Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study
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{"title"=>"Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study", "type"=>"journal", "authors"=>[{"first_name"=>"Christopher", "last_name"=>"Millett", "scopus_author_id"=>"8610765600"}, {"first_name"=>"Sutapa", "last_name"=>"Agrawal", "scopus_author_id"=>"35799714800"}, {"first_name"=>"Ruth", "last_name"=>"Sullivan", "scopus_author_id"=>"37110235500"}, {"first_name"=>"Mario", "last_name"=>"Vaz", "scopus_author_id"=>"57200842571"}, {"first_name"=>"Anura", "last_name"=>"Kurpad", "scopus_author_id"=>"7004363127"}, {"first_name"=>"A. V.", "last_name"=>"Bharathi", "scopus_author_id"=>"7006218386"}, {"first_name"=>"Dorairaj", "last_name"=>"Prabhakaran", "scopus_author_id"=>"7004283783"}, {"first_name"=>"Kolli Srinath", "last_name"=>"Reddy", "scopus_author_id"=>"35417788900"}, {"first_name"=>"Sanjay", "last_name"=>"Kinra", "scopus_author_id"=>"6603836017"}, {"first_name"=>"George Davey", "last_name"=>"Smith", "scopus_author_id"=>"35354080500"}, {"first_name"=>"Shah", "last_name"=>"Ebrahim", "scopus_author_id"=>"7102093023"}], "year"=>2013, "source"=>"PLoS Medicine", "identifiers"=>{"pui"=>"369184402", "isbn"=>"1549-1676", "issn"=>"15491277", "doi"=>"10.1371/journal.pmed.1001459", "scopus"=>"2-s2.0-84879351144", "pmid"=>"23776412", "sgr"=>"84879351144"}, "id"=>"9a4aae8b-421b-3e83-8283-91287dcce3d8", "abstract"=>"BACKGROUND: Increasing active travel (walking, bicycling, and public transport) is promoted as a key strategy to increase physical activity and reduce the growing burden of noncommunicable diseases (NCDs) globally. Little is known about patterns of active travel or associated cardiovascular health benefits in low- and middle-income countries. This study examines mode and duration of travel to work in rural and urban India and associations between active travel and overweight, hypertension, and diabetes. METHODS AND FINDINGS: Cross-sectional study of 3,902 participants (1,366 rural, 2,536 urban) in the Indian Migration Study. Associations between mode and duration of active travel and cardiovascular risk factors were assessed using random-effect logistic regression models adjusting for age, sex, caste, standard of living, occupation, factory location, leisure time physical activity, daily fat intake, smoking status, and alcohol use. Rural dwellers were significantly more likely to bicycle (68.3% versus 15.9%; p<0.001) to work than urban dwellers. The prevalence of overweight or obesity was 50.0%, 37.6%, 24.2%, 24.9%; hypertension was 17.7%, 11.8%, 6.5%, 9.8%; and diabetes was 10.8%, 7.4%, 3.8%, 7.3% in participants who travelled to work by private transport, public transport, bicycling, and walking, respectively. In the adjusted analysis, those walking (adjusted risk ratio [ARR] 0.72; 95% CI 0.58-0.88) or bicycling to work (ARR 0.66; 95% CI 0.55-0.77) were significantly less likely to be overweight or obese than those travelling by private transport. Those bicycling to work were significantly less likely to have hypertension (ARR 0.51; 95% CI 0.36-0.71) or diabetes (ARR 0.65; 95% CI 0.44-0.95). There was evidence of a dose-response relationship between duration of bicycling to work and being overweight, having hypertension or diabetes. The main limitation of the study is the cross-sectional design, which limits causal inference for the associations found. CONCLUSIONS: Walking and bicycling to work was associated with reduced cardiovascular risk in the Indian population. Efforts to increase active travel in urban areas and halt declines in rural areas should be integral to strategies to maintain healthy weight and prevent NCDs in India. Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/associations-between-active-travel-work-overweight-hypertension-diabetes-india-crosssectional-study", "reader_count"=>118, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>7, "Librarian"=>3, "Researcher"=>21, "Student > Doctoral Student"=>13, "Student > Ph. D. 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Student"=>23, "Student > Postgraduate"=>6, "Student > Master"=>20, "Other"=>4, "Student > Bachelor"=>10, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>6}, "reader_count_by_subject_area"=>{"Unspecified"=>7, "Agricultural and Biological Sciences"=>6, "Arts and Humanities"=>1, "Business, Management and Accounting"=>4, "Computer Science"=>2, "Economics, Econometrics and Finance"=>2, "Engineering"=>5, "Environmental Science"=>1, "Nursing and Health Professions"=>9, "Medicine and Dentistry"=>48, "Neuroscience"=>1, "Sports and Recreations"=>8, "Psychology"=>2, "Social Sciences"=>22}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>48}, "Social Sciences"=>{"Social Sciences"=>22}, "Sports and Recreations"=>{"Sports and Recreations"=>8}, "Psychology"=>{"Psychology"=>2}, "Unspecified"=>{"Unspecified"=>7}, "Environmental Science"=>{"Environmental Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Engineering"=>{"Engineering"=>5}, "Neuroscience"=>{"Neuroscience"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>6}, "Computer Science"=>{"Computer Science"=>2}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>4}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>9}}, "reader_count_by_country"=>{"Canada"=>2, "Colombia"=>1, "United States"=>1, "China"=>1, "United Kingdom"=>5, "Germany"=>1, "India"=>2}, "group_count"=>6}

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  • {"files"=>["https://ndownloader.figshare.com/files/1081130"], "description"=>"<p>Duration of travel = minutes for total daily journey to and from work.</p>a<p>Unadjusted risk ratio.</p>b<p>Adjusted risk ratio: adjusted for age, sex, caste, SLI, occupation, factory location, leisure time physical activity, fat intake, smoking status, alcohol intake with an individual-specific random effect of sib-pair.</p><p>doi:10.1371/journal.pmed.1001459.t006</p>", "links"=>[], "tags"=>["cardiovascular", "epidemiology", "Global health", "Metabolic disorders", "Public health", "adjusted", "ratios", "duration", "bicycling"], "article_id"=>716043, "categories"=>["Medicine"], "users"=>["Christopher Millett", "Sutapa Agrawal", "Ruth Sullivan", "Mario Vaz", "Anura Kurpad", "A. V. Bharathi", "Dorairaj Prabhakaran", "Kolli Srinath Reddy", "Sanjay Kinra", "George Davey Smith", "Shah Ebrahim"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001459.t006"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unadjusted_and_adjusted_risk_ratios_for_duration_of_bicycling_and_walking_to_work_and_overweight_obesity_hypertension_and_diabetes_/716043", "title"=>"Unadjusted and adjusted risk ratios for duration of bicycling and walking to work and overweight/obesity, hypertension, and diabetes.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-06-11 01:40:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/1081131"], "description"=>"a<p>Unadjusted relative risk ratio.</p>b<p>Adjusted risk ratio: adjusted for age, sex, caste/tribe status, standard of living, occupation, leisure time physical activity, fat intake, smoking status, alcohol intake, and factory location.</p><p>doi:10.1371/journal.pmed.1001459.t007</p>", "links"=>[], "tags"=>["cardiovascular", "epidemiology", "Global health", "Metabolic disorders", "Public health", "between-pair"], "article_id"=>716044, "categories"=>["Medicine"], "users"=>["Christopher Millett", "Sutapa Agrawal", "Ruth Sullivan", "Mario Vaz", "Anura Kurpad", "A. V. Bharathi", "Dorairaj Prabhakaran", "Kolli Srinath Reddy", "Sanjay Kinra", "George Davey Smith", "Shah Ebrahim"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001459.t007"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Within_and_between_pair_effects_of_mode_of_travel_to_work_and_overweight_obesity_hypertension_and_diabetes_/716044", "title"=>"Within- and between-pair effects of mode of travel to work and overweight/obesity, hypertension, and diabetes.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-06-11 01:40:44"}
  • {"files"=>["https://ndownloader.figshare.com/files/1081132"], "description"=>"<p>Percentages refer to the prevalence of each CVD risk factor by mode of travel to work.</p>a<p>Unadjusted risk ratio.</p>b<p>Adjusted risk ratio: adjusted for age, sex, caste, standard of living, occupation, factory location, leisure time physical activity, fat intake, smoking status, alcohol intake with an individual-specific random effect of sib-pair.</p>c<p>Undiagnosed hypertension = SBP>140 mm Hg or DBP>90 mm Hg excluding those with doctor reported hypertension.</p>d<p>Undiagnosed diabetes = fasting blood glucose ≥7 mmol/l excluding those with doctor reported diabetes.</p><p>doi:10.1371/journal.pmed.1001459.t004</p>", "links"=>[], "tags"=>["cardiovascular", "epidemiology", "Global health", "Metabolic disorders", "Public health", "adjusted", "ratios", "overweight"], "article_id"=>716045, "categories"=>["Medicine"], "users"=>["Christopher Millett", "Sutapa Agrawal", "Ruth Sullivan", "Mario Vaz", "Anura Kurpad", "A. V. Bharathi", "Dorairaj Prabhakaran", "Kolli Srinath Reddy", "Sanjay Kinra", "George Davey Smith", "Shah Ebrahim"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001459.t004"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unadjusted_and_adjusted_risk_ratios_with_95_CI_for_mode_of_travel_to_work_and_overweight_and_obesity_hypertension_and_diabetes_/716045", "title"=>"Unadjusted and adjusted risk ratios (with 95% CI) for mode of travel to work and overweight and obesity, hypertension, and diabetes.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-06-11 01:40:45"}
  • {"files"=>["https://ndownloader.figshare.com/files/1081133"], "description"=>"<p>Percentages refer to the prevalence of low and high HOMA values by mode of travel to work. Duration of travel = minutes for total daily journey to and from work. HOMA score excludes doctor diagnosed diabetes cases and cases where fasting blood glucose ≥7 mmol/l.</p>a<p>Unadjusted risk ratio.</p>b<p>Adjusted risk ratio: adjusted for age, sex, caste, SLI, occupation, factory location, leisure time physical activity, fat intake, smoking status, alcohol intake with an individual-specific random effect of sib-pair.</p><p>doi:10.1371/journal.pmed.1001459.t005</p>", "links"=>[], "tags"=>["cardiovascular", "epidemiology", "Global health", "Metabolic disorders", "Public health", "adjusted", "ratios", "duration", "homa"], "article_id"=>716046, "categories"=>["Medicine"], "users"=>["Christopher Millett", "Sutapa Agrawal", "Ruth Sullivan", "Mario Vaz", "Anura Kurpad", "A. V. Bharathi", "Dorairaj Prabhakaran", "Kolli Srinath Reddy", "Sanjay Kinra", "George Davey Smith", "Shah Ebrahim"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001459.t005"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Unadjusted_and_adjusted_risk_ratios_for_mode_of_travel_and_duration_of_active_travel_with_HOMA_values_/716046", "title"=>"Unadjusted and adjusted risk ratios for mode of travel and duration of active travel with HOMA values.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-06-11 01:40:46"}
  • {"files"=>["https://ndownloader.figshare.com/files/1081134", "https://ndownloader.figshare.com/files/1081135", "https://ndownloader.figshare.com/files/1081137", "https://ndownloader.figshare.com/files/1081138", "https://ndownloader.figshare.com/files/1081139"], "description"=>"<div><p>Background</p><p>Increasing active travel (walking, bicycling, and public transport) is promoted as a key strategy to increase physical activity and reduce the growing burden of noncommunicable diseases (NCDs) globally. Little is known about patterns of active travel or associated cardiovascular health benefits in low- and middle-income countries. This study examines mode and duration of travel to work in rural and urban India and associations between active travel and overweight, hypertension, and diabetes.</p><p>Methods and Findings</p><p>Cross-sectional study of 3,902 participants (1,366 rural, 2,536 urban) in the Indian Migration Study. Associations between mode and duration of active travel and cardiovascular risk factors were assessed using random-effect logistic regression models adjusting for age, sex, caste, standard of living, occupation, factory location, leisure time physical activity, daily fat intake, smoking status, and alcohol use. Rural dwellers were significantly more likely to bicycle (68.3% versus 15.9%; <i>p</i><0.001) to work than urban dwellers. The prevalence of overweight or obesity was 50.0%, 37.6%, 24.2%, 24.9%; hypertension was 17.7%, 11.8%, 6.5%, 9.8%; and diabetes was 10.8%, 7.4%, 3.8%, 7.3% in participants who travelled to work by private transport, public transport, bicycling, and walking, respectively. In the adjusted analysis, those walking (adjusted risk ratio [ARR] 0.72; 95% CI 0.58–0.88) or bicycling to work (ARR 0.66; 95% CI 0.55–0.77) were significantly less likely to be overweight or obese than those travelling by private transport. Those bicycling to work were significantly less likely to have hypertension (ARR 0.51; 95% CI 0.36–0.71) or diabetes (ARR 0.65; 95% CI 0.44–0.95). There was evidence of a dose-response relationship between duration of bicycling to work and being overweight, having hypertension or diabetes. The main limitation of the study is the cross-sectional design, which limits causal inference for the associations found.</p><p>Conclusions</p><p>Walking and bicycling to work was associated with reduced cardiovascular risk in the Indian population. Efforts to increase active travel in urban areas and halt declines in rural areas should be integral to strategies to maintain healthy weight and prevent NCDs in India.</p><p><i>Please see later in the article for the Editors' Summary</i></p></div>", "links"=>[], "tags"=>["cardiovascular", "epidemiology", "Global health", "Metabolic disorders", "Public health", "cross-sectional"], "article_id"=>716047, "categories"=>["Medicine"], "users"=>["Christopher Millett", "Sutapa Agrawal", "Ruth Sullivan", "Mario Vaz", "Anura Kurpad", "A. V. Bharathi", "Dorairaj Prabhakaran", "Kolli Srinath Reddy", "Sanjay Kinra", "George Davey Smith", "Shah Ebrahim"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001459.s001", "https://dx.doi.org/10.1371/journal.pmed.1001459.s002", "https://dx.doi.org/10.1371/journal.pmed.1001459.s003", "https://dx.doi.org/10.1371/journal.pmed.1001459.s004", "https://dx.doi.org/10.1371/journal.pmed.1001459.s005"], "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Associations_between_Active_Travel_to_Work_and_Overweight_Hypertension_and_Diabetes_in_India_A_Cross_Sectional_Study_/716047", "title"=>"Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2013-06-11 01:40:47"}

PMC Usage Stats | Further Information

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Relative Metric

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