Mauritius
- The 1.2 million people who live in Mauritius are approximately 70% Indian, 28% Creole, and 2% Chinese.1 Indians have the highest and Chinese have the lowest rates of heart disease in this island nation in the Indian Ocean.2
- CAD (coronary artery disease) mortality in women and stroke mortality in both sexes are among the highest recorded in the world. Virtually all Muslims are non-vegetarians; at least 50% of the Hindu population is vegetarian. Ironically, the Muslims had lower rates of heart disease than Hindus.3 ‘Best’ estimates of standardized mortality ratios indicate that in comparison to Hindus as the ‘standard’ population: 4
- Muslim men have 51% lower stroke mortality and similar CAD mortality
- Chinese men have 48% and Chinese women 70% lower CAD mortality
- Chinese men have 54% and Chinese women 48% lower stroke mortality
- Creole women have 19% lower CAD and 22% lower stroke mortality
- The most successful example of a community based intervention program in a developing country is from Mauritius. A pronounced improvement in the population lipid profile in Mauritius was documented due to a change in the widely used cooking oil with markedly lower saturated fat content.5 Total cholesterol level decreased by 31mg/dl as a result of replacing palm oil with soybean oil (see Cooking Oils and Saturated Fat).5
- Abdominal obesity plays a crucial role in the development of the metabolic syndrome and it appears to precede the development of other components of the syndrome.6
- High body mass index (BMI), abdominal obesity, and physical inactivity are important independent risk factors for both prediabetes and diabetes in diverse ethnic groups.7, 8
- There has also been a dramatic increase in obesity in Mauritius, which could further increase the rates of diabetes and heart disease.2, 3
Sources
1. Tuomilehto J, Li N, Dowse G, et al. The prevalence of coronary heart disease in the multi-ethnic and high diabetes prevalence population of Mauritius. Journal of internal medicine. 1993;233(2):187-194.
2. Enas EA. How to Beat the Heart Disease Epidemic among South Asians: A Prevention and Management Guide for Asian Indians and their Doctors. Downers Grove: Advanced Heart Lipid Clinic USA; 2010.
3. Hodge AM, Dowse GK, Gareeboo H, Tuomilehto J, Alberti KG, Zimmet PZ. Incidence, increasing prevalence, and predictors of change in obesity and fat distribution over 5 years in the rapidly developing population of Mauritius. Int J Obes Relat Metab Disord. 1996;20(2):137-146.
4. Vos T, Gareeboo H, Roussety F. Ethnic differences in ischaemic heart disease and stroke mortality in Mauritius between 1989 and 1994. Ethnicity & health. 1998;3(1-2):45-54.
5. Dowse GK, Gareeboo H, Alberti KG, et al. Changes in population cholesterol concentrations and other cardiovascular risk factor levels after five years of the non-communicable disease intervention programme in Mauritius. Mauritius Non-communicable Disease Study Group. Bmj. Nov 11 1995;311(7015):1255-1259.
6. Cameron AJ, Boyko EJ, Sicree RA, et al. Central obesity as a precursor to the metabolic syndrome in the AusDiab study and Mauritius. Obesity (Silver Spring, Md. Dec 2008;16(12):2707-2716.
7. Dowse GK, Zimmet PZ, Gareeboo H, et al. Abdominal obesity and physical inactivity as risk factors for NIDDM and impaired glucose tolerance in Indian, Creole, and Chinese Mauritians. Diabetes Care. 1991;14(4):271-282.
8. Dowse GK, Gareeboo H, Zimmet PZ, et al. High prevalence of NIDDM and impaired glucose tolerance in Indian, Creole, and Chinese Mauritians. Mauritius Noncommunicable Disease Study Group. Diabetes. 1990;39(3):390-396.