EPIDEMIOLOGIC-STUDY OF DIET AND CORONARY RISK-FACTORS IN RELATION TO CENTRAL OBESITY AND INSULIN LEVELS IN RURAL AND URBAN POPULATIONS OF NORTH-INDIA

In a population survey of 162 rural and 152 urban subjects aged 26-65 years at Moradabad, the findings are compared with existing data on In dian immigrants to Britain and United States. In comparison with rural subjects, urban subjects had a higher prevalence of coronary artery d isease (8.6 vs, 3.0%) and diabetes (7.9 vs 2.5%), higher blood pressur es, total and low density lipoprotein cholesterol, triglycerides and p ostprandial 2-h blood glucose and plasma insulin similar to observatio ns made in UK in immigrants compared to Europeans. Easting plasma insu lin and high density lipoprotein cholesterol levels in urban subjects were comparable with rural subjects. Mean body weights were significan tly higher in urban women, but not in men, than in rural subjects. How ever the body mass index (22.9 +/- 4.2 vs. 21.6 +/- 2.4 kg/m(2)) and w aist-hip girth ratio (0.89 +/- 0.10 vs. 0.86 +/- 0.07) were significan tly higher in urban men compared to rural men without such differences in women. Underlying these differences in risk factors, urban subject s had three times better socioeconomic status than rural subjects and were eating higher total and saturated fat, cholesterol and refined ca rbohydrates and lower total and complex carbohydrates compared to rura l men and women. Energy expenditure during routine and spare time phys ical activity was significantly higher in rural compared to urban subj ects. Those patients who had risk factors, showed lesser physical acti vity and had greater adverse factors in the diet compared to subjects without risk factors, Body mass index and waist-hip girth ratio in pat ients with risk factors were significantly higher than in subjects wit hout risk factors. The findings suggest that decreased consumption of, total and saturated fat and increased physical activity may be useful for prevention of coronary artery disease among urbans as well as in i mmigrants.