Abstract
BackgroundMigration 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 findingsThe 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.ConclusionsRural 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.
Highlights
In India the disease burden is changing
Rural to urban migration appears to be associated with both positive and negative dietary changes
The study was nested in a larger sentinel surveillance study of cardiovascular risk factors in industrial settings [33], and used a sibling-pair comparison design in which urban factory workers who had migrated from rural areas were recruited together with their rural-dwelling sibling who had not migrated
Summary
In India the disease burden is changing. Communicable diseases remain a major problem, but there is a rapid emergence of chronic disease, including obesity, diabetes, and cardiovascular disease (CVD); CVD accounts for an estimated 27% of deaths in India [1,2,3,4]. Diet is an established risk factor for CVD [5,6,7], so it is important to study the changes that occur alongside urbanisation, increased economic prosperity, and globalisation[8,9]. Regional rural and urban studies have shown higher rates of chronic disease in urban than rural areas [10,11,12,13], and recent data on rural-urban migrants in India have shown that migration is associated with marked increases in obesity and diabetes [14]. As diet is an important risk factor for both obesity and diabetes, understanding the changes in dietary intake may provide clues to the causes of these increases in chronic conditions. 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 nonmigrants
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