EP-349 | Heart Attacks, Covid Vaccine, Veg vs Non-Veg, Diet Choices & Insurance | Dr Ramakanta Panda

EP-349 | Heart Attacks, Covid Vaccine, Veg vs Non-Veg, Diet Choices & Insurance | Dr Ramakanta Panda

 https://youtu.be/mUqBbRdsqDQ?si=rEKmHXFc9GBtfP6f

Vegetarians tend to think heart attack. Unhealthy vegetarian diet, healthy nonvearian diet say 10 times dangerous. Many products today are marketed as healthy. Are these really safe? They're all poison. Anything that is processed is completely unhealthy for both very close friend. I tell him your heart is around 25.   when you operated on Dr. Manm Singh was the best patient that you can think of. He was a diabetic patient all my diabetic patients I give example of Dr. Manm Singh. How does drinking alcohol and smoking affect men's and women's uh heart differently? Both are equally bad. Vaping hoka vaping uh they're as dangerous there's a good thing about smoker those who are smoking you stop today most of things you can reverse it what is one of the biggest misconception about heart everybody thinks that I'm never going to get a heart problem the other one is going to get a heart problem that is the biggest myth that's why people get into trouble so doctors stress buster my operation theater I'm operating always there's a song going on in the background without that I don't operate What about those who go to Google? That is the most dangerous thing because it has killed more people than health. Namaste Jind. You're watching or listening to another edition of the NI podcast with Smith Prakash. Heart disease is the leading cause of death in the world. 50% of heart attack cases since 2020 in India is among adults below 40. India and other Southeast Asian countries have a genetic predisposition to early heart disease. But lifestyle changes have worsened the risk. My guest today is Dr. Ramakand Panda, cardiac surgeon who has performed over 30,000 heart surgeries. He's considered as the safest cardiac surgeon in the world. Dr. Panda, thank you so much for coming on the podcast. I understand I'm stealing you away from your patients at this time. So most grateful that you are here. Um I want to ask you about uh why is it that uh people of the Indian subcontinent are more prone to uh heart ailments uh whether they live now in India or abroad because many of our viewers are seeing this show from outside the country uh but they are of Indian origin or South Asian origin or Indian subcontinent origin. So why is it that we are prone to heart ailments more than people of other places? I think mostly physical lifestyle change and I'm just u going back four five decades back when I was in the medical college. Um we'll hardly see a patients in our uh hospital who had a coronary disease. We used to have valve problems not this blockage problems that we are talking our teachers used to teach us that this is a western problem not Indian problem. Oh really? Yeah. In five decades it has completely changed. Today we have the highest incidents. Um there's a lot of thought process going on probably genetic genetic are far less more it is all related to our lifestyle change last five years even within the country and people who have migrated also if you see the lifestyle is completely changed uh there's complete lack of exercise our food habits are completely changed our Indian food mostly it was based on a uh organic and natural food where today everything is processed food and artificial sweet content has gone gone up significantly. So much so in last 100 years our our sugar what used to our greatgrandparents used to eat in one month we are eating in one day that is the type of sugar consumption gone up stress level has gone up tobacco use gone up and lack of sleep and uh rest again recently emerging as one of very major factors for getting heart disease okay that's but it's become a genetic issue within 40 years it becomes is more lifestyle There's a major study to we thought is genetic. It's very less to genetic. Yes, heart disease. There are many risk factor why people get heart disease. It's called risk factor. Genetic is one of them. Not every person with heart disease has genetic cause. That's a very separate thing. In general Indian population look at it is largely because lifestyle change and young people getting heart attacks. uh that has become a major cause that there are videos and things of people just like you know just walking and suddenly falling dead and then people say that why is it that we are hearing more and more that people in their 40s are falling prey to heart I'll 20s I started practice in India 1993 I'll see below 30 or so age a patient who is uh uh once in a year today I see every Today two weeks back I saw two patient one 21 year old boy from I Chennai doing engineering third year got a massive heart attack a 23 year old boy from Indoor I had to do his bypass so it has in 30 years alone I have seen in my practice it has drastically change again everything almost certainly is all related to lifestyle when I say lifestyle everything everything contributes what what happen is the heart digit doesn't occur from only one reason It is multiple factors and unfortunately um the type of heart disease we are talking about there are many types of heart disease there's a valvular heart problem um there is a congenital who you get it at the birth you get it then a heart muscle weakness they're very different they constitute around 20% 80% are blockages in the heart arteries they are the largest uh uh cause of heart problem that has gone up very significantly and that is completely dependent on the lifestyle and these are All related to that is but our parents never tell us uh while you know while the child is growing up in the you know in the teenage years Why they don't tell us this right I think there a lack of knowledge now slowly it has emerged and the only way can prevent is you have to start very early this blockages starts developing inside your arteries by the time you are in teenage almost every room including myself you are not taking care by the time you are 10 11 years of age the cholesterol deposit starts taking place it might manifest after 30 40 50 years and on the other hand those two will take care of their health properly. This doesn't take place. It is like your kitchen you know you don't take care properly you keep lot of fat and chby all those things you'll find slowly slowly all those concept. Yes. The pointarian nonve also is not bad. There are many types of nonve food. Good. We'll discuss later on. And as long as you keep everything natural, you're not going to get a heart blockage. The moment you get into artificial today, everything is processed. Processed food, sugar, tobacco, lack of exercise, all these are poison. This is the reason why it is happening and stress level and very common for all the youngsters um binge watching very late night 1 2 3:00 watching Netflix and all binge watching and common thing I'll find I find the moment somebody comes 25 30 years two thing I ask them 80% times two category either IT professionals or finance. No all night they work the all of them if you don't smoke your your colleagues or friends are smoking that's as good as smoking because pass is smoking as good as artist smoking that boy I was talking about 21 exactly you are doing you binge watching with your friends at 2:30 in the night he got a heart attack by watching TV no means they continuously that is the lifestyle they've been leading for months and what happens is the again heart attack means Your heart gets blood supply. Heart supplies blood to the whole body. Now without blood you cannot survive. And not taking care and you'll be surprised 50% times proper care if there's a lot of stress and this typically is youngster late night 2 3:00 4:00 binge watching or sometimes when somebody doing an exercise on a treadmill suddenly If they fall down is usually the artery ruptures there. Oh yeah. The reason is our inside our body the blood has to there's a you have to go has created a fine balance. Now same factor. They can bleed to death. lubricating layer that is the most important thing something called chemical nitric oxide it's as simple as there will be many chemistry students it is nitric oxide which keeps us alive so nitric oxide what happens whenever you take stress and all these activity I tell it is it damages the endothelium so there's no lining is not good then the blood becomes sticky and you get a heart attack and even to get a heart attack what happens is once that area is damaged the body heals like you get a cut it heals when it heals you your skin doesn't become exactly same color it's a The same thing inside the artery. The moment this lining gets damaged, it starts healing. When it starts healing, cholesterol start getting deposited. Calcium start getting deposited and the cholesterol over time slowly slowly that's how the blockage forms and especially youngsters, elderly people who do 30, 40 or suppose the blockage had taken to develop it takes time. So that block it is very firm. It doesn't break. M on the other hand youngsters if there is a blockage has formed over a very short period of time because it is fat it is if you see cholesterol exactly like your ghee it looks yellow very very soft cheesy kind of thing it's just like cheese and any stressful condition in the body any even temporary you get very upset or or if you're uh as I said binge watching or not slept for very long time what happens is the body uh stressor hormone level goes up your body uh your arteries that endothelium gets uh weak so that becomes sticky. There's something sticky substance in the body called platelet. There's a type of cell that is job is to prevent somebody from uh dying from bleeding in case there's a cut anywhere. So that also becomes sticky. So all these multiple factors cause the heart attack. Okay. We'll get to the level of what should one do. Yes. uh when one gets a heart attack or somebody a loved one around you gets it. We'll get to that part but before that let me go to the students to ask them because you mentioned many things that young people do. So uh let's get on to that. Uh you want to ask a question? Yes. Hello sir, my name is Rajes and so my question is many people believe that the heart attacks have increased after covid pandemic. Uh what are the observations uh your observations and do you agree with this? Now uh not only in India ISMR and all over the world people have studied the long-term uh covid or covid vaccine and heart attack there's no corness it has not increased but during covid when somebody has covid or some of the vaccines when you take it increases the multiple ways it can cause heart attack but that period is only when the covid is there or the inflammatory response is there normally last for two three they got long covid symptom two is months during which time your inflammation in the body is very high. That's the only time you get a heart attack. But after that long-term no studies nowhere has shown that the covid is the cause of the sudden surge in heart attacks. The only thing awareness has come up and the vaccines did not cause vaccin there are few vaccine which immediately within 3 months they used to cause other muscle weakness especially youngsters but most of it was reversible and also in pregnant women especially those are oral contraceptive they had certain blood clot issues okay but those are all temporary only during the period of vaccination or a very short period after that no long-term no study nowhere in the world including ICM had conduct a lot of studies showed that it is not related at all. Hello sir, I am Adita Singh. My question is that sir there's a general general perception that men have more propensity to have heart diseases than women. So is it a fact or just a myth and if it is a myth to what are some other myths that you would like to burst about her diseases? Men have little higher incidence of heart disease than women because women are protected by hormone till till menopause. Uh yeah slightly protected but unfortunately the moment menopause occurs within few years there's no difference and more important the more myth is people think the women don't get heart attack the other way around women getting heart attack has more complications their death rate is much higher because a couple of things is not universal all over the world uh people look after the men and the household look after because the mothers and sisters they look after everybody nobody looks after them that is one also there's There's been many studies there's a bias by the physicians also not in this country all over the country to neglect a woman's health including heart disease and on top of that woman's heart arteries are smaller in size possibly because of lack of exercise they don't have adequate collateral alternate circulation so a woman getting a heart attack has a much higher chance of having complications and much higher chance of dying so it is a myth uh it's a myth that uh Okay. And it's more dangerous. I didn't realize that uh that uh physicians also tend to say that you know there have been studies showing that physicians not in India alone all over the world even USA also there's a bias u in uh uh less recognizing heart problem in women and treating them properly. Okay. So let's ask the next question from a woman please so that there is no we show that there's no bias here in the room. Yes. Hello. So I'm JA as you mentioned that uh binge watching on digital screen affects a lot whether it be uh women or men doesn't matter. Yeah. But since as a adult and about this generation Gen Z and also the millennials one we have this um we have adopted this uh idea of staying up at late night and sleeping and doing other stuffs uh in the morning. Uh so uh we also know that body adapts whatever the condition we uh are living in. So don't you think that or what is it that can our body adapt to this entire scenario in the sense art if we if they go to sleep at 2:00 and wake up at 10:00 they are getting their adequate sleep what will adapt but it will take you around 50,000 years I'll give you the story behind it. take 50,000 years not now because if you see we evolved from monkeys apes to human beings just 200,000 years back now we lived in started doing agriculture 30,000 years back we started living in commun 30,000 years back there's no light till 200 years back so every human being till 150 200 years back was eating and sleeping in relation to So you you go to sleep and before coming this one and human beings were never on the top of the pecking order. Now we're on the top of pecking order. We are killing all the animals. That's a different thing. But that time we are at the bottom of the pecking order. So the human beings only thing was by evening they'll run and climb up a tree survive all night. And since after that last 30,000 years everybody used to eat and sleep by 6 7:00. Your body is used to that. Now it will take another probably the new generation have to work like that for another 50,000 years then you can do any time then you your body will get used to it there's something called circadian rhythm your body internal clock is there so it shuts down after 9 10:00 and including your now recent knowledge last of course aya recognized thousands years back but the modern medicine has recognized the importance of the intestine in last few years only it is almost like another brain it it also determines your entire health including your mood, your sleep etc etc. There are trillions trillions of bacteria they also need rest in the night to keep you healthy. So occasional binge watching no problem but doing that on a regular basis uh you you need to be another 40 50,000 years then you can do that. So what what about those who sleep at uh who study at night uh you know 5 days in uh week they're studying till 2:00 a.m. maybe not watching TV or not watching OTT but they're studying till 2:00 or they're doing night shifts uh for weeks on end they can't keep to the psychic rhythm. Yeah overall it's bad for their health. There are very few people who are circular and rhythms are little different. They're probably 11 12. There are few people they can stay awake till say they can sleep at 12 1:00. By and large the whole body has given the biological basis. Uh the your the best time to sleep is 9:00 maximum 10:00. You should sleep 10:00 and sleep 8 hours. Of course that it could be 7 8 9 6 hour. Those you get a very very deep sleep you can get recovery 6 hour but very less number of people. By and large 8 to 8 hours is ideal time and same 8 hours of sleep. You read all night and sleep at 4:00 in the morning is worse than sleeping at 10:00. So unfortunately it will take our evolution is only uh 200,000 years. You need to be another modern life has to lead like that for another maybe 50,000 10,000 years before hardies become less by leading this lifestyle. And you know um uh the other thing is that uh I get it that if u if you tell your friends that you're going to sleep at 9:00 or something like that you're considered a boar. Um but 10 years from now you will be healthier than that friend of yours who was making fun of you. Absolutely. Absolutely. Absolutely. There's something nowadays called by your uh heart age. The heart age is is like see there are two things. One is something called chronological age means how somebody is 30 years or 40 or 50. One is physiological age. I'll give you example. My youngest patient I call him I operated he was 92 years old and one of my surgeon brought him uh just reports. I said why you want to operate somebody 92. He said sir just have a look at him. I looked at him not even didn't look a day older than 60 years old. So for him it is 60 years of age. I operated he's 100 plus he's still alive. the point. So we have come to now a concept called heart age. Heart means what is your actually age of the heart. Now if you lead a good lifestyle we'll discuss that you could be 30 but your heart age could be 15 that means you age whatever average Indian lives say 70 80 by the time you guys will be probably it is going to go 80 you live 10 15 years more that means you'll become 100 years on the other hand you could be 30 your heart age could be 50 also like do those boys are how do we get to know what is our heart age what test does one do yeah there are certain uh parameters you need to check it out your um height, weight, blood pressure, cholesterol level, there are multiple parameters are there. You check it out with that one can check it out. I can ask all of you to do that. Check it out. Check out your heartage. So this is very important especially when all of you would go for medical insurance. Uh when you do an insurance what happens is that they do this kind of test to figure out what that's how they determine precondition and all. So they get to know what is uh your premium that you have to pay and all of you will need health insurance soon. So they get to know what is the kind of premium based on your heart age like like what Dr. Sab is saying to say I think Dr. So you can explain this better. This is exactly like that average Indian obic today it is around 70 years of age. Now if your heart age is already 40 and you are 25 so you'll be living 30 more years. So 25 plus 30 you'll be living for 55 years of age. Insurance also calculates like that. There are multiple parameters to look at it but the most basic thing you do lead a very healthy lifestyle automatically age will be less. Okay details we'll talk about it and I'll ask all of you do that occasionally binge watching if you don't do that living life is very boring but that boring should not be every night every day do that once in a while you can keep that yeah okay namaskar sir VIP VIP treat and you know that that person is a prime minister or a chief minister which you have uh hospital authorities or other people must be calling and saying there is so much importance for this patient. Yes question and itffectience number two now also it is the best heart center in the world Cleveland Clinic so in those days every month we'll be operating one head of state or prime minister president somebody will be operating one thing I learned there with me and my mentor that treat them like a normal patient then you are not going to make those decision making errors Okay. Again I have operated 30,000. What happens is once you do that then um your surgery becomes a routine you know exactly how to do. Third thing again I learned in my experience that's what I do then without I didn't have stress I'll be lying But the level is very very less. So a correlary to what he's saying nothing about you but there are doctors who they people say that VIP nonVIP especially if somebody's coming from a village or something like that and maybe doctors don't pay that much attention by and I know everybody treats their patients equally Well, but sometime there will be always exception to everything in society, in life, everything that might be u some situations but uh for me I treat everybody exactly same rather I treat somebody who is poor little more because I don't want that patient to think that and in our hospital there's no difference our rooms are exactly same for the poorest patient or the patient who we do a lot of charity for children heart surgery would do free whether it is a free patient or the richest patient which was a sweet room our ICU is exactly same our operation theater is exactly same the only difference is in the room the room your 99% of cure is done by the time go to room your operation theater IU is the most critical phase where patient care is most important and then the cardiac care unit cardiac once you go to room is recovery phase there you are sweet room you stay in a very big room nurses will see to other rooms he has not sell still see you but in terms care we don't compromise uh doc I'm I'm going to come to the part about insurance um most Indians don't have health insurance that's a major thing and cardiac care without insurance it can wipe out families absolutely how dangerous is this situation is very bad personal bankruptcy bankruptcy healthare catastrophic illness. catastrophic illately  society cannot afford it. Even USA the most richest till till Obama care came 30% population were not covered and their budget was almost $400 billion. So it the only way you can do is by getting insurance. Without insurance, nobody can afford catastrophic illness. And all over the world, 40% of personal bankruptcy major illness at least government of India and every government now has started the insurance for the below poverty line or the most of people are covered now. But still I strongly suggest insurance age for uh for major illnesses like should a person from the age of 25 start saving for illnesses or 30 or 40 say you start earning start doing because you you budget yourself whatever money you want monthly salary you budget yourself for your clothes for your house for your food etc. If you have once you have children you keep it for the education. So always keep some money for the health and the biggest money I'll tell you to do invest in health we'll talk about is please do exercise every day. Ah okay. That is the biggest insurance that you can build any how much exercise is it 10,000 steps 20,000 steps push-ups yoga hundreds hundreds of scientific is exercise. Exercise exercise certain natural hormones mood elevating hormones that will keep you happy and healthy also. So throughout the day so I'll advise everyone to do exercise minimum minute in a week 45 to 50 minutes of brisk exercise go and play badmint and cricket cricket is not that but at least do uh football volleyball do something do some exercise number one and in terms of amount as I said 300 minutes of brisk brisk work then alternate days do weight training. You don't have to do daily weight training unless you want to go for Mr. Universe or something that is different. And these two things are most important and in addition to that uh your uh uh do yoga. Yoga has two benefits. One is yoga where do asas etc keeps your all the joints etc very supple and second one will be reducing the stress. So these breathing exercises and also for weights and all that even if you know some people may not have the money for weights but you can do resistance training and if you just go into YouTube you can find it take two bottles of min mineral water and you can do it with that you know there are there are ways and means of doing it even if you you don't have to invest in it you don't have to have yoga mat to do yoga absolutely so there are ways and means of doing every uh minute, every hour of a body. Try to build in yourself physical activity. Now recently again the new knowledge has come out that sitting for even 1 hour is as bad as smoking. Is that bad for the body? So now they know so whenever try to do as much as physical active build into it instead of taking a car just walk 100 mters in the building just take elevator don't sorry climb up the step don't take elevator and uh don't sit more than 1 hour at any place these are the new studies has come out that even 1 hour sitting in office is as bad as smoking so now view is recommended that you be as active as possible if you're conducting meeting, stand up and walk around and do meetings like that. Right. And what about water? Drinking water. People say that that is very important and it is not taken as seriously as it is hydrating your body. Yes. And especially in a dry in a hot environment sorry climate like ours. You should drink at least 2.5 to three liters of water a day. Uh water a day. Okay. Yes. Go ahead. Hello sir, my name is Atyam. As you have mentioned that the consumption of sugar has drastically increased and is really harmful for our heart health. So my question is like many products today are marketed as healthy. Zero sugar drinks, diet, sodas, low-fat snacks, sugar-free substitutes basically. So from a cardiology perspective, are these really safe or do do they pose a hidden risk for our health? Because people usually consume more thinking healthy. So what is the effect of that? You ask me they're all poison. They're all unhealthy. Everything unhealthy. Anything that is processed is completely unhealthy for body. Now having said that occasionally you take is not a problem. Don't make it a habit. So any processed food is bad for body. Anything that is natural is good for body. So so-called these are all marketing gimmicks. All of them are bad. All of them are bad and poison for the body. And uh the the reason is very simple. The your you have got three types to two. One is your you have got carbohydrate, you have got fat and you have got protein. Each of them have to be certain proportion. Now anything that has come natural uh that is comes from your field you bring it most of them let's look at rice earlier used to have a brown rice not white rice or Indians are only eating millets is only wheat came after the British came to India so they take they they are very complex carbohydrate what whenever you eat that it takes very long time for you to digest that's the reason if you eat bajraas regular roti bajra which is good for you because glycemic index glycemic index. Then on the other hand processed food are all very simple because you are not doing anything. So that much you are not using immediately. So body secrets insulin immediately. Sugar will go down but it doesn't get consumed in the body. What happens? When you do repeat it like that your pancas slowly start getting fatigue like I'll take run 100 m you'll run nicely. If I tell you every 5 minutes run 100 m run 100 m after 1 hour you will fall down. So this is some of the reason why the diabetes has gone up so much. In last 20 years the diabetes incidents are gone up double. Together we are the diabetic capital of the world and diabetes one disease that can be completely cured by your diet, exercise, lifestyle etc. Coming back to your point the so-called diet drinks etc. They're all poison. There's nothing good about it. Occasionally you have it no problem but don't make it a habit daily habit to do that also. What is the best time of the day to eat? You want to eat a slice of cake. What is the best time of the day? I'll have to eat it in the daytime, never in the night. Anything. Another thing, same thing as I told you, it will take probably another 40,000 years or 20,000 to do that because you don't don't eat any sweets in the night because after evening your body metabolism glows, slows down. You also don't do much of physical activities. So is your best time to eat will be in the daytime. I prefer in the morning time at the most lunch, not beyond that. Okay. including fruits also because fruits has a very high uh sugar content. So fruits also try to eat in the daytime. Don't eat in the night. We're also heading into the festive season. So all our festivals, all our happiness is always associated with sugar. You're going to travel. It's it's also the traditions. Yes. So how do you change a tradition? What do you do alternate? If you look at it if you see the quantum was not so much even 40 years back today it has become you can see then 20 years how much it has changed and you cannot I'll tell you if it then immediately do some exercise. One of the things that I other things again these are all recent last few years research has shown uh after every meal immediately you should do 10 to 15 minutes of exercise. Any just work in the room in the office or in your study just instead of sitting on this one just work around 10 15 minutes that increases your metabolism quickly your sugar level will get control. If I put on your earphones and listen to this myth Prakash podcast. Yes, absolutely. Absolutely. And and walk around little bit for 15 minutes. Then you can have one or two mitai and then run for 40 minutes. Okay, that's okay. Youngster they can manage that. But don't eat it every day. Silver lining. Yes. Go ahead. Hello sir, I'm Sakshi. My question is that uh how does drinking alcohol and smoking affect men's and women's uh heart differently? Smoking first smoking is uh one of the most risk factors. Now there's something before I didn't tell I'll just tell you there's something called risk factors. Uh what we have seen is from millions of patient studies that if you have any of these your chances of getting a heart disease is higher. It's called risk major risk factor. Number one is tobacco use or smoking. Number two is diabetes, blood pressure, high cholesterol, strong family history, overweight, uh stress, lack of sleep. These are multiple risk factors. So, tobacco and sweets. Tobacco forms one of the most important uh risk factor that can cause heart disease. The way it does is that nicotine and other substances they damage the internal lining that as I told in the beginning called endothelium. Number one. Number two also they make your arteries are very very hard. So both ways they increase the blood pressure damage the artery that's how you get a heart disease. Alcohol per se directly doesn't affect the this type of heart disease. We are talking about the blockage in heart arteries. But alcohol when you take it increases risk of cancer liver damages also when you take excess alcohol it can damage the heart muscles is called alcoholic cardiomyopathy. So both are equally bad. Smoking I'll never advise anyone to smoke and avoid also what is called passive smoking for friends are smoking also you are as good as smoking alcohol you can enjoy occasionally is fine no problem and uh vaping which is another vaping is vaping they're as dangerous as hookah hookah vaping uh they're as dangerous okay and very commonest uh whenever I see a young boy or girl coming for a with a heart attack first I send the parents out then ask them they do have a vaping you'll be surprised last most of the time they either doing vaping or hookah or uh binge smoking very very common so how is it worse for bad or good like what is more for men or women smoking equal bad equally bad equally bad equal bad and um you have to understand the heart attack occurs um because the artery get blocked the artery can get blocked from cholesterol deposit over 30 40 50 years somebody's getting heart disease at the age of 55 60 or 70 years of age or that heart artery can suddenly get blocked from because of all these reasons. So don't think that anybody young age also because young age will not get a heart attack. You'll be surprised almost 30% of the patient people who get heart attack don't have a blockage because of all this lifestyle change they get these heart attacks. Okay. What about uh if women are smoking say from the age of 17 till the age of 29 and then they have they conceive and have a child they stop they conceive they have a child has does the child have risk of any kind of pulmonary heart kidney anything that could get affected because the mother was a smoker ex-smoker no okay if is not they have stopped smoking before child has conceived then the effect on child is very very less. On the other hand, even in a small short period during pregnancy, it will have a serious effect on the uh child's health both short-term long-term. So as long as you stop smoking and especially the effect of smoking on lungs within 6 months almost comes back to normal level. So there's a good thing about smoker those who are smoking you stop today most of things you can reverse it including heart disease also. Heart disease in my college days when we are studying we were saying is irreversible once it happens is a continuous you cannot reverse it today we know that vast majority cases you can reverse a large extent the heart disease but 10 years back nobody said that diabetes is reversible in 10 years now the studies say that diabetes is reversible adult onset diabetes we have two types of diabetes children that is type one that you cannot that is congenital but adult onset yes it is completely reversible is all lifestyle related. Okay. Yes. We spoke about vegetarian and non-vegetarian food the diet because vegetarians tend to think but it's not necessary. You'll be surprised 80% vegetarian 20% nonvearian. So unhealthy nonvearian vegetarian diet healthy nonvearian diet say 10 times dangerous. So when you say unhealthy vegetarian diet is typically pushy what are gujarati maradis eat everything fried everything has lot of sweets everything has a lot of salt these are most dangerous and anything that's processed food is the most dangerous when I say healthy vegetarian again going back to our natural anything natural food you cook at home don't put too much oil ghee don't put too much salt that is excellent for the body veget nonvearian similarly anything egg again there's a lot of controversy egg as long as you do not have heart problem and you do not have a cholesterol level as set are not very high and you are doing regular exercise leading good habit daily one egg is not a problem uh and you can eat as much egg white there's a good protein then fish especially saltwater fish because there's some types of algae which has that omega-3 fatty acid that oil that really protects your heart from heart disease. They are only in fish that that eats those algae and they are usually in salt water. So salt water especially white fish they are very very good for body. So as long as you take egg white, white fish, chicken breast and same time you do all other things I said regular exercise keep your weight under control less stress yoga sleep 8 hours then eating non-vegetarian food is as good as eating a vegetarian food. Okay. Interesting. Another Okay. Hello, sir. And I My question was in remote are Normal pathology hospitals at least warning. because of bad lifestyle you can get a heart attack if you are completely normal 30% chance if you are not 100% heart attack because of all this factor Number two, diabetes over then you have to be careful then check up otherwise you are leading absolutely normal healthy life then don't worry you'll never get a heart attack now if you have this risk factor there certain basic test we do now and there's the most useless test Echo. Huh? That is like malaria. Absolutely. Absolutely. Both are useless to detect this heart disease. Completely useless.  So plain has no meaning. useless. Unless factor number two Those who don't know that I thought wrong we do stress that is where helps stress test or there's something called stressium youngsters Something calcium score% chance calcium Cityolester. Okay. So that is if you're in that category where you have family history. Otherwise some simple things is like just climb up four flights. If you're getting breathless or if you are walking for about half an hour in brisk pace or 20 minutes brisk pace and you're persspiring too much or getting breathless then you see that there are some warning signs which are coming your way. Many of people who are especially not fit and if suppose worked all night and next day mornings you listen to uh your podcast suddenly start doing exercise you are going to get breathless. So first and foremost you have to give adequate rest to your body and then do everything. Yeah absolutely true. Whenever I read the reach the gym the first thing that the instructor ask very very important. So if I say then I'm only doing resistance training, no cardio that I'm doing after that. If I have not slept well, that is important. It's not that I don't exercise then but then I'm doing strength training and resistance. Absolutely. No uh no cardio if you're doing that. Yeah. Yeah. And quite often you hear the sudden death also partly related to that to that. Yeah. Especially these you have film actors also who come to you. So one is hearing about those film actors also that you know suddenly and they got a heart attack and all that. Why is why is it happening to celebrities? What happens to them? Uh now it is very common not the celebrity youngsters. Just now only I was coming um on the flight one of my friend he retired at the govern deputy governor of Verar Bank. He's a uh bank chairman. He was just coming he said I just went for my uh bank's uh CFO spinner. He was only 35. He just arrested on exercise died. So it is uh getting very common uh multiple reasons. Number one uh those who have uh this one thing you don't get enough rest then because exercise you think that suppose you have not slept for 8 hours instead of 4 hours you try to make up with exercise you cannot make up with exercise and that's a more dangerous period because if you are not given adequate rest to the body inside the body your stress hormone levels are very high that is a wrong time to do exercise that they do second thing people push at the last moment marathon. We always call it last one mile. We are we are partner in Mumbai marathon for 20 years and almost always last one or two mile the heart attack because it's all over the world because people push against their limit in the last one two mile marathon try to make up little time. So many times in the gym also people push beyond it. I remember many years back I had operated one patient young son was very obese. So he said sir I'll start doing exercise. A month later I got a call from his father that he got a heart attack. We are airlifting. We airlifted him. Did angio his artery had ruptured nothing. And we found out what you had done is first time you went for exercise and he started spinning at the high speed. So what happens is when I said you not get up enough rest don't exercise. Don't push yourself against the limit. Many time people suddenly want to run they have been running say 6 7 km suddenly they want to do 14 km or 12 km for a long time. So don't stress yourself against that. Third thing also sometimes you can have hidden uh defects in the heart. There are two types of disease. One is heart muscle weakness. I talked called cardiammyopathy. Oh it can be completely uh asytomatic and when you are doing lot of exercise especially have not slept properly the heart suddenly can stop. Very very common. And fourth thing is you find quite often very healthy athletes especially have seen this uh world cup etc those footballers suddenly died or arrested because there's certain abnormal origin of the hard arteries. Mhm. Is a congenital defect. I know one of my very close friends daughter had that we manage medical without surgery. Sometimes you need to do surgery to correct it. She's now almost 34. She's doing fine. And what happens is the heart arteries that comes out it sometimes comes out in the abnormal location or it comes out between the two main artery those assigned student between the aorta and pulmonary artery. When anybody does exercise both the arteries dilate when they dilate this artery they get compressed. Oh okay. So these are the four these are the mainly four reason why people suddenly die on the and fifth one is sometimes because of the stressful condition people may not have any that cholesterol deposit suddenly ruptures and uh the chances of sudden death all these thing you'll find is much more in youngsters not in people who are 40 or 55 or 60 because the longer you are done the cholesterol deposit when it starts it is firm it is not anymore soft youngster the cholesterol deposit very very soft so at the height of exercise it can just rupture like a popcorn. will get blocked. you can get hurt that you see so many uh important people celebrities and all that and uh two celebrities who I interviewed who are very physically fit uh lead very boring lives they tell me Sunil Shetty and Akshai Kumar they they are both like you know one of the people who saying no so they wake up in the morning and their friends tease them they break their doors down party they will not do it they wake up with the sunlight and could be 4:30 or 5 in the morning and they eat typical uh food you know which is like garkana and they do that and they eat very boring lives but they are both very fit you know them right Ashaka is a very very close friend his birthday was there only two days back and um no matter what come he hell and anything he'll go to sleep by 9:00 he'll get up at 4 he'll do exercise nothing will stop it that that doesn't mean that I'll tell all of to do that but at least try to lead a routine life as normal as possible. Do as much as exercise. Ashakal is absolutely normal. I mean phenomenally disciplined life. Yeah. Yeah. And you do that you'll never get a heart problem. So uh so once there was a breakfast meeting uh that I had with him and to breakfast to I asked for avocado toast and he just looked at me and says gandhari and he got a nice uh you know uh chapati made of bajra or one. Yeah. And he must have got a huge patal this one this big juice or whatever he was drinking. But he had natural uh food which is probably come straight you know healthy food and I said but what what he says now whole day I will survive on this because I've eaten well interview kunga everything. So but his breakfast is an important thing. Most of us don't have time for breakfast. Yes. Is breakfast important? Both ways are important. Uh I'll tell you this. I'll put the other around. Till 100 years back or max 200 years back all over the world average human being was eating only one meal a day. We don't need more than that food. It is only last 100 200 years that the meals have come more than two meals. And that's where the diabetes etc has started coming in terms of food need you don't need uh one thing one younger age and what after you reach certain age your calorie requirement goes down drastically and you don't need three meals a day you decide which two meals or one meal or three meals you want to eat. Oh god. What is important is important is the evening meal has to be as early as possible because body is still used to at 6 7:00. It used to used to sunset sunrise. So the last meal has to be maximum 6 7 6 7:00. That's the healthiest. So eat in the morning like a king and by night eat like a papa. Oh don't eat at all. Don't eat at all. For example, today I had my lunch. We had a medical meeting and that's it. This is my tea and that's it. You don't need more nourishment than that jeans because Gujaratis and Punjabis need to eat. Yeah. Now while growing up you need all proteins. Everything is very very important. What I said is not for everybody. All youngster while growing up you need to have both carbohydrate, fat and protein everything to build up. If you see the uh earlier generation, current generation everybody is growing 6 in 8 in taller. So it's very important for you to have everything. You need to have three meals or four meals. My son when he was growing up he became 6' three. Um between the age of 14 to 17 will find his head inside the freeze all the time. So so but thin people tend to think that they are very healthy. Thin people also can get heartache. Oh absolutely absolutely thinness has nothing to do with they would not get heart attack. It's the lifestyle you lead the type of food you eat and other genetic other factors. M so coming back to our food thing for youngsters you have three meals have balanced diet occasionally go do the beans food whatever I call it Sunday you keep it as a sin day six days you keep good so six days eat nice do everything one day you can enjoy and once you reach 40 45 what happens is over then your muscle start getting less and less that's why if you see the same person at the age of 20 25 can eat four five chapati and so much rice nothing happens at the age of 45 did two chapati you put on weight. Yeah. So once you do that that my age even if I smell it I put on weight. Yes. So you won't believe uh there's time in my college days I was only 47 kilo. Now I'm a 67. So uh the so you don't need to number one your calorie requirement goes down drastically but very important that you have to have a very balanced diet. You should have a good high quality carbohydrate high quality protein and same time all other nutrients that is very important for your body. So average for anybody after 42 meals is more than adequate. While growing up all youngsters please eat whatever you want to as long as healthy eating please do that and do regular exercise and do gyming weight training every alternate days. Namaste sirinum city. Thanks urbaniz once you come to urban life same Heart disease. The moment you go to urban life automatically all these factor causes to one life is not bad his heart age will be like 25 years always I tell him your heart age is around 25 but what about when you uh uh operated on Dr. from Manm Singh. After that when you told him because post surgery also uh the care is important. So was he listening to you? Did he do? No, he he was a fantastic patient. He was one of the most uh the best patient that you can think of. Huh? He did everything that you told him to. Yeah. Yeah. And if you see he was diabetic always all because all my diabetic patients I give example of Dr. man and uh he lived for u uh 16 years heart no heart problem his sugar was always controlled he was a diabetic patient but his sugar hb once you check it out never above more than 6.5 he was such a good patient also uh Joe family's uh support is very important I mean your the wife who cooks the food or the mother or whatever whoever is in the house who's in charge of uh The kitchen uh should ensure that mindful or there is a tendency towards diabetes then uh and heart related issues then the diet whoever is controlling the family diet that person should be mindful every patient I focus more on the family and less on the patient because it is a it is environment and everything has to be modified without that the hard only the patient if you focus on just giving medicine he's not going to make any changes so because I remember many years back in our my high school raindo there's a very famous line one short story he had written he said if the costly medicine could save lives why should kings and emperors die the point is you need to keep yourself healthy so medicine is not going to make that much difference so that's why coming back to this is very veryant important to counsel the family. see that the entire family leads a heart healthy life then not only the person who got a heart problem everybody has to lead that you were saying alcohol but uh wine whiskey what is more dangerous don't laugh by I don't drink alcohol yes see number one alcohol is not good for health but occasionally enjoying alcohol is fine as long as one or two ps not more than that it should not be every Like one of my patient say liver was so bad before operation checked out wife was standing behind. So as long as a bottle a day is fine. So occasally again daily drink is not good for health is not good for liver increases the risk of cancer. Heart blockage it doesn't cause problem but it can damage our heart muscles. Okay. So occasionally drinking is not a problem. Okay. Emotional stress uh that also uh one question. How much does emotional stress lead to a unhealthy heart? Number one. And number two, we usually eat ghee and drink coffee on a daily basis thinking it's healthy but does it really healthy and how much does affect your heart? I'll answer the second one is smaller one easy to answer. uh ghee along it's natural ghee made in uh home you know cultured ghee you make it from di and that that is healthy aslanga 5 to 10 ml per day is fine coffee again one or two cups is all right it's good for body good for liver um doesn't make that much difference to heart but it's fine beyond that anything excess is bad and now emotional stress you see it is linked to our evolution for human beings now when you from human as I told you we are staying in jungle for 100 170,000 years so there is something called fight or flight response because human beings we are never the top of pecking order we are on the bottom either your big will come and kill human beings are all the time running around how to save themselves so there's something called fight or flight response that response is Yeah. What it does basically is increases your hormone stress hormone level. brain blood supply. Now modern lifestyle that is not there. The moment you take stress, body doesn't think that you are taking stress. Body still is in that board. It will take another 50,000 years to come out of that jungle. Body still think there's a tiger is coming to kill you or there's a vice is coming to kill you. So the hormone levels start increasing inside the body. It's called fight and flight response. It is still there inside the body. So getting stress occasionally, see life is full of stress. Getting occasional stress is not a big deal. Nothing will happen. When you have a continuous level of stress, your stress hormone level stays very high inside the body. What it does is increases the heart rate all the time. makes your arteries very all the time it is constricts the artery because it still thinks that you need to supply more blood to the muscles and less to the brain and over long time the arteries start getting damaged you start getting blockages get hypertension all other associated diseases start occurring so that's the reason stress continuous for a long time a bad for body one of the best way to do is our Indian yoga yoga is one of the best ways to reduce your stress I'm a very very firm believer of every day I do yoga. So I'll advise everybody whenever you get time 5 10 minutes you can do your yoga okay uh uh let me come to the part when heart attack like uh youngsters CPR to learn CPR at what stage should it you know should the policy makers of this country decide that school level college level USA American Heart Association and uh the government has taken they have trade everybody I very very very strongly will I will advise because hard within 3 minutes you can resuscate after 3 minutes brain get damage you cannot do that I'll very strongly I know I wish the government does that the school level train everybody it's a very very easy way to do the train so educators who are listening in to the show please don't wait till the government tells you start this um process of train uh training We've done that in our uh office. We got people to learn how to do CPR and we have saved people. Oh yes, absolutely. Absolutely. We have got so many in our bandakla complex place where located we regularly send our doctors they regularly conduct CPR training courses for everybody and we have saved so many people. Okay. To for curative purposes uh to go to hospitals is extremely expensive and like he was saying that in villages. So what would your uh advice be to governments? uh how can we improve the cardiac health of our population more hospitals or more uh universities where they are teaching uh cardiac care what should be done I think now most importantly I I'll tell you no society in the world has been able to um uh sustain um disease care okay uh when I say disease care mean you uh develop the disease and then try to treat no society No, nobody no country is able to do because disease car is terribly terribly expensive. So now focus should be maximum now on prevention healthare healthare managing your health is more important than managing the disease focus should be there. Having said that absolutely number one as I said insurance has to be there. Number two, I think the as much as possible starting from school, college, every level uh uh we should educate people as much as possible for health uh health management rather than disease management. I give you one example 1997 to 2006 10 years USA the American Heart Association the praise the public everybody took a lot of effort they brought down the heart disease by 26%. Of course again everything have gone backwards. People again become obese and not least doing that. The point you are trying to do that is a concerted effort by the government and the public and uh media everybody. We can drastically bring down the uh disease burden. Very very important that everyone has to learn that health management is much more important than disease management. And also you know it's like you hear Europe cheese cardiac issues America cardiac issues India who are more prone to cardiac you know is it north south east west which parts there if you see they Americans are very health consent they do a lot of exercise Europeans do a lot of exercise also there is certain genity if you see their their muscle masses must bigger than ours. We have got a much less muscle mass. Our food habit if you see our carbohydrate content is very high. So we have got a huge stomach that would be very bad for the health angle. M so um uh having said that in India our disease uh if you see there's a higher incidence more especially in the Gujarat or Rajasthan that again related to the type of food I don't think anything to do with genetic it is more related to that uh because they eat lot of unsaturated fat lot of sweet sugar everything fried everything processed food um again um the lesser incidence you'll find on the coastal belt where people are more uh they eat a lot of fish and also the food doesn't contain so much saturated fat and fried sewage etc. Okay, any other questions? Okay, Hanji. Uh hello sir. Hello ma'am. My name is Kashish and my question is pretty simple sir. Uh what is one of the biggest misconception about heart uh you would like to burst here any that that everybody thinks that I'm never going to get a heart problem. the other one is going to get heart problem. That is the biggest myth. That's why people get into trouble. They think there are many people who say that he was such a happy person. He was Yes, because the person smile don't know how much stress he must be taking inside genuinely smiling or taking stress whether he has any other risk factors and quite often as I said there are lot of these congenital heart defect that people don't realize sudden they get into problem and also don't ignore your mothers and sisters yes uh those who you know who you think are taking care of everybody many of them are taking all that inside and internalizing the stress that's Especially Indian society you know we neglect our mothers and sisters their health and that's how the heart disease quite often underdiagnosed or they have we always say also there's resistance doctor to take mothers they don't agree to go to the doctor yes yes the first thing is that is there anybody else okay hello sir myself I have a A question apart from health issues actually um my sister is doing u graduation in op technician and she is now doing a clinical posting uh as a OT technician but whenever she is interacting with a uh surgeons so every surgeons is like so is it as you are a surgeon so is Is it really so why there is a so many so much gender witness? OT technicians uh are usually men. Women are not encouraged to become OT technicians. My everybody is women. So I don't think there's gender bias there. So individual bias by and if look at me in our hospital all the tech are women. Okay. Yeah. Yeah. So maybe she needs to move to a nicer place. Then every profession is good. I don't think any profession there is any gender bias should be there. So doctors tension that you have patients who come and you are at the OT table and their entire life is in your hands. So how do you all uh manage stress? Doctors are just like human beings just like you. We have a same level of stress everything you take. Uh the thing is lead a balanced life. What I do I always advise everybody that your profession is the only not the only thing in your life. You have got a family, you have got friends, you have got society, you have got hobbies. Always I advise everybody do some hobbies. I have got a hobby. I do lot of wildlife photography. Second thing I listen to music. So my operation theater while I'm operating always there's a song going on in the background. without that I don't operate. Oh, so there are many ways you can reduce your stress. Yeah. Yeah. So I'll advise always everybody and that uh don't let your uh profession or your study consume everything also keep some little bit time to smell the roses. So relaxation time with friends and not binge watching at 2 in the night. Occasionally once in a month you can do not on regular basis. So have a hobby, do something that keeps you happy. Okay. Yes. Go ahead. Hi sir, I'm Kalpnab. I read a book a while ago uh by the name uh that our body keeps a score meaning that our body stores emotions and uh uh sometimes we feel bad emotions. So that turns into psychosomatic diseases. So what kind of emotions actually get stored uh in our heart which which can or which causes heart diseases and number two uh how can we overcome that and my another question is I I saw a documentary called blue zone documentary. So uh so the gist of it was that the purple colored uh food are for our nervous system, red color food are for our good for our heart. So is it true? I'll ask the second one. This jelly bees also red jelly be so natural that's not natural. Carrots yes any colored fruits usually has lot of antioxidants very good for the body. So there is for heart not only for heart is for overall even reducing cancer because there's something called antioxidant the body produces all the time toxins in the body that needs to be cleaned up from the body. So a lot of colored fruits are very good because they are very very high in antioxidant the alcohol your wine came from there that's somebody asked should I should I take a red wine every day I said instead of red wine eat red grapes so that is as good as red wine. So this is called antioxidant coming out the fruits. Now in terms of the stress this is again it it is all mediated through the stress pathway I explained to you that's why it causes the heart disease. Yeah. Okay doc this another thing which I've heard is is it true if there is no incidence of heart problem where anybody everybody is healthy I don't see any indications of keep and how do you figure out gas heart attack yes that's very common thing unfortunately heart that is very important question you asked is the commonest symptoms of heart disease is you get a very heaviness as if some stone Phone is kept on your chest is pressing your chest. Unfortunately almost 30% patients you don't get that symptoms. You get what is called atypical symptoms or no symptoms at all. Atypical means you might getting a jaw pain. We have got patients who have gone to dentist and got a heart attack after few days. People have gone to gastroentertology. Recently actually one of the very famous uh Telugu after his uh I had operated him and his do daughter went for 6 months for gastronally suddenly dropped dead that was in the news. Uh so this is called atypical pain or referred pain. One have to be a little careful as long as you do not have any risk factor in the family and you yourself don't have any risk factor don't have to worry if you are having uh acidity or chest burn or jaw pain it is not but on the other hand if papers any risk factors and especially youngster now especially if you are doing any of these beans things that I said there two guys two boys I one I operated and one was we managed without anything because the artery we opened up with a stent And um they had no other problem. So because they are doing very binge watching that's why they got into trouble. Oh my god. Yeah. Just binge watching resulted in binge watching with cigarette. And so when you binge watching happen doesn't happen only that it happens cigarette it happens with your um your pizzas burger all those things everything starts with that whole ecosystem. When that happens then you have to be careful. Other than that all the things I said if you are doing all of them you are not going to get a heart problem unless you got a very strong family or something. What about pediatric uh cardiac issues like you hearing about 10 year olds 11 year olds getting uh heart attacks. How is B? There's very different type of heart attack that's not related to this blockage type of heart attack that different type of these are the born with heart defects so they get into heart attack. Somebody's arteries are coming on the wrong location heart muscles are weak. These are different type of heart. So, so those 8 10 year olds is not because they were obese because then headlines not related to this type of heart. There's a different type of all right having said that the youngest one I have done I have operated one 16 year old girl. uh unfortunately she had a very uh very very strong familiar history her uh triglyceride level was 1400 cholesterol level was around 800 so that was very different situation so there's no need for servitate uh but if there's a high risk in the family the best thing I'll suggest is immediately consult your doctor rather than self treating yourself and what about those who go to Google and AI that is the most dangerous thing because because It has killed more people than help anybody. And reason is quite often your acidity and the heart attack symptoms will similar. You got acidity you take aspirine then you are going to get a massive bleeding from the stomach. And until few years back we used to recommend because one of the commonest best medicine to when you somebody gets a heart attack we give aspirin. So so much so there was a lot of thought process going on among doctors that we give aspirin to everybody above 50. Then we realize when they started doing more people died from complication of aspirin than from having a heart problem. So now the recommendation is don't give aspirin to anybody unless the person has a heart problem. So many times people advise keep an aspirin. You can have a certainly suspect a chest pain you take it but it could be acidity also. The best way is consult the doctor and then whatever the doctor adise take it. Don't self-medicate. Okay? Because doctors available 1 minute away from a phone call. Right. Hello sir. My name is Rahul. I very strongly adise don't take any of this processed protein natural vegetarian paneer tofu so many different types of different vegetarian protein nonvearian egg white chicken try to avoid processed this Yes. So, so take natural protein rather than any of this processed protein. Okay. So, any last message that you have uh before we uh complete the show? Anything that you would advise uh when a person feels that they have a heart issue? Of course, rush to the doctor. But uh is it something to fear that most of us will get it? What should we look out for in today's time? My first advice will be don't worry at all about heart disease. Even if you get it, today it is almost curable. When I studied medicine, we thought it's heart disease was considered worse than cancer. Even from there today, you have come to a stage anybody has heart problem can still completely normal life. You don't have to worry at all that in case you get a heart disease, you your life is gone. You can absolutely lead a normal life both quality of life and length of life and more important than that please do all the thing that I suggest I advise to keep yourself healthy so that you don't get a heart problem and your family members also don't get that. Are you happy that you chose this line doctor? Would you rather be a wildlife photographer than be a cardiac surgeon? given a 100 times I'll still do heart surgery and uh during my heart surgery we have been trained those days uh the sleep this new knowledge those days knowledge are not there nowadays we are not allowed to do that kind of training anymore we used to get trained around 36 to 40 hours continuously yeah we'll be working for morning 6:00 till next evening 8 or 9:00 go home sleep for 8 hours 10 hours come back and work that time this knowledge was not there uh and we'll be got trained like that for 5 years and uh if you ask like that at the end of 36 hours if ask your name also you will not know what is your name is that kind of exhaustion we went through but having said that given a choice I'll do that again because that is my first and last love and while I photograph my second love okay thank you so much for being here all the best thank you for watching or listening to this edition of the NI podcast with Smith Prakash. Do like or subscribe on whichever channel you have seen this or heard this. Namaste Jind. Click here to watch the previous episodes.