Cardiologists could learn about people from economists.

In support of Swasth Bharat, which means 'healthy India', the Cardiology Association of India recommends the elimination of 6S from our lifestyle, to prevent coronary artery disease. These are smoking, sugar, salt, sedentary lifestyle, saturated fats and stress. There is no debate about the harmful effects of smoking, lack of exercise or obesity, but what about the others. Wild animals never put 3 things in their mouths, which are tobacco, refined sugar and milk of another species. In fact, adult animals never drink milk, only humans do. So, should cow's milk be banned? However, animals love alcohol if they can get it, as chimpanzees showed in Africa. Salt is essential for life. We need about 5 grams per day but get too much from processed foods. Sugar is very bad. It is just empty calories, with no vitamins or minerals, and is primarily responsible for cavities in teeth. However, on average Indians consume very little sugar compared to western countries. The US tops the list because of the consumption of soft drinks. One bottle of cola drink contains around 11 spoons of sugar. Saturated fats come mainly from animal sources, such as milk products, meat, and eggs. So, should all of us become vegetarians? Gujarat, which is mostly vegetarian, has the highest number of diabetics as well as hypertension cases. Diabetes is an independent risk factor for coronary artery disease while patients of hypertension have a higher risk of stroke. The trouble is that diabetes and hypertension do not cause any symptoms until far advanced and so a lot of people remain ignorant of their diagnosis. People dislike taking medicines so stop treatment when they feel better and Indians have a much greater faith in alternative forms of medicine such as ayurveda or homeopathy and waste a lot of time going to various quacks, who promise complete cure to milk their money, until serious complications set in. Diabetes is unique in that it is the only disease in which the patient is mostly responsible for control, because sugar comes from the diet, which is controlled by the patient, and food is addictive. People do not like needles and so avoid tests and so 90% of diabetics in India are not controlled. Poor control means more complications. On the other hand checking blood pressure means visits to doctors, which cost money. People hate paying doctors so hypertension remains uncontrolled. Although bulging tummies of middle aged Indian men provide cartoonists with a lot of material, rate of obesity is among the lowest in the world. Economists have understood that human beings are basically irrational and will hang on to extreme opinions even when presented with proofs to the contrary. This can be explained with Bayes' Theorem. Perhaps cardiologists need to talk to economists before trying to change people's lifestyle. Understand people first.