Associations between active travel and adiposity in rural India and Bangladesh: a cross-sectional study.
BACKGROUND
Data on use and health benefits of active travel in rural low- and middle- income country settings are sparse. We aimed to examine correlates of active travel, and its association with adiposity, in rural India and Bangladesh.


METHODS
Cross sectional study of 2,122 adults (≥18 years) sampled in 2011-13 from two rural sites in India (Goa and Chennai) and one in Bangladesh (Matlab). Logistic regression was used to examine whether ≥150 min/week of active travel was associated with socio-demographic indices, smoking, oil/butter consumption, and additional physical activity. Adjusting for these same factors, associations between active travel and BMI, waist circumference and waist-to-hip ratio were examined using linear and logistic regression.


RESULTS
Forty-six percent of the sample achieved recommended levels of physical activity (≥150 min/week) through active travel alone (range: 33.1 % in Matlab to 54.8 % in Goa). This was more frequent among smokers (adjusted odds ratio 1.36, 95 % confidence interval 1.07-1.72; p = 0.011) and those that spent ≥150 min/week in work-based physical activity (OR 1.71, 1.35-2.16; p < 0.001), but less frequent among females than males (OR 0.25, 0.20-0.31; p < 0.001). In fully adjusted analyses, ≥150 min/week of active travel was associated with lower BMI (adjusted coefficient -0.39 kg/m(2), -0.77 to -0.02; p = 0.037) and a lower likelihood of high waist circumference (OR 0.77, 0.63-0.96; p = 0.018) and high waist-to-hip ratio (OR 0.72, 0.58-0.89; p = 0.002).


CONCLUSIONS
Use of active travel for ≥150 min/week was associated with being male, smoking, and higher levels of work-based physical activity. It was associated with lower BMI, and lower risk of a high waist circumference or high waist-to-hip ratio. Promotion of active travel is an important component of strategies to address the growing prevalence of overweight in rural low- and middle- income country settings.
Department of Primary Care and Public Health, Imperial College London, London, UK. ailsa.mckay08@imperial.ac.uk.
Ailsa J
AJ
McKay
Department of Primary Care and Public Health, Imperial College London, London, UK.
Anthony A
AA
Laverty
Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, India.
Krithiga
K
Shridhar
Centre for Global Health Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.
Dewan
D
Alam
Goa Medical College, Sangath, Goa, India.
Amit
A
Dias
Voluntary Health Services, Chennai, India.
Joseph
J
Williams
Department of Primary Care and Public Health, Imperial College London, London, UK.|Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, India.
Christopher
C
Millett
Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Shah
S
Ebrahim
Centre for Chronic Conditions and Injuries, Public Health Foundation of India, Gurgaon, India.
Preet K
PK
Dhillon
D050154:Adiposity; D000328:Adult; D001459:Bangladesh; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000209:etiology*; D050177:Overweight; D015995:Prevalence; D012424:Rural Population; D012737:Sex Factors; D012907:Smoking; D014186:Transportation; D014195:Travel; D055105:Waist Circumference; D049629:Waist-Hip Ratio; D014937:Work; D055815:Young Adult