Study attempts to shed light on the 'causes of the causes' of heart disease
TORONTO - A new Canadian study is shedding light on what its authors call "the causes of the causes" of heart disease around the globe.
The risk factors or causes of heart disease have been well documented — things like smoking, being overweight, Type 2 diabetes and high cholesterol.
But this work, done by researchers from McMaster University in Hamilton, is trying to tease out why individuals and societies around the world have those risk factors.
The information is being presented at the European Society of Cardiology Congress in Munich, Germany.
The researchers gathered data from nearly 154,000 people from 628 communities in 17 countries.
The team hopes the findings will be used to help governments design public health programs that fit their individual situations.
Many of the findings don't come as a surprise. People in poorer countries expend more energy, and have less varied diets that rely heavily on carbohydrates.
People in wealthier countries eat diets that contain more fruits and vegetables, proteins and total fats than those from poorer countries. They're also quitting smoking at higher rates than those from poorer countries. But they are less physically active.
A co-investigator of the ongoing study says its goal is to provide hard data so that policy formation doesn't have to rely on supposition.
"We have lots of data on mostly white, Caucasian adults living in North America and Europe. So you might say: What's new about the information from that perspective?" says Dr. Sonia Anand, who is a professor of medicine at McMaster.
"But the global projections of where the greatest number of cardiovascular deaths will occur are that 80 per cent of the burden of cardiovascular disease will be occurring in low-income and middle-income countries in the year 2020. So we need to understand what the trends are in those regions in order to come up with prevention programs, policy changes, etc., to prevent the epidemic in those regions."
Trying to persuade low- and middle-income countries to act based on data from elsewhere — for instance, saying "Your people are getting richer, so you're going to start to see these problems" — generally results in push back, says Anand. The response is: "Your information is not directly applicable to us."
"Now the beauty of this study is we have data from so many countries and communities that the local community and the country can use this information for health policy and planning," Anand says.
The study looked at a range of countries selected to represent income classifications delineated by the World Bank. Canada, Sweden and United Arab Emirates represent high income countries. Upper middle income countries include Argentina, Brazil, Chile, Poland, Turkey, South Africa and Malaysia. China, Colombia and Iran represent lower middle income countries. And India, Bangladesh, Pakistan and Zimbabwe make up the lower income nations.
The study shows patterns that are a cause of concern. As a country's wealth grows, its people start to acquire the poor health habits seen in wealthier countries.
"We used to think — and there's strong evidence showing that as you become more wealthy, your water supply improves, the food contamination decreases, so acute infectious disease improve with acquisition of wealth. But the risk factors for chronic diseases increase," Anand says.
"Although we all think that acquisition of wealth is good for a person, and actually improves their health, what we're seeing with those transitions from rural to urban in low income countries is that ... the diet starts to change in adverse ways. That people go from high physical activity jobs to more sedentary jobs."
"If we look at processed meats, we look at soft drink consumption, and fried foods, etc., they all go up in consumption when people gain wealth."