Cardiovasc J S Afr. 2000 Apr; 11(2): 68-75.

Coronary heart disease risk factors in Indian adolescents the role of diet.

Mia FB, Vorster HH.

Nutrition Research Group, Department of Nutrition, Potchefstroom University for CHE, Potchefstroom, North West, South Africa.

This study tested the hypothesis that the habitual diet of Indian adolescents contributes to coronary heart disease (CHD) risk factors. A random sample of 321 Indian matriculants aged 16 - 18 years participated. Anthropometric and blood pressure measurements were made with standardised methodology. Habitual dietary intakes were measured using a validated food frequency questionnaire. Serum lipids and lipoproteins and plasma fibrinogen and factor VII coagulant activity were determined on samples obtained from fasted subjects. The demographic questionnaire results indicated that 20% of the adolescents smoked. Mean serum total cholesterol levels of 43% of the non-vegetarian males and 37% of the females fell in the low CHD risk category. Mean plasma fibrinogen levels of 2.28 - 2.93 g/1 were higher than those reported for white students, but lower than those of black South Africans. These adolescents habitually ate a diet high in fat (41.5 - 47.7% of total energy) and low in carbohydrate (44.4 - 48% of total energy). The significant relationships observed between nutrient intakes and the risk factors for CHD suggest that diet plays an important role in the development of CHD in this population. The significant relationships between triglycerides, blood pressure, weight, percentage of high-density lipoprotein (HDL) cholesterol and fibrinogen further suggest a clustering of risk factors all known to be associated with an insulin-resistant state. It is concluded that although a possible genetic and dietary interaction of causative risk factors results in the high CHD risk of this population, the role of diet in the clustering of risk factors in these Indian adolescents should be further examined. It is suggested that compliance to a culture-sensitive, low-fat, high-carbohydrate diet could possibly lower their risk.