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

Constraints to adoption of appropriate breast feeding practices in a squatter settlement in Karachi, Pakistan

Appropriate breast feeding practices [ABFP] are important for successful lactation. Constraints to adoption of ABFP by mothers in a squatter settlement in Karachi, Pakistan are reported. One hundred and two mother-infant pairs were followed from birth to 16 weeks of age. Eighty-seven infants received prelacteal feeds of honey as a quasi-religious ritual, 16 received ghutti for 'cleansing of stomach', other prelacteal feeds were given as substitutes for breast feeding. Twenty nine mothers initiated breast feeding within 4 hours of birth. Supplemental water was given to 53 infants; major reasons being mothers' perception of thirst and diarrhoea in the infant. Supplemental milk was given to 24 infants. Insufficient milk and work load of mothers were main reasons for supplementation. Home remedies were given in 36 instances for prevention/treatment of indigestion or colds. Quasi-religious ritual of giving honey, perception that child birth was a major stress and early initiation of breast feeding adds to that stress, fear of dehydration and perception of insufficient breast milk were the major constraints to adoption of appropriate breast feeding practices