Will your lifestyle kill you? It depends on your race, say researchers

She didn't know it at the time, but when Loretta Steyn discovered eight years ago that she had high blood pressure, she was fulfilling her destiny.

As a coloured woman, Steyn belongs to a population group with a high risk of hypertension, according to research which, for the first time in the new SA, looks at how lifestyle diseases are taking their toll on different race groups.

Hypertension turns out to be the curse of the coloured community, a finding borne out by Steyn's immediate family, in which three out of six people diagnosed with high blood pressure have died.

Steyn, 65, from Belhar in Cape Town, has lost her mother and two sisters. Her brother is recovering from a stroke after years of living with hypertension. Her 37-year-old son is on medication after he was diagnosed with high blood pressure a few years ago.

The former shop manager is convinced the condition is in her family's genes, but she also acknowledged her "bad lifestyle" as a factor. "For many years I didn't live right," she said.

"When I was working I didn't care much about what I ate and as a result I consumed a lot of takeaways because I could afford them. As I was working very hard, I often got too tired to prepare healthy meals at home."

It was in 2010, after suffering constant headaches and fatigue, that Steyn was diagnosed with hypertension, and even though she now eats healthily and exercises, she fears the damage is done.

"Had I lived the way I do now at a much younger age I think I would have delayed developing the disease," she said. "At a younger age we were too glad just to eat, and we didn't care how healthy the food was."

In the new study, carried out by the Medical Research Council (MRC) and the Heart and Stroke Foundation and just published in the journal PLOS One, blacks and Indians emerge as the groups most likely to die from diabetes, and white men emerge as the heaviest drinkers.

Robert Delaney, 82, who started drinking in his teens, said: "There is probably some truth to that. I started drinking at a very young age with friends. They used to drink a lot, especially on weekends, and would go for big meals such as steaks.

"But I don't consider myself a heavy drinker, or a big eater for that matter. I don't drink more than three glasses of wine. If I'm having whisky I will have a maximum of three tots, or I will only have two beers."

Delaney, who is in remission from cancer of the lymph nodes diagnosed 10 years ago, believes fruit and vegetables have contributed to his relatively good health.

"Since a young age I always opted for the simple foods, such as fruits and nuts. I stay clear of sugary foods and I don't indulge in meat. I strongly believe what we eat determines whether we will have good or bad health," he said.

"A lot of my friends who were heavy drinkers and used to go out for big dinners have lifestyle diseases such as heart problems, so this goes to show that what we put in our mouths is paramount."

Researchers led by Nasheeta Peer, from the MRC noncommunicable diseases unit, questioned 8,000 people from five provinces, and found that the heaviest smokers were Indian men, and black people consumed the fattiest and saltiest foods.

People in their late 40s were screened for diabetes, hypertension and hypercholesterolaemia (high cholesterol), and one of the most startling findings was that black and coloured people were between two and three times more at risk of diabetes than whites, and Indians faced an even higher threat.

Fouzia Adams, 60, of Mitchells Plain in Cape Town, who has been living with diabetes for a decade, and hypertension and high cholesterol for six years, said she wanted a healthier lifestyle but struggled to afford it.

"My doctor has told me to stay away from starchy foods such as mealie meal and oats, but if I can't eat these in the morning what else can I eat?" she said.

"The diet that they recommend for us is very expensive and is not sustainable. Even though my doctor doesn't recommend bread, I have to eat ... and that's what I can afford."

Peer and her colleagues found that blacks had the least healthy fat distribution, which was linked to insulin resistance and diabetes.

Black men were worst off - possibly because of having more abdominal and visceral fat.

Other findings included:

• Indian men are most at risk for high cholesterol, but are the least obese;
• Obesity is highest among black and coloured women;
• Hypertension is the most common lifestyle disease, affecting 52% of men and 49% of women; and
• About 14% of men and 13% of women have diabetes, and high cholesterol affects 32% of men and 37% of women.

Peer said future research could identify behavioural factors that influence the development of cardio-metabolic diseases. "This will enable the development of culturally tailored prevention strategies and may contribute to better management of cardiovascular diseases in the disadvantaged South African populations," she said.

7 TOP WAYS TO AVOID CARDIO-METABOLIC DISEASES

1.  Eat salt sparingly - Salt is a huge contributor to hypertension.
2.  Eat fat sparingly - Avoid fried and deep-fried food. Fried food is associated with greater risk of type 2 diabetes, heart disease and obesity.
3. Eat fruit and vegetables - Try to consume at least five a day. This may help to reduce the risk of high blood pressure, heart disease and some cancers.
4. Get moving - Be active for at least 30 minutes on most days. 
5. Lose the booze - Limit alcohol intake to one or two standard drinks per day, with meals.
6. Do not smoke - Smoking damages your heart and circulation, and increases your risk of stroke or heart disease.
7. Reduce stress - Stress is linked to high blood pressure, heart problems, obesity and diabetes.