Updated: Nov 8, 2022
By Dr. Sandra Piedad Cardona
My first contact with heart disease
My first memory of a hospital, and the one that made me want to become a medical doctor was at age 10 when my father was hospitalized for several days. On my first visit, I remember thinking, “one day, I want to work in a place like this.” My father had had a heart attack, which was my first experience with this deadly disease.
My first contact with death
A year before, the first person I knew to die was my maternal grandmother. She had previously suffered two cerebral thromboses and died from the third one.
Death revisited me
Two years after my father’s heart attack, death revisited us when two uncles and my 23-year-old brother died after suffering massive and fatal heart attacks. None had even made it to the hospital. Years later, my father was in the hospital again for surgery—3 coronary bypasses. Yet, six months later, he suffered a cerebral thrombosis, an intestinal thrombosis, and a cerebral hemorrhage, and he died.
Coronary and cerebrovascular diseases continue to be part of my life
Ten years later, after succeeding in my goal to become a doctor, I observed my older brother's triple coronary bypass surgery after he suffered a heart attack. Sometime later, I watched my older sister's surgery due to similar circumstances. In November 2021, at 63, she passed away from cerebral thrombosis and subsequent cerebral hemorrhage.
The story does not stop here. My mother's life was irreparably changed after her first cerebral thrombosis. To date, she has suffered at least three cerebral thromboses and my older brother recently underwent another cardiovascular procedure: a coronary stent application in one of his previous bypasses.
One might think that we inherited all these severe cardiovascular diseases. Yes, they are inherited, but not genetically. They result from family, cultural, and environmental factors. Let me explain this. It is part of something called EXPOSOME.
My family's traditional diet
I come from a small town in the Colombian coffee mountains. The last time I visited my family with my husband, he went to the local market to get some groceries and made an interesting observation. Most of the fresh food supply was predominantly beef, chicken, and pork; less than 10% of stores sold fruits and vegetables with minimal variety.
That observation made me remember that while I lived there, our diet mainly consisted of beef or pork at breakfast, lunch, and dinner. At least once a week, we included organ meats, what we call fritanga, and chicharrón (pork skin), an ingredient in our traditional dish, the bandeja paisa. Our traditional diet includes classic side dishes such as rice, plantains, potatoes, and cassava-- often three of those in the same meal accompanied by beans. Dairy products were always included in our diet. We used to eat whole fruits or juices, also, as a complement after nearly every meal, we drank "agua de panela", a drink made from sugar cane juice. Salads were generally limited to small portions of cabbage, carrots, beets, onions, and tomatoes, most frequently served on Sundays.
Does it looks familiar?
This diet looks familiar to many, but it doesn't mean that is good. An unbalanced diet high in meats, dairy, and carbohydrates, while also low in vegetables, leads to several problems. Many references and studies show that this diet significantly predisposes people to cardiovascular diseases.
High consumption of beef, pork, chicken, and dairy products is rich in protein. Considering current “protein-rich” diet trends at face value may sound reasonable. The point is that it is also rich in saturated fat, one that becomes solid at room temperature. You may have noticed that the fat left in the pan after frying bacon solidifies at room temperature after breakfast; that's saturated fat. That fat is the one that accumulates in the arteries walls.
When we eat many carbohydrates, our body also uses them to make fat. Part of that fat becomes energy and the fundamental structure of our body. Still, consuming more than we need accumulates in the abdominal wall, buttocks, legs, and our internal organs, including our arteries.
Conversely, when we don't consume enough dark green and colored vegetables, we miss out on a protective factor they contain, Nitric Oxide. This substance helps dilate arteries and reduce inflammation when accumulated fat.
What is the relationship between the fat and the arteries?
Normal arteries are elastic and flexible. When fat accumulates in their walls, they become thick and stiff and develop a “cheese-like” development along the artery wall. The buildup of this fat is called plaque.
The plaque cause arteries to narrow and progressively block blood flow. If the arteries that supply the blood with oxygen and nutrients to the heart's walls become clogged, the heart won't be able to beat usually, which will cause cardiac arrest.
The fatty plaque can also rupture and bleed, giving rise to a blood clot that can clog the artery at the same site as the plaque, or it can travel and clog the artery elsewhere. This condition is called thrombosis. One of the most frequent and deadly places for thrombosis is the brain.
This article illustrates how when one food group is too heavily incorporated and neglected the “balanced nature” and importance of others; health problems are practically destined.
For generations, the history of cardiovascular disease in the families in my region has been very similar to my family's history. Since this kind of health condition has evolved over many generations, it would appear genetic. As I mentioned, it is not due to inheritance by passing on a specific gene that predisposes us to these health conditions, but an environmental heritage. How we learn to consume food according to the product's availability is what becomes our cultural diet.
A balanced diet, including grains, meats, legumes, fats, dairy products, fruits, and vegetables, helps us maintain adequate sources of nutrients that prevent deadly diseases such as cardiovascular disease. But limited food supply and solid cultural heritage condemn people to suffer from these deadly diseases.
Dr. Sandra Piedad Cardona, MD
Co-founder at Atuvera