Health and fitness: Not that easy

Doctors feel that we need to understand the difference between fitness and health in order to avoid severe health events like heart attacks. But are we there yet? Read this article.

Last Updated on March 18, 2024 by Neelam Singh

Nithin Kamath, the CEO of Zerodha, suffered a mild stroke earlier this year. Fitness enthusiasts were in disbelief. How could this happen to a super fit person who was just 44, wondered many.

This episode has shed light on an important aspect of health that often gets overshadowed by the pursuit of fitness. As the co-founder of Zerodha, one of India’s largest brokerage firms, Kamath’s public persona as a successful entrepreneur was often associated with vigour and vitality. However, his stroke serves as a stark reminder that fitness does not equate to health, and that understanding the difference between the two is crucial.

WHO on Fitness and Health

The World Health Organisation (WHO) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Fitness is the capacity to carry out routine tasks with maximum strength, endurance, and performance in order to minimise disease, weariness, stress, and inactive behaviour.

In the last few years, the incidence of heart attacks has increased among young adults. Myocardial infarction (MI) or heart attack, which was once known to occur among the older people, is now becoming common among patients under the age of 40.

Fitness and Health for Indian Population


Kamath’s stroke, despite his presumably fit appearance, underscores the fact that underlying health conditions can exist regardless of outward fitness levels. “The Indian population is different from the Caucasian population, and we are more prone to non-communicable diseases genetically. Fitness is about lifestyle. You exercise a minimum of 30 minutes every day; you don’t smoke; and you don’t consume alcohol. Stress, obesity, and pollution, particularly pollution that isn’t easy to control, are big contributors to non-communicable diseases. Now research is going on to know the reasons behind heart attacks among fit people”, says Dr Vitthul Gupta, Bhatinda-based physician who is also Chairman, Association of Physicians of India.

A study published in the National Library of Medicine in 2023 revealed that over 5.8 million Indians lose their lives each year to NCDs like diabetes, cancer, heart disease, and stroke.

What to do?

According to medical professionals, you can run marathons, go to the gym frequently, and participate in sports, but you still run the danger of having a heart attack if you lack sleep, are under stress, or drink alcohol. Another key factor is genetics. When well-known Kannada actor Puneeth Rajkumar passed away at the age of 46 due to a heart attack, doctors counted his genetic predisposition among the three factors that caused silent ischemia or a silent heart attack. It is believed that two of Puneeth’s brothers and their iconic Kannada actor father, Rajkumar, suffered from artery-related issues.

In the case of Nithin Kamath, following the incident, the CEO shared that the days leading to the heart attack were full of stress, lack of sleep and exertion. Kamath had lost his father a few days before the stroke.

Dr Keshava R

Dr Keshava R, Senior Director, Interventional Cardiology, Fortis Hospital, Cunningham Road, Bengaluru, points out, “So, one is taking care of his diet by eating the right food at the right time. One is managing weight by doing exercises but what about other factors like sleep and stress? The important thing to understand is, heart attacks are multifactorial. You have to take care of your sleep, manage stress levels and exercise in moderation.” 

Check your life, lifestyle and inconsistencies

In order to reduce the risk of mortality, a study that was published in the journal Circulation suggested that adults perform at least 150 to 300 minutes of moderate exercise, 75 to 150 minutes of vigorous activity, or an equivalent combination of both intensities per week.

“So, 150 minutes of exercise is good enough. Cardiac mortality comes down by 8,000 to 10,000 steps. One shouldn’t become overzealous and do 15-20,000 steps because it increases cardiac mortality. There’s no proof that people who do 20,000 steps are healthier than people who do 10,000 steps a day,” adds Dr Keshava R.

Doctors also stress regular check-ups like cholesterol, BP and sugar. They recommend a holistic approach, which includes taking care of mental health as well. 

Dr Das

“A lot of us shy away from doing routine check-ups which are important. One should go through regular screenings for diabetes, cholesterol, BP and uric acid. Another belief is that I want to avoid medicines and instead opt for a healthy lifestyle. Of course, one should delay medicines, but the harm caused by any drug is much more than any drug. It takes away your years, puts the burden of medical expenses on people. Exercise is good but if you are thinking of starting a rigorous exercise regime, it is better to consult a doctor,” Dr Subrata Das, HOD, Internal Medicine and Diabetology, Sakra World Hospital, Bengaluru.

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