Coronary heart disease prevention in Kolkata,India

Abstract

Studies have shown that Asian Indians, both in India and the UK, have a high prevalence of coronary heart disease (CHD). A diet rich in saturated fats and a sedentary lifestyle are contributory factors. There is published data recommending dietary change as one measure for primary prevention of CHD in India.

The aims of the study were to:

• Investigate patients’ understanding and awareness of dietary measures in the prevention of CHD

• Advise patients on how to modify their diet, taking into consideration religious and financial constraints

• Provide some answers to the questions which patients often have about CHD and its prevention.

The project was carried out at the R G Kar Hospital, a government hospital in north Kolkata (formally Calcutta), West Bengal, in eastern India and at a general practice six kilometres south of the hospital. Patients admitted with angina, myocardial infarction, elevated serum cholesterol or a past medical history of diabetes mellitus or ischaemic heart disease, were identified. A questionnaire was devised containing a list of foods commonly used by those on Bengali food. Patients were asked to mark on the list, or report verbally, those they felt were suitable for them to eat. They were also asked about their daily food intake and advised as to how their diet could be modified.

At the hospital, 28 subjects were interviewed. Of the responses relating to identification of suitable foods 48% were found to be correct; of the responses identifying unsuitable foods 39% were correct. In general practice, 62 subjects were interviewed; 50% of the responses identifying suitable foods were correct whereas 60% of the responses identifying unsuitable foods were correct.

The study showed that there is a need for further patient education regarding the effects of diet on the heart. The study was of greater use in the general practice setting, which caters for a middle class population; this group is at greater risk of CHD due to their food habits and lifestyle. Lower classes are, however, also at risk but are less likely to consume many of the unhealthy foods simply on account of their higher price.