Abstract

BackgroundThere is little published data on the potential health benefits of active travel in low and middle-income countries. This is despite increasing levels of adiposity being linked to increases in physical inactivity and non-communicable diseases. This study will examine: (1) socio-demographic correlates of using active travel (walking or cycling for transport) among older adults in six populous middle-income countries (2) whether use of active travel is associated with adiposity, systolic blood pressure and self-reported diabetes in these countries.MethodsData are from the WHO Study on Global Ageing and Adult Health (SAGE) of China, India, Mexico, Ghana, Russia and South Africa with a total sample size of 40,477. Correlates of active travel (≥150 min/week) were examined using logistic regression. Logistic and linear regression analyses were used to examine health related outcomes according to three groups of active travel use per week.Results46.4 % of the sample undertook ≥150 min of active travel per week (range South Africa: 21.9 % Ghana: 57.8 %). In pooled analyses those in wealthier households were less likely to meet this level of active travel (Adjusted Risk Ratio (ARR) 0.77, 95 % Confidence Intervals 0.67; 0.88 wealthiest fifth vs. poorest). Older people and women were also less likely to use active travel for ≥150 min per week (ARR 0.71, 0.62; 0.80 those aged 70+ years vs. 18–29 years old, ARR 0.82, 0.74; 0.91 women vs. men).In pooled fully adjusted analyses, high use of active travel was associated with lower risk of overweight (ARR 0.71, 0.59; 0.86), high waist-to-hip ratio (ARR 0.71, 0.61; 0.84) and lower BMI (−0.54 kg/m2, −0.98;− 0.11). Moderate (31–209 min/week) and high use (≥210 min/week) of active travel was associated with lower waist circumference (−1.52 cm (−2.40; −0.65) and −2.16 cm (3.07; −1.26)), and lower systolic blood pressure (−1.63 mm/Hg (−3.19; −0.06) and −2.33 mm/Hg (−3.98; −0.69)).ConclusionsIn middle-income countries use of active travel for ≥150 min per week is more common in lower socio-economic groups and appears to confer similar health benefits to those identified in high-income settings. Efforts to increase active travel levels should be integral to strategies to maintain healthy weight and reduce disease burden in these settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-015-0223-3) contains supplementary material, which is available to authorized users.

Highlights

  • Recent evidence has highlighted a secular trend of increasing Body Mass Index (BMI) across countries at all stages of development [1]

  • This study aims to (1) characterize the socio-demographic correlates of using active travel among older adults in six populous middleincome countries (2) examine whether use of active travel is associated with adiposity, systolic blood pressure (SBP) and self-reported diabetes in these countries

  • We examined self-reported diabetes (answers of yes to the question “Have you ever been diagnosed with diabetes? (Not including diabetes associated with a pregnancy)”) and systolic blood pressure (SBP), based on the mean value from three measurements

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Summary

Introduction

Recent evidence has highlighted a secular trend of increasing Body Mass Index (BMI) across countries at all stages of development [1]. There is an increasing amount of data available on physical activity levels globally [5], a lack of research on the correlates of physical activity and active travel in low and middle-income countries has been noted [15, 16] Such evidence can inform local and national policy makers in decisions on the relative merits of strategies to encourage active travel, and may inform efforts to combat NCDs in these settings. There is little published data on the potential health benefits of active travel in low and middle-income countries This is despite increasing levels of adiposity being linked to increases in physical inactivity and non-communicable diseases. This study will examine: (1) socio-demographic correlates of using active travel (walking or cycling for transport) among older adults in six populous middle-income countries (2) whether use of active travel is associated with adiposity, systolic blood pressure and self-reported diabetes in these countries

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