The association of religious affiliation with cholesterol levels among South Asians: the Mediators of Atherosclerosis in South Asians Living in America study

Grishma Hirode,Eric Vittinghoff,Namratha R Kandula,Nazleen H Bharmal,Alka M Kanaya

doi:10.1186/s12872-019-1045-z

Abstract

BackgroundSouth Asians have disproportionately high rates of cardiovascular disease. Dyslipidemia, a contributing factor, may be influenced by lifestyle, which can vary by religious beliefs. Little is known about South Asian religions and associations with dyslipidemia.MethodsCross-sectional analyses of the MASALA study (n = 889). We examined the associations between religious affiliation and cholesterol levels using multivariate linear regression models. We determined whether smoking, alcohol use, physical activity, and dietary pattern mediated these associations.ResultsMean LDL was 112 ± 32 mg/dL, median HDL was 48 mg/dL (IQR:40–57), and median triglycerides was 118 mg/dL (IQR:88–157). Muslims had higher LDL and triglycerides, and lower HDL, while participants with no religious affiliation had lower LDL and higher HDL. The difference in HDL between Muslims and those with no religious affiliation was partly explained by alcohol consumption.ConclusionsReligion-specific tailoring of interventions designed to promote healthy lifestyle to reduce cholesterol among South Asians may be useful.

Highlights

South Asians have disproportionately high rates of cardiovascular disease
Using data from the Mediators in Atherosclerosis in South Asians Living in America (MASALA) study, we examined the association between religious affiliation and cholesterol levels among a religiously heterogeneous South Asian immigrant cohort
In conclusion, our results suggest that religion is associated with cholesterol levels in South Asians, and that some lifestyle behaviors may partially explain this risk

Summary

Introduction

South Asians have disproportionately high rates of cardiovascular disease. Dyslipidemia, a contributing factor, may be influenced by lifestyle, which can vary by religious beliefs. Compared to other racial/ ethnic groups, South Asians (individuals from India, Pakistan, Bangladesh, Nepal, and Sri Lanka) have higher rates of dyslipidemia-related conditions, such as atherosclerosis and coronary heart disease (CHD) [6,7,8,9,10,11,12,13]. While certain individuals are genetically predisposed to dyslipidemia-related conditions, the high prevalence of dyslipidemia among South Asians may be driven by acculturation, socio-economic status, and lifestyle behaviors such as high fat and calorie dense diets and physical inactivity [4, 5, 15,16,17,18]. Seventh-day Adventists (SDA) have traditionally had lower rates of chronic diseases, including obesity, CVD and diabetes than the general population because of their prescriptive lifestyle [25].

Methods

Results

Discussion

Conclusion