We need to focus on loving and listening to our bodies when it comes to our diet

In the U.S., diet culture began in the early 1900s and has since accumulated an exhaustive list of different dieting fads for people to attemptcleanses, low-carb, ketogenic, paleo, etc. Companies like Atkins and Weight Watchers have made a profit by supporting the narrative that people need to lose weight in order to love themselves and to be considered healthy. Although these programs are not as popular as they once were, new diet trends that engender the same narrative have taken their place.

A-list celebrities, popular magazines and social media influencers are at the top of the list for promoting these diet trends. By just posting pictures of their meals or grocery hauls, they influence thousands of people to start a diet they know nothing about. I, myself, have fallen into this trap before, just to quickly find out that I do not have the resources nor the education to be making these decisions about the food I eat.

More importantly, what works for one person, doesnt always work for everyone else. All bodies are different and therefore require different foods and methods for losing weight. Consequently, most diets arent tailored to individual needsa potential reason why some people see progress and others do not while on the same diet.

Generally, people arent quick to share the negative outcomes or hardships we experience day-to-day. Instead, we tend to use social media to highlight the favorable and positive aspects of our lives. In regards to dieting, its more pleasing to show the successful results rather than the struggles and lack of progress. Sadly, this generates the idea that certain diets are easy and accessible for everyone.

Self-control and deprivation are the two pillars of dieting. Diets require you to exercise self-control in order to deprive yourself of certain foods, and thereby satisfaction, depending on the rules of your diet. In reality, not all days can be good ones, and a quick mood fixing solution is the comfort food that tends to exist outside the bounds of our diet. Thus, the purpose of a cheat day. The name itself, however, carries a negative connotation thats intended to make us feel guilty for defying the rules of our diet. Its inherently dangerous to not only deprive ourselves of the foods we may actually need, but also to deprive ourselves of something that may bring us happiness.

Although weight loss goals originally intended to motivate us to stay on track with our diet, setting them poses a threat to our well-being. Setting unrealistic and unattainable goals leads to disappointment and, more dangerously, unhealthy eating habits. Losing weight does not happen overnight, making it hard to stay inspired. As a consequence, people may lose hope and develop disordered eating habits.

This does not mean dieting is always ineffective and bad. In fact, many people have success stories. But its important to note that dieting and depriving yourself of certain foods is not the only way to become healthy. Listening to your body, tuning in to your emotions and being rational about the food you eat is a much more substantial way to live. Intuitive eating is not a diet plan, rather it pushes you to reject the diet mentality altogether.

For far too long, diet culture has convinced us that our bodies arent good enough or that we need to change ourselves to appease societys unrealistic standards. Rather than measuring our self-worth against the superficial wellness represented in movies, television and on social media, the focus needs to be switched from losing weight to loving and listening to our bodies.

Written by: Kacey Cain klcain@ucdavis.edu

Disclaimer: The views and opinions expressed by individual columnists belong to the columnists alone and do not necessarily indicate the views and opinions held by The California Aggie

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Strict diets can deprive us of our happiness and health - The Aggie

Mila Clarke Buckleylived with atype 2 diabetes diagnosisfor four years before learning in August 2020 that she actually had another type of diabetes: latent autoimmune diabetes in adults (LADA). She wants people to know that adiabetes-friendly dietdoesnt have to be boring or leave one feeling hangry(a state of irritability that can result from a dip in blood glucose).

Thats why she shares such delectable images with her 37,000Instagramfollowers and visitors to her Hangry Woman blog. Her recipe posts forgrilled fish tacosandJamaican jerk chicken wingsare accompanied by mouthwatering photos.

Type 2 diabetes results when the body cannot properly processinsulin, causingblood sugar (glucose) to rise too high. LADA, on the other hand, is an autoimmune disease that is similar totype 1 diabetes, in which the bodys immune system attacks and destroys the cells that make insulin which is why its also known astype 1.5 diabetes. LADA tends to happen later in life and much more gradually than type 1 diabetes.

People with any form of diabetes can experience blood sugar dips that produce that hangry feeling, also known ashypoglycemia. But rather than coming off as irritable, Buckley, a Houston resident, has a gregarious persona to match her blogs mission, which she says is to help people with diabetes feel less alone in their managementbut to alsoshow them that you can live a happy,healthy life with diabetes and enjoyyour favorite foods.

She says her new diagnosis wont change that mission. I lived with a type 2diabetes diagnosisfor four years that includes the feeling of shame, stigma, and being judged for what other people deemed my fault, and lack of access to the tools that would help me manage diabetes best. Although my [diagnosis] changed, it doesnt take away any of those experiences, and it doesnt mean that I experience them less. To me, it means having the opportunity to bridge the gap a bit more, and help all people with diabetes understand each other.

Buckley includes recipes for those who follow aketogenic or keto diet, but before you try them, check with your doctor to make sure the regimen is right for you. If you takeoral diabetes medication, the diet may increase yourrisk of hypoglycemia, andthis high-fat, low-carb diet can pose other health risksto some. Plus, more studies are needed before keto can be recommended for everyone with type 2 diabetes.

Buckleys personal favorite blog post is titled, Diabetes Is Not a Joke, and it takes aim at the stigma that can be attached to the disease because of its link to diet. People often think diabetes deserves to be a punch line, but its more serious than the jokes it often sets off, she says.

RELATED:What People With Type 2 Diabetes Must Know About the Keto Diet

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A new study published in Science offers a stark warning about the climate crisis: Even if we completely halted fossil fuel use in the near term, we would still blow through the carbon budget needed to avoid catastrophic climate change unless we change the trajectory of emissions from the global food sector. Although many have warned about the climate impact of modern food production and land use, this new science is soberingly clear, and it has garnered attention around the world.

Without radically reducing emissions from agriculture, the research shows we wont meet the Paris Agreements goal to limit average warming to 1.5C 2C degrees. And yet, even those targets still position us to face some pretty extreme climate impacts.

Civil Eats talked with Michael Clark, a researcher at the Nuffield Department of Population Health at the University of Oxford and one of the lead authors on the study, about the findings, what they teach us about collective action to move the needle on climate, and how we might build the political will to do so.

Why does the food system have such a big climate toll?

One of the main sources of greenhouse gas emissions from food systems is meat, and within that red meat from ruminants: beef, sheep, goats, andto a lesser extentother livestock like pork. The reason why ruminants have a relatively large impact is two-fold: Theyre particularly inefficient at converting grass into things we can eat; or, if theyre not being fed grass, converting soy or other feed into food for humans. This matters because you have to include the climate impacts of producing the feed we then give to cows and other ruminants. Another reason why ruminants are particularly high emitters is because during their digestive process, they convert their food into methane, a potent greenhouse gas that they then burp.

The other large source of emissions within food systems is from fertilizer usefrom how it is processed to emissions from application. Nitrogen naturally converts into nitrous oxide, which is one of the other very potent greenhouse gases.

This I think has been a blind spot. Weve disrupted the carbon cycle, but weve disrupted the nitrogen cycle, too.Exactly. Estimates are that humans have doubled the amount of reactive nitrogen in the worldthat is human sources of reactive nitrogen are at least as large as the amount of reactive nitrogen that is naturally available. Not ideal.

Your findings paint a picture based on current trends. What trends did you track?

Very broadly speaking, emissions from the food system are a function of what we eat, how its produced, and the size of the population. We looked at these three factors and trends to date and projected out if these patterns continue over the next several decades.

What we found at a global scale is that the most important driver is changes in dietary habits; populations eating more food and eating a larger proportion of that food from animal sources, either meat, dairy, or eggs. Population growth is an important driver, but its not as important as dietary habit change. And while changes in food productionlike having better management techniques and reducing emissions per unit of foodcould counter those shifts, it would not be by a huge amount.

Now, all this is at a global scale; for any single country, that global pattern may not match up. Diets are changing, but not uniformly. For instance, diets are not changing by a huge amount in the United States, but if you go to a place like China or Brazil, countries experiencing large economic transitions, there are massive dietary shifts happening and with them those emissions are going to be driven up.

Do you feel the story of food systems emissions has been late to the game in climate change?

Rightfully, a lot of the effort, focus, and political will has targeted emissions abatement through fossil fuels. That makes a huge amount of sense. But were getting better knowledge about the impact food has had on the environmentand the trajectory of emissionsand starting to see, thankfully, food becoming a bigger part of the conversation.

Talk about some of the main levers for change. First, plant-rich diets: Lets get into what you mean by that and why this diet shift makes a difference.

We mean a reduction in meat, dairy, and eggs and an increase in fruits, vegetables, whole grains, nuts, legumes, and so on. Whats critical here is that while the endpoint is similar for everyone in the world, the direction you might need to go to get there will be really different. In the United States, for instance, this shift in diets might mean a typical person eating much less meat and much more fruits and vegetables. The second thing I really want to stress is that these plant-rich diets are associated with pretty large increases in health outcomes. While for this paper we focused on climate, plant-rich diets have enormous co-benefits.

Lets talk about another lever for reducing food system emissions; what you and your co-authors call healthy calories.

Approximately half the global adult population is eating too much or not enough. In certain countries the figures are even more extreme. For my co-authors and me, the healthy diet lever meansindependent of a plant-rich dietwhat proportion of calories are coming from fruit, vegetables, and other healthy sources of calories. We know that so many people are not getting the right amounts of food for a healthy diet. Similar to the plant-rich lever, this means in some places, eating a lot less, in other places, it will mean people eating more [healthy foods].

Food waste has gotten a lot more attention in the past few yearsin part, I think, because the percent of food that is wasted is so high and because addressing food waste feels so doable.

Yes, its pretty shocking: About one-third of all food that is produced remains uneaten, ether because its thrown away, rots, or otherwise doesnt get to the people who want to eat it. The sources differ widely by country, sometimes its a lack of refrigeration, lack of storage, grain silos, and so on. In the United States, a family of four wastes on average $1,600 worth of produce a year. Thats a pretty big incentive to act.

It always surprises people that if the emissions associated with food loss were a country, it would be the third largest emitter in the world.

Lets talk about what you are seeing in terms of policy responses.

One of the joys and complications of working on a global study is that the policy responses are going to look very different wherever you are. We talked earlier about the climate impacts of nitrogen fertilizer use. One policy that has really been effective has been the 1991 European Union Nitrates Directive. Now, when it was passed, it was designed to reduce nitrogen runoff because agricultural sources of runoff were one of the main causes of water pollution in Europe. Since then, fertilizer applications per hectare have decreased by about half, yet crop yields have continued to increase as they were before. Its just one example of a relatively large geographically scaled policy that is working. While it wasnt specifically designed to address emissions, it most certainly has had emissions benefits.

We can look at farmers choosing different production pathways. Like in some cases adding more crop rotations into their planning or using agroecological approaches, such as planting hedgerows, agroforestry, and more. Honestly, there really is a huge amount that can be done. But its important to stress that no single action is going to solve the problem.

One of the big food-climate debates is about soil carbon sequestration and livestock. What do you think about those who argue for livestocks ability to rehabilitate soils?

We know for sure we can be doing a lot better in terms of soil carbon storage. And we are seeing incredible results from a range of strategies, like some I mentioned: planting cover crops, intercropping, and silvopasture, planting hedges between fields that can prevent soil lossand more. All of these can help sequester more carbon in the soil, but I think the key message should be: Soil carbon sequestration is part of the solution, but it isnt the only solution.

Now, for the debate about cows! The instances where Ive seen cows or other ruminants potential to be net negative in terms of greenhouse gas emissionsafter accounting for methane emissionsis over short timescales, in certain conditions, on previously degraded land. So, yes, it may be possible for cows to play a helpful role, but in a limited way. How the cows are raised matters; but how many cows youre raising matters more.

Do you feel like any parts of your paper have been misunderstood as this complex story gets translated for the general public?

I actually think the coverage has been good. There are basically three main points and I think the media has been capturing them well: One, food matters to climate and if we continue eating the way we are, it will result in catastrophic climate change; two, there is a lot we can do; third, everyone has a role to playconsumers, businesses, food processors, everyone.

I know one question those who work on climate often gets asked is, Are you optimistic or pessimistic?but, I feel I should ask the same of you.

Im laughing because its an uncomfortable question to answer. We are starting to move in the right direction, but honestly, were not moving anywhere close to as fast as we need to. We need to start acting now. It would have been great to have made these changes years ago, but we didnt.

Right. As they say, the best time to plant a tree was 10 years ago. The second best time is today.

Exactly.

This interview has been edited for length and clarity.

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New Research Confirms What We Eat Is Central to the Climate Crisis - Civil Eats

The facts are clear: our food system isnt working as well as it should be for people or planet.

Too many people are going hungry whilst too much food is going to waste. Too many of us are not consuming a balanced diet and too much of the food we eat contributes to greenhouse gas emissions. When I look to the future challenges our children will be facing, it brings it home how much we need to do together to lead for change.

We all know the global food system is unsustainable and unless the average persons diet changes drastically by 2050, we are in danger of depleting the planet. The statistics are sobering: one billion people around the worldare hungry;two billion are obese or overweight; one third of all food produced is thrown away and animal agriculture is the second-largest contributor to greenhouse gas emissions.

We need to move even faster as an industry to build a system which recognises a better for you, better for the planet approach. As part of our new global food strategy, Future Foods, we have two clear objectives: to help people move towards healthier diets and to reduce the environmental impact of our global food chain. We are actioning this by setting ourselves a 1bn sales target for plant-based meat and dairy alternatives in the next five to seven years, raising nutritional standards across our brands and halving food waste in our direct operations by 2025.

These ambitions are grounded in the ethos of our business. In the UK we already have ambitious shared commitments on food waste and carbon reduction as part of the 2025 Courtauld Commitments. Weve also been expanding our plant-based meat and dairy alternatives business for several years, as well as increasing vegan alternatives from our brands.

As a responsible manufacturer, its not only about reducing our impact on the planet and tackling food waste, its about driving healthier choices for people. We understand the urgency with which we need to tackle these issues, and while we cant tell people what to eat, we can offer tastier, healthier and more sustainable foods to choose from.

We are committed to reformulating our products to reduce sugar, salt and calories, as well as reducing portion sizes and creating healthier options. However, its not just about the products we sell, its the way we market them which will help us with this ambition. Simply put, shoppers need to learn about healthier options through advertising and promotions. Thats why we have committed that before the end of 2021 we will also include the healthier version of our core product alongside the core in all of our food and refreshment advertising here in the UK. Were all creatures of habit and we need to be able to inspire and engage in order to get people to try something new.

We absolutely share the governments ambition to tackle the obesity crisis. There is of course a role for regulation, but it needs to be evidence-based, proportionate and have a demonstrable impact on positive outcomes for consumers. Crucially, it needs to provide incentives for manufacturers to invest resources into innovation at a time when this is more important than ever. This incentive is removed if were unable to advertise and promote the vast majority of our reformulated or healthier products, which are included in the governments proposed ban on online advertising and in-store promotions of high fat, salt and sugar foods.

Innovation and renovation is the life-blood of our industry and is fundamental to the positive changes we, as manufacturers, can all lead for. We want to continue to make improvements to our products, tell people about those products and empower people to make responsible choices. We want to use our world-class insight and understanding of our consumers to drive positive behaviour change and encourage people to eat healthier diets.

But more broadly, we want to work hand in hand with retailers, manufacturers, NGOs and government to ensure the UK food ecosystem is more sustainable. We hope these stretching global targets mean Unilever can play a meaningful part in making that happen.

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Despite the fact that women tend to outlive men in almost all societies, they experience more sickness along the way. This so-called gender-health paradox has long puzzled researchers. Biological differences between the sexes females higher body fat percentage, for example are often presumed to be the reason women are subject to a higher burden of chronic disease. But, as COVID-19s disproportionate effect on womens employment and productivity has made plain, women experience different and often compounding stressors, which can contribute to poorer health.

A new study published in the Proceedings of the National Academy of Sciences points to gender norms as a primary cause of health disparities between men and women. Researchers working among the Mosuo, a minority society in Southwest China, compared communities with two different sets of expectations for household membership and inheritance (called kinship norms).

Siobhn Mattison, assistant professor of Anthropology at The University of New Mexico and director of the Human Family and Evolutionary Demography Lab is the research team leader and has been working in China with the Mosuo since 2016.

Evolutionary Anthropology graduate student Adam Reynolds is the first author of this study, participated in fieldwork in China, and has led numerous analyses, including for this study, to understand how kinship systems affect social and well-being outcomes.

Matrilineal Mosuo typically pass land, home, and wealth from mothers to daughters, who form the backbone of society, with men in more peripheral roles. Patrilineal Mosuo typically pass inheritance from fathers to sons. Because of this, in matrilineal Mosuo communities, women tend to have more autonomy and control of resources. Language, religion, and other cultural beliefs and practices are largely similar across matrilineal and patrilineal Mosuo communities, which makes these factors unlikely explanations of observed differences in health between these communities.

Our work shows that in cultures with norms that favor men, women may have worse health because they experience more stress or adversity than men do.

- Adam Reynolds, Evolutionary Anthropology graduate student

As part of a larger National Science Foundation-funded project, the research brought together an interdisciplinary team of anthropologists, biologists, and demographers from US and Chinese universities to study the impacts of economic change on health and well-being. During two years of data collection, the researchers visited hundreds of Mosuo households in Yunnan Province, interviewing people about their socio-economic circumstances and using blood drawn from finger-pricks as a minimally-invasive method to study participants health.

The researchers leveraged their interdisciplinary expertise to test an old, but under-tested hypothesis that women experience improved health in cultures where they enjoy higher status and empowerment. When the research team, including first author Reynolds, a graduate student of the University of New Mexicos Human Family and Evolutionary Demography Lab, compared matrilineal and patrilineal Mosuo, the difference was striking: women had higher rates of hypertension and inflammation than men in patrilineal communities, but lower rates than men in matrilineal communities.

This is to our knowledge the first time that a complete reversal in markers of chronic disease for men and women has been observed, says Mattison. It suggests that the mainstream biomedical understanding of gender disparities in health may discount the contributions of prevailing gender norms that favor men in most societies. Because there are both matrilineal and patrilineal communities of Mosuo, this unique population provides a kind of natural experiment for testing the effects of fundamental cultural features, such as gender norms, on biology and health, tests that are difficult to perform in most populations studied by biomedical researchers.

The reversal in health disparities was driven by differences in womens health: mens health was roughly similar across the two communities, but women had lower rates of hypertension and inflammation in the matrilineal community. Although the researchers cant pinpoint exactly how differences in gender norms affect health, their analysis suggests that a combination of factors, including better access to resources and kin support for women may be important. This is consistent with work suggesting that empowering women within households and communities improves womens health.

Weve long known that stress is an important factor in health and disease. However, when it comes to gender disparities in health, the common assumption is that hormones and sex chromosomes are the primary culprits, says Reynolds. Our work shows that in cultures with norms that favor men, women may have worse health because they experience more stress or adversity than men do.

People in both patrilineal and matrilineal communities consume rice, pork, and yak butter regularly. Both women and men contribute to agricultural labor. Given the similarities in diet and lifestyle, we were able to isolate kinship norms as our primary unit of comparison," says Chun-Yi Sum, lecturer of social sciences at Boston University, fieldwork team leader, and co-author on the study.

Over their fifteen years of research with the Mosuo, the research team has seen rapid economic development in the region, due primarily to rapidly growing ethnic tourism in the area. Like many other cultures globally, as Mosuo diets and lifestyles change, they are at increasing risk for chronic diseases such as hypertension, obesity, and diabetes. Increasing tourism has led to an influx of wealth, more processed foods in the diet, and sedentary lifestyles that together increase chronic disease risk, says co-author Katherine Wander, assistant professor of anthropology at Binghamton University. As chronic diseases continue to increase in prevalence around the world, our work suggests that women will continue to be disproportionately affected, not because they are inherently more vulnerable, but because gender and kinship norms often disadvantage them.

The authors hope this work will inspire broader thinking about womens health: Even though women live longer lives than men, they dont live healthier lives. Overall, women tend to have higher rates of chronic disease. Our research suggests that this inequality isnt going to be solved purely by biomedicine or typical public health interventions. There is no way to solve these problems without considering the cultural systems that constrain or empower people, Mattison concluded.

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UNM researchers show gender norms that favor women reverse gender disparities in health - UNM Newsroom

Have you ever wondered if that glass of red wine with dinner might have triggered the pounding headache you felt later that night? The answer might be yes.

"Several studies show a link between food and beverages and migraines," says Thomas Berk, MD, neurologist and headache specialist at NYU Langone Health and Assistant Professor of Neurology at NYU Grossman School of Medicine.

Migraine affects over one billion people worldwide, and 39 million in the US alone. Learn more about the disease, including the most common foods that can trigger a migraine.

The difference between headaches and migraines is largely to do with the severity of the pain.

A headache can be uncomfortable and last for hours to days. Whereas a migraine is considered to be a neurological disease and the most debilitating type of headache, with more than 90% of sufferers incapable of working or doing normal activities during a migraine attack.

"A headache is any kind of pain in the head or face, and there are over 120 different kinds of headaches, which include migraines," says Berk.

A migraine generally includes severe throbbing pain, typically on one side of the head, and it can last from four to 72 hours. Additional symptoms may include sensitivity to light, sound, and smell, nausea, vomiting, and a visual disturbance known as an aura.

"There is no universal food or beverage that triggers migraines," says Berk. Everyone predisposed to migraines has different triggers, some of which may be food or drink-related. Whatever the trigger may be, all migraine triggers affect the brain in the same way by lowering the threshold to migraines.

Here's an example of what could happen. You drink a glass of wine, which is a migraine trigger for you. That drink leads to the creation of inflammatory neurotransmitters that are produced in the brain. Those neurotransmitters make the blood vessels around the brain dilate, and the nerve endings send signals back to the brain to feel symptoms such as pain, sensitivity to light, nausea, and more.

Based on Berk's research and discussions with patients, here is his list of the eight most common foods, drinks, and food-related triggers for migraine headaches:

"Migraine disease is complex and affected by many factors," says Simy Parikh, MD, program director of Thomas Jefferson University's Post-Graduate Certificate Program in Advanced Headache Diagnosis and Management and Assistant Professor in the Department of Neurology at Thomas Jefferson University.

Here Parikh offers some steps you can take to potentially reduce migraine triggers:

Eat healthily and consistently. You may have noticed that the migraine trigger list was lacking a few major food groups "healthy" foods such as fruits, vegetables, and protein, in particular. A 2020 review showed that most "migraine-friendly" healthy eating plans, such as low-fat diets, provided a decrease in the frequency of migraine attacks.

In addition to eating healthy foods, it's important to keep a consistent eating schedule to avoid migraines.

"Low blood glucose can trigger headaches," says Parikh. To keep your blood sugar steady, eat at roughly the same time every day without an extended amount of time between meals, she says. Parikh also suggests to all of her patients to maintain a healthy diet and weight.

Track food triggers and eliminate them from your diet. Since multiple factors contribute to migraines, many sufferers keep a headache diary. This is where they can list the frequency, duration, and intensity of migraines, as well as possible triggers, including food and drink.

If a food, beverage, or additive is identified as a possible trigger, Parikh suggests avoiding it for a month to see what happens. It's important to eliminate only one potential exposure each month, otherwise, you won't be certain what is triggering an attack.

Tracking the impact of a dietary change can help distinguish actual food triggers from migraine-associated food cravings. It's also important to work with a doctor when making any diet changes, says Parikh.

Get your sleep. Sleep and migraine are closely linked. A 2020 review showed the two-way relationship between sleep disorders and migraines. In other words, poor sleep quality is a trigger for migraines, and migraine sufferers are also at an increased risk of sleep disorders. To reduce the risk of sleep as a trigger for migraines, Parikh recommends that her patients stick to a specific sleep schedule.

Reduce stress. Stress can also trigger migraines. In fact, in one study, four out of every five people with migraines reported stress as a trigger. Here are some ways to reduce stress:

Certain foods, drinks, and additives may trigger migraines, and tracking them in a headache diary with one elimination per month may be helpful. Getting good quality sleep, exercise, and reducing stress can also reduce migraine attacks.

Migraines can be brutally painful and life-altering. The causes of migraines are complex and not always known. However, research has shown that there are ways to potentially lessen the frequency, duration, and intensity of attacks.

Parikh emphasizes that it's important to support migraine sufferers and not blame them for trigger exposures that may provoke migraine attacks. "There are many factors that come together to cause migraines, and you can do everything 'right' and still get them," she says.

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8 foods and drinks that are common migraine triggers, according to a neurologist - Insider - INSIDER

For years, Sharad Acharyas frequent hikes in the mountains outside Denver would leave him short of breath. But a real wake-up call came three years ago when he suddenly struggled to breathe while walking through an airport.

An electrocardiogram revealed that Acharya, a Nepali American from Broomfield, Colorado, had an irregular heartbeat on top of the high blood pressure he already knew about. He had to immediately undergo triple bypass surgery and get seven stents.

Acharya, now 54, thought of his late father and his many uncles who have had heart problems.

Its part of my genetics, for sure, he said.

South Asian Americans people with roots in Nepal, India, Pakistan, Sri Lanka, Bangladesh, Bhutan and the Maldives have a disproportionately higher risk of heart disease and other cardiovascular ailments. Worldwide, South Asians account for 60% of all heart disease cases, even though at 2 billion people they make up only a quarter of the planets population.

In the United States, theres increasing attention on these risks for Americans of South Asian descent, a growing population of about 5.4 million. Health care professionals attribute the problem to a mix of genetic, cultural and lifestyle influences but researchers are advocating for more resources to fully understand it.

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Rep. Pramila Jayapal (D-Wash.) is sponsoring legislation that would direct $5 million over the next five years toward research into heart disease among South Asian Americans and raising awareness of the issue. The bill passed the U.S. House in September and is up for consideration in the Senate.

The issue could gain more attention after Sen. Kamala Harris (D-Calif.) becomes the nations first vice president with South Asian lineage. Harris mother, Shyamala Gopalan, moved from India to the U.S. in 1958 to attend graduate school. Gopalan, a breast cancer researcher, died in 2009 of colon cancer.

A 2018 study for the American Heart Association found South Asian Americans are more likely to die of coronary heart disease than other Asian Americans and non-Hispanic white Americans. The study pointed to their high incidences of diabetes and prediabetes as risk factors, as well as high waist-to-hip ratios. People of South Asian descent have a higher tendency to gain visceral fat in the abdomen, which is associated with insulin resistance. They also were found to be less physically active than other ethnic groups in the U.S.

One of the nations largest undertakings to understand these risks is the Mediators of Atherosclerosis in South Asians Living in America study, which began in 2006. The MASALA researchers, from institutions such as Northwestern University and the University of California-San Francisco, have examined more than 1,100 South Asian American men and women ages 40-79 to better understand the prevalence and outcomes of cardiovascular disease. They stress that high blood pressure and diabetes are common in the community, even for people at normal weights.

Thats why, said Dr. Alka Kanaya, MASALAs principal investigator and a professor at UCSF, South Asians cannot rely on traditional body mass index metrics, because BMI numbers considered normal could provide false reassurance to those who might still be at risk.

Kanaya recommends cardiac CT scans, which she said help identify high-risk patients, those who need to make more aggressive lifestyle changes and those who may need preventive medication.

Another risk factor, this one cultural, is diet. Some South Asian Americans are vegetarians, though its often a grain-heavy diet reliant on rice and flatbread. The AHA study found risks in such diets, which are high in refined carbohydrates and saturated fat.

We have to understand the cultural nuances [with] an Indian vegetarian diet, said Dr. Ronesh Sinha, author of The South Asian Health Solution and an internal medicine physician. That means something totally different than a Westerner whos going to be consuming a lot of plant-based protein and tofu, eating lots of salads and things that typical South Asians dont.

But getting South Asians to change their eating habits can be challenging, because their culture expresses hospitality and love through food, according to Arnab Mukherjea, an associate professor of health sciences at California State University-East Bay. One of the things South Asians tend to take a lot of pride in is transmitting cultural values and norms knowledge to the next generation, Mukherjea said.

Acharyas health is still an issue. He said he had to get four more stents this year, and the surgeries have put pressure on his family. But hes breathing well, watching what he eats and once more exploring his beloved mountains.(Eli Imadali for KHN)

The intergenerational transmission goes both ways, according to MASALA researchers. Adult, second-generation South Asian Americans might be the key to helping those in the first generation who are resistant to change adopt healthier habits, according to Kanaya.

In the San Francisco Bay Area, El Camino Hospitals South Asian Heart Center is one of the nations leading centers for educating the community. Its three locations are not far from Silicon Valley tech giants, which employ many South Asian Americans.

The centers medical director, Dr. Csar Molina, said the center treats many relatively young patients of South Asian descent without typical risk factors for cardiovascular disease.

It was like the typical 44-year-old engineer with a spouse and two kids showing up with a heart attack, he said.

The South Asian Health Center helps patients make lifestyle changes through meditation, exercise, diet and sleep. The nearby Palo Alto Medical Foundations Prevention and Awareness for South Asians program and the Stanford South Asian Translational Heart Initiative provide medical support for the community. Even patients in the later stages of heart disease can be helped by lifestyle changes, Sinha said.

Dr. Kevin Shah, a University of Utah cardiologist who co-authored the AHA study, said people with diabetes, hypertension and obesity are also at higher risk of COVID-19 complications so should now especially work to improve their cardiovascular health and fitness.

In Colorado, Acharyas health is still an issue. He said he had to get four more stents this year, and the surgeries have put pressure on his family. But hes breathing well, watching what he eats and once more exploring his beloved mountains.

Nowadays, I feel very, very good, he said. Im hiking a lot.

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Push Is On in US to Figure Out South Asians High Heart Risks - Kaiser Health News