What is life? By Mark Chit Tat

Below is a comment written by Mr Mark Chit Tat following my article on

 "What Is Life? A Dialogue Between Biology, Thermodynamics, and the Breath of God (Part 2)"

He posted his comment 30 mins ago  

But I thought I should make it a small article written by him instead of going into the comment column 

Here is what Mr Mark wrote:

No small dialogue, "a conversation still unfinished," Dr.Lin Ru Wu (林 如 武), your name also speaks aptly of the balance and elements of life. A dialogue of the weightier and "dense"🙂 issues of life, its meaning or purpose, something that is more than what we know or can understand.

After all, it had been "hidden" from us since that day the first Man chose not to eat of that Tree of Life but of the Tree of Knowledge of Good and Evil. So life is somewhat reduced to something like just birth and death, clueless of God's Plan A, so much so that Solomon, the wisest of the ancients lamented that "all is vanity"! But reiterated that "The end of the matter, everything having been heard, fear God and keep His commandments, for this is the entire man.(Eccles 12:8 &13, Rabbi A.J.Rosenberg, Chabad.org)".

However, all that you had shared earnestly and tirelessly in this blog of yours is so propitious to us all and shall remain a legacy accessible and beneficial to many in years to come too.

Jia you! 加油! Dr.Lin Ru Wu (林 如 武)

What Is Life? A Dialogue Between Biology, Thermodynamics, and the Breath of God (Part 2)

  

This is Part 2, a continuation of my thoughts in Part 1 - to give it a more philosophical touch on the definition of life in this link:  

https://scientificlogic.blogspot.com/2025/10/what-is-life-dialogue-between-biology.html

Life is the most familiar and yet the most mysterious phenomenon in the universe. Every second, countless living things awaken, feed, divide, heal, and die; still, the essence that makes them alive remains elusive. The cell biologist defines life in it by its metabolism and replication, the physicist by energy exchange and entropy, the philosopher by consciousness, and the theologian by the breath of God. Each perspective touches part of a greater truth, and together they form a dialogue between science and spirit, a conversation still unfinished.

Biology begins its answer with the cell, that shimmering unit of order in a sea of chaos. Within its fragile membrane, thousands of reactions proceed in exquisite coordination, examples,  proteins fold, DNA copies, ATP fuels every pulse of work. The biologist calls this self-sustaining network “autopoiesis”, the ability of matter to maintain and reproduce itself. Yet even as we map every gene and molecule, something greater seems to hover above the chemistry, like a melody arising from vibrating strings. A living system is not merely a collection of parts; it is dynamic wholeness sustained by information, pattern, and purpose.

Physiology extends the story into the rhythms of energy. Life feeds on disequilibrium. Every heartbeat, every neuron’s spark, depends on gradients, of ions, gases, and potentials. When these gradients flatten, life ceases. From the standpoint of thermodynamics, a living organism is a local rebellion against entropy, continuously importing free energy from its surroundings to keep its inner order intact. Schrödinger, pondering this paradox, wrote that organisms “feed on negative entropy.” We might say more simply that life borrows time from the universe’s long drift toward disorder.

Yet thermodynamics also humbles biology. No creature can outrun the second law forever. Cells age, tissues falter, and entropy reclaims what structure had defied it. Death, in this light, is not a punishment but a physical reconciliation - a return of organized energy to cosmic equilibrium. Still, even as matter decays, information can endure: in offspring, in memory, in the genome that whispers forward through time. Thus physics does not extinguish meaning; it transposes it into new forms.

Philosophy approaches from another side. The vitalists once argued that living beings possess a special essence, a “vital spark” beyond chemistry. Modern science dismissed that notion when it learned to synthesize organic compounds from inorganic ones, yet the intuition persists that something non-mechanical animates the living. Today, some philosophers of mind echo that intuition when they ask whether consciousness can emerge from matter alone. Is awareness merely an algorithm of neurons, or is it the universe becoming self-aware through us? Between mechanism and mystery lies the field where wonder still grows.

Across cultures, humanity has never been content with a purely mechanical account of life. Ancient Egyptians spoke of the ka, the life-force breathed into each person. In Hindu thought, prana is the cosmic breath that circulates through all beings. Chinese philosophy calls it qi, the flowing energy of heaven and earth. The Hebrew Scriptures describe creation with a similar image: “The LORD God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul” (Genesis 2:7). In this simple verse, dust and breath meet, the physical and the divine entwined.

The biological breath and the biblical breath, though different in language, describe the same marvel: that matter can host awareness, desire, and compassion. Oxygen enters the lungs, diffuses into blood, fuels the mitochondria that power thought and love. But breath is more than gas exchange; it is the symbol of participation, the rhythmic reminder that life is shared. Each inhalation draws in the world; each exhalation returns a part of ourselves. When the final breath leaves, the body remains, but the pattern - the harmony of exchanges- is gone.

From a thermodynamic viewpoint, this cessation is simply the collapse of gradients; from a spiritual viewpoint, it is the release of spirit. Both can be true within their frames. The scientist observes the dispersal of energy; the believer perceives a passage. Between them stands the mystery that language can barely hold.

If we compare definitions, science emphasizes organization, metabolism, growth, adaptation, and reproduction. Theology speaks of soul, purpose, and divine image. Yet neither definition alone suffices. An artificial cell might one day mimic every metabolic step, but would it feel alive? A theologian might affirm that all breath comes from God, but must also acknowledge the physical processes that sustain it. The two accounts do not cancel each other; they complete one another like stereo channels revealing depth.

Death, therefore, is not the antithesis of life but part of its continuity. The atoms that once formed a heartbeat soon nourish soil, plankton, or star-dust anew. Energy changes costume but not existence. As Ecclesiastes reminds us, “Then shall the dust return to the earth as it was: and the spirit shall return unto God who gave it” (Ecclesiastes 12:7). Even in decay, life’s story expands.

Culturally, people have translated this intuition into rituals and ethics. Funerary rites, from the pyramids to modern memorials, affirm that life’s essence deserves reverence. Philosophers from Aristotle to Bergson spoke of entelechy or élan vital, a striving toward fulfillment that shapes every organism. In modern biology, this striving becomes the language of homeostasis and feedback loops, systems perpetually adjusting to preserve integrity. Whether we call it purpose or regulation, the tendency is the same: life seeks to remain itself.

The dialogue between biology and theology grows most intimate when we ask not what life is, but why it is. Evolution explains the mechanisms of adaptation, yet it cannot alone address why the universe gives rise to beings capable of asking questions. Physics can chart the energy exchanges of a heartbeat, yet it cannot explain why music can quicken it. Meaning itself seems to bloom in the interstices between data and devotion.

In recent decades, the science of complexity has offered a bridge. From chaos theory to systems biology, we learn that self-organization can arise spontaneously from simple rules, that feedback can produce order from noise. But even this elegant mathematics evokes wonder: why should the laws of nature permit such harmony at all? The more we decode the machinery of life, the more its existence feels like a gift rather than an accident.

Perhaps that is why poets and prophets speak of life as light. “In Him was life; and the life was the light of men” (John 1:4). Light and life are both acts of transformation, energy becoming visibility, matter becoming awareness. Thermodynamics tells us that every photon absorbed by a leaf becomes sugar, and every sugar molecule can become thought. Scripture tells us that divine light enlightens every human being. The metaphors converge: to live is to shine.

From a public-health perspective, recognizing this unity carries practical wisdom. To care for life is to respect its delicate balance of energy and purpose - nutrition, rest, love, and community all sustain the thermodynamic miracle within us. Pollution, exploitation, and neglect are not merely ethical failures; they are violations of the very principles that keep systems alive. The stewardship of life therefore extends from cell biology to planetary ecology.

And yet, amid this grandeur, life remains intimate. It begins in the invisible union of molecules, grows in the warmth of a mother’s body, learns to walk, to hope, to forgive. Each personal story is a local expression of the universal drive to persist, to connect, to transcend. When we say someone has “lost the will to live,” we are describing not only biochemical exhaustion but the dimming of meaning. Spirit and physiology intertwine until the last pulse.

So, what is life? It is a self-maintaining pattern of matter and energy, open to the flow of the universe, able to transform and be transformed. It is the dance between entropy and information, between dust and breath. It is the signature of the cosmos learning to love through conscious beings. To describe it purely in formulas is to know its skeleton; to encounter it with reverence is to touch its soul.

In my own conviction as simple lim ju boo by name, or by my Chinese name -  lim ru wu, (林 如 武)  after following both microscopes and scriptures, I believe life is neither random chemistry nor magic alone. It is the language through which the universe, and perhaps its Creator - speaks coherence into chaos. Every cell, every heartbeat, every act of compassion is a syllable in that divine dialogue. When science measures, it listens to the grammar; when faith worships, it hears the music. Both are hearing the same voice.

And when the breath finally leaves, I imagine it not as extinction but translation. The molecules return to soil and star; the pattern returns to the Source that first uttered it. Between the physicist’s entropy and the psalmist’s praise, a single truth gleams: “I will praise Thee; for I am fearfully and wonderfully made” (Psalm 139:14). Life is that wonder made visible.

 

References

1. Schrödinger E. What Is Life? The Physical Aspect of the Living Cell. Cambridge University Press, 1944.

2. Prigogine I., Stengers I. Order out of Chaos: Man’s New Dialogue with Nature. Bantam, 1984.

3. Margulis L., Sagan D. What Is Life? University of California Press, 1995.

4. Kauffman S. A World Beyond Physics: The Emergence and Evolution of Life. Oxford University Press, 2019.

5. Ecclesiastes 12:7 (King James Version).

6. Genesis 2:7 (King James Version).

7. John 1:4 (King James Version).

8. Psalm 139:14 (King James Version).

9. Bergson H. Creative Evolution. Macmillan, 1911.

10. Capra F. The Systems View of Life. Cambridge University Press, 2014.

My next 3 articles spread out over next two weeks, shall be on Molecular Biology, namely: 

1. Molecular Biology: The Language of Life and Its Transformative Power Across Science,  Medicine to Forensic Investigations 

2.  Molecular Biology in Medicine: From Genes to Therapeutics  - Dedicated to the advancement of human health through molecular insight and scientific compassion.

3. Molecular Biology in Forensic Science: Unveiling Truth Through DNA in Crime Investigation with a number of examples on high profile cases in Malaysia  

 

What Is Life? A Dialogue Between Biology, Thermodynamics, and the Breath of God (Part 1)

 

Anne Carol commented on "What Happens to the Soul of a Clinically Dead Person in Coma?"

She commented:

"Fascinating article as always. Can you tell us more about the mystery of life and death? How would you define life, and what happens when it dies? We have always wondered on this question for an answer.

Can you tell us more on this, Dr Lim?" 

Here's an extension of my thoughts for Anne Carol  in blue: 

Presently, we have no definition for life. The acronym for living things is often given as MRS GREN to mean Movement, Respiration, Sensitivity, Growth, Reproduction, Excretion, and Nutrition.

But these are defining the characteristics of something that is  living,  but it is not the definition of life itself. So  what is the true definition of life? Is it some biological entity, some life energy, life force, spiritual life or what  resides inside a physical body, and what  happens when it leaves the body? The direct answer is -  the body dies?
The true definition of life is a complex and debated topic, but scientifically, life is defined by a set of characteristics, such as those in the MRS GREN acronym, that describe how an organism functions, rather than a separate "life force".  There is no evidence in the eyes of science for a non-biological "life energy" leaving the body at death; rather, death is the cessation of these biological processes.
Biological definition of life is a process, not a thing.  Science defines life by its functions, such as metabolism, growth, and reproduction, rather than a singular entity. These key characteristics is a useful starting point, but a more comprehensive list of non-entity characteristics that define life is needed such as life or vital force 

On the existence of "life force" or "spiritual life", unfortunately currently we have no scientific basis for this. The idea of a non-biological "life force" or "life energy" is a concept from spirituality and philosophy, not biology. As far a s science is concerned, death is the end of a biological function. When a body dies, it is because the complex biological processes that sustain it have permanently stopped, not because a non-physical entity has left the body - at least this is what science describes. Science defines life through observable and measurable biological processes, not through a spiritual or metaphysical concept. While MRS GREN is helpful, a complete understanding of what makes something becoming alive is more than than just describing the characteristics of life. 

The cessation of these biological processes is what defines death according to science, not the departure of a separate life force as religion sees it.  
Since science cannot define exactly what is life, except define its characteristics as something living, can we give the definition as the breath of God?  This question brings two distinct ways of understanding the world - the scientific and the theological, into conversation. Science describes how living things function, reproduce, and evolve by observing their characteristics.
Religion explains the metaphysical source of life, offering a divine or spiritual explanation for its origin and essence. Therefore, one framework cannot be directly substituted for the other.
Science does not attempt to define the ultimate "essence" of life. Instead, it uses a set of observed characteristics to classify things as living, non-living, or dead. The characteristics of life is just a list of working models seen in living things. It is not the definition of life itself. Moreover, some entities like viruses challenge this criteria highlights that life is a complex process that resists a simple, catch-all definition. 

The theological perspective ("Breath of God"): 
The concept of the "Breath of God" is a religious explanation for the origin of life, not a description of its biological functions. In the Bible on Genesis, God is described as breathing the "breath of life" into humanity, an intimate act that brings a physical form to life. This theological idea addresses the ultimate source of existence rather than the biological mechanisms through which it is sustained. It is a different realm of inquiry. Our question conflates a scientific model with a theological explanation, which occupy different realms of thought:
Science answers "how?" It provides mechanistic, evidence-based answers for how biological systems operate. Science cannot explain everything. It does not mean that only when something we can see, touch, detect and measure, are real and exist - the rest all not real and does not exist? It is so clear and real we see life creeping, crawling and flying everywhere on earth, and just because we  cannot understand or define what they are, and why they are living, and what makes them alive,  they are not science, and not real? But religion has the answer, and philosophy answers "why?" These fields explore questions of ultimate purpose, origin, and meaning, often outside the scope of scientific inquiry. The abundance of life presence on earth challenge of a single definition
The attempt to force a single, universal definition of life is not only difficult for science but also problematic in a philosophical context. As a 2024 paper wrote, there is no comprehensive scientific definition that perfectly separates living from non-living things, in part because life is a continuous, evolving process rather than a discrete, static category.

Therefore, equating the characteristics listed in the MRS GREN acronym with the "breath of God" mixes a functional, descriptive model with a spiritual, metaphysical explanation. The two ideas serve different purposes and offer different types of understanding. 

The entity that gives a body life is known as a "vital force," "spirit," or "soul," but there is no scientific consensus on what it is, and it cannot be detected or measured by current scientific methods. From a biological and scientific perspective, life is the result of a complex interplay of chemical and biological processes, and death occurs when these processes cease. Different cultural and spiritual beliefs attribute death to the departure of the soul or spirit from the body.

But what makes a body alive? From a scientific perspective,  life is a property of organized biological systems, a result of cellular and biochemical processes, not a single "entity" or "force".
But from a spiritual / cultural perspective, life is often attributed to a "vital force," "spirit," or "soul" that resides within the body and animates it. The specific beliefs about this entity vary across cultures and religions.

Then why does death occur? From the scientific perspective, death is the irreversible cessation of all biological functions that sustain a living organism. When the body's systems, such as the brain, heart, and lungs, stop functioning, the organism dies.

From the spiritual perspective, death is considered the point at which this non-physical "soul" or "spirit" leaves the physical body, which is why the body can no longer live.

Then many have continued to ask for ages can we detect or measure this living force? In the eyes of science, the answer is no. There is no scientific evidence or method for detecting or measuring a "vital force," "soul," or "spirit" in this context. Science relies on empirical evidence that can be observed and tested, and these concepts are beyond its current scope. But from the spiritual perspective, those who believe in a soul or spirit do not see it as something that can be measured by physical instruments, but rather something that is experienced or known through faith or spiritual intuition.

This brings us back to the "true" definition of life which is a complex and debated topic, but scientifically, life is defined by a set of characteristics that describe how an organism functions, rather than a separate "life force". Currently we have no evidence for a non-biological "life energy" leaving the body at death; rather, death is the cessation of these biological processes. Biological definition of life is, it is a process, not a thing. 

Science defines life by its functions.  But the idea of a non-biological "life force" or "life energy" is beyond science, a concept from spirituality and philosophy, not biology.  But others will ask the scientist why does the body finally dies? In the eyes of a scientist, death is the end of biological function. 

When a body dies, it is because the complex biological processes that sustain it have permanently stopped, not because a non-physical entity has left the body. 

When a body dies, biological processes begin, including the cessation of breathing, circulation, and brain activity, followed by cooling and decomposition,  

The question of what happens to "life" or consciousness is a matter of faith and philosophy, with different beliefs including an afterlife, reincarnation, or the cessation of consciousness at death. Science currently has no evidence for the continuation of consciousness after death, attributing near-death experiences to the brain shutting down. In death there are physical changes to the body. There is initial shutdown when  breathing, heart, and brain activity cease. Blood circulation stops, and all the body's systems shut down. 

The body temperature drops until it reaches the ambient temperature. 

Decomposition begins when 

bacteria begin to break down the body's tissues. Enzymes digest cells, and bacteria in the intestines and other tissues start digesting the body, which can cause bloating and gas. There is 

structural collapse when over time, the soft tissues will disintegrate, leaving behind a skeleton that will eventually crumble. That's from a biological and chemical stand-point. 

From a physics, and thermodynamics 

standpoint, death is when a body stops maintaining its organized state and its energy disperses into the surroundings.  Life maintains low entropy by constantly consuming energy to organize its matter, but death is a point where this process ends, and the body's energy, stored in chemical bonds and mass, dissipates as heat and is broken down through decomposition, increasing the overall disorder (entropy) of the universe. The body's energy dissipates but the energy is conserved. 

The first law of thermodynamics states that energy cannot be created or destroyed, only transferred or changed in form. The energy in the body doesn't disappear; it is released. 

The body's internal heat, produced by metabolism, transfers to the colder environment, causing the body to cool down to ambient temperature. This is a major part of why medical examiners can estimate time of death based on body temperature. 

The energy stored in the body's chemical bonds (like those in sugars, fats, and proteins) is released as molecules break down through decomposition. This dispersed energy is then available to be absorbed by the environment, such as by decomposers like bacteria and insects, or eventually to be incorporated into new life forms. 

Life is low entropy - 

Living organisms are highly organized systems that maintain low entropy by using energy to stay structured and functional. 

Death is high entropy -  

The second law of thermodynamics states that entropy (disorder) in a closed system always increases over time. Death is the point where the body's ability to fight this natural tendency for disorder ends. 

Decomposition is the result: 

Decomposition is the final thermodynamic process where the body's organized matter breaks down into simpler, less organized components, increasing the overall entropy of the universe.

Beliefs about "life" or consciousness in religions and atheists views  are: 

Afterlife: 

Many religions, including Christianity, Islam, and Judaism believe the soul or spirit continues to exist in another world, such as heaven and hell, or a spiritual realm. 

Reincarnation: 

Religions like Hinduism and some others believe the soul is reborn into a new physical body after death, continuing a cycle of life and death. 

 Enlightenment:

Some Buddhist beliefs suggest that it is possible to escape the cycle of death and rebirth through spiritual enlightenment. 

Some people believe that consciousness is a product of the brain, and that when the brain dies, consciousness simply stops, with no life after death. 

Near-death experiences like seeing a bright light or feeling peace during a near-death experience may be caused by changes in the brain to be able to 'see' as it shuts down but this is hotly disputed, because there were people blind from birth who could not describe how the physical world looks like, but when the return from death they could describe clearly what the physical world looks like though still blind when they returned from death. Moreover changes in the brain chemistry during death do not provide evidence of consciousness continuing after death, according to Verywell Health. 

In conclusion for a scientist, science defines life through observable and measurable biological processes, not through a spiritual or metaphysical concept.  The cessation of these biological processes is what defines death, but in the eyes of science it is not the departure of a separate life for. But in the eyes of religion, especially in Christianity, life is the breath of God  that is not meant to be measures or detected, and it shall go back to where it belonged 

And the LORD God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul (Genesis 2:7).The phrase "the soul returns to where it came" is a well-known line from Ecclesiastes 12:7 in the Bible, which states that after death, the body returns to the earth as  star  dusts from another world brought here through a supernova explosion, and the "spirit returns to God who gave it" 

In many traditions, this signifies a return to a divine source or a state of being beyond the physical world. Other belief systems describe different outcomes, such as reincarnation or a cycle of life, death, and rebirth. 

Unlike other scientists, this is what I strongly believe.  

(I shall write more on this subject in a more philosophical tone in Part 2)  

Does Plant-Based Diets Protect Against Heart Disease?

 

A friend of mine who is a participant in my WhatsApp chat group sent us this news -  that the world's first vegetarian bodybuilder Varinder Singh Ghuman died of a heart attack in Amritsar. He was an actor who played the lead role in the Punjabi film 'Kabaddi Once Again' and worked with Salman Khan in 'Tiger 3'. Ghuman was chosen by Arnol Schwarzenegger to represent his products in Asia. He was widely known as the world's first vegetarian bodybuilder, yet he died of a heart attack. He had gone to Amritsar's Fortis Hospital to undergo a minor operation for a bicep injury. Since it was a minor operation, he was supposed to return today. However, Ghuman suffered a cardiac arrest and died. He was 42.  The details is in this link: 

https://www.indiatoday.in/movies/regional-cinema/story/punjabi-actor-varinder-ghuman-dies-due-to-heart-attack-in-amritsar-2800656-2025-10-09.

Another friend of mine, a medical doctor then asked me how could a vegetarian die of heart disease when vegetables are full of antioxidants that protects a person from free radical damage?

Below written in blue is my answer and opinion on whether or not a vegan or vegetarian diet can protect a person against heart attack and heart disease. 

Plant-Based Diets and Heart Disease: 

Lessons from the Death of Vegetarian

Bodybuilder Varinder Singh Ghuman 

Abstract

The unexpected cardiac death of Varinder Singh Ghuman, a high-profile vegetarian professional bodybuilder and actor who suffered cardiac arrest after a routine shoulder procedure, has prompted questions and myth-checking about diet, fitness and cardiovascular risk. This article explains why plant-based diets lower but do not eliminate cardiovascular risk, outlines other biological and external contributors to heart attacks (genetics, inflammation, arrhythmia, perioperative events and possible performance-enhancing drug effects), and discusses specific concerns in elite bodybuilding. Let  me synthesize current evidence on vegetarian and vegan dietary effects on cardiovascular risk factors, summarize what is known about perioperative cardiac arrest, review the cardiovascular harms associated with anabolic-androgenic steroids (AAS), and end with a public-health message and a brief biblical reflection on mortality and stewardship of the body. The central message: diet matters, but so do many other determinants of heart health. PM

 

Introduction

 

When a public figure widely celebrated for physical strength dies suddenly from a heart attack, the public reaction is immediate and searching: How could this happen? For some, the surprise is compounded when that person follows a vegetarian or vegan diet, because plant-based eating is commonly associated with protection against chronic disease. But as physicians, scientists and public communicators, we must resist simplistic causal leaps. Cardiovascular disease is multi-factorial: genes, inflammation, arrhythmogenic risk, perioperative stressors, medication or supplement use (legal and illicit), and the quality of the diet itself all influence outcomes. The recent reports that Varinder Singh Ghuman suffered cardiac arrest after a routine surgical procedure and could not be revived have been confirmed by multiple news outlets and by his treating hospital. India Today+1

 

What the reports say (briefly)

According to hospital and media statements, Ghuman, a winner of national bodybuilding titles, an actor with film credits, and widely described in media as a professional vegetarian bodybuilder,  had visited a private hospital in Amritsar for treatment of a shoulder/biceps injury. After a routine procedure he experienced a sudden cardiac arrest and died despite resuscitation efforts. Official statements from the treating hospital expressed regret; detailed autopsy or toxicology results were not publicly released at the time of reporting. India Today+1

 

Plant-based diets and the cardiovascular evidence base

 

Multiple cohort studies, systematic reviews and meta-analyses show that healthy plant-based diets are associated with lower blood pressure, lower low-density lipoprotein (LDL) cholesterol, lower body mass index and reduced incidence of cardiovascular events compared with typical Western diets. Meta-analyses in recent years report modest but consistent reductions in cardiovascular risk and improvement in lipid profiles among vegetarians and vegans when diets emphasize whole grains, legumes, fruits, vegetables, nuts and minimally processed foods. PMC+2PMC+2

Mechanisms explaining these benefits include lower intake of saturated fats, higher intake of fiber and antioxidants, improved endothelial function, and more favorable gut-microbiome metabolites. However, the term “plant-based” is wide: a diet of whole foods is different from a diet relying on processed vegan snacks and fried foods. Recent meta-analyses emphasize that quality matters, healthful plant-based patterns confer benefit, while unhealthful plant-based patterns do not. ScienceDirect+1

 

Why a vegetarian (or vegan) person can still have a heart attack, a doctor friend asked me to explain 4 days ago.

A lower risk is not zero risk. Several categories of explanation are important:

1. Diet quality and composition. A diet labelled “vegan” can still be rich in refined carbohydrates, trans-fats (from hydrogenated oils), sodium, and added sugars, all of which increase cardiovascular risk when consumed in excess. Conversely, a carefully planned plant diet that includes sources of omega-3s, adequate protein, and micronutrients is more protective. PMC+1

2. Nutrient gaps. Strict vegans are at risk for deficiencies in vitamin B12, vitamin D, long-chain omega-3 fatty acids (EPA/DHA), iron (either deficiency or, rarely, excess from supplements), and possibly iodine. Elevated homocysteine from B12 deficiency and low omega-3 status have been linked to adverse cardiovascular outcomes and arrhythmic risk. Many guidelines therefore recommend monitoring and supplementing when appropriate. NCCIH+1

3. Genetic predisposition and non-dietary risk factors. Familial hypercholesterolemia, inherited cardiomyopathies, congenital electrical disorders (e.g., long QT syndromes), and familial clotting disorders can produce coronary events or sudden death despite an otherwise healthy lifestyle. These are not prevented solely by diet.

4. Inflammation and immune-mediated disease. Chronic inflammatory conditions (autoimmune disease, chronic infection) contribute to atherosclerotic progression independent of diet.

5. Cardiac structural or electrical disease. An enlarged heart (hypertrophy), cardiomyopathy, scarring from prior myocarditis, or primary arrhythmic conditions can precipitate sudden cardiac arrest without classical atherosclerotic plaque rupture.

6. Perioperative events and acute triggers. Surgery, even a minor procedure, can trigger cardiac events through anesthesia-related hemodynamic changes, electrolyte disturbances, pulmonary embolism, massive sympathetic surge from pain or stress, or intraoperative arrhythmia. The incidence of perioperative cardiac arrest is low but real: modern series report rates in the low per-10,000 procedure range with higher risk in older patients and those with elevated ASA (American Society of Anesthesiologists) physical status. PubMed+1 

7. Drugs, supplements and illicit substances. Performance-enhancing drugs used in bodybuilding, notably anabolic-androgenic steroids (AAS), growth hormone, erythropoiesis-stimulating agents, stimulants and certain “cutting” agents,  have been associated with hypertension, dyslipidemia, left ventricular hypertrophy, accelerated atherosclerosis, pro-thrombotic states and sudden cardiac death. Even if a subject publicly states a vegetarian diet, that does not rule out exposure to cardiotoxic compounds. The strong signal in the literature is that AAS use increases cardiovascular risk and contributes to fatal events in athletes and bodybuilders. PMC+1

 

The specific cardiovascular concerns in elite bodybuilding. 

 

Extreme cardiac remodeling. Intense strength training and associated hemodynamic loads can produce concentric and eccentric hypertrophy. While adaptive in athletes, pathological enlargement (particularly when combined with hypertension or drug effects) may predispose to arrhythmia or heart failure.

High-protein diets and supplements. These are usually well tolerated, but some protein supplements can be adulterated or contaminated.

Performance-enhancing regimens. Evidence links supraphysiologic AAS exposure to adverse remodeling, endothelial dysfunction, thrombosis and arrhythmia. Multiple case reports and series document sudden cardiac death temporally associated with AAS use. PMC+1

 

Importantly, we do not have public evidence that any one of these factors applied to Mr. Ghuman specifically; this is a synthesis of known risks in the population and the plausible contributors in similar cases. Responsible reporting must distinguish known facts (he died of cardiac arrest after a procedure) from speculation (e.g., about drug use) until official toxicology or autopsy results are published. India Today+1

 

Perioperative cardiac arrest: mechanisms and incidence

Perioperative cardiac arrest is uncommon but carries high mortality. Causes include:

1. Myocardial ischemia from plaque rupture or supply–demand mismatch

2. Massive pulmonary embolism

3. Anesthetic complications (hypoxia, massive aspiration)

4. Severe electrolyte disturbances and arrhythmias

5. Hemorrhage and hypovolemia

6. Acute anaphylaxis

7. Large observational studies and systematic reviews put perioperative cardiac arrest incidence in modern series at roughly 2–6 per 10,000 anesthetics, with higher rates in emergency surgery and in patients with significant pre-existing disease. Outcomes depend on rapid recognition and high-quality resuscitation. Again, a minor procedure does not make a person immune to these rare but catastrophic events. PubMed+1

 Omega-3s, B12 and other modifiable gaps in plant-based diets

Two recurring nutritional themes merit attention:

1. Omega-3 (EPA/DHA) and cardiac outcomes. Long-chain omega-3 fatty acids (EPA/DHA) are concentrated in oily fish; strict vegans often have lower blood levels. While the magnitude of benefit shown in trials is modest and heterogeneous, pooled analyses suggest modest reductions in coronary events with EPA/DHA supplementation in at-risk populations. Plant-based ALA (alpha-linolenic acid) converts inefficiently to EPA/DHA in many people; clinical guidance often recommends algae-derived EPA/DHA supplementation for vegans who are at cardiovascular risk. NCCIH+1 

2. Vitamin B12 and homocysteine. B12 deficiency, common when animal products are absent, it elevates homocysteine, a biomarker associated with vascular risk. Routine screening and replacement are inexpensive and effective preventive measures. PMC

 

These are practical and addressable gaps; their correction improves population-level risk profiles but will not eliminate genetically driven or acute non-atherosclerotic causes of cardiac arrest.

My public health message to all: clarity without fear. From a public-health standpoint this case supports several clear recommendations:

1. Promote high-quality plant-based diets rather than simply “plant-only” diets: emphasize whole grains, legumes, vegetables, nuts, seeds and limited processed food. This is the pattern associated with the strongest cardiovascular benefits. PMC+1 

2. Screen and supplement appropriately. For people on strict plant diets: check vitamin B12, vitamin D, iron indices when indicated, and counsel about omega-3s (consider algae-based EPA/DHA supplements). PMC+1

3. Acknowledge non-dietary cardiovascular risks. Family history, unexplained exertional syncope, palpitations, or a history suggestive of illicit substance use warrant cardiology evaluation, ECG, and where appropriate imaging. Statements like “I eat healthy, I can’t get heart disease” are dangerous; vigilance matters. PubMed

4. Targeted education for athletes and bodybuilders. The fitness community needs honest, non-judgmental public health messaging about the risks of anabolic steroids and other performance-enhancing agents, routine cardiac screening for elite athletes, and regulation and quality control of supplements. Health systems should make confidential help available for those seeking to stop harmful substances. PMC+1

5. Perioperative assessment is essential. All patients, even those appearing fit, should undergo appropriate pre-operative screening tailored to the procedure and personal risk factors. Hospitals should continue to strengthen protocols for early recognition and management of perioperative emergencies. Association of Anaesthetists

 

Case reflection and responsible inference

 

In high-profile deaths the temptation to reduce the story to a single cause, “vegetarianism failed” or “steroids killed him”,  is strong. Science demands evidence based support. In Ghuman’s case the confirmed facts are: a well-known vegetarian bodybuilder underwent a procedure and suffered cardiac arrest at the hospital. We do not yet have a publicly released autopsy, toxicology or full perioperative report. Until those data are available, the proper stance is one of careful hypothesis: plausible contributors include an unrecognized structural cardiac problem, an arrhythmia, a thromboembolic event, perioperative physiological stress, or exposure to cardiotoxic substances, alone or in combination. By discussing these mechanisms frankly, clinicians and the public can learn how to reduce future risk without leaping to unjustified conclusions. India Today+1

Practical advice for readers (summary checklist)

If we follow a vegetarian or vegan diet: arrange periodic checks for blood pressure, fasting lipids, vitamin B12 and (if indicated) omega-3 status.

Choose whole-food plant patterns over processed vegan convenience foods.

If we are an athlete pursuing extreme physique goals: disclose any supplement or drug use to your health provider; consider scheduled cardiology screening (ECG, echocardiogram) and avoid illicit substances.

Before elective surgery: disclose full medication and supplement history; ensure anesthetic and surgical teams are informed about any prior cardiac complaints, substance use, or supplement intake.

Public and clinical institutions: continue to expand harm-reduction programs targeted to athletes, and ensure perioperative safety protocols remain robust. PMC+1

 

Biblical reflection: strength, stewardship and the transience of life

As we analyze mechanisms and statistics, it is right and human to respond emotionally. The biblical tradition offers a salutary reminder of life’s fragility and the ethical duty of stewardship over the body. Scripture often places human strength alongside humility: great physical power does not exempt one from mortality. “Teach us to number our days, that we may apply our hearts unto wisdom” (Psalm 90:12) and Ecclesiastes repeatedly reflects on the ephemeral nature of earthly achievement. These passages do not condemn the love of health or disciplined living; rather, they invite perspective: our bodies are entrusted to us for a time, and within that time we owe care to ourselves and compassion to others. A responsible, faith-informed approach to health combines scientific prudence with gratitude and humility, seeking to preserve life while accepting that ultimate outcomes are not wholly within our control.

 

My final opinion is that, Varinder Singh Ghuman’s sudden death is a tragic reminder that no single lifestyle choice confers absolute protection. High-quality plant-based diets lower many cardiovascular risks, but diet is one thread in a complex fabric of determinants that includes genetics, inflammation, structural heart disease, perioperative events and possibly exposure to cardiotoxic agents. Public health responses should emphasize high-quality nutrition, targeted screening and education for athletes, and robust perioperative safety. Clinicians and the public alike should resist simplistic explanations, and instead use such events to learn and improve preventive care, while holding a compassionate space for grief and, for those who share that faith, a biblical perspective that invites humility and stewardship.

 

References

 

1. India Today — Varinder Ghuman suffered cardiac arrest after shoulder surgery, says hospital. (Oct 10, 2025).

2. Fortis Hospital / Times of India coverage — official statements and reporting on the event. The Times of India+1

3. Landry MJ, et al. Vegetarian dietary patterns and cardiovascular risk factors: systematic review and meta-analysis. (2024). (meta-analysis showing reductions in CVD risk factors with vegan/vegetarian patterns). PMC

4. Koch CA, et al. Vegetarian or vegan diets and blood lipids: a meta-analysis. (2023). (reduction in LDL and ApoB). PMC

5. Satija A, et al. Plant-based diets and cardiovascular health: review. (2018). (mechanisms and evidence linking plant diets and lower CVD risk). PubMed

6. Torrisi M, et al. Sudden cardiac death in anabolic-androgenic steroid users. (2020). (case series/review linking AAS to sudden death). PMC

7. Perry JC, et al. Anabolic steroids and cardiovascular outcomes. (2020 review). PMC

8. Nunnally ME, et al. Incidence and risk factors for perioperative cardiac arrest. (2015). (perioperative cardiac arrest epidemiology). PubMed

9. Armstrong RA, et al. Peri-operative cardiac arrest: epidemiology and clinical practice review. (2024). (modern incidence and causes). Association of Anaesthetists

10. National Center for Complementary and Integrative Health (NCCIH). Omega-3 supplements: what you need to know. (2020 review summary of trials). NCCIH

11. Dempsey M, et al. Influence of dietary and supplemental omega-3 fatty acids on cardiovascular outcomes. (2023). PMC