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

Background - The impact of socioeconomic (SES) factors-maternal education, and -household wealth, on diet and consequently on a host of cardiovascular diseases (CVD) biomarkers, is rarely examined among Indian adolescents, aged 10 to 19 years. This study examines the socio-economic patterning of dietary behaviour and their correlation with overweight/obesity and the CVD biomarkers in this population. Methods - We use the nationally representative data on dietary pattern 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 by using a summary indicator- Dietary Diversity Score. Overweight/obesity and the CVD biomarkers, including ratio of total cholesterol to high-density lipoprotein-cholesterol, serum triglycerides, hypertension, and pre-diabetic/diabetic are analysed. Results – Adolescents from higher SES have higher dietary diversity compared to those from lower SES. This socio-economic patterning is concentrated on higher daily consumption of certain foods including fats and oil, sugar and jaggery and those high in fats, sugar, and salt (HFSS) 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 household wealth index (worse health for the more economically advantaged) and among urban dwellers, though 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). Conclusions – There is a clustering of overweight/obesity and the CVD biomarkers among adolescents from urban and wealthier households, that may be associated with an increased consumption of HFSS in this cohort.