Abstract
ObjectiveTo investigate the relationship between rural to urban migration and physical activity (PA) in India.Methods6,447 (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).ResultsTotal 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.ConclusionOur 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.
Highlights
India, like other low and middle income countries (LMIC), is in a state of transition with marked social, demographic and epidemiological changes underway [1]
Health benefits associated with physical activity (PA) include lowered blood pressure, reduced body fat and central adiposity, enhanced musculoskeletal health and improved glucose metabolism, in turn reducing the risk of cardiovascular disease (CVD), obesity, diabetes and certain cancers [13,14]
Six hundred and twenty seven individuals (9%) were excluded from these analyses; 519 migrated to work from rural areas, 38 were urbanrural migrants, seven had incomplete questionnaire data, 62 accounted for #12 hours of activity daily and one reported $36 hours of activity. This left a total of 6,447 participants for the present analysis on whom complete data was available except for Physical Activity Level (PAL) (3 missing)
Summary
Like other low and middle income countries (LMIC), is in a state of transition with marked social, demographic and epidemiological changes underway [1] This shift is characterised by increased longevity underlying population growth; an increasingly urbanised population, projected to rise from 28% in 2001 to 50% by 2025 [2] and a rising burden of chronic disease. As urbanisation continues with the expansion of cities and rural-urban migration, so too has the adoption of a more urbanised lifestyle, characterised by lower levels of physical activity (PA) and a diet higher in saturated fats [4,5,6,7] These behavioural shifts have contributed to the increase in cardiovascular disease (CVD) risk factors such as obesity, diabetes, and hypertension [6,8,9]. Health benefits associated with PA include lowered blood pressure, reduced body fat and central adiposity, enhanced musculoskeletal health and improved glucose metabolism, in turn reducing the risk of CVD, obesity, diabetes and certain cancers [13,14]
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