Geographical aspects of acute myocardial infarction in India with special reference to patterns of diet and eating.

Abstract

A survey of the incidence of acute myocardial infarction and the dietary behavior in railway populations in India showed that the disease was 7 times more common among South Indians as compared with the Punjabis in the North, even though the fat intake of Punjabis was 8-19 times more than that of South Indians, and was chiefly of animal origin. Other differences in the pattern of diet and eating, rather than the amount and type of fats eaten, are important, e.g. the chain-length of the dietary fatty acids, the size of the fat globules, the roughage and cellulose content, and the patterns of cooking and eating foods. The differences in the incidence rates of acute myocardial infarction between the South Indians and the Punjabis are probably due to the fact that the fatty acid composition of fed fats affects the relative proportion of short-chain verus long-chain fatty acids in the plasma, which in turn inflences the dynamic balance between blood coagulation and fibrinolytic enzyme systems. The possible role of the differences in the particle size of dietary fat is also discussed.