The prevalence CVD in South Asia is higher than in any other developing countries, with the diversity of diets in nations thought be one explanation for the variation.
Therefore, this study, published in BMC Nutrition, sought to explore the association between dietary patterns and the presence of cardiovascular risk factors among Pakistani low income urban adults.
Socio demographic, physical activity and dietary information was collected from 1546 Pakistani subjects aged under 40 and then researches used cluster analysis to identify dietary patterns from a food frequency questionnaire.
It was then investigated to what extent there was an association between dietary clusters and cardiovascular risk factors.
Overall, researchers found The most prevalent CVD risk factors among participants were elevated low density lipoprotein- cholesterol (LDL-C) (69.8 %) and systolic blood pressure (SBP) (68.2 %), followed by central obesity (57.1 %), low levels of high density lipoprotein-Cholesterol (HDL-C) (56.3 %), overall obesity (46.0 %), high total cholesterol (32.3 %), and elevated fasting blood sugar (FBS) (34.9 %).
Meanwhile the cluster analysis generated three non-overlapping diet patterns.
Cluster 1 (a traditional Pakistani diet), was dominated by fruits, vegetables, milk products and chicken. It included participants with high mean body mass index (BMI), waist circumference (WC), HDL-C and low mean SBP.
Cluster 2 (classed as a moderate diet) reflected a moderate intake of most food items and included participants with significantly higher mean SBP.
Cluster 3 (a fatty diet) was characterised by a high intake of beef, whole milk, paratha and lentils. This cluster had a low mean HDL-C and high SBP.
In analysis controlling for age, gender, tobacco use and physical activity, participants in the traditional diet cluster were more likely to be overweight or have high central adiposity than participants in the moderate diet cluster. However, they were less likely to have elevated SBP.
DL-C levels were higher in both the traditional Pakistani diet and fatty diet cluster compared to the moderate diet cluster. Low HDL-C was also more prevalent among the traditional Pakistani diet cluster.
“Though [the traditional] diet pattern has some foods that are relatively healthier, the usual intake in this group was highest for most foods, thereby increasing the total energy intake, that may have been resulted in higher prevalence of overweight and obese adults in this pattern,” states the study.
The study points out limited research has been done to identify the different type of diets that are normally consumed by Pakistani people.
In addition, currently no dietary guidelines, recommendations, or evidence-based dietary indices have been established by health and nutrition authorities in Pakistan.
“Therefore, studies using data driven methods including factor and cluster analysis are essential to identify existing dietary patterns among Pakistani people and inform public health initiatives in Pakistan,” they add.
The study concludes by stating the research shows that some of the CVD risk factors including obesity and hypertension are highly prevalent among low income urban Pakistani adults.
“Effective Public health strategies and multiple lifestyle change initiatives are required against obesity and hypertension among Pakistani adults to avert rise in CVD,” it added.
Source: BMC Nutrition
“Do dietary patterns explain high prevalence of cardiovascular risk factors among Pakistani urban adults? A cross-sectional study”
Authors: Nilofer F. Safdar, et al.