Epidemiologic study of diet and coronary risk factors in relation to central obesity and insulin levels in rural and urban populations of North India

Singh, Ram B.; Ghosh, Saraswati; Niaz, Arif M.; Gupta, Surbhi; Bishnoi, Indira; Sharma, J. P.; Agarwal, Poonam; Rastogi, Shishir; Beegum, Raheena; Chibo, Hong; Zhu, Shu

doi:10.1016/0167-5273(94)02186-m

Cited by 72 publications

(32 citation statements)

References 17 publications

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“…In India, saturated fat intake in rural, North Indian urban and South Indian urban population were 4.9%, 9.2% and 14.2% and the prevalence of CAD were 3%, 8.6% and 13.9%, respectively. 61,62 The respective serum cholesterol levels in these population were 4.3, 5.2 and 5.4 mmol/L indicating that low saturated fat intake may be associated with lower serum cholesterol level but a significant public health problem of CAD. In the Indian Lifestyle and Heart Study, the prevalence of CAD in subjects consuming low saturated fat (7e10% en/day) was 10.6% in men and 6.2% in women and the mean serum cholesterol levels were 5.01 and 5.02 mmol/L respectively.…”

Section: Indian Scenario Of Cardiovascular Diseasesmentioning

confidence: 86%

“…Studies In Indian rural and urban subjects 61 showed lower saturated fat consumption (4.9% and 9.2%) and low serum cholesterol levels [167 mg/dl (4.3 mmol/L) and 203 mg/dl (5.2 mmol/L)], respectively which were associated with a significantly increased prevalence of CAD in urban (8e13%) compared to rural (3%) population. 13,62,63 These studies indicate the possibility of an Indian paradox, and that the concept of normal saturated fat intake and normal cholesterol level may have little meaning among Indians.…”

Section: Indian Scenario Of Cardiovascular Diseasesmentioning

confidence: 98%

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Cardiovascular disease risk factors in Asian Indian population: A systematic review

Nag

Ghosh

2014

Journal of Cardiovascular Disease Research

117

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a b s t r a c tBackground: Cardiovascular diseases (CVDs) are the number one cause of death globally and are the leading cause of death in India also. Several surveys conducted across the country over the past few decades have shown a rising prevalence of major risk factors for CVD in Asian Indian population. The problem of increasing risk factors for CVD in India is because of lack of surveillance system and lack of proper diagnosis. This study will help to point out the need of research so that some advanced diagnosis system may be developed for proper diagnosis of CVDs and to reduce the growing burden of CVDs in the country. Methods: We did a literature search for the period from 1968 to 2012 using PUBMED search to identify all relevant studies of cardiovascular diseases. Besides PUBMED searching, manual searching has also been done. This article provides a review of current understanding of the epidemiology of cardiovascular disease, particularly, coronary heart disease (CHD), stroke and related risk factors in Asian Indian population. Results: Hypertension and diabetes are highly prevalent among Asian Indian population, which may explain their high rate of stroke and heart attack in India. The increasing rate of CVD may be explained by the high rates of other risk factors including adverse lipid profile. The etiology of cardiovascular diseases (CVD) is multifactorial and no single factor is an absolute cause. Conclusion: The cardiovascular diseases and its risk factors are increasing with a rapid pace in Asian Indian population. Though the prevalence of CVD risk factors is found higher in urban population, yet it is increasing at an alarming rate in rural population also, which is a serious threatening to the nation. Since majority of the Indians live in rural area, CVD may lead to epidemic proportions. We need health promotion programs and reorientation of primary health care to improve CVD detection in earlier stage and its management.

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Section: Indian Scenario Of Cardiovascular Diseasesmentioning

confidence: 86%

Section: Indian Scenario Of Cardiovascular Diseasesmentioning

confidence: 98%

Cardiovascular disease risk factors in Asian Indian population: A systematic review

Nag

Ghosh

2014

Journal of Cardiovascular Disease Research

117

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“…(Chadha et al, 1990;Gupta et al, 1995). A higher incidence of CHD and CHD risk factors was observed in urban compared with rural Indian subjects (Singh et al, 1995), and urban subjects had a similar risk factor profile to Indian emigrants to the UK.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for coronary heart disease in two similar Indian population groups, one residing in India, and the other in Sydney, Australia

Mahajan

Bermingham

2004

Eur J Clin Nutr

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Objective: To identify the prevalence of coronary risk factors among South Asian Indians in Australia and India. Design: Cross-sectional intercountry comparison. Subjects: Healthy volunteers aged 23-75 y recruited from the Indian community in Sydney Australia (n¼125), and their nominated relatives in India, (n¼125). Results: The two groups were of similar background with over 90% of the group in India being siblings, parents or relatives of the group in Australia. There was no difference in the populations between India and Australia with regard to mean age (40711.5 vs 39710. Conclusion:The group in Australia (especially women) have a more favourable disease risk profile than those in India. The fact that the groups are of such similar background and partly related, make it unlikely that changes due to migration have a strong genetic bias. In contrast to other studies, the absence here of excessive weight gain on migration may be a key factor in disease risk prevention.

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“…9,10 However, migrants from the Indian subcontinent do have a high prevalence of characteristics of the metabolic syndrome, including elevated plasma triacylglycerol (TAG) and small dense LDL (LDL3, the putative atherogenic LDL particles) levels, low plasma levels of high-density lipoprotein cholesterol (HDL-C), insulin resistance and a preponderance of central (visceral) fat. 7,[11][12][13] Studies have consistently shown that hyperinsulinaemia is present in a high percentage of both urban and migrant Asian Indians 10,13-15 and could be a contributory factor to the increased prevalence of type II diabetes and CHD. 11 However, the pathology of the hyperinsulinaemia and insulin resistance in the Indian Asian population is unclear.…”

Section: Introductionmentioning

confidence: 99%

“…3,[5][6][7][8] This increased prevalence of CHD and diabetes within these ethnic groups cannot be explained by the classical risk factors, such as elevated plasma total and low-density lipoprotein cholesterol (LDL-C), high blood pressure, high smoking incidence or obesity. 9,10 However, migrants from the Indian subcontinent do have a high prevalence of characteristics of the metabolic syndrome, including elevated plasma triacylglycerol (TAG) and small dense LDL (LDL3, the putative atherogenic LDL particles) levels, low plasma levels of high-density lipoprotein cholesterol (HDL-C), insulin resistance and a preponderance of central (visceral) fat.…”

Section: Introductionmentioning

confidence: 99%

Lack of association between central adiposity and lipaemia in UK Sikh men

et al. 2003

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OBJECTIVE: To determine whether the positive statistical associations between measures of total and regional adiposity and measures of glucose, insulin and triacylglycerol (TAG) metabolism reported in Caucasian men, are also observed in UK Sikhs. DESIGN: A matched cross-sectional study in which each volunteer provided a blood sample after a 12-h overnight fast and had anthropometric measurements taken. SUBJECTS: A total of 55 healthy Caucasian and 55 healthy UK Sikh men were recruited. The Caucasian and Sikh men were matched for age (48.7710.9 and 48.3710.0 y, respectively) and body mass index (BMI) (26.172.8 and 26.373.2 kg/m 2 , respectively). MEASUREMENTS: Anthropometric measurements were performed to assess total and regional fat depots. The concentrations of plasma total cholesterol, high-density cholesterol (HDL-C), low-density cholesterol (LDL-C) and small dense LDL (LDL3), TAG, glucose, fasting insulin (ins) and nonesterified fatty acids (NEFA) were analysed in fasted plasma. Surrogate measures of insulin resistance (HOMA-IR) and insulin sensitivity (RQUICKI) were calculated from insulin and glucose (HOMA-IR) and insulin, glucose and NEFA (RQUICKI) measurements. RESULTS: The Sikh men had significantly higher body fat, with the sum of the four skinfold measurements (Ssk) (P ¼ 0.0001) and subscapular skinfold value (P ¼ 0.009) higher compared with the Caucasian men. The Sikh volunteers also had characteristics of the metabolic syndrome: lower HDL-C (P ¼ 0.07), higher TAG (P ¼ 0.004), higher % LDL3 (P ¼ 0.0001) and insulin resistance (P ¼ 0.05 ). Both ethnic groups demonstrated positive correlations between insulin and waist circumference (Caucasian: r ¼ 0.661, P ¼ 0.0001; Sikh: r ¼ 0.477, P ¼ 0.0001). The Caucasian men also demonstrated significant positive correlations between central adiposity (r ¼ 0.275, P ¼ 0.04), other measures of adiposity (BMI and suprailiac skinfold) and plasma TAG, whereas the Sikh men showed no correlation for central adiposity (r ¼ 0.019, ns) and TAG with a trend to a negative relationship between other measures (Ssk and suprailiac) which reached near significance for subscapular skinfold and TAG (r ¼ À0.246, P ¼ 0.007). The expected positive association between insulin and TAG was observed in the Caucasian men (r ¼ 0.318, P ¼ 0.04) but not in the Sikh men (r ¼ 0.011, ns). CONCLUSIONS: In the Caucasian men, the expected positive association between plasma TAG and centralized body fat was observed. However, a lack of association between centralized, or any other measure of adiposity, and plasma TAG was observed in the matched Sikh men, although both ethnic groups showed the positive association between centralized body fat and insulin resistance, which was less strong for Sikhs. These findings in the Sikh men were not consistent with the hypothesis that there is a clear causal relationship between body fat and its distribution, insulin resistance, and lipid abnormalities associated with the metabolic syndrome, in this ethnic group.

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Epidemiologic study of diet and coronary risk factors in relation to central obesity and insulin levels in rural and urban populations of North India

Cited by 72 publications

References 17 publications

Cardiovascular disease risk factors in Asian Indian population: A systematic review

Cardiovascular disease risk factors in Asian Indian population: A systematic review

Risk factors for coronary heart disease in two similar Indian population groups, one residing in India, and the other in Sydney, Australia

Lack of association between central adiposity and lipaemia in UK Sikh men

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