CHANGES IN POPULATION CHOLESTEROL CONCENTRATIONS AND OTHER CARDIOVASCULAR RISK FACTOR LEVELS AFTER 5 YEARS OF THE NONCOMMUNICABLE DISEASE INTERVENTION PROGRAM IN MAURITIUS

Objective-To study changes in the prevalence of risk factors for cardiovascular disease after a five year population-wide intervention programme promoting a healthy lifestyle in a developing country. Design-Cross sectional cluster surveys in 1987 and 1992. Methodology included a two hour 75 g oral glucose tolerance test, measurement of body mass index, waist:hip ratio, basal Lipid concentrations, and blood pressure; and a lifestyle questionnaire. Setting-Mauritius, in the Indian Ocean. Subjects-All adults aged 25-74 years residing in geographically defined clusters. Main outcome measures-Age standardised prevalence of categorical disease and risk factor conditions and mean levels and frequency distributions of continuous variables. Results-Response rates were 86.2% (5080/5892) in 1987 and 89.5% (5162/5770) in 1992. Significant decreases were found in the prevalence of hypertension (15.0% to 12.1% in men and 12.4% to 10.9% in women); cigarette smoking (58.2% to 47.2% and 6.9% to 3.7% respectively); and heavy alcohol consumption (38.2% to 14.4% and 2 6% to 0.6% respectively). Moderate leisure physical activity increased from 16.9% to 22.1% in men and from 1.3% to 2.7% in women. Mean population serum total cholesterol concentration fell appreciably from 5.5 mmol/l to 4.7 mmol/l (P < 0.001). The prevalence of overweight or obesity increased, and the rates of glucose intolerance changed little. The population frequency distributions of blood pressure, serum lipid concentration, and a composite risk factor score shifted advantageously. Conclusions-Lifestyle intervention projects can be implemented and have positive effects in developing countries. A pronounced improvement in the population lipid profile in Mauritius was probably related to a change in the saturated fat content of a widely used cooking oil.