Urban rural differences in diet, physical activity and obesity in India: are we witnessing the great Indian equalisation? Results from a cross-sectional STEPS survey

Abstract

BackgroundThe rising morbidity and mortality due to non-communicable diseases can be partly attributed to the urbanized lifestyle leading to unhealthy dietary practices and increasing physical levels of inactivity. The demographic and nutrition transition in India has also contributed to the emerging epidemic of non-communicable diseases in this country. In this context, there is limited information in India on dietary patterns, levels of physical activity and obesity. The aim of the present study was thus to assess the urban rural differences in dietary habits, physical activity and obesity in India.MethodsA household survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals using the WHO STEPS questionnaire.ResultsNo rural urban difference was found in dietary practices and prevalence of overweight and obesity except the fact that a significantly higher proportion of respondents belonging to rural area (15.6 %) always/often add salt before/when eating as compared to urban area (9.1 %). Overall 95.8 % (94.6–97.0) of participants took less than 5 servings of fruits and/or vegetables on average per day. No significant urban rural difference was noted in both sexes in all three domains of physical activity such as work, transport and recreation. However, rural females (19.1 %) were found to be engaged in vigorous activity more than the urban females (6.3 %). Males reported high levels of physical activity in both the settings. Absence of recreational activity was reported by more than 95 % of the subjects. Higher prevalence of obesity (asian cut offs used) was seen among urban females (34.3 %) as compared to their rural counterparts (23.2 %). Abdominal obesity was found to be significantly higher among females in both the settings compared to males (p < 0.001).ConclusionsPoor dietary practices and physical inactivity seems to fuel the non-communicable disease epidemic in India. Non communicable disease control strategy need to address these issues with a gender equity lens. Rapid urbanization of rural India might be responsible for the absence of a significant urban rural difference.

Correlates of sedentary behaviour in Asian adults: A systematic review

“…Living in an urban area was positively associated with total SB in all East Asian (Chinese) samples . In contrast, studies from South‐East Asia and the Middle East, as well as three out of four studies in South Asians, reported no relationships between urban residency and total SB . Urban residence was unrelated to occupational and transport‐related SB based on one study from Oman, while it was positively associated with leisure‐time SB according to one Chinese study .…”

“…53,59,60,97 In contrast, studies from South-East Asia 92 and the Middle East, 82,87 as well as three out of four studies in South Asians, reported no relationships between urban residency and total SB. 53,93,96,97 Urban residence was unrelated to occupational and transport-related SB based on one study from Oman, 83 while it was positively associated with leisure-time SB according to one Chinese study. 58 Results related to screen time were mixed: positive association in older Chinese adults, 59 no association in Omanis, 83 and Chinese students.…”

Visceral Adiposity Index and Lipid Accumulation Product Index: Two Alternate Body Indices to Identify Chronic Kidney Disease among the Rural Population in Northeast China

“…VAI and LAPI have the advantages of low cost, easy measurements, and good social profit. Furthermore, research has shown VAI and LAPI are effective markers for identifying metabolic obesity [35,39] and correlate with metabolic syndrome [40]. We suggest that VAI and LAPI as effective markers of visceral obesity are simpler and more sensitive predictors of CKD than the traditional indices in females.…”

“…Some studies have pointed out that women were more likely to have abdominal obesity [34,35]. Furthermore, according to research on the southern Chinese population, Jun et al found a strong correlation between VAI scores and CKD in females but not in males [34].…”

Non-communicable diseases in Indian slums: re-framing the Social Determinants of Health

“…Supporting this, Anand et al [4] found through a quantitative survey of the slums in Faridabad that physical inactivity was higher amongst men than women. Tripathy et al [47] used the STEPwise approach to NCD risk factor surveillance (STEPS) survey to draw a similar conclusion, citing the lack of recreational resources for PA amongst women in slums. The STEPS survey however, has been criticised for its inability to capture the physical activity related to housework, for which women are primarily responsible [4].…”