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Doc. Earm’s ‘K-Health’: Risk Factors for Heart Disease
By Yung E. Earm (Professor Emeritus, Department of Physiology, College of Medicine, Seoul National University; Research Fellow, Department of Physiology, Anatomy and Genetics, University of Oxford )
◇ Various Causes of Heart Disease
It is difficult to pinpoint the exact causes of heart disease, but there are several well-known risk factors. The most representative include smoking, lack of exercise, excessive drinking, obesity, family history of hypertension or hyperlipidemia. Psychological factors, poverty, education level, and environmental pollution such as fine dust are also recognized risks.
Unhealthy eating habits or a sedentary lifestyle—such as sitting for long hours watching television—can harm vascular and heart health. In addition, there are some unexpected factors that also increase the risk of heart disease.
For women, one such factor is early menarche (the first menstrual period before age 12). In the 1920s and 1930s, girls typically began menstruation around age 17, but today it occurs much earlier. Recent surveys show that the average age of menarche among girls is now 11.5 years.
Even more concerning is the rise of precocious puberty. If starting menstruation before age 12 negatively affects cardiovascular health, then most modern girls carry that risk.
In general, women who begin menstruation early are more likely to experience early menopause. After menopause, the likelihood of cardiovascular disease increases significantly, as the protective effects of female hormones disappear. Without hormonal protection, obesity develops more easily, and obesity accelerates arteriosclerosis, thereby raising the risk of heart disease.
Taking diet pills also puts extreme strain on the heart. Depending on the medication, side effects may include neurosis, hyperthyroidism, tachycardia, and hypertension.
Severe influenza is another harmful factor. The flu weakens the body’s immune system, worsening chronic diseases—especially pulmonary conditions like asthma—or heart-related illnesses such as coronary artery disease and heart failure.
Psychological factors are also cited as major causes of heart disease. Severe loneliness, childhood abuse, or the pain of heartbreak can all negatively affect heart health. Though it may sound surprising, the heart is indeed an organ closely tied to the mind.
An example of this connection is seen in heart transplant patients. Some recipients undergo dramatic changes in personality or habits, adopting traits of the donor. This remains one of medicine’s unresolved mysteries, reminding us that our current knowledge is far from complete.
Extreme stress is another danger to the heart. In the past, Koreans under extreme stress usually suffered digestive problems. Many people have experienced constipation or diarrhea before important exams.
Stress-related gastrointestinal disorders are known to be characteristic of East Asians, including Koreans, Japanese, and Chinese. In contrast, Westerners rarely suffer from digestive issues under stress—hence the limited availability of digestive medicine in Western pharmacies. Instead, stress in Westerners tends to manifest as heart disease.
This cultural difference is striking. However, in recent years, more Koreans have also begun developing stress-related heart conditions—likely due to Westernized diets and lifestyles.
◇ Enemies on the Dining Table
So, what foods should be avoided? First are those that disrupt intestinal balance. Highly processed foods are a major culprit.
Foods so heavily processed that their original ingredients are unrecognizable should be avoided as much as possible. The main reason these foods disrupt intestinal balance is that they impair the function of the intestinal mucosa—the layer of cells lining the small and large intestines.
This mucosal barrier prevents food from being directly absorbed into the bloodstream and acts as a defense wall against harmful substances. Normally, this barrier forms a tight protective layer, but it can be damaged by various factors.
The most common cause is consuming harmful foods or substances that should not be absorbed. When this happens, inflammation can develop, sometimes accompanied by reactions like hives. Prolonged inflammation weakens mucosal function, leading to symptoms such as heartburn, bloating, skin rashes, and even joint pain, obesity, and depression.
Therefore, if you experience such symptoms, you should carefully consider whether certain foods are causing them and pay close attention to your diet.
Excessive consumption of alcohol, coffee, or soft drinks is also harmful, though moderate amounts are generally fine. As I’ve emphasized, processed foods are especially bad, and since alcohol, fruit juices, and sodas often contain large amounts of sugar and additives, one must be particularly cautious.
Unfortunately, food labeling in Korea is often inadequate, making it difficult to identify these additives.
For example, when I was a medical student, I visited a soju factory and was shocked to see that, at the time, they poured in industrial artificial sweeteners during production.
Consider the price of soju today—it sells for just over 1,000 won per bottle at supermarkets. Of that, the cost of raw ingredients is probably only 200 to 300 won. Could genuine, high-quality liquor be made at such a low cost?
Of course not. Most of the ingredients in soju are imported because high-quality domestic products cannot meet that price point. Instead, manufacturers use imported plant roots and similar materials, ferment them into alcohol, dilute it with water, and then sell it. That is why I personally avoid drinking soju, as it contains far too many sweeteners and additives.
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