Exporting Heart Disease to Developing Countries: India Zeeshan Ali, Ph.D.
Mortality Rate Heart disease is the number one cause of mortality. Accounts for one-fourth of all deaths in India. Source: Gupta R. Heart 2008;94(1):16-26
Disease Burden Estimates 1990 Disease Burden Estimates 2020 Source: Nutrition Transition in India, 1947-2007. Ministry of Women and Child Welfare
Percentage 80 Percentage of First Heart Attack (Cumulative) 70 67 60 55 50 40 40 30 25 20 10 0 <40 years <45 years <50 years <55 years Age groups Source: Southasianheartcenter.org
Years of Life Lost due to CVD in Populations Aged 35-64 Years Portugal S. Africa 0.04 0.05 0.3 0.4 USA 1.6 2 Russia 3.3 3.2 PPYLL in 2000 PPYLL in 2030 China 6.7 10.5 India 9.2 17.9 0 5 10 15 20 Number in Millions Source: Reddy K.S. J. Am. Coll. Cardiol. 2007;50:1370-1372
Dietary Changes Easy access to high-fat, low-fiber, and highcholesterol meals. Increased consumption of commercially processed food. Decreased consumption of carbohydrates and increased consumption of fats. Source: Misra A. J. Diabetes 2011;3(4):278-292
Numbers Fast Food Outlets in India: 2008 vs. 2013 700 650 600 500 400 300 200 126 242 207 296 187 313 2008 2013 100 34 0 McDonalds Dominos KFC Pizza Hut
Meat and Dairy Products in Indian Diet
Million tons Chicken Production in India 4 3.5 3 2.5 2 1.9 2 2.25 2.5 2.6 2.7 2.9 3.2 3.4 3.6 1.5 1 0.5 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Year Source: Foreign Agricultural Service, USDA
Grams Per Capita Per Day Fat Intake in Urban and Rural India 60 50 49.6 47.5 47.9 52.5 40 30 42 31.4 36.1 35.5 38.3 41.6 Rural 20 Urban 10 0 1993 1999 2004 2009 2011 Year Source: NSS Report No.560: Nutritional Intake in India, 2011-12
National Action Plan and Monitoring Framework for Prevention and Control of NCDs Developed by WHO and Government of India, 2012-2013 Targets for the year 2025: 25% reduction in premature mortality from NCDs. 10% reduction in physical inactivity. 25% reduction in raised blood pressure. 0% increase in diabetes and obesity.
National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) Developed by Government of India, 2008 Strategies: Health promotion for the general population Education on dietary changes and physical activity at community level, school, and work place. Disease prevention for the high risk groups Early diagnosis and disease management to reduce morbidity and mortality
Community-Based Programs The Chennai Urban Population Study, India 1996 Mohan V. J. Assoc. Physicians India 2006;54:858-62 Community empowerment through public lectures and video clippings to promote physical activity. North Karelia WHO Project, Finland, 1972-1997 Cholesterol-lowering campaigns in villages. Working with food manufactures to come out with low fat products.
Age adjusted mortality rate North Karelia WHO Project, Finland (Age 35-64 years) Year CHD Mortality in all Finland and in North Karelia 35-64 year old men per 100,000 population
Physicians Committee s Work in India 21-Day Health Challenge- Kickstart India Online Program Lecture Tour of India
21DayKickstartIndia.org
Celebrity Coaches
Traditional Food
Kickstart India 26,000
Kickstart Results 95% experienced significant changes in their diets. 50% lost weight during three weeks. Less than 1% reported that they would go back to their old eating habits.
Physicians Committee s Six-City Lecture Tour 2015 Bhopal, June 25 Hyderabad, June 26 Bangalore, June 29 Mumbai, July 1 Chennai, July 2 New Delhi, July 6
Learning Objectives: Manage, prevent, and even reverse chronic diseases. Maintain long-term weight control. Lower cholesterol and blood pressure.
Hindi Language Educational Resources
Collaborators in India: Sagar Institute of Science and Technology (SISTec), Bhopal Krishna Institute of Medical Sciences (KIMS), Hyderabad Manipal Health Enterprises Pvt. Ltd., Bangalore Delhi University Women's Association, New Delhi Andhra Social & Cultural Association, Chennai
Partners in India Pramod Tripathi, M.B.B.S., founder of India s Freedom from Diabetes Clinic. Nandita Shah, L.C.E.H., founder and director of the nonprofit SHARAN a natural health organization that promotes a plant-based diet.
Media Coverage
We will continue building a healthy India!
Thank You! Zeeshan Ali, Ph.D. Kickstart India Program Specialist zali@pcrm.org