Urbanisation and coronary heart disease risk factors in South Asian children.

BACKGROUND Coronary Heart Disease (CHD) and other Non Communicable Diseases (NCDs) are increasing globally. Comparison of various sections of the South Asian populations living at different levels of urbanization can help in understanding the role of demographic transition in the increased prevalence of these diseases in urbanized populations. OBJECTIVE To compare the prevalence of certain CHD risk factors in 10-12 year old school children living at different levels of urbanization. METHOD Differences in height, Body Mass Index (BMI), Waist Hip Ratio (WHR), Fasting Blood Glucose (FBG) and Total Blood Cholesterol (TBC) were studied. SUBJECTS Anthropometric and biochemical measurements of six groups of 10-12 year old children, representing various urbanization categories, were studied. Three groups of children were recruited from Punjab, Pakistan: rural, middle income urban and high income urban and they were assigned urbanization rank (UR) 1, 2 and 3. Another three groups of children were recruited from Slough, UK: British Pakistani, British Indian, and British Caucasian and they were assigned urbanization rank 4, 5 and 6 respectively. RESULTS Proportion of children having high CHD risk increased with urbanization rank. Increase in BMI and TBC with urbanization status was steadier than the increase in FBG and WHR. Stunting which have been found to have a positive association with obesity and increased risk of CHD was higher among the less urbanized groups. BMI and TBC of the urbanized South Asian groups were lower, but FBG was higher than the British Caucasian, who served as controls. CONCLUSION These findings support the hypothesis that high CHD death rate among South Asians in UK may have its origin in the genetic predisposition to diabetes but are not likely to be solely due to this factor. The environmental factors like under nourishment in early life, adoption of urbanized life style or a combination of both could be the major determinants of CHD morbidity and mortality.