Diet, nutrition and cardiovascular disease: The role of social determinants
Keywords:
Nutrition
Abstract
Cardiovascular diseases (CVD) arethe leading cause of disability and mortality in India with ever increasing trends. The
ubiquitous prevalence of CVD risk factors, despite some heterogeneity across different social strata, urban-rural locations
and geographical regions, has been proven in several studies. Diet and nutrition have played a definitive role in this
phenomenon. As India grapples with a dual burden of under- and over-nutrition, social factors at multiple levels such as
individual’s education and income, local food environment, migration and urbanization of populations, national agricultural
produce and policies as well as global trade policies have complex relationships with diet as well as CVD. A deeper
understanding of these factors is vital in designing public health interventions that are more targeted and relevant for the
Indian population. Policy changes and community interventions based on societal needs may be necessary if we are to
achieve the sustainable development goal targets by 2030, benefitting the larger population.
References
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S R, Joshi P P, Dhandhania V K, Rao P V, Sudha V, Subashini
R, Unnikrishnan R, Madhu S V, Kaur T, Mohan V and
Shukla D K (2014) ICMR–INDIAB Collaborative Study
Group. Physical activity and inactivity patterns in India -
results from the ICMR-INDIAB study (Phase-1) [ICMRINDIAB-5]
Int J Behav Nutr Phys Act 11 26
Astrup A (2006) The trans fatty acid story in Denmark
Atheroscler Suppl 7 43-6
Basu S, Babiarz K S, Ebrahim S, Vellakkal S, Stuckler D and
Goldhaber- Fiebert J D (2013) Palm oil taxes and
cardiovascular disease mortality in India: economicepidemiologic
model BMJ 347 f6048
Basu S, Vellakkal S, Agrawal S, Stuckler D, Popkin B and Ebrahim
S (2014) Averting obesity and type 2 diabetes in India
through sugar-sweetened beverage taxation: an economicepidemiologic
modeling study PLoS Med 11 e1001582
doi: 10.1371/journal.pmed.1001582
Chaturvedi S, Ramji S, Arora N K, Rewal S, Dasgupta R,
Deshmukh V; for INCLEN Study Group (2016) Timeconstrained
mother and expanding market: emerging model
of under-nutrition in India BMC Public Health 16 632
Chopra M (2002) Globalization and food: Implications for the
promotion of “healthy” diets. Geneva: World Health
Organization
Colchero M A, Molina M and Guerrero-López C M (2017)
After Mexico Implemented a Tax, Purchases of SugarSweetened
Beverages Decreased and Water Increased:
Difference by Place of Residence, Household Composition,
and Income Level J Nutr 147 1552-1557
Danaraj T J, Acker M S, Danaraj W, Wong H O and Tan B Y
(1959) Ethnic group differences in coronary heart disease
in Singapore: an analysis of necropsy records Am Heart J
58 516-526
Devi S M, Balachandar V, Lee SI and Kim I H (2014) An Outline
of Meat Consumption in the Indian Population – A Pilot
Review Korean J Food Sci Anim Resour 34 507-15
Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V,
Iqbal R, Kumar R, Wentzel-Viljoen E, Rosengren A, Amma
LI, Avezum A, Chifamba J, Diaz R, Khatib R, Lear S,
Lopez-Jaramillo P, Liu X, Gupta R, Mohammadifard N,
Gao N, Oguz A, Ramli AS, Seron P, Sun Y, Szuba A,
Tsolekile L, Wielgosz A, Yusuf R, Hussein Yusufali A, Teo
K K, Rangarajan S, Dagenais G, Bangdiwala S I, Islam S,
Anand S S, Yusuf S; Prospective Urban Rural Epidemiology
(PURE) study investigators. Associations of fats and
carbohydrate intake with cardiovascular disease and
mortality in 18 countries from five continents (PURE): a
prospective cohort study Lancet 2017; 390 2050-2062
Dowse G K, Gareeboo H, Alberti K G, Zimmet P, Tuomilehto J,
Purran A, Fareed D, Chitson P and Collins V R (1995)
Changes in population cholesterol concentrations and other
cardiovascular risk factor levels after five years of the noncommunicable
disease intervention programme in
Mauritius. Mauritius Non-communicable Disease Study
Group BMJ 311 1255-9
Escalon H, Cogordan C and Arwidson P (2016) Parents support
for the ban on television food advertising to children is
particularly high in France, especially compared to the
USA. This result should influence political decisionmaking
to restrict food marketing targeting young people
Sante Publique 28 7-17
Finzer L E, Ajay V S, Ali M K, Shivashankar R, Goenka S,
Sharma P, Pillai D S, Khandelwal S, Tandon N, Reddy K S,
Narayan K M and Prabhakaran D (2013) Fruit and
vegetable purchasing patterns and preferences in South
Delhi Ecol Food Nutr 52 1-20
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United Nations Research Institute for Social Development
(UNRISD). Retrieved from: http:// unrisd.org/unrisd/
website/document.nsf/ab82a6805797760f80256b4f
005da1ab/7ee 221555523155dc1256c77003cfaed/$FILE/
ghoslong.pdf
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States: Institute for Health Metrics and Evaluation
(IHME), 2017. Available from http://ghdx.healthdata.org/
gbd-results-tool
Green R, Milner J, Joy E J, Agrawal and Dangour A D (2016)
Dietary patterns in India: A systematic review Br J Nutr
Diet and Cardiovascular Disease 953
116 142-8
Gupta S (2012) Food expenditure and intake in the NSS 66th
round - Economic and Political Weekly. Available at: http:/
/www.epw.in/commentary/foodexpenditure-and-intakenss-66th-round.html
Gupta R, Misra A, Vikram N K, Kondal D, Gupta S S, Agrawal
A and Pandey R M (2009) Younger age of escalation of
cardiovascular risk factors in Asian Indian subjects BMC
Cardiovasc Disord 9 28
Hawkes C (2007) WHO Commission on Social Determinants of
Health. Globalization, Food and Nutrition Transitions.
Globalization and Health Knowledge Network, Research
Papers. Ottawa: Institute of Population Health
Hawkes C, Chopra M and Friel S (2009) Globalization, Trade,
and the Nutrition Transition. Globalization and Health:
Pathways, Evidence and Policy 2009. 10.4324/
9780203881026
Jeemon P, Prabhakaran D, Goenka S, Ramakrishnan L,
Padmanabhan S, Huffman M, Joshi P, Sivasankaran S,
Mohan B V, Ahmed F, Ramanathan M, Ahuja R, Sinha N,
Thankappan K R and Reddy K S (2012) Sentinel
Surveillance in Industrial Populations Study Group. Impact
of comprehensive cardiovascular risk reduction programme
on risk factor clustering associated with elevated blood
pressure in an Indian industrial population Indian J Med
Res 135 485-493
Joshi P K and Rao P P (2017) Global pulses scenario: Status and
outlook Ann N Y Acad Sci 1392 6-17
Kadiyala S, Harris J, Headey D, Yosef S and Gillespie S (2014)
Agriculture and nutrition in India: Mapping evidence to
pathways Ann N Y Acad Sci 1331 43-56
Kanungsukkasem U, Ng N, Van Minh H, Razzaque A, Ashraf A,
Juvekar S, Masud Ahmed S and Huu Bich (2009) Fruit
and vegetable consumption in rural adults population in I
DEPTH HDSS sites in Asia Glob Health Action 28 2
Miller V, Yusuf S and Chow C K (2016) Availability, affordability,
and consumption of fruits and vegetables in 18 countries
across income levels: findings from the Prospective Urban
Rural Epidemiology (PURE) study Lancet Glob Health 4
e695-703
Misra A, Singhal N, Sivakumar B, Bhagat N, Jaiswal A and
Khurana L (2011) Nutrition transition in India: secular
trends in dietary intake and their relationship to diet-related
non-communicable diseases J Diabetes 3 278-92
Misra A, Sharma R, Pandey R M and Khanna N (2001) Adverse
profile of dietary nutrients, anthropometry and lipids in
urban slum dwellers of northern India Eur J Clin Nutr 55
727-734
National Family Health Surveys 2005-06 and 2015-16. Available
at http://rchiips.org/nfhs/; accessed on 14th June 2018
Pan A, Lin X, Hemler E and Hu F B (2018) Diet and Cardiovascular
Disease: Advances and Challenges in Population-Based
Studies Cell Metab 27 489-496
Prabhakaran D, Jeemon P, Goenka S, Lakshmy R, Thankappan
K R, Ahmed F, Joshi P P, Mohan B V, Meera R, Das M S,
Ahuja R C, Saran R K, Chaturvedi V and Reddy K S
(2009) Impact of a worksite intervention program on
cardiovascular risk factors: A demonstration project in an
Indian industrial population J Am Coll Cardiol 53 1718-
1728 doi: 10.1016/j.jacc.2008.12.062
Prabhakaran D, Jeemon P and Reddy K S (2013) Commentary:
Poverty and cardiovascular disease in India: do we need
more evidence for action? Int J Epidemiol 42 1431-5
Prabhakaran D, Jeemon P and Roy A (2016) Cardiovascular
Diseases in India. Current Epidemiology and Future
Directions Circulation 133 1605-1620
Price G K, Landes R and Govidan A (2003) India’s Pulse Sector:
Results of Field Research. Washington DC: United States
Department of Agriculture
Ramachandran P (2006) The Double Burden of Malnutrition in
India. ftp://ftp fao.org/docrep/fao/009/a0442e/a0442e01.
pdf. Rome, Italy; Food and Agriculture Organization
Ramachandran A, Ramachandran S, Snehalatha C, Augustine C,
Murugesan N, Viswanathan V, Kapur A and Williams R
(2007) Increasing expenditure on health care incurred by
diabetic subjects in a developing country: a study from
India Diabetes Care 30 252-256
Roth G A, Johnson C, Abajobir A et al. (2017) Global, Regional,
and National Burden of Cardiovascular Diseases for 10
Causes, 1990 to 2015 J Am Coll Cardiol 70 1-25
Trichopoulou A, Martínez-González M A, Tong T Y, Forouhi N
G, Khandelwal S, Prabhakaran D, Mozaffarian D, de
Lorgeril M Definitions and potential health benefits of the
Mediterranean diet: views from experts around the world.
BMC Med. 2014 Jul 24; 12 112
WHO Healthy diet. Available at http://www.who.int/news-room/
fact-sheets/detail/healthy-diet. Accessed on 14th June 2018
WHO physical activity recommendations. Available at http://
www.who.int/dietphysicalactivity/factsheet_
recommendations/en/ Accessed on 14th June 2018
Zatonski WA, McMichael A J and Powles J W (1998) Ecological
study of reasons for sharp decline in mortality from
ischaemic heart disease in Poland since 1991 BMJ 316
1047-51.
S R, Joshi P P, Dhandhania V K, Rao P V, Sudha V, Subashini
R, Unnikrishnan R, Madhu S V, Kaur T, Mohan V and
Shukla D K (2014) ICMR–INDIAB Collaborative Study
Group. Physical activity and inactivity patterns in India -
results from the ICMR-INDIAB study (Phase-1) [ICMRINDIAB-5]
Int J Behav Nutr Phys Act 11 26
Astrup A (2006) The trans fatty acid story in Denmark
Atheroscler Suppl 7 43-6
Basu S, Babiarz K S, Ebrahim S, Vellakkal S, Stuckler D and
Goldhaber- Fiebert J D (2013) Palm oil taxes and
cardiovascular disease mortality in India: economicepidemiologic
model BMJ 347 f6048
Basu S, Vellakkal S, Agrawal S, Stuckler D, Popkin B and Ebrahim
S (2014) Averting obesity and type 2 diabetes in India
through sugar-sweetened beverage taxation: an economicepidemiologic
modeling study PLoS Med 11 e1001582
doi: 10.1371/journal.pmed.1001582
Chaturvedi S, Ramji S, Arora N K, Rewal S, Dasgupta R,
Deshmukh V; for INCLEN Study Group (2016) Timeconstrained
mother and expanding market: emerging model
of under-nutrition in India BMC Public Health 16 632
Chopra M (2002) Globalization and food: Implications for the
promotion of “healthy” diets. Geneva: World Health
Organization
Colchero M A, Molina M and Guerrero-López C M (2017)
After Mexico Implemented a Tax, Purchases of SugarSweetened
Beverages Decreased and Water Increased:
Difference by Place of Residence, Household Composition,
and Income Level J Nutr 147 1552-1557
Danaraj T J, Acker M S, Danaraj W, Wong H O and Tan B Y
(1959) Ethnic group differences in coronary heart disease
in Singapore: an analysis of necropsy records Am Heart J
58 516-526
Devi S M, Balachandar V, Lee SI and Kim I H (2014) An Outline
of Meat Consumption in the Indian Population – A Pilot
Review Korean J Food Sci Anim Resour 34 507-15
Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V,
Iqbal R, Kumar R, Wentzel-Viljoen E, Rosengren A, Amma
LI, Avezum A, Chifamba J, Diaz R, Khatib R, Lear S,
Lopez-Jaramillo P, Liu X, Gupta R, Mohammadifard N,
Gao N, Oguz A, Ramli AS, Seron P, Sun Y, Szuba A,
Tsolekile L, Wielgosz A, Yusuf R, Hussein Yusufali A, Teo
K K, Rangarajan S, Dagenais G, Bangdiwala S I, Islam S,
Anand S S, Yusuf S; Prospective Urban Rural Epidemiology
(PURE) study investigators. Associations of fats and
carbohydrate intake with cardiovascular disease and
mortality in 18 countries from five continents (PURE): a
prospective cohort study Lancet 2017; 390 2050-2062
Dowse G K, Gareeboo H, Alberti K G, Zimmet P, Tuomilehto J,
Purran A, Fareed D, Chitson P and Collins V R (1995)
Changes in population cholesterol concentrations and other
cardiovascular risk factor levels after five years of the noncommunicable
disease intervention programme in
Mauritius. Mauritius Non-communicable Disease Study
Group BMJ 311 1255-9
Escalon H, Cogordan C and Arwidson P (2016) Parents support
for the ban on television food advertising to children is
particularly high in France, especially compared to the
USA. This result should influence political decisionmaking
to restrict food marketing targeting young people
Sante Publique 28 7-17
Finzer L E, Ajay V S, Ali M K, Shivashankar R, Goenka S,
Sharma P, Pillai D S, Khandelwal S, Tandon N, Reddy K S,
Narayan K M and Prabhakaran D (2013) Fruit and
vegetable purchasing patterns and preferences in South
Delhi Ecol Food Nutr 52 1-20
Ghosh J (2002) Social policy in Indian development. Geneva:
United Nations Research Institute for Social Development
(UNRISD). Retrieved from: http:// unrisd.org/unrisd/
website/document.nsf/ab82a6805797760f80256b4f
005da1ab/7ee 221555523155dc1256c77003cfaed/$FILE/
ghoslong.pdf
Global Burden of Disease Collaborative Network. Global Burden
of Disease Study 2016 (GBD 2016) Results. Seattle, United
States: Institute for Health Metrics and Evaluation
(IHME), 2017. Available from http://ghdx.healthdata.org/
gbd-results-tool
Green R, Milner J, Joy E J, Agrawal and Dangour A D (2016)
Dietary patterns in India: A systematic review Br J Nutr
Diet and Cardiovascular Disease 953
116 142-8
Gupta S (2012) Food expenditure and intake in the NSS 66th
round - Economic and Political Weekly. Available at: http:/
/www.epw.in/commentary/foodexpenditure-and-intakenss-66th-round.html
Gupta R, Misra A, Vikram N K, Kondal D, Gupta S S, Agrawal
A and Pandey R M (2009) Younger age of escalation of
cardiovascular risk factors in Asian Indian subjects BMC
Cardiovasc Disord 9 28
Hawkes C (2007) WHO Commission on Social Determinants of
Health. Globalization, Food and Nutrition Transitions.
Globalization and Health Knowledge Network, Research
Papers. Ottawa: Institute of Population Health
Hawkes C, Chopra M and Friel S (2009) Globalization, Trade,
and the Nutrition Transition. Globalization and Health:
Pathways, Evidence and Policy 2009. 10.4324/
9780203881026
Jeemon P, Prabhakaran D, Goenka S, Ramakrishnan L,
Padmanabhan S, Huffman M, Joshi P, Sivasankaran S,
Mohan B V, Ahmed F, Ramanathan M, Ahuja R, Sinha N,
Thankappan K R and Reddy K S (2012) Sentinel
Surveillance in Industrial Populations Study Group. Impact
of comprehensive cardiovascular risk reduction programme
on risk factor clustering associated with elevated blood
pressure in an Indian industrial population Indian J Med
Res 135 485-493
Joshi P K and Rao P P (2017) Global pulses scenario: Status and
outlook Ann N Y Acad Sci 1392 6-17
Kadiyala S, Harris J, Headey D, Yosef S and Gillespie S (2014)
Agriculture and nutrition in India: Mapping evidence to
pathways Ann N Y Acad Sci 1331 43-56
Kanungsukkasem U, Ng N, Van Minh H, Razzaque A, Ashraf A,
Juvekar S, Masud Ahmed S and Huu Bich (2009) Fruit
and vegetable consumption in rural adults population in I
DEPTH HDSS sites in Asia Glob Health Action 28 2
Miller V, Yusuf S and Chow C K (2016) Availability, affordability,
and consumption of fruits and vegetables in 18 countries
across income levels: findings from the Prospective Urban
Rural Epidemiology (PURE) study Lancet Glob Health 4
e695-703
Misra A, Singhal N, Sivakumar B, Bhagat N, Jaiswal A and
Khurana L (2011) Nutrition transition in India: secular
trends in dietary intake and their relationship to diet-related
non-communicable diseases J Diabetes 3 278-92
Misra A, Sharma R, Pandey R M and Khanna N (2001) Adverse
profile of dietary nutrients, anthropometry and lipids in
urban slum dwellers of northern India Eur J Clin Nutr 55
727-734
National Family Health Surveys 2005-06 and 2015-16. Available
at http://rchiips.org/nfhs/; accessed on 14th June 2018
Pan A, Lin X, Hemler E and Hu F B (2018) Diet and Cardiovascular
Disease: Advances and Challenges in Population-Based
Studies Cell Metab 27 489-496
Prabhakaran D, Jeemon P, Goenka S, Lakshmy R, Thankappan
K R, Ahmed F, Joshi P P, Mohan B V, Meera R, Das M S,
Ahuja R C, Saran R K, Chaturvedi V and Reddy K S
(2009) Impact of a worksite intervention program on
cardiovascular risk factors: A demonstration project in an
Indian industrial population J Am Coll Cardiol 53 1718-
1728 doi: 10.1016/j.jacc.2008.12.062
Prabhakaran D, Jeemon P and Reddy K S (2013) Commentary:
Poverty and cardiovascular disease in India: do we need
more evidence for action? Int J Epidemiol 42 1431-5
Prabhakaran D, Jeemon P and Roy A (2016) Cardiovascular
Diseases in India. Current Epidemiology and Future
Directions Circulation 133 1605-1620
Price G K, Landes R and Govidan A (2003) India’s Pulse Sector:
Results of Field Research. Washington DC: United States
Department of Agriculture
Ramachandran P (2006) The Double Burden of Malnutrition in
India. ftp://ftp fao.org/docrep/fao/009/a0442e/a0442e01.
pdf. Rome, Italy; Food and Agriculture Organization
Ramachandran A, Ramachandran S, Snehalatha C, Augustine C,
Murugesan N, Viswanathan V, Kapur A and Williams R
(2007) Increasing expenditure on health care incurred by
diabetic subjects in a developing country: a study from
India Diabetes Care 30 252-256
Roth G A, Johnson C, Abajobir A et al. (2017) Global, Regional,
and National Burden of Cardiovascular Diseases for 10
Causes, 1990 to 2015 J Am Coll Cardiol 70 1-25
Trichopoulou A, Martínez-González M A, Tong T Y, Forouhi N
G, Khandelwal S, Prabhakaran D, Mozaffarian D, de
Lorgeril M Definitions and potential health benefits of the
Mediterranean diet: views from experts around the world.
BMC Med. 2014 Jul 24; 12 112
WHO Healthy diet. Available at http://www.who.int/news-room/
fact-sheets/detail/healthy-diet. Accessed on 14th June 2018
WHO physical activity recommendations. Available at http://
www.who.int/dietphysicalactivity/factsheet_
recommendations/en/ Accessed on 14th June 2018
Zatonski WA, McMichael A J and Powles J W (1998) Ecological
study of reasons for sharp decline in mortality from
ischaemic heart disease in Poland since 1991 BMJ 316
1047-51.
Published
2018-11-13
Section
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Copyright (c) 2018 Arun Pulikkottil Jose, Krithiga Shridhar, Dorairaj Prabhakaran
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