Effects on cardiometabolic diseases in adolescents and young adults residing in food streets in Karachi, Pakistan: A mixed methods study

Limited evidence exists from lower-middle-income countries (LMICs) on the contribution of the neighbourhood food environment towards cardiometabolic diseases (CMD). Pakistan witnesses 7% of myocardial infarctions in individuals <40. Karachi, its largest city with 10 million people aged <25 years, is undergoing a rapid nutrition transition that led to the mushrooming of calorie-dense food shops and commercial 'Food Streets' (FS) within residential areas. FS has a variety of food shops in one place. Residents of FS may have a high intake of calorie-dense foods due to the constant exposure and accessibility of unhealthy food within walking distance. High intake of calorie-dense food can initiate physiologic dysregulation of lipids and sugar in the body, causing CMD (1). We propose a mixed methods study examining the relationship between the food environment, dietary intake, and CMD (prediabetes, diabetes, prehypertension, hypertension, and dyslipidemia) among 15-25-year individuals residing within a 2-kilometer radius of FS through mediation analysis. Semi-structured interviews of young residents, shopkeepers, regulatory authorities, and nutrition experts will explore the barriers and facilitators to enabling a healthy eating environment. The key outcome of my work, driven by study findings, will be the co-creation of an intervention package with participants, to foster a healthy food environment.