How History Still Weighs Heavy On South Asian Bodies Today

Walking home from secondary school with my sister many years ago, I spotted a London bus plastered with a depressing advert, solemnly warning of the dangers of diabetes. “What’s the big deal?” I asked rhetorically. “Diabetes for an Asian person is a regular Tuesday.”

Though I was being facetious, I wasn’t wrong. South Asians do seem more susceptible to diabetic conditions. According to Diabetes.co.uk, the likelihood of developing type 2 diabetes is reported to be as much as six times higher in South Asians than in Europeans, with a number of factors – mostly linked to lifestyle – believed to be behind this increased risk.

But have we also considered the role history plays here? Is colonialism another overlooked factor that contributes to South Asian bodies? It’s well understood that people can inherit psychological trauma from previous generations but, for many racialised people, there can be physical consequences, too.

Think back to GSCE history. You may have learned the Indian subcontinent was subject to many famines, with some particularly severe ones occurring under British rule. For centuries, up until India gained independence in 1947, starvation plagued the nation, in part a byproduct of colonial times.

The East India Company’s raising of taxes, policy failures (including a “denial of rice”), resources being deployed to the military, and droughts that were met with British inaction, resulted in the deaths of millions. In 1943, West Bengal saw the worst of it all, a famine in which up to three million people died of malnutrition.

Yet, famines in the British era were not due to a lack of food, but due to the inequalities in the distribution of that food, Nobel Prize winning economist Amartya Sen argues, linking this inequality to what he describes as the fundamentally undemocratic nature of the British Empire.

You might wonder what’s all this got to do with South Asians now? Well, not only was the “great famine” in Bengal only 79 years ago (for some, a part of living memory), but when a group of people are exposed to starvation on this scale, it can affect subsequent generations.

Dr Mubin Syed, a 56-year-old radiologist from Ohio who also works in vascular and obesity medicine, recently went viral on TikTok and Instagram for making this crucial link.

As he explains in his video, South Asians have a tendency to generate and store fat and not burn it off, amassing low lean muscle mass. This, he points out, is because South Asians are “starvation-adapted”, due to having to survive at least 31 famines, especially during the 18th and 19th century.

Surviving just one famine doubles the risk of diabetes and obesity in the next generation, even without a famine, according to a study by Brown university. The risk of cardiovascular disease increases 2.7 times for their grandchildren.

Dr Syed, whose research in this area for the past five years led him to these conclusions, tells HuffPost UK: “Exposure to even one famine has a multi-generational effect of causing metabolic disorders including diabetes, hyperglycemia and cardiovascular diseases. Imagine having an exposure to at least 24 major famines in a 50-year period.”

And the problem carries through to the present.

“In the modern era of abundance, it becomes an evolutionary mismatch. Our adaptation to scarce food availability is no longer suitable for our environment of food abundance,” he says.

So, storing nutrients was an evolutionary response to famine, but now, where scarcity is no longer a problem for much of the modern, western world, it creates a conflict, heightening our risk of certain health conditions.

“South Asians have a unique physiology,” Dr Syed explains. “For instance, we have higher body fat percentage and lower lean muscle mass. We have a six times greater risk of developing diabetes, one of the highest rates of diabetes and pre-diabetes in the world, and a four times greater risk to have a heart attack before the age 50. Furthermore, one in three South Asians will die of heart disease before 65.”

While our genes, inherited from our ancestors, can explain some of these predispositions, diet is another contributor – though not in a straightforward way. “It’s a multifactorial perfect storm,” says Dr Syed. :Genetics is one issue, but of course, lifestyle is always important. But, South Asians have to exercise twice as much as Caucasians to get the same health benefits.”

Dr Syed has been researching this area for half a decade

Mubin Syed

Dr Syed has been researching this area for half a decade

It certainly feels like Indians, Bangladeshis, and Pakistanis, who once made up India, are still reeling from the effects of colonialism, mentally and physically.

My family are certainly still feeling its effects. Though my parents weren’t around when the Bengal famine took place, their generation is impacted; my dad is diabetic while my mum is prediabetic, and this leaves me in a precarious position, too.

Another concern for the community is a lack of awareness about how our past informs our future. This is why filmmaker Phelan Chatterjee, 26, set out to create a short documentary, Straining The Rice that captures the trauma endured by Bengali people, told through the lens of a grandmother, Nana (not his own).

The London-based producer laments how little people know of the famine and how it affects us today.

He tells HuffPost UK: “I had a lot of conversations with Asian friends and family in the UK. I found very little mention or memorialisation of the catastrophe, despite the enormous number of people who died, and its effects today.

“The sheer number of lives lost, the brutal way in which they perished and the helplessness of those demanding change at the time. It’s difficult to come to terms with the fact that it’s not a part of our national conversation in any meaningful way.”

Phelan's film Straining the Rice includes testimony from Nana, who experienced the famine as a child.

Phelan Chatterjee

Phelan’s film Straining the Rice includes testimony from Nana, who experienced the famine as a child.

Chatterjee questions those who say the famine was simply an environmental consequence, and asks why there’s no accountability for why such conditions were created.

“The protagonist of the film, an elderly Bengali woman says the famine sparked a great deal of protest against the colonial government of the day,” he says.

“This suggests there had always been a keen awareness of the links between policy choices and the famine. But frequently, I’ve experienced famines and similar events to be thought of as beyond human control.

“I wonder what a reappraisal of those policies might bring, and how that could inform the way we understand contemporary famines, global inequality – including health inequality – and climate change.”

Straining the Rice focuses on a family discussion of the Bengal famine

Phelan Chatterjee

Straining the Rice focuses on a family discussion of the Bengal famine

If schools, for instance, taught students about these historical atrocities and their contemporary implications on us mentally and physically, we might have a better understanding of how to navigate our lives now. Healthcare research and responses might even cater better to our bodies, as a result.

But, despite the risks and impact of inequalities on South Asians today, Dr Syed says it doesn’t mean ill health is inevitable for us.

“It’s not a doom and gloom scenario,” he says. “The risks are avoidable, we just have to pay closer attention to diet, exercise/fitness, sleep, stress and other substances.” This means how much alcohol and tobacco we consume, says Dr Syed, and for South Asians who enjoy it, consumption of betel nut or supari.

Nana remembers how beggars would ask for the starchy rice water

Phelan Chatterjee

Nana remembers how beggars would ask for the starchy rice water

“Even our dental health,” he adds. “The key thing is awareness, getting regular check-ups, including lipid profiles, is critical. Do not assume you are healthy, as normal height/weight BMIs are misleading for South Asians.”

Many South Asians in the West who are told “colonialism was a long time ago” and not to “dwell on the past” will struggle with all these conflicting messages. We certainly can’t nor should forget a history that still continues to impact us. And there are many who still remember the harshness of colonial times.

For those who came before us, as well as ourselves, it’s imperative we keep educated and informed of our past and how plays a crucial role in our future.

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Diabetes drug ‘significantly reverses memory loss’ in mice with Alzheimer’s

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Health24.com | This group of people has a 7 times greater risk of sudden heart death

People younger than 50 with diabetes have a seven-times higher risk of dying from sudden cardiac death, preliminary research suggests.

And their risk of dying from any kind of heart disease is eight times higher than for those without diabetes, the long-term Danish study also found.

Without warning

“It is important that healthcare providers are aware that young patients with diabetes have an elevated risk of mortality and that this is mainly explained by an increased risk of sudden cardiac death,” said the study’s lead author Jesper Svane, a medical student at Copenhagen University Hospital in Denmark.

Sudden cardiac death is caused by malfunctions in the heart’s electrical system. It often occurs without warning, according to the American Heart Association.

Dr James Catanese, chief of cardiology at Northern Westchester Hospital in Mount Kisco, New York, said he wasn’t surprised to see the link between diabetes and heart disease deaths.

“What was surprising was the amount of increased risk – a seven or eight times higher risk is astounding, particularly in people below age 50,” added Catanese, who wasn’t involved in the study.

The 10-year study included health information from all Danes between one and 35 years old in 2000–2009 and from those 36 to 49 years old in 2007–2009.

Of more than 14 000 people who died, 5% had diabetes, according to the study. Almost 500 of them had type 1 diabetes, which is an autoimmune disease. And nearly 200 who died had type 2 diabetes, which is the more common form of the disease and it’s generally linked to excess weight.

Overall, the researchers found, people with diabetes had a five times higher mortality rate than people without diabetes.

Sudden cardiac death

More specifically, they found, death from heart disease was five times higher in people with type 2 diabetes, and 12 times higher in people with type 1 diabetes. Svane said this may be because type 1 is often diagnosed in childhood, so patients have the disease for a longer period of time.

The research couldn’t prove a cause-and-effect relationship, only an association, Svane explained.

But what might cause this association between diabetes and the risk of heart disease?

“Fluctuating blood sugars, abnormal cholesterol and high triglycerides, which are present in many persons with diabetes mellitus, increases the risk of [hardening of the arteries] and coronary heart disease,” he noted. This eventually increases the risk of sudden cardiac death or heart failure, he explained.

An additional risk factor for people with type 1 diabetes is a condition called “dead-in-bed” syndrome. This term describes a sudden, unexplained death in a young person with type 1 diabetes, Svane said.

“The underlying mechanism leading to dead-in-bed syndrome remains unknown. However, growing evidence is pointing at both autonomic neuropathy and nocturnal hypoglycaemia (low blood sugar) as causes,” Svane said. There were six dead-in-bed cases included in the current research.

Benefits of weight loss

Autonomic neuropathy is a complication of diabetes that causes nerves that control important body functions – such as digestion or blood pressure regulation – to malfunction, the American Diabetes Association says.

So what should people with diabetes do to lessen their risk?

Svane said previous studies have shown that tight control and effective treatment of cholesterol, blood pressure and blood sugar can reduce the risk of heart-disease-related deaths in people with diabetes.

“Pay attention to diet and to a lack of physical activity,” he advised. “Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure and help reduce the risk for heart attack and stroke.” And anyone who smokes should quit, he added.

Catanese agreed that aggressive treatment of diabetes, cholesterol and blood pressure is key.

“People with diabetes need to know they’re at risk of heart disease death right now, and they need to take care of their heart right from the onset of diabetes,” he added.

Image credit: iStock

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