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Wangdi K, Jamtsho T. Risk factors for self-reported diabetes among Bhutanese adults: A nationally representative survey data analysis. PLoS One 2018; 13:e0206034. [PMID: 30439962 PMCID: PMC6237308 DOI: 10.1371/journal.pone.0206034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 10/07/2018] [Indexed: 11/18/2022] Open
Abstract
Background Bhutan, a small land-locked country in the eastern Himalayas has been undergoing an epidemiological and nutritional transition in the last two decades. The objective of this paper was to determine the prevalence and explore the risk factors of self-reported diabetes among Bhutanese adults. Methods We conducted a secondary data analysis among adults 18 years and older Bhutanese using the data from the National Health Survey 2012 (NHS, 2012) of Bhutan. The self-reported information on risk factors was obtained using standard protocols of the WHO STEPwise approach to Surveillance. The outcome of interest was self-reported diabetes on medication. Adjusted and unadjusted logistic regression analyses were performed to identify the risk factor of diabetes. Results A total of 31,066 participants aged 18 years and older were included for the analysis. The prevalence of self-reported hypertension was 1.8% (491). Risk factors for diabetes were: age groups: 35–44 years adjusted odds ratio (AOR) = 2.82 (95% CI, 1.07, 7.41), 45–54 years AOR = 6.02 (95% CI, 2.29, 15.83), 55–64 year AOR = 15.7 (95% CI 5.93, 41.55) and >65 years AOR = 19.60 (95% CI, 6.93, 55.71); high school and diploma/certificate education AOR = 2.57, (95% CI 1.62, 4.07) and AOR = 3.92 (95% CI 1.70, 9.07); and urban dwellers AOR = 2.37, (95% 1.58, 3.57); hypertension AOR = 3.3, (95% CI 2.47, 4.41); and fruit servings of 1–3 per week AOR = 1.63 (95% CI 1.15, 2.31). Conclusion The number of Bhutanese adults with diabetes and co-morbidities associated with it is likely to increase with the ageing of the population, nutrition transition, and high rural-urban migration in the near future. This calls for an urgent need to implement strategies to prevent diabetes in the Bhutanese population targeting risk factors including healthy lifestyle with increased physical activities and reduced smoking. At the same time treating other chronic morbidities including hypertension.
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Affiliation(s)
- Kinley Wangdi
- Phuentsholing General Hospital, Phuentsholing, Bhutan
- Department of Global Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia
- * E-mail:
| | - Tshering Jamtsho
- School of Demography, ANU College of Arts & Social Sciences, The Australian National University, Canberra, Australia
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Shridhar K, Satija A, Dhillon PK, Agrawal S, Gupta R, Bowen L, Kinra S, Bharathi AV, Prabhakaran D, Srinath Reddy K, Ebrahim S. Association between empirically derived dietary patterns with blood lipids, fasting blood glucose and blood pressure in adults - the India migration study. Nutr J 2018; 17:15. [PMID: 29422041 PMCID: PMC5806276 DOI: 10.1186/s12937-018-0327-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 01/19/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dietary patterns (DPs) in India are heterogenous. To date, data on association of indigenous DPs in India with risk factors of nutrition-related noncommunicable diseases (cardiovascular disease and diabetes), leading causes of premature death and disability, are limited. We aimed to evaluate the associations of empirically-derived DPs with blood lipids, fasting glucose and blood pressure levels in an adult Indian population recruited across four geographical regions of India. METHODS We used cross-sectional data from the Indian Migration Study (2005-2007). Study participants included urban migrants, their rural siblings and urban residents and their urban siblings from Lucknow, Nagpur, Hyderabad and Bangalore (n = 7067, mean age 40.8 yrs). Information on diet (validated interviewer-administered, 184-item semi-quantitative food frequency questionnaire), tobacco consumption, alcohol intake, physical activity, medical history, as well as anthropometric measurements were collected. Fasting-blood samples were collected for estimation of blood lipids and glucose. Principal component analysis (PCA) was used to identify major DPs based on eigenvalue> 1 and component interpretability. Robust standard error multivariable linear regression models were used to investigate the association of DPs (tertiles) with total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides, fasting-blood glucose (FBG), systolic and diastolic blood pressure (SBP and DBP) levels. RESULTS Three major DPs were identified: 'cereal-savoury' (cooked grains, rice/rice-based dishes, snacks, condiments, soups, nuts), 'fruit-vegetable-sweets-snacks' (Western cereals, vegetables, fruit, fruit juices, cooked milk products, snacks, sugars, sweets) and 'animal food' (red meat, poultry, fish/seafood, eggs) patterns. High intake of the 'animal food' pattern was positively associated with levels of TC (β = 0.10 mmol/L; 95% CI: 0.02, 0.17 mmol/L; p-trend = 0.013); LDL-C (β = 0.07 mmol/L; 95% CI: 0.004, 0.14 mmol/L; p-trend = 0.041); HDL-C (β = 0.02 mmol/L; 95% CI: 0.004, 0.04 mmol/L; p-trend = 0.016), FBG: (β = 0.09 mmol/L; 95% CI: 0.01, 0.16 mmol/L; p-trend = 0.021) SBP (β = 1.2 mm/Hg; 95% CI: 0.1, 2.3 mm/Hg; p-trend = 0.032); DBP: (β = 0.9 mm/Hg; 95% CI: 0.2, 1.5 mm/Hg; p-trend = 0.013). The 'cereal-savoury' and 'fruit-vegetable-sweets-snacks' patterns showed no association with any parameter except for a positive association with diastolic blood pressure for high intake of 'fruits-vegetables-sweets-snacks' pattern. CONCLUSION Our results indicate positive associations of the 'animal food' pattern with cardio-metabolic risk factors in India. Further longitudinal assessments of dietary patterns in India are required to validate the findings.
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Affiliation(s)
- Krithiga Shridhar
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Ambika Satija
- Harvard T. H. Chan School of Public Health, Boston, USA
| | - Preet K Dhillon
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India.
| | - Sutapa Agrawal
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Ruby Gupta
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India
| | - Liza Bowen
- London School of Hygiene and Tropical Medicine, London, UK
| | - Sanjay Kinra
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - D Prabhakaran
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, Haryana, India.,London School of Hygiene and Tropical Medicine, London, UK.,Centre for Chronic Disease Control, Gurgaon, Haryana, India
| | | | - Shah Ebrahim
- London School of Hygiene and Tropical Medicine, London, UK
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Kapoor N, Naufahu J, Tewfik S, Bhatnagar S, Garg R, Tewfik I. A Prospective Randomized Controlled Trial to Study the Impact of a Nutrition-Sensitive Intervention on Adult Women With Cancer Cachexia Undergoing Palliative Care in India. Integr Cancer Ther 2017; 16:74-84. [PMID: 27252077 PMCID: PMC5736069 DOI: 10.1177/1534735416651968] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/11/2016] [Accepted: 04/25/2016] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Advanced cancer patients with disease progression develop cachexia. Nevertheless, cancer patients at nutritional risk have shown improved body weight and quality of life with oral nutritional supplements. METHOD This was a randomized controlled trial in adult female cancer patients (n = 63) attending palliative clinics, with symptoms of cachexia. Eligible patients were randomly distributed into control (n = 33) and intervention (n = 30) groups. Both groups were provided with nutritional and physical activity counseling, but the intervention group received an additional 100 g of Improved Atta (IAtta) for 6 months daily consumption. This study was designed to assess the efficacy of IAtta (with counseling) in enhancing the health status of cachexic patients. Anthropometric measurements, dietary intake, physical activity level and quality of life parameters were assessed at baseline, after 3 months, and at the end of 6 months. RESULTS Patients in the control group (n = 15) had significantly decreased body weight ( P = .003), mid-upper-arm circumference ( P = .002), and body fat ( P = .002) by the end of intervention. A trend of body weight gain in the intervention group (n = 17; P = .08) and significant increase of body fat ( P = .002) was observed; moreover, patients reported a significant improvement in fatigue ( P = .002) and appetite scores ( P = .006) under quality-of-life domains at the end of intervention. CONCLUSIONS Embedding a nutrition-sensitive intervention ( IAtta ) within Indian palliative care therapy may improve quality of life and stabilize body weight in cancer cachexia patients.
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Affiliation(s)
| | | | | | - Sushma Bhatnagar
- The All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Rakesh Garg
- The All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Viljakainen HT, Ben-Shlomo Y, Kinra S, Ebrahim S, Kuper H, Radhakrishna KV, Kulkarni B, Tobias JH. Urban-Rural Differences in Bone Mineral Density: A Cross Sectional Analysis Based on the Hyderabad Indian Migration Study. PLoS One 2015; 10:e0140787. [PMID: 26484878 PMCID: PMC4618924 DOI: 10.1371/journal.pone.0140787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 09/30/2015] [Indexed: 11/23/2022] Open
Abstract
Background Fracture risk is rising in countries undergoing rapid rural to urban migration, but whether this reflects an adverse effect of urbanization on intrinsic bone strength, as reflected by bone mineral density (BMD), is currently unknown. Methods Lumbar spine (LS) and total hip (TH) BMD, and total body fat and lean mass, were obtained from DXA scans performed in the Hyderabad arm of the Indian Migration Study (54% male, mean age 49 years). Sib-pair comparisons were performed between rural-urban migrants (RUM) and rural non-migrated (RNM) siblings (N = 185 sib-pairs). Results In analyses adjusted for height, gender, age and occupation, rural to urban migration was associated with higher lumbar and hip BMD and greater predicted hip strength; ΔLS BMD 0.030 (0.005, 0.055) g/cm2, ΔTH BMD 0.044 (0.024; 0.064) g/cm2, Δcross-sectional moment of inertia 0.162 (0.036, 0.289) cm4. These differences were largely attenuated after adjusting for body composition, insulin levels and current lifestyle factors ie. years of smoking, alcohol consumption and moderate to vigorous physical activity. Further analyses suggested that differences in lean mass, and to a lesser extent fat mass, largely explained the BMD differences which we observed. Conclusions Rural to urban migration as an adult is associated with higher BMD and greater predicted hip strength, reflecting associated alterations in body composition. It remains to be seen how differences in BMD between migration groups will translate into fracture risk in becoming years.
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Affiliation(s)
- Heli T. Viljakainen
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sanjay Kinra
- Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shah Ebrahim
- Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- South Asia Network for Chronic Disease. Public Health Foundation of India, New Delhi, India
| | - Hannah Kuper
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Jon H. Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
- * E-mail:
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Migrant youth's emerging dietary patterns in Haiti: the role of peer social engagement. Public Health Nutr 2014; 18:1262-71. [PMID: 25068484 DOI: 10.1017/s1368980014001372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study examines whether rural-to-urban migrant youth consume a greater diversity of high-sugar beverages and fried snacks (HSBFS) compared with their peers who remain in rural areas. It also tests whether the association between migration and HSBFS diversity is moderated by migrant youth's social engagement with their peers. DESIGN Participants were recruited in August and September 2011 following the completion of primary school (6th grade) and shortly before many rural youth migrate to urban areas. Participants were re-interviewed six months later. HSBFS diversity was assessed at follow-up; analyses control for baseline and follow-up characteristics. SETTING Baseline interviews occurred in rural Southeast Haiti. Follow-up interviews of migrants occurred at urban destinations in Haiti. SUBJECTS The sample includes 215 youth (mean age 15.9 years; 43.3 % female; 21.9 % rural-to-urban migrants) who were interviewed at baseline and follow-up. RESULTS Rural-to-urban migrant youth consumed a greater diversity of HSBFS products at follow-up than their rural counterparts (b=0.70, P≤0.05). Moreover, we found that this relationship varied by level of peer social engagement. Youth who migrated and had a high degree of peer social engagement consumed 2.2 additional types of HSBFS products daily than their counterparts who remained in rural areas and had low peer social engagement. CONCLUSIONS Higher HSBFS diversity among migrant youth is consistent with the patterns proposed by the nutrition transition. Interactions with peers may have an important influence as migrant youth adopt new dietary preferences. Emerging dietary patterns among youth migrants have important implications for health trajectories and the development of degenerative diseases.
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Basu S, Vellakkal S, Agrawal S, Stuckler D, Popkin B, Ebrahim S. Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: an economic-epidemiologic modeling study. PLoS Med 2014; 11:e1001582. [PMID: 24409102 PMCID: PMC3883641 DOI: 10.1371/journal.pmed.1001582] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 11/19/2013] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Taxing sugar-sweetened beverages (SSBs) has been proposed in high-income countries to reduce obesity and type 2 diabetes. We sought to estimate the potential health effects of such a fiscal strategy in the middle-income country of India, where there is heterogeneity in SSB consumption, patterns of substitution between SSBs and other beverages after tax increases, and vast differences in chronic disease risk within the population. METHODS AND FINDINGS Using consumption and price variations data from a nationally representative survey of 100,855 Indian households, we first calculated how changes in SSB price alter per capita consumption of SSBs and substitution with other beverages. We then incorporated SSB sales trends, body mass index (BMI), and diabetes incidence data stratified by age, sex, income, and urban/rural residence into a validated microsimulation of caloric consumption, glycemic load, overweight/obesity prevalence, and type 2 diabetes incidence among Indian subpopulations facing a 20% SSB excise tax. The 20% SSB tax was anticipated to reduce overweight and obesity prevalence by 3.0% (95% CI 1.6%-5.9%) and type 2 diabetes incidence by 1.6% (95% CI 1.2%-1.9%) among various Indian subpopulations over the period 2014-2023, if SSB consumption continued to increase linearly in accordance with secular trends. However, acceleration in SSB consumption trends consistent with industry marketing models would be expected to increase the impact efficacy of taxation, averting 4.2% of prevalent overweight/obesity (95% CI 2.5-10.0%) and 2.5% (95% CI 1.0-2.8%) of incident type 2 diabetes from 2014-2023. Given current consumption and BMI distributions, our results suggest the largest relative effect would be expected among young rural men, refuting our a priori hypothesis that urban populations would be isolated beneficiaries of SSB taxation. Key limitations of this estimation approach include the assumption that consumer expenditure behavior from prior years, captured in price elasticities, will reflect future behavior among consumers, and potential underreporting of consumption in dietary recall data used to inform our calculations. CONCLUSION Sustained SSB taxation at a high tax rate could mitigate rising obesity and type 2 diabetes in India among both urban and rural subpopulations.
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Affiliation(s)
- Sanjay Basu
- Prevention Research Center; Centers for Health Policy, Primary Care and Outcomes Research; Center on Poverty and Inequality; and Cardiovascular Institute, Stanford University, Stanford, California, United States of America
- Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sukumar Vellakkal
- South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
| | - Sutapa Agrawal
- South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
| | - David Stuckler
- Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Sociology, Oxford University, Oxford, United Kingdom
| | - Barry Popkin
- School of Public Health, University of North Carolina at Chapel Hill and the Carolina Population Center, Chapel Hill, North Carolina, United States of America
| | - Shah Ebrahim
- South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Satija A, Agrawal S, Bowen L, Khandpur N, Kinra S, Prabhakaran D, Reddy KS, Smith GD, Ebrahim S. Association between milk and milk product consumption and anthropometric measures in adult men and women in India: a cross-sectional study. PLoS One 2013; 8:e60739. [PMID: 23593300 PMCID: PMC3620205 DOI: 10.1371/journal.pone.0060739] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 03/02/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The nutritional aetiology of obesity remains unclear, especially with regard to the role of dairy products in developing countries. OBJECTIVE To examine whether milk/milk product consumption is associated with obesity and high waist circumference among adult Indians. METHODS Information on plain milk, tea, curd and buttermilk/lassi consumption assessed using a Food Frequency Questionnaire was obtained from the cross-sectional sib-pair designed Indian Migration Study (3698 men and 2659 women), conducted at four factory locations across north, central and south India. The anthropometric measures included were Body Mass Index (BMI) and Waist Circumference (WC). Mixed-effect logistic regression models were conducted to accommodate sib-pair design and adjust for potential confounders. RESULTS After controlling for potential confounders, the risk of being obese (BMI ≥ 25 kg/m(2)) was lower among women (OR = 0.57;95%CI:0.43-0.76;p ≤ 0.0001) and men (OR = 0.67;95%CI: 0.51-0.87;p = 0.005), and the risk of a high WC (men: >90 cm; women: >80 cm) was lower among men (OR = 0.71;95%CI:0.54-0.93;p = 0.005) and women (OR = 0.79;95%CI:0.59-1.05;p>0.05) who consume ≥1 portions of plain milk daily than those who do not consume any milk. The inverse association between daily plain milk consumption and obesity was also confirmed in sibling-pair analyses. Daily tea consumption of ≥ 1 portion was associated with obesity (OR = 1.51;95%CI:1.00-2.25;p>0.050) and high WC (OR = 1.65;95%CI:1.08-2.51;p>0.019) among men but not among women but there was no strong evidence of association of curd and buttermilk/lassi consumption with obesity and high waist circumference among both men and women. CONCLUSIONS The independent, inverse association of daily plain milk consumption with the risk of being obese suggests that high plain milk intake may lower the risk of obesity in adult Indians. However, this is an observational finding and uncontrolled confounding cannot be excluded as an explanation for the association. Therefore, confirmatory studies are needed to clarify this relationship.
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Affiliation(s)
- Ambika Satija
- Public Health Foundation of India, New Delhi, India
- South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
| | - Sutapa Agrawal
- South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
| | - Liza Bowen
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | | | - Shah Ebrahim
- South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Ohlhorst SD, Slavin M, Bhide JM, Bugusu B. Use of Iodized Salt in Processed Foods in Select Countries Around the World and the Role of Food Processors. Compr Rev Food Sci Food Saf 2012. [DOI: 10.1111/j.1541-4337.2011.00182.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Sullivan R, Kinra S, Ekelund U, Bharathi AV, Vaz M, Kurpad A, Collier T, Reddy KS, Prabhakaran D, Ben-Shlomo Y, Davey Smith G, Ebrahim S, Kuper H. Socio-demographic patterning of physical activity across migrant groups in India: results from the Indian Migration Study. PLoS One 2011; 6:e24898. [PMID: 22022366 PMCID: PMC3194815 DOI: 10.1371/journal.pone.0024898] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Accepted: 08/19/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate the relationship between rural to urban migration and physical activity (PA) in India. METHODS 6,447 (42% women) participants comprising 2077 rural, 2,094 migrants and 2,276 urban were recruited. Total activity (MET hr/day), activity intensity (min/day), PA Level (PAL) television viewing and sleeping (min/day) were estimated and associations with migrant status examined, adjusting for the sib-pair design, age, site, occupation, education, and socio-economic position (SEP). RESULTS Total activity was highest in rural men whereas migrant and urban men had broadly similar activity levels (p<0.001). Women showed similar patterns, but slightly lower levels of total activity. Sedentary behaviour and television viewing were lower in rural residents and similar in migrant and urban groups. Sleep duration was highest in the rural group and lowest in urban non-migrants. Migrant men had considerably lower odds of being in the highest quartile of total activity than rural men, a finding that persisted after adjustment for age, SEP and education (OR 0.53, 95% CI 0.37, 0.74). For women, odds ratios attenuated and associations were removed after adjusting for age, SEP and education. CONCLUSION Our findings suggest that migrants have already acquired PA levels that closely resemble long-term urban residents. Effective public health interventions to increase PA are needed.
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Affiliation(s)
- Ruth Sullivan
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Bhatnagar D. Nutrition and metabolism. Curr Opin Lipidol 2011; 22:313-4. [PMID: 21743306 DOI: 10.1097/mol.0b013e328348a526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bowen L, Ebrahim S, De Stavola B, Ness A, Kinra S, Bharathi AV, Prabhakaran D, Reddy KS. Dietary intake and rural-urban migration in India: a cross-sectional study. PLoS One 2011; 6:e14822. [PMID: 21731604 PMCID: PMC3120774 DOI: 10.1371/journal.pone.0014822] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 12/07/2010] [Indexed: 11/19/2022] Open
Abstract
Background Migration from rural areas of India contributes to urbanisation and lifestyle change, and dietary changes may increase the risk of obesity and chronic diseases. We tested the hypothesis that rural-to-urban migrants have different macronutrient and food group intake to rural non-migrants, and that migrants have a diet more similar to urban non-migrants. Methods and findings The diets of migrants of rural origin, their rural dwelling sibs, and those of urban origin together with their urban dwelling sibs were assessed by an interviewer-administered semi-quantitative food frequency questionnaire. A total of 6,509 participants were included. Median energy intake in the rural, migrant and urban groups was 2731, 3078, and 3224 kcal respectively for men, and 2153, 2504, and 2644 kcal for women (p<0.001). A similar trend was seen for overall intake of fat, protein and carbohydrates (p<0.001), though differences in the proportion of energy from these nutrients were <2%. Migrant and urban participants reported up to 80% higher fruit and vegetable intake than rural participants (p<0.001), and up to 35% higher sugar intake (p<0.001). Meat and dairy intake were higher in migrant and urban participants than rural participants (p<0.001), but varied by region. Sibling-pair analyses confirmed these results. There was no evidence of associations with time in urban area. Conclusions Rural to urban migration appears to be associated with both positive (higher fruit and vegetables intake) and negative (higher energy and fat intake) dietary changes. These changes may be of relevance to cardiovascular health and warrant public health interventions.
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Affiliation(s)
- Liza Bowen
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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