Socio‐Ecological Determinants of Type 2 Diabetes among South‐Indians: Influence of Sedentary Behaviours and High Energy Intakes

Abstract

ObjectiveTo examine the association between energy intakes (EI) and physical activity (PA) levels with prevalence of type 2 diabetes (T2D) among adults from the state of Tamil Nadu, IndiaMethodsPURSE‐HIS is an ongoing population‐based study following a sample of 8080 adults, men and women, >20y from rural, semi‐urban and urban areas of Chennai City, Tamil Nadu. Participants were assessed by questionnaire for PA, EI with 24‐hr recalls and prevalence of T2D by history or oral glucose tolerance test. SES was assessed with the Kuppuswamy index.ResultsIn the low SES group, 74% of men and women had moderate PA across rural, semi urban and urban areas. High PA was reported by only 5% of the sample with more (11%) of rural men reporting high PA. Women with high PA had lower EI than recommendations with highest deficit in rural women (18%). Men with high PA in rural and semi urban areas had EI deficits of 18% and 8%. Across areas and sexes with low and moderate PA, excess EI was seen. Among men highest excess in EI was seen in urban (40%) and semi urban (36%) men with low PA (p< 0.01). Low PA was associated with highest prevalence of T2D among rural (25%), semi urban (26%) and urban (30%) women. Among men, highest prevalence of T2D (26%) was in the low and moderate PA groups of all three areas. Significant association were seen among low PA, excess EI and prevalence of T2D across sex and regions (p <0.01).Key findingsLow physical activity and excess energy intake are associated with higher prevalence of T2D in the low socio‐economic groups.