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Prevalence of Selected Intermediate Risk Factors for Non-communicable Diseases in an Apparently Healthy Indian Community in KwaZulu-Natal, South Africa


South Africa, burdened with the emerging chronic diseases, is home to one of the largest migrant Indian population, however, little data exists on the risk factors for non-communicable diseases in this population. The aim of this study was to determine the prevalence of yet undiagnosed selected intermediate risk factors for non-communicable diseases among the Indian population in KwaZulu-Natal. We randomly selected 250 apparently healthy Indians, aged 35–55 years, living in KwaDukuza to participate in this study. Clinical and anthropometric measurements were taken under prescribed clinical conditions using Asian cut-off points. Pearson correlations was used to detect associations between anthropometric and clinical risk markers. A large percentage of participants’ systolic blood pressure fell within the normal range. Diastolic blood pressure was >85 mmHg for 61 % of the participants and triglyceride levels were >1.69 mmol/L for 89 % of the participants’; 94 % of the women and 87 % of the men were classified as centrally obese. Raised fasting blood glucose was seen in 39 % of participants’. Waist circumference and body mass index showed statistically significant associations with all clinical risk markers except for diastolic blood pressure. Our findings suggest that the use of ethno specific strategies in the management of the disease profile of South African Indians, will enable the South African health system to respond more positively towards the current trend of increased metabolic and physiological risk factors in this community. Moreover, key modifiable behaviours such as increased physical activity and weight reduction may improve most of these metabolic abnormalities.

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  1. 1.

    McKeigue, P. M., Miller, G. J., & Marmot, M. G. (1989). Coronary heart disease in South Asians overseas: A review. Journal of Clinical Epidemiology, 42(7), 597–609.

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Prakaschandra, D. R., Esterhuizen, T. M., Gathiram, P., & Naidoo, D. P. (2016). High prevalence of cardiovascular risk factors in Durban South African Indians: The Phoenix Lifestyle Project. South African Medical Journal, 106(3), 284–289.

    Article  PubMed  Google Scholar 

  3. 3.

    Tunstall-Pedoe, H., Kuulasmaa, K., Amouyel, P., Arveiler, D., Rajakangas, A. M., & Pajak, A. (1994). Myocardial infarction and coronary deaths in the WHO Monica Project—Registration procedures, event rates and case fatality in 38 populations from 21 countries in 4 continents. Circulation, 90(1), 583–612.

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Lovegrove, J. A., Lovegrove, S. S., Lesauvage, S. V. M., Brady, L. M., Saini, N., & Minihane, A. M. (2004). Moderate fish-oil supplementation reverses low-platelet, long-chain n-3 polyunsaturated fatty acid status and reduces plasma triacylglycerol concentrations in British Indo-Asians. American Journal of Clinical Nutrition, 79(6), 974–982.

    CAS  PubMed  Google Scholar 

  5. 5.

    Bhopal, R. S., & Rafnsson, S. B. (2009). Could mitochondrial efficiency explain the susceptibility to adiposity, metabolic syndrome, diabetes and cardiovascular diseases in South Asian populations? International Journal of Epidemiology, 38(4), 1072–1081.

    Article  PubMed  Google Scholar 

  6. 6.

    Enas, E. A., Yusuf, S., & Mehta, J. L. (1992). Prevalence of coronary artery diseases in Asian Indians. American Journal of Cardiology, 70(9), 945–949.

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Seedat, Y. K. (1996). Ethnicity, hypertension, coronary heart disease, and renal diseases in South Africa. Ethnicity Health, 1(4), 349–357.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Bhatnagar, D., Anand, I. S., & Durrington, P. N. (1995). Coronary risk factors in people from the Indian subcontinent living in West London and their siblings in India. Lancet, 345(8947), 405–409.

    CAS  Article  PubMed  Google Scholar 

  9. 9.

    Mukhopadhyay, B., Forouhi, N. G., Fisher, B. M., Kesson, C. M., & Sattar, N. (2006). Comparison of glycaemic and metabolic control over time among European and South Asian patients with type 2 diabetes: Results from follow up in a routine diabetes clinic. Diabetic Medicine, 23(1), 94–98.

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Mayosi, B. M., Flisher, A. J., Lalloo, U. G., Sitas, F., Tollman, S. M., & Bradshaw, D. (2009). The burden of non-communicable diseases in South Africa. Lancet, 374(9693), 934–947.

    Article  PubMed  Google Scholar 

  11. 11.

    Gholap, N., Davies, M., Patel, K., Sattar, N., & Khunti, K. (2011). Type 2 diabetes and cardiovascular disease in South Asians. Primary Care Diabetes, 5(1), 45–56.

    Article  PubMed  Google Scholar 

  12. 12.

    Nojilana, B., Bradshaw, D., Pillay-van Wyk, V., et al. (2016). Emerging trends in non-communicable disease mortality in South Africa, 1997–2010. South African Medical Journal, 106(3), 477–484.

    Article  Google Scholar 

  13. 13.

    Statistics SA. (2012). Census 2011 statistical release (p. 17). Pretoria: Statistics South Africa.

    Google Scholar 

  14. 14.

    Department of Health: Medical Research Council, OrcMacro. (2007). South Africa demographic and health survey 2003. Pretoria: Department of Health.

    Google Scholar 

  15. 15.

    Lee, R. D., & Nieman, D. C. (2002). Nutritional assessment. New York: McGraw-Hill.

    Google Scholar 

  16. 16.

    WHO, IASO, IOTF. (2000). The Asia-Pacific perspective: Redefining obesity and its treatment. Sydney: Health Communications Australia.

    Google Scholar 

  17. 17.

    National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). (2002). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation, 106(25), 3143–3421.

    Google Scholar 

  18. 18.

    Shisana, O., Labadarios, D., Rehle, T., et al. (2013). The South African National Health and Nutrition Examination Survey, 2012: SANHANES-1 (pp. 4–7). Cape Town, CT: HSRC.

    Google Scholar 

  19. 19.

    Khan, A. R., & Khan, M. Q. (2008). Association and pattern of diastolic dysfunction in patients of metabolic syndrome. Journal of Ayub Medical College Abbottabad, 20, 70–75.

    Google Scholar 

  20. 20.

    Norman, R., Gaziano, T., Laubscher, R., Steyn, K., & Bradshaw, D. (2007). Estimating the burden of diseases attributable to high blood pressure in South Africa in 2000. South African Medical Journal, 97(8 Pt 2), 692–698.

    PubMed  Google Scholar 

  21. 21.

    Thomas, I., Gupta, S., Sempos, C., & Copper, R. (1986). Serum lipids of Indian physicians living in the U.S. compared to U.S.-born physicians. Atherosclerosis, 61(2), 99–106.

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Greenland, P., Bowley, N. L., Meiklejohn, B., Doane, K. L., & Sparks, C. E. (1990). Blood cholesterol concentration: Finger prick plasma vs. venous serum sampling. Clinical Chemistry, 36(8 Pt 1), 628–630.

    CAS  PubMed  Google Scholar 

  23. 23.

    Yagalla, M. V., Hoerr, S. L., Song, W. O., Enas, E., & Garg, A. (1996). Relationship of diet, abdominal obesity, and physical activity to plasma lipoprotein levels in Asian Indian physicians residing in the United States. Journal of American Dietetic Association, 96(3), 257–261.

    CAS  Article  Google Scholar 

  24. 24.

    Banerji, M. A., Faridi, N., Atluri, R., Chaiken, R. L., & Lebovitz, H. E. (1999). Body composition, visceral fat, leptin, and insulin resistance in Asian Indian men. Journal of Clinical Endocrinology and Metabolism, 84(1), 137–144.

    CAS  PubMed  Google Scholar 

  25. 25.

    Misra, A., Sharma, R., Pandey, R. M., & Khanna, N. (2001). Adverse profile of dietary nutrient, anthropometry and lipids in urban slum dwellers of northern Indians. European Journal of Clinical Nutrition, 55(9), 727–734.

    CAS  Article  PubMed  Google Scholar 

  26. 26.

    Motala, A. A., Pirie, F. J., Gouws, E., Amod, A., & Omar, M. A. (2003). High incidence of type 2 diabetes mellitus in South African Indians: A 10-year follow-up study. Diabetic Medicine, 20(1), 23–30.

    CAS  Article  PubMed  Google Scholar 

  27. 27.

    Bradshaw, D., Norman, R., Lewin, S., Joubert, J., Schneider, M., Nannan, N., et al. (2007). Strengthening public health in South Africa: Building a stronger evidence base for improving the health of the nation. South African Medical Journal, 97(8 Pt 2), 643–649.

    PubMed  Google Scholar 

  28. 28.

    World Health Organization. (1985). Diabetes mellitus report of a WHO study group. Technical report series no 727. Geneva: World Health Organization.

  29. 29.

    Deurenberg, P., Deurenberg-Yap, M., & Guricci, S. (2002). Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship. Obesity Reviews, 3(3), 141–146.

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Das, U. N. (2003). Metabolic syndrome X is common in Indians: But why and how? Journal of the Association of Physicians of India, 51, 987–998.

    CAS  PubMed  Google Scholar 

  31. 31.

    Neter, J. E., Stam, B. E., Kok, F. J., Grobbee, D. E., & Geleijnse, J. M. (2003). Influence of weight reduction on blood pressure: A meta-analysis of randomized controlled trials. Hypertension, 42(5), 78–884.

    Article  Google Scholar 

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The authors would like to thank the field workers in the KwaDukuza community for devoting their time and effort to facilitate this study. This research was funded by Grants from the South African Medical Research Council, National Research Foundation and North-West University.

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Correspondence to Ashika Naicker.

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Naicker, A., Venter, C.S., MacIntyre, U.E. et al. Prevalence of Selected Intermediate Risk Factors for Non-communicable Diseases in an Apparently Healthy Indian Community in KwaZulu-Natal, South Africa. J Community Health 42, 122–128 (2017).

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  • Non-communicable diseases
  • Risk factors
  • South African Indians
  • Asian cut-offs