Dr P P Joshi says“Healthy lifestyle can reduce the risk of diabetes, heart ailment, strokes”

Dr Joshi's study INTERHEART published in Journal of American Medical Association revealed


By Vikas Vaidya

Indians can prevent and escape from non-communicable diseases like heart attacks, paralytic stroke, cancers, diabetes and high blood pressure  by changing their lifestyles. For example, healthy eating habits and increased physical activity alone can reduce the risk of developing diabetes by 58%, reduce the risk of developing high blood pressure by 66%, and reduce the risk of developing heart attacks and strokes by 40-60%. One-thirds of cancers too can be prevented by embracing a healthy diet, decreasing saturated fats in the diet, increasing consumption of fruits and vegetables and increasing physical activity level.
This has been revealed by a research paper of Dr P P Joshi, Head, Department of Medicine, Indira Gandhi Government Medical College and Hospital, Nagpur. The research paper INTERHEART south Asia study published in the prestigious Journal of American Medical Association (JAMA), with Dr PP Joshi as the first lead author. The INTERHEART INTERHEART is a global study of risk factors for heart attack, conducted in 272 centres from 52 countries in all inhabited continents, with a massive sample size consisting of more than 15000 cases of first attacks and an equal number of controls.
The study showed that 9 potentially modifiable and easily measurable risk factors explain more than 90% of the risk of heart attacks globally as well as in India. India is experiencing an accelerating epidemic of heart attacks at a younger age. Indians suffer  from heart attacks about a decade earlier than other countries. Similarly, deaths due to heart attacks also occur a decade earlier in Indians as compared to western countries.
This study showed that these lifestyle factors and not genetics are responsible for the escalating epidemic of heart attacks in India. All forms of tobacco use were found to be harmful. No type of tobacco is safe, use of any type is associated with an increased risk of heart attack, in addition to causing cancers and lung diseases. Indians eat fewer fruits and vegetables, (despite vegetarianism common in India; Prolonged cooking common in Indian households destroys 90% of the good folate), exercise less, have greater abdominal obesity, and Diabetes. Only 6% of Indians were involved in moderate intensity exercise daily. The average intake of fruits in Indians is 13o gms/day as against the daily WHO recommended intake of 400-500 gms/day. The study also showed that abdominal obesity is more dangerous than generalized obesity (measured by body mass index) in causing heart attack.  Stress and mental tension was found to be an important contributor to heart attacks. This is the largest Study in native Indians and the first to compare data across 5 South Asian countries of India, Pakistan, Bangladesh, Srilanka and Nepal.  Alcohol intake in Indians was associated with higher risk in Indians (while it was protective in western countries), for which binge drinking of hard liquor common in Indians is responsible.
Dr Joshi and colleagues in an article in a prestigious medical journal “The Lancet”  has have also clearly demonstrated that, contrary to popular belief, the heart attack epidemic in Indians is not confined to the rich but, in fact, is equally common in the poor and the uneducated Indians.
The escalating non-communicable disease epidemic (like heart attacks, strokes, cancers, diabetes, high blood pressure) is clearly driven by the above lifestyle risk factors which have increased steeply over the past 3 decades in India. Dr PP Joshi along with others have also demonstrated, in a WHO sponsored study,  published  in the prestigious Journal of American College of Cardiologists (JACC) that a comprehensive risk factor reduction package significantly reduced lifestyle risk factors over a 5 year period in an Indian Industrial setting. National interventions such as increasing tobacco taxes, labelling unhealthy foods and trans fats, reduction of salt in processed foods and better urban design to promote physical activity will help to control the heart attack epidemic.

Dr PP Joshi to present his original
research at APICON 14

Dr Joshi will be delivering his talk on “Life-style factors in Non-communicable Diseases in India – Lessons from the INTERHEART study” the 69th Annual Conference of Association of Physicians of India -APICON 14 – a national conference of physicians to be held at Ludhiana, Punjab. He is the only physician from Nagpur to be invited as a guest speaker for the conference.