When your food and lifestyle turn you into a heart patient

Who would have known that trans-fat intake would cause the deaths of hundreds of thousands of people when French chemist Paul Sabatier won the 1912 Nobel Prize in Chemistry for discovering the hydrogenation method to produce it?

Trans-fat or Trans-fatty Acid (TFA) is one type of fat that is usually found in processed foods such as baked goods, snack foods, fried foods, shortening, margarine, and certain vegetable oils.

In parallel to other reasons like leading an unhealthy lifestyle, high salt and sugar intake and so on, eating trans-fat increases blood cholesterol levels and the risk of heart disease.

According to a recent report by the World Health Organization (WHO), Bangladesh is among 15 countries with the world's highest chronic heart disease (CHD) burden due to trans-fat.

Each year, Bangladesh sees more than 11,000 deaths due to trans-fat out of some 2.77 lakh CHD caused deaths.

Globally, TFA intake is estimated to be responsible for more than half a million deaths from coronary heart disease each year.

"The harsh reality is that people—many of them are doctors—are not aware of the danger of trans-fat. Usually, all types of baked foods contain this harmful fat," Dr SM Mustafa Zaman, a professor of cardiology at the Bangabandhu Sheikh Mujib Medical University (BSMMU) told The Daily Star.

In a 2014 study by the Bangladesh Council on Scientific and Industrial Research (BCSIR) and the Jagannath University, the TFA was found to constitute 5 to 39 percent of total fat in 12 types of bakery biscuits in the market which is 20 times higher than the WHO limit.

According to nutrition experts, when a vegetable oil is used again and again to fry foods, it also produces TFA.

Besides, any food turns harmful when Dalda or Bonospoti Ghee is added to them.

In May 2018, the WHO launched a programme to support governments to bring down the industrially produced TFA to two percent per 100mg fat in the global food supply by 2023.

So far, Bangladesh has no law or regulation to ensure this limit.

"We have been working to finalise a draft regulation in this regard for the last one year. Hopefully we will be able to turn it into an act soon," Prof Dr Md Abdul Alim, member of the Bangladesh Food Safety Authority (BFSA) told The Daily Star.

TFA IS NOT THE LONE ENEMY

Asraful Alam, 45, a businessman in Dhaka's Kamalapur area, never felt that he had heart problems.

But suddenly in 2014, he had a heart attack and needed to set four rings in his heart. Later in 2018, he again had another heart attack and needed to set two rings.

Since then, he has not been able to return to normal life.

"I was quite okay before the heart attack, except a feeling of mild pain in my right hand. Later, I learnt from the doctors that it was a sign prior to heart attack," Asraful Alam told The Daily Star.

According to the eighth Bangladesh Demographic Health Survey (BDHS) 2017-18 published in January this year, hypertension among people aged 35 and above went up to 40 percent in 2017 from 26 percent in 2011.

During the same period, the number of diabetic patients of the same age group increased to 14 percent from 11.

According to the survey, some three crore people aged 18 and above were hypertensive (with blood pressure above 90 and 140) and 1.1 crore of the same age group suffer from high blood sugar.

"Of all types of heart disease, the ischemic heart disease (heart attack) is the most worrying. Due to high intake of fats, especially trans-fat, the vein becomes blocked or narrowed and prevents blood from circulating back to the heart and this leads to a heart attack," Dr Sohel Reza Chowdhury, a professor at the National Heart Foundation and Research Institute told The Daily Star.

So what are the lifestyle factors that cause heart disease?

Dr Aliya Naheed, a team member of the latest BDHS who works at icddr,b told The Daily Star, "Inadequate physical exercise, carbohydrate-based food habit, junk food, a lot of salt and sugar intake, and smoking are the habits to blame for this."

According to experts, each adult needs to walk at least 30 minutes to keep the heart in good health.

"People need to modify their lifestyles. We need to ensure the safety of food. We need a multi-sectoral approach to address the issue," Dr Aliya said.

Awareness among the people is the most important factor to fight the wave of heart disease, she said. "We have to learn how to lead a stress-free life in line with other strategies. We have to teach our children in schools about this issue."