Profile of Risk Factors for Non-Communicable Diseases in Punjab, Northern India: Results of a State-Wide STEPS Survey

Abstract

BackgroundEfforts to assess the burden of non-communicable diseases risk factors has improved in low and middle-income countries after political declaration of UN High Level Meeting on NCDs. However, lack of reliable estimates of risk factors distribution are leading to delay in implementation of evidence based interventions in states of India.MethodsA STEPS Survey, comprising all the three steps for assessment of risk factors of NCDs, was conducted in Punjab state during 2014–15. A statewide multistage sample of 5,127 residents, aged 18–69 years, was taken. STEPS questionnaire version 3.1 was used to collect information on behavioral risk factors, followed by physical measurements and blood and urine sampling for biochemical profile.ResultsTobacco and alcohol consumption were observed in 11.3% (20% men and 0.9% women) and 15% (27% men and 0.3% women) of the population, respectively. Low levels of physical activity were recorded among 31% (95% CI: 26.7–35.5) of the participants. The prevalence of overweight and obesity was 28.6% (95% CI: 26.3–30.9) and 12.8% (95% CI: 11.2–14.4) respectively. Central obesity was higher among women (69.3%, 95% CI: 66.5–72.0) than men (49.5%, 95% CI: 45.3–53.7). Prevalence of hypertension in population was 40.1% (95% CI: 37.3–43.0). The mean sodium intake in grams per day for the population was 7.4 gms (95% CI: 7.2–7.7). The prevalence of diabetes (hyperglycemia), hypertriglyceridemia and hypercholesterolemia was 14.3% (95% CI: 11.7–16.8), 21.6% (95% CI: 18.5–25.1) and 16.1% (95% CI: 13.1–19.2), respectively. In addition, 7% of the population aged 40–69 years had a cardiovascular risk of ≥ 30% over a period of next 10 years.ConclusionWe report high prevalence of risk factors of chronic non-communicable diseases among adults in Punjab. There is an urgent need to implement population, individual and programme wide prevention and control interventions to lower the serious consequences of NCDs.

The HDD Study (Hypertensive, Diabetes & Dyslipidemia) -Cardiovascular Risk Factor Epidemiology in Desk Job Workers - A Preliminary Study

“…[25][26][27] Hypertension and dyslipidemia was found to be predominant in males in our study consistent with other studies. 17,18,27,28 While diabetic prevalence has been reported to vary with gender based on various studies involving different racial and ethnic subgroups across the globe, 25,29,30 no such association was found in our study. Hypertension and diabetes was found to increase with increasing BMI with 68% hypertensive's being overweight to obese and 64% diabetics being overweight to obese in the present study.…”

“…16 Further in the present study smokers and alcoholics were predominantly males, as reported across studies. [16][17][18][19] The prevalence of overweight (43%) and obesity (14%) is higher in the present study than that reported across studies in India, 17,19,20 while lower than that reported in specific occupational group. 21 Females were predominantly overweight to obese in comparison to males in the present study (67% against 51%), consistent with other studies.…”

High prevalence of dietary and physical activity related risk factors for non-communicable diseases among apparently healthy urban women in Kochi, Kerala, South India

“…The prevalence of low physical activity among women was 41.4 %( 95% CI 36.3-46.3) in the STEPS survey conducted in Punjab. 10 In a study from Vellore, 86% of the urban women fell into the low physically active category. Low level of physical activity especially among women seems to be prevalent all over the country.…”

Pattern of current tobacco use in a rural block of North India

“…Prevalence of tobacco smoking was high among adults aged 18-44 years old (8.0%, 95% CI: 6.1-10.0) and in urban areas (9%; 95% CI: 5.8-12.1) compared to those in rural areas (6.0%; 95% CI: 4.2-7.8). 13 Other community based studies conducted in rural India by Sugathan et al in Kerala and Bhardwaj et al in Nagpur, Maharashtra showed higher prevalence of current tobacco-smoking use among males as 40% & 20.5% respectively than in females 0.4% & 0.0% respectively.…”