The Silent Cardiometabolic Crisis in South Asians - with Dr. Namratha Kandula

In this episode of Soma Says, Dr. Soma Mandal sits down with Dr. Namratha “Nammi” Kandula — Professor of Medicine and Preventive Medicine at Northwestern University and a leading investigator in the MASALA Study — to unpack a critical and often overlooked topic: cardiovascular risk in South Asian populations, especially women.

Drawing from her clinical training at Bellevue and public health work in Bangladesh, Dr. Kandula shares how culture, migration, and social determinants of health shape disease risk in ways traditional medicine often misses.

Together, they explore the groundbreaking MASALA Study (Mediators of Atherosclerosis in South Asians Living in America) — a long-term research initiative designed to better understand why South Asians face disproportionately high rates of diabetes, hypertension, and heart disease — even at lower body weights.

🎧 In this episode, you’ll learn:

• Why South Asians have higher cardiometabolic risk — even when “healthy”
• The surprising diversity within South Asian diets and metabolic outcomes
• How stress, discrimination, and acculturation impact long-term health
• The protective role of community, culture, and social support
• What women need to know across the life course — from pregnancy to menopause

🩺 Key takeaways for women:

• A history of gestational diabetes is a major long-term risk marker
• Postmenopausal changes can increase cardiovascular risk, including calcium buildup
• The importance of screening for lipoprotein(a) and tracking waist circumference
• Why strength training, sleep, and stress management are essential — not optional
• How to advocate for better, more personalized preventive care

This is a must-listen for women navigating midlife health, clinicians seeking deeper insight into health disparities, and anyone interested in the intersection of culture, biology, and prevention.

⏱️ Timestamps

00:00 – Welcome and Disclaimer 01:01 – Meet Dr. Kandula 01:40 – Residency at Bellevue 02:46 – Public Health Work in Bangladesh 05:42 – Why Focus on South Asian Health 09:19 – Origins of the MASALA Study 12:51 – Key Cardiometabolic Risk Findings 15:25 – South Asian Diet Patterns 17:34 – Culture and Social Support 20:15 – Stress and Discrimination 24:22 – Family Stress and Health 24:39 – Preventive Care for Women 25:27 – Pregnancy History as Risk 26:29 – Menopause and Calcium Rise 27:04 – Genetic Risk and Lipoprotein(a) 27:40 – Strength Training and Sleep 29:15 – Gendered Stress and Support 32:31 – Key Tests and Markers 35:40 – Statins and Lifestyle Choices 37:49 – South Asian Diabetes Biology 39:49 – Community Outreach and Action 41:52 – Healthcare Access and Dignity 43:30 – Representation and Reception 45:00 – MASALA Study Next Steps 45:59 – Closing and Signoff

👩‍⚕️ Connect with Us

Connect with Dr. Kandula: https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=15620

Follow Dr. Soma Mandal: Instagram: @drsomamandalmd Website: https://www.getcare.hackensackmeridianhealth.org/provider/soma-mandal/5921600