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PAPERS: Debbie A Lawlor, Maarike Harro, Niels Wedderkopp, Lars Bo Andersen, Luis B Sardinha, Chris J Riddoch, Angie S Page, Sigmund A Anderssen, Karsten Froberg, David Stansbie, and George Davey Smith Association of socioeconomic position with insulin resistance among children from Denmark, Estonia, and Portugal: cross sectional study BMJ 2005; 331: 183 [Abstract] [Full text]

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Community values, social advancement and health behaviour.

Arvindan Veiraiah   (25 July 2005)

Community values, social advancement and health behaviour. 25 July 2005
Arvindan Veiraiah, SpR Clinical Pharmacology Llandough Hospital, CF64 2XX Send response to journal: Re: Community values, social advancement and health behaviour.	Dear Editor, The authors provide a fascinating account of the different health effects of social advancement in different countries. I do not find that surprising, having seen the effect of socioeconomic advancement on the diet and lifestyle of some Indian communities in India. In fact, I have often wondered whether the deleterious effect of social advancement could explain the high incidence of coronary artery disease among Asian expatriates in the UK. Refined sugar and high quality oil were expensive and difficult to get hold of in the rural community from which my parents came. Only the rich and the socially advanced could afford to regularly have high-quality sweets and fatty foods. Others could only enjoy such foods during feasts; making the ability to eat such unhealthy food a sign of a person's status. Another status symbol was the ability to avoid strenuous physical exertion; the ability to get away from the fat-busting labours of the common lot. It is therefore not surprising that the people of my parents' generation used to consider that looking 'well-fed' and squidgy was desirable. This was a culture that encouraged obesity among those who could afford it. A culture that primed its expatriates to use their newfound wealth to indulge excessively in oily and sweet food; to indulge in inactivity and a life of leisure. So maybe the rise of insulin resistance and obesity in some communities is not Westernisation after all. Maybe people are just paying the price for playing out the fantasies of their forefathers! Competing interests: None declared