A Disease of Affluence: Coronary Heart Disease

By Alex Jackson

What is Coronary Heart Disease (CHD)?

Coronary heart disease is the term that describes what happens when your heart’s bloody supply is blocked or interrupted by a build up of fatty substances in the coronary arteries.

Limiting/Preventing The Development of CHD

  • Limit the energy intake from fats and shift fat consumption from saturated fats and unsaturated fats as well as limiting the intake of trans-fatty acids.
  • Increase consumption of omega-3 from fish oil and plants.
  • Consume a diet low in refined grains and high in vegetables, nuts and whole grain.
  • Avoid excess healthy or sugary foods.
  • Carry out at least 30 minutes of exercise per day.
  • Avoid smoking.
  • Maintain a healthy diet.

Risk Factors Contributing to CHD

People in MEDCs generally have low levels of physical activity due to the more “luxurious” lifestyles that they lead. People are generally employed in the tertiary sector, so little exercise is involved in their work and they spend long stretches of time sat at a desk. Furthermore, people often do not live close to their workplace, so they spend long commutes inside cars or on public transports when they could have been walking. Finally, the availability of TVs, games consoles and computers have significantly reduced physical activity, especially in children, leading to increased obesity levels, a major factor in the development of CHD.

This is not an issue in LEDCs as people do not have access to technology for entertainment and so find entertainment in other forms which often involve exercise. People in LEDCs also do not have easy access to vehicles, so they must walk greater distances, keeping people active and fit.

The lifestyle of people in MEDCs is also a significant factor in the development of CHD. As people have access to more disposable income, they are able to spend their money on luxuries such as tobacco and alcohol both of which have been shown to aid the development of CHD. In addition, more people in MEDCs are living to an old age and, as they get older, they become more likely to obtain “old age” diseases such as CHD.

The types of foods consumed in MEDCs is vastly different to the types consumed in LEDCs. Access to more money means people can access a wider range of foods, many of which are unhealthy (e.g chocolate, crisps/chips, chips/fries). These foods result in an increased calorie intake and, combined with a low level of activity, can lead to obesity and a significantly increased risk of contracting CHD. The more demanding or stressful lifestyle of people in MEDCs means that people don’t have time to cook their own food and will instead opt for the easier option of eating take-aways or ready made meals. These meals are often very unhealthy, containing significantly more salt and fat than most foods.

Effective Interventions to Prevent CHD

  • In Mauritius, cholesterol reduction was achieved by a government led effort to switch the main source of cooking oil from palm oil to soya bean oil which contains significantly less cholesterol.
  • [South] Korea has worked to retain its traditional, healthy, diet after an increasing amount of westernisation of the country’s cuisine. Government led initiatives and mass media campaigns to promote local cuisine and traditional cooking methods where effective in reducing the prevalence of CHD.
  • In Japan, government led health campaigns have greatly reduced general salt consumption in the diet of the Japanese people. Coupled with increased blood pressure treatment, the blood pressure of the population has been reduced nation-wide.
  • In the U.S.A, a decrease in saturated fat intake in the late 60s began the large decline of CHD cases seen in the last few decades.
  • In New Zealand, the introduction of labelling logos for healthier foods forced many food companies to reformulate their products so that they would too be applicable for these labels. This led to a large decrease in the salt content of processed foods.

CHD In The UK

  • CHD is the most common cause of death in the UK. It’s responsible for around 94,000 deaths per year.
  • 1 in 5 men & 1 in 7 women die from CHD each year.
  • Death rates in the UK have been falling since the 70s but are still among the highest in Europe.
  • Within the UK, death rates are highest in Scotland and northern England. They are lowest in South England. There is a strong positive relationship between the number of deaths and the levels of deprivation in an area.

The southwest of England has a moderately high number of deaths from CHD while the rest of southern England has much lower levels. The exception to this is the city of London, which has a very high number of deaths from CHD. Northern England has a much higher number of deaths from CHD, especially in the north west in cities such as Liverpool. Southern Wales, around Cardiff, have a similar death rate from CHD.