Dr Mauroof Athique | Ep #11 | Deconstructing South Asian predisposition to heart disease

us today he is one of the pioneers in bringing ayurveda to the uk and an influential figure in this space he is the director of the college of ayurveda and president of the british ayurvedic medical council he has almost 50 years of experience as an ayurvedic physician and a panchakarma specialist in the uk so i shall say no more and just go ahead and give a warm welcome to dr maruf atti thank you so much for coming on to our show dot if the podcast we’re super glad to have you here with us today thank you very much for inviting me for this discussion so i guess today we’re going to be talking about you know the cardiovascular and heart disease impact into the south asian community so i wanted to read a quote that said that according to a o report by 2020 south asians will comprise of 25 percent of the world’s population but will suffer over 50 percent of the world’s cardiovascular deaths so i think that’s like an incredibly alarming statistic to read and concerning actually do you think that like in terms of the cardiovascular health in the south asian community is it something that is prevalent in our genetics or is it something that you know is caused by the environment what is your take on this doctorate yeah no cardiovascular disease is one of the five biggest killer in the world and among high among the southeast asian can be related both to the genetic makeup of that community as well as the environment within which the community lives now the genetic makeup is only a very small element which is about five percent and the 95 percent is our lifestyle the way we interact the way it relates to things nutrition um and about exercise sleep patterns and all of these things are together we lump it as a lifestyle so now those are the environmental impacts now the genetic component is something that we can hardly change now the major cause that the southeast asian countries are with a very high rate of heart disease mortality is because they have gone through a massive change in their way of living and that change has impact mainly both in their genetic component and in their adaptation they have made a massive change in the way they consume their food in the way they relate to the environment so when you refer to change are you saying more about like the immigration so people who’ve like immigrated to a country that’s the change that you’re talking about that’s one of the major current changes but if you go evolutionarily and changes is when the conquests and the the country was taken over by foreign and these changes impacted more and then it sort of planted the seed right so that migration also puts an effort into our normal routines now that plays a major role in creating disorders or diseases right so everything that we take in for our sustenance for us to live we have to eat that’s our first most important component that we take in second we have to breathe so we take the environment in thirdly we have to interact with the environment we have to relate with the environment yeah now these three things are when we are born it’s all uh genetically determined so as we start living these changes creep into our system so our bodies constantly have to adjust and change and there is only a certain limit how much our body can change so if it exceeds that limit then there is a breakdown in like in anything so we kind of touch upon the environment but part so could you tell us about the difference between what we are born with versus the 95 percent you were talking about that is your environment how you eat the changes that that are around you the five percent is what you’re born with how would you qualify those things what is it from yes it is it is what we call the genetic makeup or the impressions that we get at the time of conception from both our parents now these gains are impressions which can be turned on or turned off due to environmental factors now these in modern science we call as epigenetics or these are switches which turns those and endowed genes with which we are born and that turning on and off if it is in a regular harmonious pattern then we sustain our lifestyle as we are the diseases which is prevalent for that particular region or country or things that that works out nature has a way of equalizing everything and so it’s basically nature is geared to preserve things not to destroy things it’s man who destroys it so when man acts against nature he it creates that sort of destructive influence even within himself now our body is never still every second thousands of interactions takes place yeah because cells change cells have to be repaired we are all constantly thinking we are breathing we are acting we are moving all of this requires energy energy is our transformation of food that we eat and the air we breathe the glucose from our carbohydrates go into our mitochondria the air we breathe in go into the mitochondria it produces the energy which is necessary for every single function in our body even thinking even when we are sleeping and that is what we call as basal metabolic rate we are using energy and then we are using energy is changing interaction that between the atp adp constant change when the constant change is occurring at a very very fast rate there is always reasons to for things to go wrong and if we don’t keep ourselves in harmony in balance now these things can accumulate our genes are made in such a way we have what we call repair genes in our body which can automatically repair any change damage occurring to these inscriptions so instructions information that allows things to happen within our body if we keep eating rubbish things that is polluted heavily processed too much of sugar too much as salt too much of fat now these are processed food every processed food has little preservatives which are not part of the normal food if you can take a vegetable from your garden or from a market it doesn’t have within itself any preservatives or additives or insecticides or pesticides unless we put it into them right right yeah but not part of the normal routine so these additional things are the one this causes the disruption that breakdown in our system so it’s first to clean up the way we eat our food there’s a lot of talk about vegetarianism or meat eating it’s not meat eating that is bad or good or vegetarianism is bad or good it’s everything that what your body needs had to be simple easy to digest and it easy to assimilate for the body to work with without much effort if you put additional things into that then the body has to do additional work and that will seem more energy now that is the sort of seed for any type of disease as you just mentioned i was a patient with a heart disease now i come from sri lanka which is southeast asian country yeah i came here i was about 25 26 now i have been here for the last 50 years so that’s that’s a long time a third of my country is in my birth country where my gene pool is and i come 93 percent from southeast asia and there is a little bit of variety from other mediterranean countries wow so i have a question dr you mentioned like genetic factors and environmental factors right and in the environmental factors if you had to break it down to some degree right as an overall umbrella what kind of environmental factors would contribute to enhancing or making your your pre-existing health condition worse or you know putting you in a position where it would be worse when i came to the uk i had no heart conditions i was perfectly a healthy specimen but the the stresses first is the nutritional stress my whole diet pattern changed right i was like burger kings and whichever i can get hold of i have no time i’ve been working very hard and things my whole uh routine changed and the second is the environmental impact is the stress that the change brings about when you come from an environment to another environment you have that initial adjustment now if you don’t manage your stress then the stress becomes disruptive because stress that is a very primitive reflex in everybody from our ancestors thousands of years ago it is the same effect like in a thousand two thousand years ago people were worried about the lions and the tigers in the jungle was going to kill them yeah yeah now other worry the stress is still there the same stress how we manage that stress is very important now there are a lot of techniques that we can use to do that now with meditation mindfulness yoga skills uh but you guys the whole philosophy of calming yourself your mind your outlook exercises just physical work what do you think makes southeast asian men more predisposed for heart diseases um one is the type of genes that cannot metabolize fat properly so that tends to allow the fat to accumulate and get lined along the arterial walls and causing atherosclerosis and hypertension high blood pressure now high blood pressure is the first symptom of a heart disease anybody who have high blood pressure or diabetes are at a high risk for heart disease or a stroke people are also on the obese side now obesity is a very big uh endemic massively taking place in all over the world and this way obesity is brought about mainly our change in our habit our lifestyle our eating patterns are changed we eat on the run um we don’t digest our food properly and if you remember if you look back at a time when we you always sit around the table always there’s a family meme and we don’t have that anymore so the whole habit has changed and unless these foods are digested eating is not enough it’s not what is on the plate that is important it’s what’s digested and absorbed into your bloodstream that’s where it counts but if we don’t give the time and the necessary space for that to happen so if you are always on the moon or not concentrating on the food we are eating yeah enzymes that is necessary to digest the food are not going to come in in proper quantities of proper quality and the digestion will tend to suffer yeah yep i think the culture is that we have to be fast-paced and i remember reading something where they said if you’re on the go and you’re eating it is one of the worst things you can cultivate as a habit because your body is correlating stress and food as the very foundation of how your body is going to process food so that really resonated with me it made me realize how my habits for the last like five years for example every morning rushing to the office in traffic i’ll be having like a sandwich that would be my breakfast rather than sitting and eating like at the time consciously yeah yeah be mindful of the practice it’s how we consume are we giving that sandwich to be digested we are sort of doing two or three things at a time so our body is not geared to do two three things at a time and you briefly mentioned that you’ve experienced some of those those changes as well and you’ve experienced yourself a heart a heart disease as well um i started getting my blood pressure going up and also we have asthma within the family so when i went to the gp they thought it must be asthma right because whenever they did my cardiovascular ecg they said oh it is normal your breathing difficulties and your tiredness is related to your asthma so i was in bronchodilators so you noticed that your blood pressure was rising that already on its own how did you recognize that were you already monitoring yourself no first i was having headaches right i was feeling tired i was having headaches and then i went to have my checkup done okay initially i didn’t pay much attention i just thought oh it’s stress and i did some yoga or meditation and then saw a snow was very good i used to practice my almost every day is a technique where you um tense your body and let go so you calm yourself you increase your parasympathetic nervous system we have two nervous systems within our body which are automatic which regulates everything that we do apart from our central nervous system which is voluntary these are involved in treatment and they have two one is a stimulator one is a relaxant the stimulator is the flight and white syndrome which is a protective mechanism um which keeps us alert all of the time so we are worried about the tiger behind us it keeps us ready for either to fight or to fly fly or to freeze now the other one is relax and digest and so also we have um it’s nurturing it nurtures our body it really allows us to regenerate recuperate now that is controlled by the parasympathetic nervous system or the vagus nerve which controls every single activity that goes on in the body and it regulates it’s that one so by deep breathing we stimulate the parasympathetic nervous system you will always see when you are stressed your breathing becomes very shallow it’s very rapid right so shallow breathing is of no use that’s like a coat that we need to use shallow breathing is of no use because like even if you think about it in another way shallow means also like without meaning or fast-paced breathing has no use it applies for all facets of your life shallow is not necessarily the best because when we breathe in the air has to go right into our alveoli which are the smaller breathing tubes where air exchange can take place so we need to really push our air down and that’s what we do when you do deep breathing or in pranayama which is what we call diaphragmatic breathing i mean these techniques have been there for years and years for centuries but now science is rediscovering it and renaming it validating ancient rishis or sages so so deep breathing is a very essential part a lot of us if we look at them they’re just breathers we need to breathe from our stomach even if we have to do five minutes that’s fine that’s good at least something is better than nothing you have to change slowly every time every day by little you cannot do a massive change change is something nobody can do uh all of a sudden so that is that approach we need to use and try and change our habits slowly dr would it be bold for me to say that um with this this kind of concept for for shallow breathing right um for me i feel like it’s a direct link to cardiovascular health issues because if they’re not doing this on a regular basis that means they’re storing all this stress which is contributing to the impact of how their heart is is operating for their body it would it be accurate to say that oh yeah certainly there is it is the stresses which accumulates in our body makes disease worse but when we deep breathe body gets rid of the excess fat which is accumulating so for that blood pressure to go up so you’ve not been practicing that you’re a younger day you’re too busy do all that i do a little bit of my meditation that’s useful but then there was no choice when it came to our situation when there are structural changes you have to go for chemical medicine you have to go to take western medicine your lifestyle changes are not going to change acute conditions if you are in acute pain go and see the doctor after that when your pain has abated then rethink of your lifestyle of the way or what you eat how much is right you’re taking how much of exercise so it’s what we say is prevention is better than intervention so it’s interesting to it’s interesting to see how you make that parallel between modern or western medicine as like a chemical medicine right because what basically you’ve been saying is that for blood pressure to be regulated you needed you know a pill you needed modern medicine to intervene because it was it was acute it was immediate and you needed that as like somewhat of an emergency but then once that is regulated you you want to go and see kind of how you lead your life and what are the things you overlooked for you to get to that situation um so it started with headaches you saw your blood pressure was high and what did you do afterwards yeah the blood pressure was high and then we went to the gp he wanted to put me on blood pressure medication i was a bit reluctant i was not a fan of chemical medicine really maybe my fault i sort of neglected the factors that contributed to the rising blood pressure and causing cholesterol being deposited in the blood vessels that went on and then i had these after the blood pressure i had difficulty in exertion when i get tired very quickly when i walk a big long distance so when i climbed up a hill i had to stay for a little while catch my breath and when i went to the doctors they they did an ecg but the ecg looked normal so they attributed that to my history of asthma within the family so i was treated for asthma and then once we used to go on holidays back to sri lanka at least once a year or even so one of these times my wife and i we said okay let’s do a health check yeah and then we went and had a health check in one of the hospitals over there which is a good one and they discovered that my blood pressure was too high and have a look at the heart and then put me on the treadmill this they didn’t never did that to me in the uk so i went on the treadmill and i collapsed wow and they had to resuscitate me and then he did an angiogram and on the angiogram he said you got four of your blood vessels supplying blood to your heart is blocked you need to very quickly do something about it either a stent or an angiography oh you’re not going to survive i said no they wanted to do it they are in sri lanka itself so i said no i had to go back i had to consult my family and everything so when i came back and within two months i had my angiogram all my blood vessels also replaced and now it’s it was surprising it’s interesting how you’re the one who had to bring it up to your gp but i think that it’s potentially highlighting the fact that um kind of those predisposition or those um patterns in terms of sicknesses for different ethnic backgrounds where when you’re going to see your gp potentially he or she is trained in you know the uk system so they recognize the patterns that are more prevalent in their region and so potentially for caucasians this is not something that is something that they learn to recognize and so it’s only when you were back in sri lanka where you know this is quite common and yeah that’s very important point to see because you see you had to treat the whole person right you’re just treating the parts of a person no use treating because i feel tired or my breathing is not good so look at the lungs it has to become the whole thing how i live how i move about how i eat what stresses i have what how i relate to the the rest of the environment what pollutions are around me what food i eat all these are equally important i mean 20 30 years ago gps did that gps knew everybody within the family we had a really a family doctor he go to your medication he will ask our house your parents and obviously your brothers and sisters see that nowadays the systems have all changed it is not time we can’t blame anyone it’s because it is as we go up more and more we are aware of more disorders when most of the people who go to the gps can do with some advice lifestyle changes and things not use the gps time where the deepest time can be used for other important uh areas so now they sort of ration uh the way you have only 15 minutes with the gp and you can only treat one complaint it’s so interesting how it’s evolved like over i guess the last few decades and how life has changed completely because a large part of this is also like capitalism right the fact that it’s so busy that doctors cannot like attribute that more than 15 minutes to patient and i guess in that sense we should really have a more preventive uh proactive approach to our health and looking at like the multiple means or methods to be able to like manage our health outside of just like western medicine right yeah this is most important the whole training process is to quickly identify diagnose and then give a pill so we know what we have in the gp is a pill to a needle you complain a headache you get a tablet you complain knee pain you get another tablet so you end up with a bag full of tablets yeah it’s so true but instead of that if we look at the whole person and focus more on illness prevention or health promotion and that is what is more lacking in our national health system and how did you use natural kind of preventive uh ways to go about your health for heart disease yeah yeah because um in an acute state and the immediate attend condition when i saw things were going wrong for me i had to do surgery right after surgery i had to think back the way i am living my lifestyle the diet i take i’m taking eating too much fat or too much sugar too much salt and these things attribute to oh our meeting made more refined food so i had to go back to like whole meal uh brown bread rice i mean it’s no harm anything we haven’t we don’t take enough fiber within our fiber is very important to regulate the gut health and also to maintain our microbiome our long history of having antibiotics have changed a lot of people’s gut bacteria right now the gut bacteria is very very important for our health because there is a symbiotic uh relationship with our bacteria then we feed them and they do some uh useful work for us where the body cannot do by giving antibiotics we kill we wipe out all those gut bacteria the good ones yeah and doctor did you use ayurveda to help you manage your health after your surgery i used both medicines chemical medicines as well as ayurvedic medicine but uh one thing is you should not mix the two together because they have different functions there are different rates of absorption then one will interfere with the other i use right as a preventative medicine and chemical medicine has something for acute care which is needed for that time to manage that situation once we’ve got that under control next step we need to think is how can we keep it down and prevent it getting any further or causing more damage or more risk and this is where then you need to think of your food you need to think of your lifestyle and how you manage your cope with your stress also social relationships are very very useful we are getting more and more isolated much right so social interaction is very very important oh having a pet is a a good way to interact opens a new dimension of conversation and and just interaction like it’s literally food for your soul coming back to the that concept of body mind connection so what would what would you say would be like three key takeaways for people who are either predisposed or you know might be in that situation uh who already are being regulated through western medicine um with heart disease take some time out for yourself right relax a little st sit back give at least 5-10 minutes to de-stress meditate or do some yoga or even exercise and look at your nutrition what you put into yourself are you putting wholesome food or are you putting processed food um but it’s how much we eat when we eat and this is more important than what we eat we may eat the best food but if that food is not properly digested and absorbed and that is going to waste and so concentrate on your diet to breathing and and food and and what would be the last one that you would recommend for people love laughter enough as much as you can that’s so sweet but it’s true it’s true it’s exercise when you laugh you get about 10 or 20 muscles that exercise in your face when you don’t laugh you don’t exercise any of them when you when you laugh it creates a lightness in your mind when you’re sad you can’t laugh yeah so it’s getting to with people interaction social interaction develop a group talk to people yeah we can laugh and have fun keep safe stay healthy be happy listen amazing thank you so much yeah that’s so sweet and it’s yeah it’s a holistic way of living life get back to your roots yeah thank you thank you for that if you enjoyed this episode go ahead and select that follow or subscribe button for now stay safe and we’ll see you next week