Study seeks to explain rise in heart attacks among Chinese Canadians

Researchers regard lifestyle factors, like diet and physical activity levels, as prime suspects

Study seeks to explain rise in heart attacks among Chinese Canadians
With more and more Chinese Canadians being admitted to hospitals due to heart attacks, experts believe changes in lifestyle among that community could be at fault.

“For second-generation Chinese Canadians, Western fast foods may be a major culprit,” said Dr. Jack Tu, a professor of medicine at the University of Toronto, in a piece published by the Toronto Star. He explained that traditional Chinese diets leaned toward rice, noodles and vegetables, allowing small portions of meat and rare inclusions of sugary desserts.

Chinese immigrants might also be getting less exercise than before. Tu shared how three decades ago, he visited China and found widespread use of bicycles, as well as traditional disciplines like t’ai chi and chi gong in public areas. “Today, with the adoption of more Westernized lifestyles, heart disease, obesity, diabetes and cholesterol levels aren’t just rising among Chinese migrants — they’re exploding in China too,” he said.

While lifestyle factors like diet and exercise are the prime suspects, there’s little hard evidence to definitively identify them as the root cause of increasing heart attacks. Ethnic minorities have been under-represented in medical studies looking for possible causes of heart disease and cancer, Tu said.

Cultural barriers also exist. Immigrants may hail from countries that lack a tradition of medical research. Such people tend to underestimate the impact participating in studies could have on medical care for ethnic communities, as well as the safeguards in place to protect their privacy. Language could also hinder research involving immigrants.

To address this problem, Tu and his fellow researchers are conducting a pan-Canadian multi-ethnic study called the Canadian Alliance for Healthy Hearts and Minds. The study examines people from various ethnic backgrounds including white Caucasians, South Asians, East Asians, and indigenous peoples, with the aim of finding chronic disease factors that may be unique to each group.

“For example, South Asians and Chinese may gain weight around their bellies,” he explained. That means the traditional BMI, which was developed largely from studies of Caucasians, might not be the best way to determine whether someone from another ethnic group is overweight.

Effects of migration will also be considered through detailed questions about lifestyle changes that followed immigrants’ moving into Canada, and comparing that with native born Canadians. Chinese and Western diets will be examined, as well as the possible impact of one’s neighbourhood on smoking, diet, physical activity, and healthcare access.

Participants will also have MRI scans of their heart, liver, brain, and neck done at Toronto’s Sunnybrook Health Sciences Centre. Heart scans may reveal ethnic differences in heart structure, while liver and abdominal fat measurement may uncover a better way to determine obesity — a major risk factor in diabetes and heart attacks — than BMI. Finally, brain and neck imaging might also be useful in predicting strokes.

“Once we know each group’s particular vulnerabilities, we can create heart-healthy guidelines specific to them,” Tu said.


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