New research indicates that global heart-health guidelines, often based on data from high-income nations, may not be universally applicable. Professor Scott Lear from Simon Fraser University highlights that factors like environment and socioeconomic status significantly impact cardiovascular disease risk. Cardiovascular disease (CVD) is the leading cause of death worldwide. CVD contributes to 80 per cent of deaths in low and middle-income countries. Lifestyle factors can significantly contribute to these diseases. One way to slash the risk is to exercise and eat a healthy diet. But can everyone afford these changes, especially those living in low and middle-income countries? These privileged prescriptions may not be for everyone, says a leading cardiovascular disease researcher from Simon Fraser University.Exercise and healthy food – A luxury?International heart-health guidelines are primarily based on research from high-income countries and often overlook upstream causes of CVD, says Scott Lear, a health sciences professor at SFU and the Pfizer/Heart & Stroke Foundation Chair in Cardiovascular Prevention Research. The review is published in the European Heart Journal. “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, “Lear, the lead author of a new review examining the impact of social, environmental, and policy factors on cardiovascular disease globally, said in a release.He pointed out how getting even 75 minutes of exercise a week can be different for people living in different parts of the world. “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. We cannot assume that life is the same everywhere. The environments in which people live and the kind of work they do make a huge difference to their health,” he noted. The review paper looked at the underlying factors contributing to cardiovascular disease (CVD), from the data taken from the ongoing Prospective Urban Rural Epidemiology (PURE) study, a global research collaboration that has gathered information from high, middle, and low-income countries since 2002. The study has more than 212,000 participants across 28 countries on five continents. The study data is collected every three years and includes a core survey, physical measurements (such as height, weight, blood pressure, waist-hip circumference, and lung capacity), and additional questionnaires targeting specific research interests, including CVD.Along with the physical activity environments, Lear’s review study also looked at 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. Exercise is sometimes a privilege Lack of exercise is a major risk factor for cardiovascular disease, but the type and context of physical activity people do also play a role.In the review, Lear found that people in high-income countries reported the most physical activity, even though more than 22% of them sat for over eight hours a day. In contrast, only 4.4% of people in low-income countries sat that long, but their total activity was still lower. The key difference, Lear explains, is the nature of the activity. In low-income countries, physical activity is usually part of daily chores, work, or transportation, and not something done for fun or exercise.
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A healthy diet is crucial to reducing the risk of cardiovascular diseases. This diet should include fruits, vegetables, legumes, nuts, fish, and dairy. Lear reported that regardless of country income, fruits and vegetables were more readily available and more affordable in urban areas. But he was also surprised to find that consumption of fruits and vegetables is lower in low-income countries because farmers can’t afford to eat their own produce.“This is a real eye opener. 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,” Lear notes.
