If you follow the obesity crisis, the output of the ‘learned study’ machine, and official, ‘expert’ recom-mendations, you’ll know that the standard prescription to control weight is ‘eat less, exercise more…’ MDs are now saying, ‘One size does not fit all!’
It’s also the ‘default’ advice for folks who want to improve their cardio health. But it’s easier to say than it is to do. And it’s downright impossible for folks in some low- and middle-income countries…
The problem…
A leading cardiovascular disease researcher from Simon Fraser University (SFU) (British Columbia) is calling out the ‘research industry’ on its routine recommendations for fighting Cardiovascular Disease (CVD).
Scott Lear, a health sciences professor at SFU and the Pfizer/Heart & Stroke Foundation Chair in Cardiovascular Prevention Research observes, 80 percent of CVD deaths occur in low- and middle-income countries. However, international heart-health guidelines are primarily based on research from high-income countries and often overlook the ‘upstream causes’ of CVD.
A dangerous ‘divide’
“The world extends beyond high-income countries when we think about universal recommendations like ’75 minutes of exercise each week’ or getting ‘five servings of fruit and vegetables every day’,” says Lear, lead author of a new review examining the impact of social, environmental, and policy factors on cardiovascular disease globally.
“There’s a stark contrast between a daily sidewalk stroll in Vancouver’s West End and walking to work in New Delhi, the world’s most polluted city, where many people cannot afford to drive and public transit is lacking,” Lear points out. “We cannot assume that life is the same everywhere. The environ-ments in which people live and the kind of work they do makes a huge difference to their health.”
What he did
Lear’s data-mining ‘review’ study involved data from the ongoing collaborative Prospective Urban Rural Epidemiology (PURE) study. This ongoing study has been collecting data from high-, middle- and low-income countries since 2002, and now includes over 212,000 participants from 28 countries across five continents.
In addition to physical activity environments, Lear’s review study identified several other causes behind the causes of CVD worldwide, including nutrition, education, tobacco use, air pollution, climate change, social isolation and access to medication, treatment and health care.
What he found
Lear suspects that the results of studies which rely on participants self-reporting their activity and dietary status are often skewed by the types of physical activity they get and economic factors – not the activities they’d prefer to take part in or what they would prefer to eat, given the creedom to choose.
Lear’s analysis of the PURE data showed that over 22 per cent of participants reported sitting for more than eight hours a day. By contrast, only 4.4 per cent of participants in low-income countries reported sitting for more than eight hours a day. Yet their reported overall physical activity levels were lower.
Likewise, fresh fruits and veggies were more available in lower-income countries. But the farmers who grow them say they tend to send their produce to ‘town’ to generate cash income, rather than consuming it themselves.
“This is a real eye opener,” Lear says. “For many of these farmers, getting the recommended minimum of five servings of fruits and vegetables a day would eat up 50 per cent of their household income.”
The takeaway
To make meaningful cardio-health recommendations for both low-and high-income populations, we need to know not only how uch physical activity they’re getting and what kind. Likewise, we can’t make assumptions about the foods they ‘have access to’ vs. what they actually eat.
My take
You would think the forgoing would be obvious. But apparently it’s not. At least for the ‘privileged’ folks who make the official recommendtions about what to do and eat to optimize heart health…
~ Maggie J.