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American Journal of Clinical Nutrition, Vol. 69, No. 4, 621-631, April 1999
© 1999 American Society for Clinical Nutrition


Original Research Communications

Cardiovascular disease risk factors in 2 distinct ethnic groups: Indian and Pakistani compared with American premenopausal women1,2,3

Savitri K Kamath, Erum A Hussain, Daxa Amin, Erica Mortillaro, Barbara West, Charles T Peterson, Faustina Aryee, Genoveva Murillo and D Lee Alekel

Background: Although people from the Indian subcontinent have high rates of cardiovascular disease (CVD), studies of such in Indian and Pakistani women living in the United States are lacking.

Objective: This study accounted for variability in serum lipid (total cholesterol and triacylglycerol) and lipoprotein [LDL cholesterol, lipoprotein(a), and HDL cholesterol] concentrations in Indian and Pakistani compared with American premenopausal women in the United States. Body composition, regional fat distribution, dietary intake, and energy expenditure were compared between groups.

Design: The 2 groups were 47 Indian and Pakistani and 47 American women. Health was assessed via medical history, physical activity, body composition (via anthropometry and dual-energy X-ray absorptiometry), dietary intake (via 7-d food records), and serum lipids.

Results: Serum total cholesterol, triacylglycerol, LDL cholesterol, lipoprotein(a), the ratio of total to HDL cholesterol, and the ratio of LDL to HDL cholesterol were greater (P <0.03), whereas HDL-cholesterol values were lower (P = 0.011) in Indians and Pakistanis than in Americans. Multiple regression analysis indicated that {approx}18% of the variance in total cholesterol (P = 0.0010) and LDL cholesterol (P = 0.0009) was accounted for by ethnicity, energy expenditure, and the ratio of the sum of central to the sum of peripheral skinfold thicknesses. Ethnicity, sum of central skinfold thicknesses, ratio of polyunsaturated to saturated fat, and monounsaturated fat intake accounted for {approx}43% of the variance in triacylglycerol concentration (P <= 0.0001). Monounsaturated fat, percentage body fat, and alcohol intake accounted for {approx}26% of variance in HDL cholesterol. Ethnicity contributed {approx}22% of the 25% overall variance in lipoprotein(a).

Conclusions: Results suggest that these Indian and Pakistani women are at higher CVD risk than their American counterparts, but that increasing their physical activity is likely to decrease overall and regional adiposity, thereby improving their serum lipid profiles.

Key Words: Ethnicity • lipids • lipoproteins • body composition • regional fat distribution • dietary intake • Indians • Pakistanis • premenopausal women • Americans • cardiovascular disease




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