04/06/2025
A must read.
Heart Attacks in the Young: A Cardiologistâs Perspective on a Growing Crisis
By Dr. Gotabhaya Ranasinghe
A Shocking Trend in My Own Practice
As a cardiologist practicing for over 25 years, I have seen a disturbing rise in heart attacks among young adultsâespecially in Sri Lanka and other South Asian countries. What was once rare in people under 40 has now become alarmingly common. Every month, I encounter individuals in their late 20s and early 30s suffering from heart attacksâmany without traditional risk factors like obesity or family history.
So whatâs driving this surge?
In my professional opinion, the answer lies primarily in modern lifestyle choicesâspecifically, poor diet, physical inactivity, chronic stress, and inadequate sleep. These arenât just âbad habitsâ anymore. They are root causes of inflammation, oxidative damage, and early plaque formation in coronary arteries.
The Hidden Dangers in the Modern Diet
One of the most overlooked contributors to early heart disease is poor diet, especially the consumption of:
1.â â Refined Sugar
Sugar is not just empty calories. It is a potent inflammatory and oxidative agent. Excessive sugar intake leads to insulin resistance, metabolic syndrome, and damages the endothelial lining of arteries, triggering the formation of atherosclerotic plaques. In Sri Lanka, the consumption of sugary foods and beverages is rampantâespecially among the youth. This is reflected in the rising rates of type 2 diabetes, even in teenagers and young adults.
2.â â Seed Oils (Industrial Vegetable Oils)
Most processed and fast foods are cooked in oils like sunflower, canola, soybean, corn, and palm oilâwhat we call seed oils. These oils are high in omega-6 polyunsaturated fatty acids (PUFAs), which are highly unstable and prone to oxidation when heated. This generates free radicalsâhighly reactive molecules that damage the endothelium (the inner lining of your blood vessels), increasing the risk of plaque buildup.
In contrast, coconut oil (traditionally used in Sri Lanka) and olive oil are much more stable and heart-friendly.
3.â â Ultra-Processed Foods
Almost every packaged snack or fast food contains either refined sugar or seed oilsâor both. These foods are engineered to be hyper-palatable but are toxic to the cardiovascular system when consumed regularly.
Sedentary Life: A Modern Killer
Many young people now live highly sedentary lives. Whether itâs due to screen time, commuting, or work, daily movement has drastically decreased. Physical inactivity leads to insulin resistance, poor circulation, and increased visceral fatâeven in people who are not visibly overweight.
My recommendation:
At minimum, engage in 40 minutes of physical activity at least five days a week. You donât need a gym membership. Walking is the simplest and most powerful habit to protect your heart. Other activities like swimming, cycling, or dancing are excellent too. The key is consistency.
The Forgotten Pillar: Sleep
Many young professionals and students sacrifice sleep in pursuit of productivity or entertainment. But what they donât realize is that sleep deprivation is a major cardiovascular risk factor. Poor sleep increases stress hormone levels (like cortisol), impairs glucose metabolism, and produces oxidative stress that damages the arteries.
Aim for at least 7 hours of quality sleep per night. Itâs not a luxuryâitâs a medical necessity.
Final Thoughts: Prevention Is Possibleâand Essential
Young people must realize that heart disease is not just their parentsâ problem anymore. It is now a disease of the youngâquiet, creeping, and often fatal when ignored.
But this is not inevitable. The good news is, early lifestyle changes are extremely powerful. You can reverse many of these risk factors before they become dangerous.
As a cardiologist, hereâs my advice to everyone under 40:
⢠Cut down refined sugar and processed carbs.
⢠Avoid seed oilsâstick to coconut oil or olive oil.
⢠Eliminate ultra-processed foods from your diet.
⢠Move your body daily.
⢠Sleep 7â8 hours every night.
⢠Listen to your bodyâdonât ignore unusual fatigue, palpitations, or chest tightness.
⢠Do regular health check-ups starting from your late 20s, especially if thereâs a family history.
Your heart doesnât wait until retirement to give out. But it will reward you if you take care of it now.
