Rural to urban migration associated with increased obesity and diabetes risk in India

Migration from rural to urban areas is associated with increasing levels of obesity and is a factor driving the diabetes epidemic in India, according to a new study published this week in PLoS Medicine.

India, like the rest of the world, is experiencing a diabetes epidemic. Diabetes has increased in urban areas of India from 5% to 15% between 1984 and 2004. As in other developing countries this is thought to result from increased consumption of saturated fats and sugar and reduced levels of physical activity. The process of urbanization - migration from rural areas to towns and cities and the expansion of urban areas into the periphery - is linked to changes in diet and behaviour. To examine how migration has impacted on obesity and diabetes in India, Shah Ebrahim and colleagues interviewed rural migrants working in urban factories.

The researchers recruited rural-urban migrants working in four factories in central, north and south India and the spouses of these workers if they were living in the same town. Each migrant worker or spouse asked a sibling still living in the rural area that they were originally from to join the study. Non-migrant factory workers and their siblings from urban areas were also recruited. Each participant answered questions about their diet and physical activity and had their blood sugar and body mass index measured.

The results showed similar levels of obesity in urban and migrant men (41.9% and 37.8% respectively), in comparison with 19% of men in rural areas. Diabetes also stood at similar levels in urban and migrant men (13.5% in urban and 14.3% respectively), in comparison with 6.2% in rural men. These patterns of obesity and diabetes were similar in women.

The findings demonstrate that rural-urban migration in India is associated with rapid increases in obesity and diabetes and also indicated that changes in migrant behaviour - such as reduced physical activity - put them at similar risk to the urban population. The authors conclude that health promotional activities targeting migrants and their families would help reduce the risk factors for obesity and diabetes and slow the progress of the epidemic.