Fast-food-loving younger Chinese Singaporeans at higher risk of heart disease

You would expect younger, more physically active people who also smoke less to have a lower risk of developing coronary heart disease — even if they ate fast food once or twice a week. Apparently, this is not so.

According to a joint study by the University of Minnesota's School of Public Health (UM) and National University of Singapore's (NUS) Saw Swee Hock School of Public Health, a person's age, smoking status and level of physical activity may have less of an impact on one's risk of developing coronary heart disease — when compared to a Western fast food diet.
The joint UM-NUS study of 52,584 Singaporean Chinese men and women, aged 45 to 74, was conducted over 16 years starting in 1993. The findings were published online on 2 July 2012 by the American Heart Association.

Higher risk of coronary heart disease for fast food lovers
In the study, participants who ate fast food more frequently were younger, physically more active, had a lower incidence of high blood pressure and smoked less.
Due to their demographics, "you would expect this group to have a lower risk of developing coronary heart disease. Instead, these study participants had a higher incidence of coronary heart disease, suggesting a strong association between frequent intake of Western fast food and coronary heart disease," says Dr Ho Kay Woon, consultant, Department of Cardiology, National Heart Centre Singapore (NHCS).

How bad is Western fast food for the heart?
The study showed that eating even one Western fast food once a week could increase a person's risk of dying from coronary heart disease (also called coronary artery disease) by 20 per cent.

The risk increases to 50 per cent for those who eat Western fast food two to three times a week, and to 80 per cent for those who eat it four times or more a week.
Eating fast food two times or more a week could also increase the risk of developing type 2 diabetes mellitus by 27 per cent.
What makes Western fast food so unhealthy?
A Western fast food diet is typically high in calories, sodium, trans-fat, and low in dietary fibre. Such a diet, predominantly featuring processed meat and refined carbohydrates, has been associated with the development of diseases such as coronary heart disease, type 2 diabetes mellitus and metabolic syndrome, says Ho.
Related article: Why is dietary fibre so important?
Examples of popular Western fast food in Singapore are: pizzas, burgers, fries, hot dogs, deep-fried chicken and fast food sandwiches.
Limit intake of local fast food for a healthy heart
Ho lists local favourites such as fried kway teow, roti prata, fried dough fritters, preserved canned food (with high salt content) and processed meat like luncheon meats as equivalent to Western fast foods.
"These local foods have a similar unhealthy nutritional profile and are also expected to be associated with adverse cardiometabolic conditions. The key is eating in moderation," says Ho.
Related article: What should I order at the hawker centre?
What are the early signs of possible heart disease?
Typically, coronary heart disease presents with chest discomfort or tightness that comes with exertion. The discomfort will be relieved after a period of rest and recur when exertion is resumed, explains Ho.
Sudden, severe gripping chest pain, which may be associated with sweating or nausea, may indicate a heart attack. The pain usually persists for more than 30 minutes. However, some patients may present with less typical symptoms such as breathlessness on exertion or gastric discomfort, especially in diabetic patients.
Causes of premature coronary heart disease
A study by Tambyah et al. (Singapore Medical Journal 1996; 37:31-33) identified the characteristics of patients aged below 40 who were admitted for acute myocardial infarction (heart attack).
84 per cent of them smoked
56 per cent had high cholesterol
20 per cent had a family history of premature coronary disease
19 per cent had high blood pressure
16 per cent had diabetes mellitus
The UM-NUS study shows that a Western diet is another factor associated with coronary heart disease. Though all risk factors act in concert, this study does serve as a reminder to maintain a healthy diet to live long and healthy, says Ho.
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This article was written by Teresa Cheong for Health Xchange, with expert input from Dr Ho Kay Woon, Consultant with the Department of Cardiology at National Heart Centre Singapore (NHCS).
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