Relation between family history, obesity and risk for diabetes and heart disease in Pakistani children

Objective: To assess the differences in relative risk of developing diabetes and CHD, obesity, fasting blood glucose, insulin and lipids of children having family history of diabetes or heart disease in first or second degree relatives as compared to control group

Design: Children were given a questionnaire to collect demographic data and to assess their dietary habits and family history. Anthropometric measurements and blood samples for fasting blood glucose, insulin and lipids of 8-10 years old children from 4 schools was taken

Setting: The samples of ninety-nine children were obtained to assess fasting blood glucose, insulin and lipids of children

Subjects: Children having positive family history of diabetes [n=44] or heart disease [n=16] in first or second degree relatives were compared with a control group [n=39]

Results: Children having positive family history for diabetes had slightly higher mean values for BMI, waist circumference, arm fat% as compared to the controls but the differences were not statistically significant. Overweight children [>85[th] Percentile of BMI for age] did not differ significantly in terms of various risk indicators however those who were in the uppermost tertile of arm fat% had significantly higher total Cholesterol, Triglycerides, LDL-C, LDL:HDL and Insulin levels [P<0.05 in each case]

Conclusion: Diabetes and CVD risks from positive family history for the disease are probably mediated through increased body fat percentage. Thus even when information about family history of disease is lacking, arm-fat-percentage could be used as an important screening tool for determining the risk status of children

Socioeconomic differences in housewife's ability to take nutrritional care

To explore socio-economic differences in 'Nutritional Care Potential' [NCP] of housewives belonging to three distinctively different income groups living in urban areas of Karachi. Data was collected from families living in small, medium and large sized houses located in the authorized urban residential areas of Karachi. A total of 180 housewives [60 each for low, middle and high income groups] were interviewed. Trained data collectors visited the households, interviewed the housewives about family's socio-demographic characteristics and their own nutritional knowledge, health locus of control and decision making. The total NCP scores increased with income level [Low = 14.8+5.6; Middle 16.58+5.5; High = 17.28+5.3] but the difference was statistically significant only between low and high income groups [t-test P = 0.015]. The mean nutrition knowledge score of low income group was lower [mean score = 11.7+4.1] and significantly different from both middle [mean score = 13.5+3.4 t-text P = 0.013] and high income group [mean score = 14.2+4.0, t-test P = 0.001]. All the three income groups had firmer belief in internal health locus of control [mean score less than one out of a total of 4]. Though, the mean score was highest for the high income group and lowest for the middle income group but the difference were not statistically significant. There were no marked differences in decision making power of the three groups. The results of this study document socioeconomic difference in nutrition care potential. Though nutrition care potential of housewives was not found to be commendable at any income level, the fact that it is low at lower income levels indicates that poor nutritional status at lower income level is not because of income only

Food insecurity in metropolis of the developing world - observations from central district of Karachi, Pakistan

To asses the prevalence of household food insecurity at various income levels in urban areas of Karachi A cross sectional survey of different localities in the central district of Karachi was carried out. The data was collected through household interviews of housewives conducted by trained nutritionist. Housewives were interviewed about food security status of the household. A total of 797 families were visited from the central district of Karachi. Mean Food Security Score increased with income level. The difference was statistically significant [ANOVA] between 1st and second [P=0.000] and 2nd and 3rd group [P=0.000] but not between 3rd and fourth group. At the very low and low income levels 83% and 51% families respectively were food insecure in any degree, while this percentage was very low at the middle [6.3%] and high income level [1.8%]. The difference in prevalence of food insecurity between the VLI and LI, and, LI and MI income groups was statistically significant [chi.sq. test, p<0.001 in each case]. Hunger [because of lack of money] was experienced in the preceding year only by "very low income" [37%] and "low income" families [17%]. Use of coping strategies was most frequently mentioned for parents and then for children and only occasionally for infants or grand parents. Females were more likely to be effected by food insecurity than males. Meat, milk and fruits were the food groups which were preferred and considered healthy but were avoided because of lack of money by a majority [51%-86%] of families. Conclusions: In spite of having an impression of being an affluent city of Pakistan, the prevalence of food insecurity with and without hunger is rampant not only among very low income [slum dwellers] but also among low income families of Karachi

Urbanisation and coronary heart disease risk factors in South Asian

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. To compare the prevalence of certain CHD risk factors in 10-12 year old school children living at different levels of urbanization. Differences in height, Body Mass Index [BMI], Waist Hip Ratio [WHR], Fasting Blood Glucose [FBG] and Total Blood Cholesterol [TBC] were studied. 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. 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. 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