Occupational status and cardiovascular disease risk factors in the rapidly developing, high-risk population of Mauritius.

This study examined the relation between occupation and cardiovascular disease (CVD) risk factors in 2,795 individuals between ages 35 and 54 years from the rapidly developing island nation of Mauritius. Participants attended a 1992 population-based survey of noncommunicable disease (89.1 % response rate). Occupational status, physical activity in the previous year, cigarette smoking, and alcohol consumption were assessed by questionnaire. Anthropometric and metabolic measures included body mass index (kg/m2),waist-to-hip ratio, fasting serum high density lipoprotein cholesterol and low density lipoprotein cholesterol (LDL cholesterol), triglycerides, 2-hour postload plasma glucose and serum insulin concentrations, and blood pressure. In comparison with professional/skilled workers, age-adjusted means of insulin and glucose, LDL cholesterol, triglycerides, and systolic and diastolic blood pressures were significantly (p < 0.05) lower, and the age-adjusted mean for high density lipoprotein cholesterol was significantly higher for unskilled men. In women, risk factors other than LDL cholesterol varied significantly (p < 0.05) across occupational categories, with homemakers tending to have the least favorable profile. Unskilled workers reported significantly more physical activity (p < 0.01), alcohol consumption, and cigarette smoking (men only) (p < 0.05) than did the other groups. Adjustment for multiple covariates revealed an independent association between occupational status and most CVD risk factors, with physical activity attenuating this association. These results elucidate mediating behaviors of CVD risk across occupational categories that could be applied to intervention strategies in Mauritius.

Physical inactivity and glucose intolerance in the multiethnic island of Mauritius.

The island nation of Mauritius, located in the southwest Indian Ocean, has a high prevalence of non-insulin-dependent diabetes mellitus (NIDDM) among all of its ethnic groups (Hindu and Muslim Indians, African-origin Creoles, and Chinese). These high rates of NIDDM among groups of varying genetic background provide strong support for the importance of environmental components in the etiology of the disease. Research in Mauritius using a simple activity scale has suggested that physical inactivity may be one of these components. The current investigation further examined the association between glucose tolerance and physical activity in middle-aged nondiabetic residents of Mauritius using a more extensive physical activity questionnaire (the Modifiable Activity Questionnaire). Excluding individuals with NIDDM, a statistically significant (P < 0.05) inverse relationship between physical activity and 2-h post-load glucose concentration was found for both males (rho = -0.14) and females (rho = -0.11). Stratifying by ethnic group, similar inverse correlations were observed in Hindu, Creole, and Chinese males, and in Hindu females (P < 0.05), as well as weaker relationships in Muslim males and Creole females (P < 0.10). Total physical activity remained an independent predictor of 2-h post-load glucose concentration after controlling for body mass index, waist-hip ratio, age, and family history of NIDDM. These data are supportive of a potentially important role of physical activity in the prevention of NIDDM in middle-aged inhabitants of Mauritius.

Changes in population cholesterol concentrations and other cardiovascular risk factor levels after five years of the non-communicable disease intervention programme in Mauritius. Mauritius Non-communicable Disease Study Group.

OBJECTIVE: To study changes in the prevalence of risk factors for cardiovascular disease after a five year population-wide intervention programme promoting a healthy lifestyle in a developing country. DESIGN: Cross sectional cluster surveys in 1987 and 1992. Methodology included a two hour 75 g oral glucose tolerance test, measurement of body mass index, waist:hip ratio, basal lipid concentrations, and blood pressure; and a lifestyle questionnaire. SETTING: Mauritius, in the Indian Ocean. SUBJECTS: All adults aged 25-74 years residing in geographically defined clusters. MAIN OUTCOME MEASURES: Age standardised prevalence of categorical disease and risk factor conditions and mean levels and frequency distributions of continuous variables. RESULTS: Response rates were 86.2% (5080/5892) in 1987 and 89.5% (5162/5770) in 1992. Significant decreases were found in the prevalence of hypertension (15.0% to 12.1% in men and 12.4% to 10.9% in women); cigarette smoking (58.2% to 47.2% and 6.9% to 3.7% respectively); and heavy alcohol consumption (38.2% to 14.4% and 2.6% to 0.6% respectively). Moderate leisure physical activity increased from 16.9% to 22.1% in men and from 1.3% to 2.7% in women. Mean population serum total cholesterol concentration fell appreciably from 5.5 mmol/l to 4.7 mmol/l (P < 0.001). The prevalence of overweight or obesity increased, and the rates of glucose intolerance changed little. The population frequency distributions of blood pressure, serum lipid concentration, and a composite risk factor score shifted advantageously. CONCLUSIONS: Lifestyle intervention projects can be implemented and have positive effects in developing countries. A pronounced improvement in the population lipid profile in Mauritius was probably related to a change in the saturated fat content of a widely used cooking oil.