Exposure to an urban, sedentary work environment and higher socioecono
mic status (SES) may stimulate adoption of Westernized lifestyles by p
opulations in developing countries reversing the historically low risk
for coronary heart disease. In a study of serum lipids in 1407 Nigeri
an civil servants, aged 25-54 years, we found a more atherogenic lipid
profile among higher SES males and females compared with lower SES (L
DL-cholesterol, 113 vs. 97 mg/dl, males, 125 vs. 114 mg/dl, females).
Mean body mass index (BMI, kg/m(2)) in higher and lower SES was 22.6 a
nd 21.3, respectively, males, and 24.7 and 24.4, respectively, females
. A strong relationship was observed between BMI and lipids although t
his relationship was absent among the leanest half of the population (
BMI < 21.8). In multiple regression, SES and BMI were both strong and
independent predictors of cholesterol. Both high and low SES consumed
a typical Nigerian low fat, high carbohydrate diet, but somewhat highe
r meat, milk and egg intake suggested that some Westernization of the
diet had occurred among the higher SES. Physical activity was lower am
ong the higher SES. We conclude that SES related changes in lifestyle
contribute to substantially higher total and LDL-cholesterol even in a
generally lean population consuming a low fat diet.