title: Associations between diet, physical activity and body fat distribution: a cross sectional study in an Indian population.
abstract: BACKGROUND
  Obesity is a growing health problem in India and worldwide, due to changes in lifestyle. This study aimed to explore the independent associations between dietary and physical activity exposure variables and total body fat and distribution in an Indian setting.
  
  
  METHODS
  Individuals who had participated in the Indian Migration Study (IMS) or the Andhra Pradesh Children And Parents' Study (APCAPS), were invited to participate in the Hyderabad DXA Study. Total and abdominal body fat of study participants was measured using DXA scans. Diet and physical activity (PA) levels were measured using questionnaires.
  
  
  RESULTS
  Data on 2208 participants was available for analysis; mean age was 49 yrs in IMS, 21 yrs in APCAPS. Total energy intake was positively associated with total body fat in the APCAPS sample: a 100 kcal higher energy intake was associated with 45 g higher body fat (95% CI 22, 68). In the IMS sample no association was found with total energy intake, but there was a positive association with percent protein intake (1% higher proportion of energy from protein associated with 509 g (95% CI 138,880) higher total body fat). Broadly the same pattern of associations was found with proportion of fat in the abdominal region as the outcome. PA was inversely associated with total body fat in both populations (in APCAPS, one MET-hour higher activity was associated with 46 g (95% CI 12, 81) less body fat; in the IMS it was associated with 145 g less body fat (95% CI 73, 218)). An inverse association was observed between PA and percentage abdominal fat in the IMS but no association was seen in the APCAPS population.
  
  
  CONCLUSIONS
  In this Indian population, there was an inverse association between PA and body fat. Associations between body fat and dietary variables differed between the younger APCAPS population and older IMS population. Further longitudinal research is needed to elucidate causality and directions of these associations across the life course.
authors.affiliation: St George's University, London, UK. lizabowen@gmail.com.
authors.forename: Liza
authors.initials: L
authors.lastname: Bowen
authors.affiliation: School of Experimental Psychology, University of Bristol, Bristol, UK. amy.taylor@bristol.ac.uk.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Taylor
authors.affiliation: Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. ruthms72@hotmail.com.
authors.forename: Ruth
authors.initials: R
authors.lastname: Sullivan
authors.affiliation: Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. shah.ebrahim@lshtm.ac.uk.
authors.forename: Shah
authors.initials: S
authors.lastname: Ebrahim
authors.affiliation: Department of Non Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. sanjay.kinra@lshtm.ac.uk.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kinra
authors.affiliation: Clinical Division, National Institute of Nutrition, Hyderabad, India. vijrkk@yahoo.com.
authors.forename: K V Radha
authors.initials: KV
authors.lastname: Krishna
authors.affiliation: Clinical Division, National Institute of Nutrition, Hyderabad, India. dr.bharatikulkarni@gmail.com.
authors.forename: Bharati
authors.initials: B
authors.lastname: Kulkarni
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK. Y.Ben-Shlomo@bristol.ac.uk.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Cambridge, UK. ulf.ekelund@nih.no.|Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway. ulf.ekelund@nih.no.
authors.forename: Ulf
authors.initials: U
authors.lastname: Ekelund
authors.affiliation: Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK. jonathan.wells@ucl.ac.uk.
authors.forename: Jonathan C K
authors.initials: JC
authors.lastname: Wells
authors.affiliation: Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK. hannah.kuper@lshtm.ac.uk.
authors.forename: Hannah
authors.initials: H
authors.lastname: Kuper
mesh_terms: D000273:Adipose Tissue; D000293:Adolescent; D000328:Adult; D000368:Aged; D050218:Body Fat Distribution / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult