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Objective and design — The objective of the study was to find out the prevalence of overweight, obesity, undernutrition and physical activity status in the urban populations of India. Cross-sectional surveys were conducted in 6-12 urban streets in each of five cities in five different regions of India using a common study protocol and criteria of diagnosis. Subjects and methods — A total of 6940∞∞subjects (3433 women and 3507∞∞men) aged 25∞∞years and above were randomly selected from the cities of Moradabad (n∞∞=∞∞2002),Trivandrum (n∞∞=∞∞1602), Calcutta (n∞∞=∞∞900), Nagpur (n∞∞=∞∞894) and Bombay (n∞∞=∞∞1542). Evaluation and validation were performed by a physician and dietitian-administered questionnaire at Moradabad. After pooling of data, all subjects were divided into various age groups for men and women. Obesity (body mass index∞∞=∞∞30 ≥ kg/m 2 ) and overweight (BMI ≥ 25-29.9∞∞kg/m 2 and∞∞>∞∞23∞∞kg/m 2 ) as well as waist-hip ratio (∞∞>∞∞0.85 in women and∞∞>∞∞0.88 in men, central obesity) were calculated and physical activity status assessed by a validated questionnaire. Results — The overall prevalence of obesity was 6.8% (7.8 vs. 6.2%, P∞∞ ∞∞23∞∞kg/m 2 was 50.8% and central obesity 52.6%.The overall prevalence of sedentary behaviour was 59.3% among women and 58.5% among men. Both sedentary behaviour and mild activity showed a significant increasing trend in women after the age of 35-44∞∞years. In men, such a trend was observed above the age of 45∞∞years. Sedentary behaviour was significantly (P

The association between social classes, food intake and coronary risk factors was determined. Cross-sectional surveys were conducted in 6‐12 urban streets in each of five cities, each one from five different regions of India using similar methods of dietary intakes and criteria of diagnosis. We randomly selected 3257 women aged 25‐64 years inclusive, from Moradabad (n = 902), Trivandrum (n = 760), Calcutta (n = 410), Nagpur (n = 405) and Bombay (n = 780). All subjects, after pooling of data, were divided into social class 1 ( n = 985), class 2 (n = 790), class 3 (n = 774), class 4 (n = 602) and class 5 (n = 206) based on various attributes of socioeconomic status. Social class 1 was the highest and 5 was the lowest social class. Social classes 1‐3 had greater intake of pro-atherogenic foods; total visible fat, milk and milk products, meat and eggs, as well as sugar and confectionery, compared to social classes 4 and 5. The consumption of wheat, rice, millets, fruits, vegetables and legume/total visible fat ratio were inversely associated with social class. Mean body mass index (BMI), obesity, overweight, central obesity and sedentary lifestyle were also significantly more common among subjects from higher social classes. Spearman’s rank correlation showed that bodyweight, BMI, wheat, rice, millets, total visible fat, milk and milk products, meat, eggs, sugar and jaggery intakes were significantly correlated with social class. Social class 5 subjects had a lower intake of all foods and a lower BMI, suggestive of a higher rate of undernutrition among them. The findings indicate that the consumption of pro-atherogenic foods and other coronary risk factors are more common in higher social classes compared to lower social classes.

Objective To study the prevalence of central obesity and age-specific waist:hip ratio of urban women from five Indian cities. Design and setting Cross-sectional surveys were conducted in 6-12 urban streets in different parts of India using similar methods of sample selection and criteria of diagnosis. Subjects and methods We randomly selected 3212 women, aged 25-64 years, from Moradabad (n = 902), Trivandrum (n = 760), Calcutta (n = 365), Nagpur (n = 405), and Bombay (n = 780). Evaluation was by a questionnaire administered by a physician and a dietician, a physical examination, and anthropometric measurements. Results The overall prevalence of central obesity among the total number of women was 55.0%, with the highest prevalence in Calcutta (62.2%) and the lowest in Bombay (47.4%). Waist:hip ratio was 0.85 +/- 0.13 (mean +/- SD) with the highest ratio for women in Calcutta (0.87 +/- 0.12) and the lowest for women in Moradabad (0.84 +/- 0.16). After pooling of data from all five cities, multivariate logistic regression analysis showed that, regardless of age, body mass index (> 23 kg/m2; odds ratio 1.12), sedentary lifestyle (odds ratio 2.51), and family history of obesity (odds ratio 2.15) were strongly associated with central obesity. Excess intake of fat was weakly associated with central obesity but age was not a risk factor for central obesity, although the prevalence was highest among those aged over 55 years in Moradabad, Calcutta, and Nagpur. Conclusions The overall prevalence of central obesity among the urban women of India has increased, more so in Calcutta and Trivandrum. Body mass index, sedentary lifestyle, and family history of excess intake of fat were significant risk factors for central obesity.

Objective: To measure the prevalence of hypertension and age-specific blood pressure in urban populations from five Indian cities. Cross-sectional surveys were conducted in six–twenty urban streets in different cities from five different corners of India, using similar methods of sample selection and criteria. There were 3212 randomly selected women from Moradabad ( n =902), Trivandrum ( n =760), Calcutta ( n =365), Nagpur ( n =405) and Bombay ( n =780), aged 25–64 years, inclusive. Evaluation was by a physician and a dietitian, an administered questionnaire, a physical examination and using a sphygmomanometer. The diagnosis of hypertension was based on old World Health Organisation criteria and new World Health Organisation/International Society of Hypertension criteria. The prevalence of hypertension (>140/90 mm Hg) was significantly ( P n =823) and isolated diastolic hypertension was the most common form of hypertension (50.5%, n =1506) in the five Indian cities. According to old criteria, the overall prevalence of hypertension (>160/95 mm Hg) was 14.8% ( n =481). Multivariate logistic regression analysis on pooled data from the five cities, after adjustment for age, showed that age (odds ratio 1.16), body mass index (1.68) and obesity were strongly associated with hypertension. A sedentary lifestyle and salt intake were weakly associated and alcohol intake was not a factor with these women.

There are few studies detailing the prevalence of prehypertension and hypertension in India.Men and women, over 25 years of age were included. After completion of a dietitian-administered questionnaire followed evaluation by a physician, physical examination and blood pressure measurement. Cross-sectional survey screened 6940 subjects, (3507 men (M), 3433 women (W): 1993-96) from cities located in five corners of India (Kolkata, n = 900; Nagpur, n = 894; Mumbai, n = 1542; Thiruanantpuram, n = 1602; Moradabad, n = 2002). Prehypertension (BP 130-139/85-89 mm Hg) and hypertension (BPor = 140/90 mm Hg) were diagnosed according to the European Society of Cardiology criteria.Prevalence of prehypertension and hypertension, respectively, was significantly greater in South India (Trivandrum:W 31.5; 31.9%; M 35.1; 35.5%) and West India (Mumbai: W 30.0; 29.1%; M 34.7; 35.6%) compared to North India (Moradabad: W 24.6; 24.5%; M 26.7; 27.0%) and East India (Kolkata: W 20.9; 22.4%; M 23.5; 24.0%). Subjects with prehypertension and hypertension were older, had a higher BMI, central obesity and a sedentary lifestyle. They had a higher salt and alcohol intake, with greater oral contraceptive usage (W). Multivariable logistic regression analysis revealed strong positive associations of hypertension with age, central obesity, BMI, sedentary lifestyle, salt and alcohol intake and oral contraceptive usage (W). Fruit, vegetable and legume intake showed inverse associations, tobacco intake showed none. One in four with hypertension was aware of their diagnosis and of those receiving treatment, one in three had well-controlled hypertension.There is little awareness that prehypertension and hypertension are public health issues in India. Ageing population, central obesity, sedentary lifestyle, excessive salt and alcohol, lower fruit, vegetable and legumes intake increase risk for blood pressure elevation.

The objective of the study was to find out the prevalence of overweight, obesity, undernutrition and physical activity status in the urban populations of India. Cross-sectional surveys were conducted in 6-12 urban streets in each of five cities in five different regions of India using a common study protocol and criteria of diagnosis.A total of 6940 subjects (3433 women and 3507 men) aged 25 years and above were randomly selected from the cities of Moradabad (n = 2002),Trivandrum (n = 1602), Calcutta (n = 900), Nagpur (n = 894) and Bombay (n = 1542). Evaluation and validation were performed by a physician and dietitian-administered questionnaire at Moradabad. After pooling of data, all subjects were divided into various age groups for men and women. Obesity (body mass index = 30kg/m(2)) and overweight (BMI 2 25-29.9 kg/m(2) and23 kg/m(2)) as well as waist-hip ratio (0.85 in women and0.88 in men, central obesity) were calculated and physical activity status assessed by a validated questionnaire.The overall prevalence of obesity was 6.8% (7.8 vs. 6.2%, P0.05) and overweight 33.5% (35.0 vs. 32.0%, P0.05) among women and men, respectively. The highest prevalence of obesity (7.8%) and overweight (36.9%) was found among subjects aged 35 to 44 years in both sexes. The prevalence of obesity was significantly (P0.05) greater in Trivandrum (8.5%), Calcutta (7. 1%) and Bombay (8.3%) compared to Moradabad (6.2%) among women and in Trivandrum (7.4%) and Bombay (7.2%), compared to Nagpur (5.0%) among men. There was a significant decreasing trend in obesity (P0.05) and overweight (P0.05) with increasing age above 35-44 years in both sexes. The overall prevalence of subjects23 kg/m(2) was 50.8% and central obesity 52.6%. The overall prevalence of sedentary behaviour was 59.3% among women and 58.5% among men. Both sedentary behaviour and mild activity showed a significant increasing trend in women after the age of 35-44 years. In men, such a trend was observed above the age of 45 years. Sedentary behaviour was significantly (P0.05) greater in Trivandrum, Calcutta, and Bombay compared to Nagpur. Sedentary behaviour was significantly (P0.001) associated with obesity in both sexes, compared to non-obese men and women. The overall prevalence of undernutrition was 5.5% (n = 380) which was significantly more common in Moradabad, north and Nagpur, central India compared to other cities.Obesity, overweight and central obesity and sedentary behaviour coexist with undernutrition, and have become a public health problem in all the five cities of India. The prevalence of obesity and sedentary behaviour was significantly greater in Trivandrum, Calcutta and Bombay compared to Moradabad and Nagpur. Sedentary behaviour was significantly associated with obesity compared to non-obese subjects in both sexes, which may be due to greater economic development in metro cities.

Objective : To find out the association between social class and coronary risk factors in women. Design and Setting : Cross-sectional surveys were conducted in six–twelve urban streets in each of five cities from various regions of India following a common study protocol and criteria of diagnosis. Subjects and Methods : We randomly selected 3257 women, aged 25–64 years inclusive, from the cities of Moradabad ( n =902), Trivandrum ( n =760) Calcutta ( n =410), Nagpur ( n =405) and Bombay ( n =780). Evaluation was by questionnaires validated at Moradabad. All subjects, after pooling of data, were divided into social class 1 ( n =985), social class 2 ( n =790), social class 3 ( n =674), social class 4 ( n =602) and social class 5 ( n =206), based on various attributes of socioeconomic status. Results : The prevalence of hypertension, diabetes mellitus, family history of coronary disease, obesity, central obesity and sedentary lifestyle were significantly associated with higher social classes and tobacco consumption was not associated with social class. Oral contraceptive intake and postmenopausal status were also more common among higher social classes, which may be due to more education and a longer lifespan among the higher social classes, respectively. Mean total cholesterol, high density lipoprotein cholesterol, systolic and diastolic blood pressure, mean body mass index and waist–hip ratio showed significant association with higher social classes. Mean age, body weight, body mass index, waist–hip ratio, systolic and diastolic blood pressure, total cholesterol and 2-h blood glucose were significantly positively correlated with social class, as assessed by Spearman's rank correlation. Higher social classes 1–3 were more common in Trivandrum and Bombay than in Moradabad. The prevalence of hypertension, diabetes mellitus and being overweight (body mass index >25 kg/m 2 ) were also more common in Trivandrum and Bombay compared to Moradabad. Undernutrition was negatively associated with higher social classes and was more common in Moradabad and Nagpur than Trivandrum. Conclusions : Higher social classes among Indian urban women have a higher prevalence of coronary risk factors, hypertension, diabetes mellitus, being overweight, central obesity, sedentary lifestyle, family history of coronary disease, oral contraceptive intake and postmenopausal status. Mean concentrations of total and high density lipoprotein cholesterol were also significantly associated with higher social classes.