Cardiovascular diseases were the largest cause of death and disability in India, as per a World Health Organisation (WHO) report published in 2020. Prioritizing the importance of heart health, Swasthya Sambad had an exclusive conversation with one of the renowned cardiologists in Odisha, Dr. Prasant Kumar Sahoo. Excerpts of the interview:
Please give us few tips on what lifestyle changes one should inculcate on a daily basis for a good and a healthy heart?
For a healthy and good heart, the mantra is very simple — number one is that first you have to come out of the stress. That’s the first thing. Everyone is under stress. Be it a student, an office worker, a housewife, a homemaker or anyone. Stress plays a major role as far as heart diseases are concerned. Be it financial or any other aspect, we are seeing a rise in cardiovascular diseases.
Next is that you have to put yourself on a heart healthy diet. What I mean by a heart healthy diet is that you have to put yourself on low fats, low carbs and try to see that you do not take unnecessary fried foods which are harmful for the heart.
The third thing that is most important is you have to spend some time doing some form of exercise daily. Whether you do walking, yoga, pranayam, cycling, dancing, aerobics everything has some form to keep yourself active.
Another important thing is that smoking is exponentially increasing and it has to be told and highlighted to each and every individual. Whatever the form may be, maybe in form of cigarettes, beedi or tobacco or anything!
And lastly, one has to keep a regular check on themselves. For example, check your blood pressure, blood sugar, and cholesterol level, so that you do not fall prey to cardiovascular diseases.
Recently, WHO announced that COVID-19 pandemic has almost come to an end. What has been the impact of COVID-19 on heart?
There is a very close intricate relationship between COVID-19 and the heart. Now, this virus, that is the COVID-19 virus is notorious for causing clots in the blood vessels. Let the blood vessels be in the heart or in the periphery or in the hands, brains, anywhere there is a tendency of blood to clot. As a result, what happens these patients present with more heart attacks, more strokes, and more limb ischemia or there is difficulty of the limbs, all these things. There has been a spurt. Now about the statement that WHO is telling that COVID is out. I don’t think so, because still we are getting patients of COVID. So we should not let this thing lose that. We should not keep our mask down and be careless and mix about because we do not know any among us. One among us may be a COVID carrier and we spread it. So please do not go with the idea that COVID is out. It is now has become our lifestyle and it is like a common cold now it can come any day. So about the statement I’m a little bit reserved that COVID is not yet out daily will see the charts at this district.
There are a lot of opinions on the internet about what oil to prefer..Refined oil or olive oil or desi ghee. There are also opinion on eating egg white but not eating egg yolk about good cholesterol and bad cholesterol. Can you give us a brief idea on what to follow and what not to follow?
Our grandfathers and grandmothers never had this high incidence of heart disease during that time. But now you see the younger mass are getting more of heart disease. Now why is it so? One of the most responsible factors is the type of oil we use now. There is a ratio of what we call as the saturated fatty acids, the monounsaturated with fat and the polyunsaturated fatty acids. Saturated fatty acids are harmful for the heart. Monounsaturated fatty acids and polyunsaturated fatty acids are good for the heart. Now there is a normally omega six to omega ratio in every oil. Now if you see after this vegetable oils came to the market, that is like the sunflower oil, the safflower oil, and these oils had a very high omega six to omega three ratio. The normal omega six to omega three ratios should be around four to five. But this oil, like sunflower and safflower have got an omega six to omega three ratios, something more than 150. So possibly after the market was flooded with these vegetable oils, we started consuming oils which were in fact toxic or notorious to cause more heart damage and finally heart disease. So, one has to be very careful in choosing oil. Now, if you ask me what is the best oil for the heart, definitely one oil which almost fits the WHO standards is the rice bean oil. This rice bean oil comes from the rice husk which you throw away. And this rice husk oil is definitely good for the heart. Definitely, ghee as such contains a lot of saturated fats, but it contains a lot of antioxidants which is good for the heart. Lastly, about the egg yolk and the egg white. Definitely egg white is something which is encouraged because it is just protein. Egg yolk contains a lot of fat and should be avoided, especially for patients whose cholesterol is high, who have a sedentary lifestyle, who do not do the regular workouts.
Is it necessary for a doctor to get emotionally attached with his patient?
Indeed a very difficult question to answer. But infact no one should not get emotionally attached to the patient. Because once you get emotionally attached to the patient, if there is the loss of the life or the loss of the family then you feel that as if you are losing someone who is very close to you and is among yourselves. But at the same time if you do not have some emotional attachment to the patient, then you do not do justice. Because, if I see the patient as one of my brother or my sister or my father or my uncle, then I’ll do justice. So here comes the property or the aspect of being emotionally attached. But one should not get more emotionally attached because treatment has its own place, emotions has its own place. So do not mix emotions with the treatment. If you mix emotions with the treatment, then you will never do justice. At the same time, I mean to say you should have a sympathetic attitude to the relatives so that they know that you are a part of the family. You’re doing whatever is best. And the most important thing is tell the truth to the patients. Don’t try to hide and don’t give them a false hope. And there I think emotions will not come. Because when you don’t give a false hope and when you speak the truth that this gentleman is not going to survive, had a massive heart attack, I cannot do much. At the end of the day when you treat a patient and the patient dies, then definitely you also do have an emotional setback. But I personally feel a doctor should not get too much emotionally attached to the patient.
From the doctor’s perspective, what is your diet like on a daily basis?
Well, you should have asked my wife what she prepares for me. But anyway, because it is me who takes the food, so I definitely would like to answer it. I am mostly a vegetarian. I occasionally take non-veg. Among non-veg, I prefer only fish and egg white. These are two things I take and once in a blue moon, maybe chicken or red meat, very rarely, unless when I go for a party or something outside. The second thing is I do not take any alcohol. That is mandatory because alcohol in any form is bad for the heart. Number three, no smoking. I don’t smoke. Fourth, yes, if you ask me to exercise regularly, possibly not, because by the time I finish my work, it’s almost like late at night, I don’t get time. But anyway, I try to keep myself busy in between whatever little bit I can do. I usually prefer to take low carb food, especially like chapatis, more vegetables and definitely fish and maybe a small amount of rice. And the rice that I take is usually the brown rice, I take because it has been seen that the brown rice, what we call as the rice, which is available in the rural areas, that rice is very good for the heart. These are certain principles I follow. Rest, I leave it to God for test over time.
Is red wine good for the heart?
See, red wine is not bad for the heart because, you’ll see, the people in France have lesser incidence of heart attacks. The reason is that red wine contains a lot of antioxidants. And these antioxidants are good for the heart. So among all the alcohol drinks that you can say among them, wine is the only drink that can be permitted.