of adipose tissue,
particularly intra-abdominal or
visceral fat. Contrary to the former
concept of fat as an inert tissue
mass, adipocytes are increasingly
being recognized as secretory
entities. Cytokines and other
inflammatory markers or signaling
molecules released by adipocytes --
termed "adipokines"--include leptin,
tumor necrosis factor alpha (TNFalpha),
interleukin-6, resistin, and
adiponectin. Adiponectin levels are
inversely related to fasting plasma
insulin and glucose levels. Weight
loss by obese individuals has been
associated with increased
adiponectin levels.
Populations that are genetically
susceptible to metabolic syndrome
include South Asians (Indian
subcontinent), Southeast Asians (eg,
Polynesian, Japanese), African-
Americans (particularly African-
American women), Mexicans, and
Native Americans (eg, Pima Indians).
The age-adjusted prevalence of
CHD in Caucasians is highest in
patients with both type 2 diabetes
and metabolic syndrome (19.2%),
Cardiovascular disease mortality in the metabolic syndrome.
followed by patients with metabolic
syndrome but not type 2 diabetes
(13.9%). Notably, the prevalence of
CHD is no higher in patients with
type 2 diabetes but without
metabolic syndrome than in
individuals who have neither type 2
diabetes nor metabolic syndrome.
The Diabetes in Indian Americans
study showed much higher ageadjusted
prevalence of Metabolic
Syndrome of 26.9% by the original
ATP III criteria, 32.7% by the
modified ATP III criteria and 38.2%
by the IDF criteria.
Life habits-Diet, Exercise or their
lack of play a major role in
unmasking the genetic
predisposition to CardioMetabolic
Syndrome in Indians.
Life Habit factors unique to Asian
Indians contributing to higher
CardioMetabolic risk!
• Being sedentary- Couch Potato!
• Meager consumption of fresh
fruits and fresh vegetables
• Excess consumption of sweets,
jaggery, dairy products and fried
foods
• Re-heating edible oils for
cooking over and over!
• High carbohydrate and low fiber
diets.
Remedies to prevent and reverse
Cardio- Metabolic Syndrome!
EXERCISE for at LEAST 30 minutes
everyday; children need to exercise
60 to 90 minutes a day!
In general 10% weight loss is
associated with 30% loss in adipose
tissue.
Nutrition
Restrict total calories, especially
from simple carbohydrates and
consume more calories from mono,
poly and Omega 3 fats.
Bake and Boil! Minimize frying;
Stop deep frying, Stop re-heating the
edible oils for cooking.
Continued on page 26
www.aapiusa.org
25