The Asian Ethnic Paradox: Differences in Dietary Fat Intake and Risk of Coronary Artery Disease in Iranian and Indian Young-Elderly Populations Publisher



Sarrafzadigan N¹ ; Singh RB¹ ; Sharma R¹ ; Neki NS¹ ; Mohammadifard N¹ ; Jalali A¹ ; Alikhassi H¹ ; Rafie M¹
Source: Journal of Nutritional and Environmental Medicine Published:2001

Abstract

Purpose: To compare the prevalence of coronary artery disease (CAD) in Indian and Iranian populations in relation to dietary fat intake. Design: Cross-sectional surveys of randomly selected subjects from the city of Moradabad in India and Isfahan in Iran in 1993-95. Methods and Materials: There were 595 Indian (314 men and 281 women) and 400 Iranian (200 men and 200 women) subjects aged 50-84 years. The survey methods were 7 day diet diaries, anthropometric measurements and electrocardiography. Subjects were divided into high, low and very low fat diet groups according to dietary fat intake. Results: The overall prevalence of CAD based on clinical histories and electrocardiograms of the subjects showed no significant difference between Indian and Iranian men (13.0 vs. 12.5%) and women (11.0 vs. 10.5%), respectively. In comparison with Indians, Iranians had significantly greater mean body weight, body mass index (BMI) and waist-hip ratio as well as a higher prevalence of obesity and sedentary behaviour compared to Indians. The prevalence of tobacco intake was greater in Indians than Iranians in both sexes. The prevalence of CAD was significantly higher in subjects consuming high and low fat diets compared to very low fat diets among Indian men and women and Iranian men. No such association was observed in Iranian women. Logistic regression analysis after adjustment for age revealed that dietary fat, obesity, BMI, waist-hip ratio, sedentary behaviour and tobacco intake in Indians of both sexes and in Iranian men were significant risk factors for CAD. Conclusions: The prevalence of CAD has become a public health problem in India and Iran. The high rates were not explained by dietary fat intake, BMI, waist-hip ratio and tobacco intake (Indian men and women, Iranian men). However, low and high fat intake showed significant association. Other environmental and genetic factors may be important.