Socio-economic patterns of diet, obesity, and biomarkers for cardiovascular disease among Indian adolescents

BackgroundThe impact of socioeconomic (SES) factors, maternal education and household wealth on diet and consequently on a host of cardiovascular disease (CVD) biomarkers is rarely examined among Indian adolescents, who are in a critical development phase. This study examines the socio-economic patterning of dietary behaviour and its correlation with overweight/obesity and CVD biomarkers among Indian adolescents aged 10 to 19 years. MethodsWe use nationally representative data on dietary patterns and CVD biomarkers from the Comprehensive National Nutrition Dataset, a nationally representative survey of 35,830 adolescents conducted from 2016 to 2018. Dietary pattern is assessed using a summary indicator-Dietary Diversity Score based on 17 specific food groups. Overweight/obesity and the biomarkers, including the ratio of total cholesterol to high-density lipoprotein-cholesterol, serum triglycerides, hypertension, and pre-diabetic/diabetic, are analysed. ResultsAdolescents from higher SES have higher dietary diversity than those from lower SES. This socio-economic patterning is concentrated on higher daily consumption of certain foods such as fats and oil, sugar and jaggery and those high in fats, sugar, and salt (HFSS) comprising-junk food, fried food, sweets, and aerated drinks among those from high SES and urban areas. This, in turn, may explain the concentration of overweight/obesity in this cohort. The SES gradient in diet, overweight/obesity, and associated CVD biomarkers among Indian adolescents remains positive for the household wealth index (worse health for the more economically advantaged) and urban dwellers. However, it is starting to shift towards negative for maternal education, resulting in an inverted U shape (better health for the lowest and highest socially advantaged, worse health for those in the middle). ConclusionsThere is a clustering of overweight/obesity and CVD biomarkers among adolescents from urban and wealthier households that may be associated with increased consumption of HFSS in this cohort.