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