New Delhi: In a world increasingly grappling with the challenges of rising rates of obesity, a stark reality is coming to light: deaths related to obesity-related heart disease are climbing at an alarming pace, particularly among young men. Recent American research suggests a three-times increase in ischemic heart disease deaths linked to obesity in the United States in the last 20 years. This crisis is mirrored in India, where lifestyle changes, urbanization, and dietary habits are fuelling a similar epidemic.
Dr. Aparna Govil Bhasker, Consultant Bariatric and Laparoscopic Surgeon, MetaHeal – Laparoscopy and Bariatric Surgery Center, Mumbai; Saifee, Apollo, and Namaha Hospitals, Mumbai, spoke about how obesity could be contributing to heart diseases in young men.
The Growing Burden of Obesity-Related Heart Disease
Obesity has long been recognized as a major risk factor for ischemic heart disease, but recent studies reveal the situation is worsening. In the U.S., the rate of deaths from obesity-related ischemic heart disease increased by 180% between 1999 and 2020. Young men are particularly vulnerable, with deaths in men aged 55 to 64 years climbing by 165%. While these figures are from the West, the trajectory in India is similarly concerning. Changing lifestyles, increased consumption of calorie-dense foods, declining physical activity, and increased stress levels are creating fertile ground for an obesity epidemic among Indian men.
In India, the National Family Health Survey (NFHS) 2019-21 indicates that obesity prevalence among men has nearly doubled over the past decade. These trends are contributing to an escalating burden of heart disease, now the leading cause of death in the country.
Heart disease is a bigger concern for Indians, as they face a higher risk, develop it at a younger age, and have more severe outcomes. Compared to the Western population, Indians tend to experience heart-related issues about 10 years earlier and thus tend to die sooner.
Why Are Young Men at Greater Risk?
Studies show that middle-aged men have noticeably higher death rates from obesity and heart disease compared to women. In the US, men’s rates rose from 2.1 deaths per 100,000 people in 1999 to 7.2 in 2020—a 243% increase. This phenomenon can be attributed to biological, social, and behavioural factors:
- Lifestyle and Behavioural Patterns: The present generation of young men are more likely to lead sedentary lives, consume processed and high-fat foods, have higher stress levels, and skip regular health check-ups. Men are also more likely to smoke or consume alcohol.
- Higher Visceral Fat: Men tend to accumulate fat in the abdominal region (central obesity), which is more metabolically active and is linked to a higher risk of ischemic heart disease. Insulin resistance plays a key role in the development of heart disease and acts as a link between obesity and heart problems.
- Hormonal factors: In women of the reproductive age group, estrogen has a protective role against heart disease by improving blood vessel function and maintaining healthy cholesterol levels.
- Stress and Workload: Increased work-related stress, combined with poor coping mechanisms, can contribute to unhealthy eating patterns and insufficient exercise.
- Lack of Awareness: Awareness about obesity’s impact on heart health is lower, leading to delayed interventions.
The Role of Racial and Regional Disparities
The U.S. study found striking disparities in obesity-related heart disease mortality based on race and geography. Similarly, in India, disparities exist across socioeconomic and regional lines. Urban men often face obesity driven by sedentary lifestyles and dietary choices, while rural populations grapple with limited access to healthcare and awareness programs. In India, access to cardiology care is also heavily skewed toward cities and towns, leaving rural populations underserved.
The Underestimated Impact of Obesity
The true impact of obesity-related ischemic heart disease may be even greater than reported. Many young men may already be living with undiagnosed or poorly managed cardiovascular conditions. Additionally, factors such as income, education, and healthcare access—key determinants of health—often hinder effective weight management and early detection of heart disease in India. This suggests that the scope of the crisis is larger than what is currently documented.
What Can Be Done?
Addressing obesity-related heart disease requires a multi-pronged approach that includes individual, societal, and medical interventions. Recommendations that resonate strongly in the Indian context include:
- Adopting a Healthier Diet: Indian diets are often high in carbohydrates and fats. Shifting toward whole grains, lean proteins, and plenty of fruits and vegetables can make a significant difference.
- Incorporate Regular Exercise: Engage in at least 45 minutes of physical activity daily—whether through walking, gym workouts, or sports—can help maintain a healthy weight.
- Health Screenings and Monitoring: Regular check-ups, including monitoring weight, cholesterol, blood pressure, and blood sugar levels, are crucial in early detection and management.
- Public Awareness Campaigns: Educating young people about the risks of obesity and its link to heart disease through targeted campaigns can drive behavioural change.
- Policy Interventions: Governments should prioritize obesity prevention through initiatives like promoting healthier food options, regulating junk food advertising, and ensuring better access to healthcare in underserved areas.
- Comprehensive Treatment Options: Effective management of obesity includes not only lifestyle and dietary changes but also medical treatments and surgical interventions where appropriate. Weight loss medications or bariatric surgery, for instance, can be a life-changing solution for many, particularly those living with severe obesity or related health complications.
The Call to Action
The sharp increase in obesity-related heart disease mortality among young men is a wake-up call for India. Public health interventions must address both individual behaviours and systemic barriers to ensure that we have the tools and support needed to lead healthier lives. Addressing this crisis requires a collective effort. Families, communities, healthcare professionals, and policymakers must work together to foster environments that support healthier lifestyles.
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