Compared to two decades ago, Delhiites are more obese, have higher blood pressure and sugar levels, and are consuming more tobacco and
alcohol.
This means that the average city resident is at a much higher risk of cardiovascular diseases (CVDs) than 20 years ago, according to a study conducted by the All India Institute of Medical Sciences (AIIMS) and funded by the Indian Council of Medical Research.
The study, '20-Year Trend of Cardiovascular Disease Risk Factors: Urban and Rural NCR of Delhi', found a spike in prevalence of overweight issues, alcohol use, high blood pressure and blood glucose levels, and increase in mean body mass index.
For the study, two representative cross-sectional surveys were conducted among men and women aged 35 to 64 years, residing in urban and rural areas of Delhi. While the first survey was done from 1991 to 1994, the second survey was conducted between 2010 and 2012. On an average, 1,000 persons per disease per sex were part of the study.
Urban population
The study found that all conventional risk factors of CVD, except smoking and lipids, worsened significantly in the urban population of Delhi. The prevalence of alcohol use increased from 16.1% to 25.6%, mainly driven by more consumption among men. The prevalence of smoking did not show much change in either sex.
Mean body mass index, however, increased from 24.4 kg/m2 to 26.0 kg/m2 and was associated with rise in prevalence of overweight issues, with similar increase in both sexes.
The overall prevalence of central obesity, or belly fat, increased from 65.9% to 75%, despite a fall in its prevalence among men — from 90.8% to 82.9%. The spike was mainly due to increase in cases among women — from 40.1% to 66.8%.
The mean systolic and diastolic blood pressure also increased among both men and women. This has resulted in an overall increase in prevalence of high blood pressure — from 23% to 42.2%.
With rise in the levels of mean fasting blood glucose, the prevalence of raised blood glucose also increased from 12.7% to 20.2%. This spike was observed in both men and women. The mean total cholesterol level, however, showed a significant decline in both sexes.
Rural population
Unlike people in urban Delhi, smoking prevalence increased from 40.5% to 46.6% in the rural population. The spike was mainly attributed to a rise in smoking among men.
Alcohol consumption saw a significant rise from 8% to 33.2%, again due to increased consumption among men. Increase in mean body mass index — from 20.2 kg/m2 to 23 kg/m2 — resulted in a three-fold increase in the prevalence of overweight in both sexes. Central obesity increased significantly and is proportionately more prevalent among women than men.
Rural Delhi also registered an overall increase in prevalence of raised blood pressure from 11.2% to 28.9%. Mean fasting blood glucose increased in both men and women, leading to an increase in prevalence of raised blood glucose from 3% to 9.6%.
Unlike urban areas, the mean total cholesterol level increased from 168.2 mg/dl to 190.7 mg/dl, in both men and women.
Post-liberalisation era
The study noted that the post-liberalisation era between the two surveys witnessed rapid urbanisation — rural to urban migration — and changes in the diet and lifestyle of the population. According to the study, this shift could have had a far reaching impact on the health of Delhiites.
Women’s health
As per the study, prevalence of obesity, raised blood pressure and blood glucose, and central obesity has seen a sharp rise among women — both in urban and rural areas of Delhi.
“Women in India have poor access to healthcare. The burden of smoking was much higher in rural women, whereas alcohol use was low among all women. This trend is also reported in the World Health Organization (WHO) report on trends of non-communicable diseases and its risk factor report,” the study noted.
It further stated that the risk reduction targets set by the WHO and India to reduce CVD burden are ambitious and call for a stronger response.
The study also highlights the need for a surveillance system in India to monitor risk factor trends on a more frequent, regular, and sustainable basis.
