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Rise in heart conditions among youth in Oman
October 3, 2019 | 10:53 AM
by Gautam Viswanathan
 
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The concept of “mind over matter” is one that is often talked about these days. The phrase precisely deals with encouraging people to focus on what needs to be done, instead of being distracted by what lies in front of us.

Another phrase – ‘head over heart’ – is a great way to deal with the topic we’re discussing in this edition of T Weekly. The phrase essentially means we must think before acting, instead of giving in to impulse, and it’s a phrase that perfectly sums up the way some of us act these days, choosing to put other concerns and needs over the welfare of our hearts.

On the occasion of World Heart Day, T Weekly spoke to doctors in Oman about the alarmingly increasing presence of heart conditions in younger people, particularly those in their 20s and 30s.

Doctors shared information on why there has been a sudden jump in the number of heart patients, the leading causes behind it, and what could be done to tackle them.



Dr Anoop Soman, a specialist cardiologist at NMC hospital Ruwi, has revealed that the current lifestyles we follow play a huge role in the increased prevalence of heart conditions among younger people. A large portion of the blame needs to be laid not just at the feet of the younger generation themselves, but their parents as well, who might not have encouraged and instructed their children to follow the right habits.

However, blame cannot be shouldered by the parents alone, for they might have warned their children time and time again, only for their advice to fall on deaf ears. While the attraction of video games, junk food and fizzy drinks is deadly, it is unfortunately a highly attractive proposition to some. Picture it (go on, do), and it’s hard to not be taken in by the seemingly easy-going and carefree lifestyle it offers you.



“The younger generation now has an increased incidence of heart conditions compared to the way things previously were. Our lifestyle and diets are big factors in this,” said Dr Soman. “Nowadays, many of the younger generation are obese and don’t do enough physical activity. They follow a sedentary lifestyle and do not care enough about their diet which can lead to many problems within the heart. They become obese, a condition that leads to the development of diabetes, heart disease, blood pressure and cholesterol abnormalities.

“All these things lead to developing cardiovascular conditions,” he added. “Other factors in our lifestyle such as daily stress also contributes towards all these things. A lot of people say that they have too much stress at work, they don’t have enough time, and some people are ignorant about their diet. Even though they are obese, they don’t mind.”

“However much we counsel them to reduce their body mass index (BMI) to below 25, they don’t listen, and some of them have BMIs that go up to 30 and even 35,” added Dr Soman. “35 is simply far too high, but we have a lot of youngsters whose BMI is even more than that. Unfortunately, there are a lot of young people who don’t bother about their condition even if their BMI is so high.”



Tackling the problem of heart conditions and other Non-Communicable Diseases (NCDs) has received attention from the Omani government, through the Ministry of Health, which in 2017 conducted a national health survey. This survey, conducted among a sample population of 9,045 Omani and non-Omani families, provided data on the number of people who suffered from NCDs such as obesity, heart disease and hypertension, across the 11 governorates of the Sultanate.

Cardiovascular diseases are responsible for nearly 18 million deaths worldwide, followed by cancer (9 million), respiratory diseases (3.9 million) and diabetes (1.6 million). They account for 80 per cent of all premature deaths caused by NCDs.

“The present generation, particularly in school and colleges, consider eating out and eating fast food to be a status symbol,” explained Dr Anoop Soman. “They don’t like taking food from home. They prefer eating fast food and even when they go out with their friends, they always go to fast food restaurants. Bachelors have a different sort of lifestyle. They prefer eating a shawarma outside instead of eating at home, for example.

“There are many people who prefer eating fast food regularly,” he added. “All of these changes have only happened however, during the last 10 years. Usually, if these people come as my patients, I advise them to eat take away food no more than once per week, maybe during the weekends. I ask them to follow a reasonably healthy diet for five or six days in a week.”

Dr Soman did say that although he did provide plenty of advice to people, in the end, the motivation and momentum to change needed to come from the young people themselves. Those around them could only provide the encouragement and show them the warning signs of what could happen if changes in lifestyle and dietary choices were not made.

A lack of awareness over the regular consumption of fruits and vegetables in the Sultanate seemed to correlate with Dr Soman’s analysis: 60.7 per cent of people surveyed ate less than the recommended five servings of fruits and vegetables every day. Of this, 57.7 per cent were Omani, and 69.9 percent were non-Omani.

Excessive consumption of junk food also directly translated into an increased intake of salt: 8.5 grams of salt were consumed daily by people in Oman, far above the recommended five grams of salt that are required every day. In addition, 65 per cent of non-Omani and 66.5 per cent of Omanis were considered to be obese or overweight. This reached 69 percent among Omani women, and 63.5 per cent among Omani men.

“If people have any health abnormalities, such as diabetes, obesity or blood pressure, I ask them to do exercises at least five or six days a week,” explained Dr Soman in this matter. “Do a reasonable diet control at least five days a week, and you can then relax on the weekend. I cannot ask people to not take fast food completely, all I can give them is some practical advice.”

He went on to say, “The number one cause of this jump in the risk factors that lead to cardiovascular diseases – these are not related to just the heart but could affect the brain in the form of strokes – is a sedentary lifestyle and obesity. There are common risk factors for all of these things – diabetes, blood pressure, a sedentary lifestyle, all of these are common factors that lead to such conditions.”

“If you are physically active and can maintain your BMI to less than 25, there is a lesser chance of developing these risk factors,” said Dr Soman. “Smoking is also a problem, because it is the most important risk factor for cardiovascular disease. Smokers have a higher chance of getting chronic coughs, lung diseases, bronchitis, and this could lead to the development of malignant tumours.”

In addition, Dr Shaju Padman, a cardiologist at Aster Al Raffah Hospital, said that the ages of the patients who came to him with heart complaints had got steadily younger over the past 10 or so years.

“Because of poor lifestyle choices, an increase in fast food habits and a lack of exercise, adolescent obesity and childhood obesity is on the rise,” he said. “Conditions such as hypertension, high cholesterol, all of these things are being seen in people in their early twenties. Earlier, this would only affect people in their late 30s and early 40s.”

Dr Padman was also quick to share with T Weekly a few case studies of patients he had encountered. He realised that while the patient himself might have heart problems, the lack of a suitable environment at home, and a lax attitude from parents, only made conditions worse.

“We had seen a young patient with very high levels of triglycerides,” he explained. “He was in his early 20s and showed repetitive occurrence of pancreatitis and other problems, but with good diet and exercise, he was able to stop his medication. The defect in patients such as him were bad lifestyle choices and poor diets. The message we are trying to convey is that heart disease is often caused due to poor lifestyle choices.

“Just a few days ago, we had a child who suffered from heart problems, and the excuse the mother gave us for this was that he was always in front of the PlayStation and never went out to play,” he added. “That is a sure shot recipe for childhood obesity. Children must be encouraged to play outside from an early age and must not become addicted to an unhealthy lifestyle and fast food habits.

“This must be inculcated in them from a very young age. Otherwise, by the time they become teens, these habits will be very difficult for them to form,” he went on to say. “Here, it is the parents who have a role. Parents should make children realise the value of playing outside, because for children, it is just another game, whether it is playing outside or playing on the computer. This exercise is necessary for growth and good health.”

With both parents in modern households opting to work, it unfortunately means that children are either left unsupervised and are required to take care of themselves, essentially becoming latchkey kids, or are looked after by maids and other caregivers such as nannies. While some nannies are definitely given instructions, others leave the child free to do as he pleases.

This sort of unchecked freedom can provide the child with the opportunity to indulge his desires, such as gaming for hours on end without taking a break or gorging on junk food and fizzy drinks with no one to stop him or tell him what to do.

“This is an issue, but the maids and nannies can be supervised,” explained Dr Shaju Padman.

“A lot of people think that lifestyle-based issues only need to be handled and controlled in old age, but in reality, you need to start handling this a lot earlier. A lot of people feel it is okay for the child to enjoy and play video games at a young age, but this discipline must begin early. They feel that it is okay for them to not exercise and eat fast food and they feel that the consequences can be handled at a later time.

“I would ask young people to exercise regularly, have a healthy diet, stop smoking, and go for a health check-up, especially after the ages of 20 or 21,” he added. “Know your blood pressure, lipid profile level and cholesterol statistics. When I started my career, I saw very few young heart patients, but that number has grown tremendously over the past few years.”

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