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The following results are related to Rural Digital Europe. Are you interested to view more results? Visit OpenAIRE - Explore.

  • Rural Digital Europe
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  • Wellcome Trust
  • Rural-urban migration: effects and ...

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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Green, Rosemary F.; Joy, Edward J.M.; Harris, Francesca; Agrawal, Sutapa; +8 Authors

    Agriculture is a major contributor to India's environmental footprint, particularly through greenhouse gas (GHG) emissions from livestock and fresh water used for irrigation. These impacts are likely to increase in future as agriculture attempts to keep pace with India's growing population and changing dietary preferences. Within India there is considerable dietary variation, and this study therefore aimed to quantify the GHG emissions and water usage associated with distinct dietary patterns. Five distinct diets were identified from the Indian Migration Study – a large adult population sample in India – using finite mixture modelling. These were defined as: Rice & low diversity, Rice & fruit, Wheat & pulses, Wheat, rice & oils, Rice & meat. The GHG emissions of each dietary pattern were quantified based on a Life Cycle Assessment (LCA) approach, and water use was quantified using Water Footprint (WF) data. Mixed-effects regression models quantified differences in the environmental impacts of the dietary patterns. There was substantial variability between diets: the rice-based patterns had higher associated GHG emissions and green WFs, but the wheat-based patterns had higher blue WFs. Regression modelling showed that the Rice & meat pattern had the highest environmental impacts overall, with 0.77 (95% CI 0.64–0.89) kg CO2e/capita/day (31%) higher emissions, 536 (95% CI 449–623) L/capita/day (24%) higher green WF and 109 (95% CI 85.9–133) L/capita/day (19%) higher blue WF than the reference Rice & low diversity pattern. Diets in India are likely to become more diverse with rising incomes, moving away from patterns such as the Rice & low diversity diet. Patterns such as the Rice & meat diet may become more common, and the environmental consequences of such changes could be substantial given the size of India's population. As global environmental stress increases, agricultural and nutrition policies must recognise the environmental impacts of potential future dietary changes. Highlights • India's food system produces large environmental impacts but these vary by diets. • We explored differences in GHG emissions and water use of Indian dietary patterns. • Rice-based diets had higher emissions but wheat-based diets used more water. • Diets with more animal products had the highest environmental impacts overall. • Diversifying diets in India may have severe consequences for environmental impacts. Graphical abstract Unlabelled Image

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Europe PubMed Centra...arrow_drop_down
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    The Science of The Total Environment
    Article . 2018 . Peer-reviewed
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      The Science of The Total Environment
      Article . 2018 . Peer-reviewed
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Harris, Francesca; Green, Rosemary F; Joy, Edward J M; Kayatz, Benjamin; +2 Authors

    Agriculture accounts for ~ 90% of India's fresh water use, and there are concerns that future food production will be threatened by insufficient water supply of adequate quality. This study aimed to quantify the water required in the production of diets in India using the water footprint (WF) assessment method. The socio-demographic associations of dietary WFs were explored using mixed effects regression models with a particular focus on blue (irrigation) WF given the importance for Indian agriculture. Dietary data from ~ 7000 adults living in India were matched to India-specific WF data for food groups to quantify the blue and green (rainfall) WF of typical diets. The mean blue and green WF of diets was 737 l/capita/day and 2531 l/capita/day, respectively. Vegetables had the lowest WFs per unit mass of product, while roots/tubers had the lowest WFs per unit dietary energy. Poultry products had the greatest blue WFs. Wheat and rice contributed 31% and 19% of the dietary blue WF respectively. Vegetable oils were the highest contributor to dietary green WF. Regional variation in dietary choices meant large differences in dietary blue WFs, whereby northern diets had nearly 1.5 times greater blue WFs than southern diets. Urban diets had a higher blue WF than rural diets, and a higher standard of living was associated with larger dietary blue WFs. This study provides a novel perspective on the WF of diets in India using individual-level dietary data, and demonstrates important variability in WFs due to different food consumption patterns and socio-demographic characteristics. Future dietary shifts towards patterns currently consumed by individuals in higher income groups, would likely increase irrigation requirements putting substantial pressure on India's water resources. Highlights • First analysis of the water used in the production of diets in India using individual-level food consumption data. • The dietary blue (irrigation) water footprint in India is greater than estimates from high-income countries. • Geographic region and socio-demographic factors are strongly associated with dietary blue water footprint. Graphical abstract Image 2

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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Millett, Christopher; Agrawal, Sutapa; Sullivan, Ruth; Vaz, Mario; +8 Authors

    BackgroundIncreasing 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 findingsCross-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%; pConclusionsWalking 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.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ CORE (RIOXX-UK Aggre...arrow_drop_down
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    PLoS Medicine
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    DOAJ
    Article . 2013
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    PLoS Medicine
    Article . 2013 . Peer-reviewed
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      Article . 2013
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      Article . 2013
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      PLoS Medicine
      Article . 2013 . Peer-reviewed
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Liza Bowen; Shah Ebrahim; Bianca De Stavola; Andy R Ness; +4 Authors

    Background Migration from rural areas of India contributes to urbanisation and lifestyle change, and dietary changes may increase the risk of obesity and chronic diseases. We tested the hypothesis that rural-to-urban migrants have different macronutrient and food group intake to rural non-migrants, and that migrants have a diet more similar to urban non-migrants. Methods and findings The diets of migrants of rural origin, their rural dwelling sibs, and those of urban origin together with their urban dwelling sibs were assessed by an interviewer-administered semi-quantitative food frequency questionnaire. A total of 6,509 participants were included. Median energy intake in the rural, migrant and urban groups was 2731, 3078, and 3224 kcal respectively for men, and 2153, 2504, and 2644 kcal for women (p<0.001). A similar trend was seen for overall intake of fat, protein and carbohydrates (p<0.001), though differences in the proportion of energy from these nutrients were <2%. Migrant and urban participants reported up to 80% higher fruit and vegetable intake than rural participants (p<0.001), and up to 35% higher sugar intake (p<0.001). Meat and dairy intake were higher in migrant and urban participants than rural participants (p<0.001), but varied by region. Sibling-pair analyses confirmed these results. There was no evidence of associations with time in urban area. Conclusions Rural to urban migration appears to be associated with both positive (higher fruit and vegetables intake) and negative (higher energy and fat intake) dietary changes. These changes may be of relevance to cardiovascular health and warrant public health interventions.

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      PLoS ONE
      Article . 2011 . Peer-reviewed
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    Authors: Dheeraj, Bansal; Ambika, Satija; Neha, Khandpur; Liza, Bowen; +4 Authors

    Objectives To study the impact of migration on food consumption among Indian factory workers and their siblings and spouses. Design A cross-sectional study was conducted to assess diet using an interviewer-administered semi-quantitative FFQ from which intake of 184 commonly consumed food items was obtained. Settings Participants recruited from factory sites in Bangalore, Lucknow, Nagpur and Hyderabad. Subjects The sample comprised 7049 participants (41·6 % female), and included urban, migrant and rural groups. Results Thirteen food items were eaten by the greatest proportion of individuals on a daily basis. These were all indigenous foods. The proportion of people consuming tandoori roti, dal with vegetables, potato and ghee on a daily basis was highest in the urban sample, intermediate in the migrant group and lowest in the rural group (P ≤ 0·01). The proportion of individuals consuming Western food on a weekly basis followed a similar trend. Conclusions The diet of this sample is predominantly indigenous in nature, irrespective of migration status, with the prevalence of daily Western food consumption being minimal.

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    Public Health Nutrition
    Article . 2010 . Peer-reviewed
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      Public Health Nutrition
      Article . 2010 . Peer-reviewed
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    Authors: Shah Ebrahim; Sanjay Kinra; Liza Bowen; Elizabeth Andersen; +11 Authors

    Editors' Summary Background India, like the rest of the world, is experiencing an epidemic of diabetes, a chronic disease characterized by dangerous levels of sugar in the blood that cause cardiovascular and kidney disease, which lower life expectancy. The prevalence of diabetes (the proportion of the population with diabetes) has been increasing steadily in India over recent decades, particularly in urban areas. In 1984, only 5% of adults living in the towns and cities of India had diabetes, but by 2004, 15% of adults in urban areas were affected by diabetes. In rural areas of India, diabetes is less common than in urban areas but even here, the prevalence of diabetes is now 6%. Obesity—too much body fat—is a major risk factor for diabetes and, in parallel with the greater increase in diabetes in urban India compared to rural India, there has been a greater increase in obesity in urban areas than in rural areas. Why Was This Study Done? Experts think that the increasing prevalence of obesity and diabetes in India (and in other developing countries) is caused in part by increased consumption of saturated fats and sugars and by reduced physical activity, and that these changes are related to urbanization—urban expansion into the countryside and migration from rural to urban areas. If living in an urban setting is a major determinant of obesity and diabetes risk, then people migrating into urban areas should acquire the high risk of the urban population for these two conditions. In this cross-sectional study (a study in which participants are studied at a single time point), the researchers investigate whether rural to urban migrants in India have a higher prevalence of obesity and diabetes than rural nonmigrants. They also ask whether migrants have a prevalence of obesity and diabetes intermediate between that of life-long urban and rural dwellers and whether a longer time since migration is associated with a higher prevalence of obesity and diabetes. What Did the Researchers Do and Find? The researchers recruited rural-urban migrants working in four Indian factories in north, central, and south regions and their spouses (if they were living in the same town) into their study. Each migrant worker and spouse asked one nonmigrant brother or sister (sibling) still living in their place of origin to join the study. The researchers also enrolled nonmigrant factory workers and their urban siblings into the study. All the participants (more than 6,500 in total) answered questions about their diet and physical activity and had their fasting blood sugar and their body mass index (BMI; weight in kg divided by height in meters squared) measured; participants with a fasting blood sugar of more than 7.0 nmol/l or a BMI of more than 25 kg/m2 were classified as diabetic or obese, respectively. 41.9% and 37.8% of the urban and migrant men, respectively, but only 19.0% of the rural men were obese. Similarly, 13.5% and 14.3% of the urban and migrant men, respectively, but only 6.2% of the rural men had diabetes. Patterns of obesity and diabetes among the women participants were similar. Finally, although the prevalence of diabetes and obesity was lower in the most recent male migrants than in those who had moved more than 10 years previously, this difference was small and not seen in women migrants. What Do These Findings Mean? These findings show that rural-urban migration in India is associated with rapid increases in obesity and in diabetes. They also show that the migrants have adopted modes of life (for example, reduced physical activity) that put them at a similar risk for obesity and diabetes as the urban population. The findings do not show, however, that migrants have an intermediate prevalence of obesity and diabetes compared to urban and rural dwellers and provide only weak support for the idea that a longer time since migration is associated with a higher risk of obesity and diabetes. Although the study's cross-sectional design means that the researchers could not investigate how risk factors for diabetes evolve over time, these findings suggest that urbanization is helping to drive the diabetes epidemic in India. Thus, targeting migrants and their families for health promotion activities and for treatment of risk factors for obesity and diabetes might help to slow the progress of the epidemic. Additional Information Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1000268. The International Diabetes Federation provides information about all aspects of diabetes, including information on diabetes in Southeast Asia (in English, French, and Spanish) DiabetesIndia.com provides information on the Indian Task Forces on diabetes care in India Diabetes Foundation (India) has an international collaborative research focus and provides information about health promotion for diabetes; it has also produced consensus guidelines on dietary change for prevention of diabetes in India The US National Diabetes Information Clearinghouse provides detailed information about diabetes for patients, health care professionals, and the general public (in English and Spanish) MedlinePlus provides links to further resources and advice about diabetes (in English and Spanish) Background Migration from rural areas of India contributes to urbanisation and may increase the risk of obesity and diabetes. We tested the hypotheses that rural-to-urban migrants have a higher prevalence of obesity and diabetes than rural nonmigrants, that migrants would have an intermediate prevalence of obesity and diabetes compared with life-long urban and rural dwellers, and that longer time since migration would be associated with a higher prevalence of obesity and of diabetes. Methods and Findings The place of origin of people working in factories in north, central, and south India was identified. Migrants of rural origin, their rural dwelling sibs, and those of urban origin together with their urban dwelling sibs were assessed by interview, examination, and fasting blood samples. Obesity, diabetes, and other cardiovascular risk factors were compared. A total of 6,510 participants (42% women) were recruited. Among urban, migrant, and rural men the age- and factory-adjusted percentages classified as obese (body mass index [BMI] >25 kg/m2) were 41.9% (95% confidence interval [CI] 39.1–44.7), 37.8% (95% CI 35.0–40.6), and 19.0% (95% CI 17.0–21.0), respectively, and as diabetic were 13.5% (95% CI 11.6–15.4), 14.3% (95% CI 12.2–16.4), and 6.2% (95% CI 5.0–7.4), respectively. Findings for women showed similar patterns. Rural men had lower blood pressure, lipids, and fasting blood glucose than urban and migrant men, whereas no differences were seen in women. Among migrant men, but not women, there was weak evidence for a lower prevalence of both diabetes and obesity among more recent (≤10 y) migrants. Conclusions Migration into urban areas is associated with increases in obesity, which drive other risk factor changes. Migrants have adopted modes of life that put them at similar risk to the urban population. Gender differences in some risk factors by place of origin are unexpected and require further exploration. Please see later in the article for the Editors' Summary Shah Ebrahim and colleagues examine the distribution of obesity, diabetes, and other cardiovascular risk factors among urban migrant factory workers in India, together with their rural siblings. The investigators identify patterns of change of cardiovascular risk factors associated with urban migration.

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    PLoS Medicine
    Article . 2010 . Peer-reviewed
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      PLoS Medicine
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    Authors: Cummins, Steven; Smith, Dianna M; Taylor, Mathew; Dawson, John; +3 Authors

    AbstractObjectiveNeighbourhood differences in access to fresh fruit and vegetables may explain social inequalities in diet. Investigations have focused on variations in cost and availability as barriers to the purchase and consumption of fresh produce; investigations of quality have been neglected. Here we investigate whether produce quality systematically varies by food store type, rural–urban location and neighbourhood deprivation in a selection of communities across Scotland.DesignCross-sectional survey of twelve fresh fruit and vegetable items in 288 food stores in ten communities across Scotland. Communities were selected to reflect a range of urban–rural settings and a food retail census was conducted in each location. The quality of twelve fruit and vegetable items within each food store was evaluated. Data from the Scottish Executive were used to characterise each small area by deprivation and urban–rural classification.SettingScotland.ResultsQuality of fruit and vegetables within the surveyed stores was high. Medium-sized stores, stores in small town and rural areas, and stores in more affluent areas tended to have the highest-quality fresh fruit and vegetables. Stores where food is secondary, stores in urban settings and stores in more deprived areas tended have the lowest-quality fresh produce. Although differences in quality were not always statistically significant, patterns were consistent for the majority of fruit and vegetable items.ConclusionsThe study provides evidence that variations in food quality may plausibly be a micro-environmental mediating variable in food purchase and consumption and help partially explain neighbourhood differences in food consumption patterns.

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    Public Health Nutrition
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Green, Rosemary F.; Joy, Edward J.M.; Harris, Francesca; Agrawal, Sutapa; +8 Authors

    Agriculture is a major contributor to India's environmental footprint, particularly through greenhouse gas (GHG) emissions from livestock and fresh water used for irrigation. These impacts are likely to increase in future as agriculture attempts to keep pace with India's growing population and changing dietary preferences. Within India there is considerable dietary variation, and this study therefore aimed to quantify the GHG emissions and water usage associated with distinct dietary patterns. Five distinct diets were identified from the Indian Migration Study – a large adult population sample in India – using finite mixture modelling. These were defined as: Rice & low diversity, Rice & fruit, Wheat & pulses, Wheat, rice & oils, Rice & meat. The GHG emissions of each dietary pattern were quantified based on a Life Cycle Assessment (LCA) approach, and water use was quantified using Water Footprint (WF) data. Mixed-effects regression models quantified differences in the environmental impacts of the dietary patterns. There was substantial variability between diets: the rice-based patterns had higher associated GHG emissions and green WFs, but the wheat-based patterns had higher blue WFs. Regression modelling showed that the Rice & meat pattern had the highest environmental impacts overall, with 0.77 (95% CI 0.64–0.89) kg CO2e/capita/day (31%) higher emissions, 536 (95% CI 449–623) L/capita/day (24%) higher green WF and 109 (95% CI 85.9–133) L/capita/day (19%) higher blue WF than the reference Rice & low diversity pattern. Diets in India are likely to become more diverse with rising incomes, moving away from patterns such as the Rice & low diversity diet. Patterns such as the Rice & meat diet may become more common, and the environmental consequences of such changes could be substantial given the size of India's population. As global environmental stress increases, agricultural and nutrition policies must recognise the environmental impacts of potential future dietary changes. Highlights • India's food system produces large environmental impacts but these vary by diets. • We explored differences in GHG emissions and water use of Indian dietary patterns. • Rice-based diets had higher emissions but wheat-based diets used more water. • Diets with more animal products had the highest environmental impacts overall. • Diversifying diets in India may have severe consequences for environmental impacts. Graphical abstract Unlabelled Image

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    The Science of The Total Environment
    Article . 2018 . Peer-reviewed
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      The Science of The Total Environment
      Article . 2018 . Peer-reviewed
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Harris, Francesca; Green, Rosemary F; Joy, Edward J M; Kayatz, Benjamin; +2 Authors

    Agriculture accounts for ~ 90% of India's fresh water use, and there are concerns that future food production will be threatened by insufficient water supply of adequate quality. This study aimed to quantify the water required in the production of diets in India using the water footprint (WF) assessment method. The socio-demographic associations of dietary WFs were explored using mixed effects regression models with a particular focus on blue (irrigation) WF given the importance for Indian agriculture. Dietary data from ~ 7000 adults living in India were matched to India-specific WF data for food groups to quantify the blue and green (rainfall) WF of typical diets. The mean blue and green WF of diets was 737 l/capita/day and 2531 l/capita/day, respectively. Vegetables had the lowest WFs per unit mass of product, while roots/tubers had the lowest WFs per unit dietary energy. Poultry products had the greatest blue WFs. Wheat and rice contributed 31% and 19% of the dietary blue WF respectively. Vegetable oils were the highest contributor to dietary green WF. Regional variation in dietary choices meant large differences in dietary blue WFs, whereby northern diets had nearly 1.5 times greater blue WFs than southern diets. Urban diets had a higher blue WF than rural diets, and a higher standard of living was associated with larger dietary blue WFs. This study provides a novel perspective on the WF of diets in India using individual-level dietary data, and demonstrates important variability in WFs due to different food consumption patterns and socio-demographic characteristics. Future dietary shifts towards patterns currently consumed by individuals in higher income groups, would likely increase irrigation requirements putting substantial pressure on India's water resources. Highlights • First analysis of the water used in the production of diets in India using individual-level food consumption data. • The dietary blue (irrigation) water footprint in India is greater than estimates from high-income countries. • Geographic region and socio-demographic factors are strongly associated with dietary blue water footprint. Graphical abstract Image 2

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    Authors: Millett, Christopher; Agrawal, Sutapa; Sullivan, Ruth; Vaz, Mario; +8 Authors

    BackgroundIncreasing 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 findingsCross-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%; pConclusionsWalking 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.

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    PLoS Medicine
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    DOAJ
    Article . 2013
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    PLoS Medicine
    Article . 2013 . Peer-reviewed
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      Article . 2013
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      Article . 2013
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      PLoS Medicine
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Liza Bowen; Shah Ebrahim; Bianca De Stavola; Andy R Ness; +4 Authors

    Background Migration from rural areas of India contributes to urbanisation and lifestyle change, and dietary changes may increase the risk of obesity and chronic diseases. We tested the hypothesis that rural-to-urban migrants have different macronutrient and food group intake to rural non-migrants, and that migrants have a diet more similar to urban non-migrants. Methods and findings The diets of migrants of rural origin, their rural dwelling sibs, and those of urban origin together with their urban dwelling sibs were assessed by an interviewer-administered semi-quantitative food frequency questionnaire. A total of 6,509 participants were included. Median energy intake in the rural, migrant and urban groups was 2731, 3078, and 3224 kcal respectively for men, and 2153, 2504, and 2644 kcal for women (p<0.001). A similar trend was seen for overall intake of fat, protein and carbohydrates (p<0.001), though differences in the proportion of energy from these nutrients were <2%. Migrant and urban participants reported up to 80% higher fruit and vegetable intake than rural participants (p<0.001), and up to 35% higher sugar intake (p<0.001). Meat and dairy intake were higher in migrant and urban participants than rural participants (p<0.001), but varied by region. Sibling-pair analyses confirmed these results. There was no evidence of associations with time in urban area. Conclusions Rural to urban migration appears to be associated with both positive (higher fruit and vegetables intake) and negative (higher energy and fat intake) dietary changes. These changes may be of relevance to cardiovascular health and warrant public health interventions.

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    PLoS ONE
    Article . 2011
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    Authors: Dheeraj, Bansal; Ambika, Satija; Neha, Khandpur; Liza, Bowen; +4 Authors

    Objectives To study the impact of migration on food consumption among Indian factory workers and their siblings and spouses. Design A cross-sectional study was conducted to assess diet using an interviewer-administered semi-quantitative FFQ from which intake of 184 commonly consumed food items was obtained. Settings Participants recruited from factory sites in Bangalore, Lucknow, Nagpur and Hyderabad. Subjects The sample comprised 7049 participants (41·6 % female), and included urban, migrant and rural groups. Results Thirteen food items were eaten by the greatest proportion of individuals on a daily basis. These were all indigenous foods. The proportion of people consuming tandoori roti, dal with vegetables, potato and ghee on a daily basis was highest in the urban sample, intermediate in the migrant group and lowest in the rural group (P ≤ 0·01). The proportion of individuals consuming Western food on a weekly basis followed a similar trend. Conclusions The diet of this sample is predominantly indigenous in nature, irrespective of migration status, with the prevalence of daily Western food consumption being minimal.

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    Public Health Nutrition
    Article . 2010 . Peer-reviewed
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      Public Health Nutrition
      Article . 2010 . Peer-reviewed
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    Authors: Shah Ebrahim; Sanjay Kinra; Liza Bowen; Elizabeth Andersen; +11 Authors

    Editors' Summary Background India, like the rest of the world, is experiencing an epidemic of diabetes, a chronic disease characterized by dangerous levels of sugar in the blood that cause cardiovascular and kidney disease, which lower life expectancy. The prevalence of diabetes (the proportion of the population with diabetes) has been increasing steadily in India over recent decades, particularly in urban areas. In 1984, only 5% of adults living in the towns and cities of India had diabetes, but by 2004, 15% of adults in urban areas were affected by diabetes. In rural areas of India, diabetes is less common than in urban areas but even here, the prevalence of diabetes is now 6%. Obesity—too much body fat—is a major risk factor for diabetes and, in parallel with the greater increase in diabetes in urban India compared to rural India, there has been a greater increase in obesity in urban areas than in rural areas. Why Was This Study Done? Experts think that the increasing prevalence of obesity and diabetes in India (and in other developing countries) is caused in part by increased consumption of saturated fats and sugars and by reduced physical activity, and that these changes are related to urbanization—urban expansion into the countryside and migration from rural to urban areas. If living in an urban setting is a major determinant of obesity and diabetes risk, then people migrating into urban areas should acquire the high risk of the urban population for these two conditions. In this cross-sectional study (a study in which participants are studied at a single time point), the researchers investigate whether rural to urban migrants in India have a higher prevalence of obesity and diabetes than rural nonmigrants. They also ask whether migrants have a prevalence of obesity and diabetes intermediate between that of life-long urban and rural dwellers and whether a longer time since migration is associated with a higher prevalence of obesity and diabetes. What Did the Researchers Do and Find? The researchers recruited rural-urban migrants working in four Indian factories in north, central, and south regions and their spouses (if they were living in the same town) into their study. Each migrant worker and spouse asked one nonmigrant brother or sister (sibling) still living in their place of origin to join the study. The researchers also enrolled nonmigrant factory workers and their urban siblings into the study. All the participants (more than 6,500 in total) answered questions about their diet and physical activity and had their fasting blood sugar and their body mass index (BMI; weight in kg divided by height in meters squared) measured; participants with a fasting blood sugar of more than 7.0 nmol/l or a BMI of more than 25 kg/m2 were classified as diabetic or obese, respectively. 41.9% and 37.8% of the urban and migrant men, respectively, but only 19.0% of the rural men were obese. Similarly, 13.5% and 14.3% of the urban and migrant men, respectively, but only 6.2% of the rural men had diabetes. Patterns of obesity and diabetes among the women participants were similar. Finally, although the prevalence of diabetes and obesity was lower in the most recent male migrants than in those who had moved more than 10 years previously, this difference was small and not seen in women migrants. What Do These Findings Mean? These findings show that rural-urban migration in India is associated with rapid increases in obesity and in diabetes. They also show that the migrants have adopted modes of life (for example, reduced physical activity) that put them at a similar risk for obesity and diabetes as the urban population. The findings do not show, however, that migrants have an intermediate prevalence of obesity and diabetes compared to urban and rural dwellers and provide only weak support for the idea that a longer time since migration is associated with a higher risk of obesity and diabetes. Although the study's cross-sectional design means that the researchers could not investigate how risk factors for diabetes evolve over time, these findings suggest that urbanization is helping to drive the diabetes epidemic in India. Thus, targeting migrants and their families for health promotion activities and for treatment of risk factors for obesity and diabetes might help to slow the progress of the epidemic. Additional Information Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1000268. The International Diabetes Federation provides information about all aspects of diabetes, including information on diabetes in Southeast Asia (in English, French, and Spanish) DiabetesIndia.com provides information on the Indian Task Forces on diabetes care in India Diabetes Foundation (India) has an international collaborative research focus and provides information about health promotion for diabetes; it has also produced consensus guidelines on dietary change for prevention of diabetes in India The US National Diabetes Information Clearinghouse provides detailed information about diabetes for patients, health care professionals, and the general public (in English and Spanish) MedlinePlus provides links to further resources and advice about diabetes (in English and Spanish) Background Migration from rural areas of India contributes to urbanisation and may increase the risk of obesity and diabetes. We tested the hypotheses that rural-to-urban migrants have a higher prevalence of obesity and diabetes than rural nonmigrants, that migrants would have an intermediate prevalence of obesity and diabetes compared with life-long urban and rural dwellers, and that longer time since migration would be associated with a higher prevalence of obesity and of diabetes. Methods and Findings The place of origin of people working in factories in north, central, and south India was identified. Migrants of rural origin, their rural dwelling sibs, and those of urban origin together with their urban dwelling sibs were assessed by interview, examination, and fasting blood samples. Obesity, diabetes, and other cardiovascular risk factors were compared. A total of 6,510 participants (42% women) were recruited. Among urban, migrant, and rural men the age- and factory-adjusted percentages classified as obese (body mass index [BMI] >25 kg/m2) were 41.9% (95% confidence interval [CI] 39.1–44.7), 37.8% (95% CI 35.0–40.6), and 19.0% (95% CI 17.0–21.0), respectively, and as diabetic were 13.5% (95% CI 11.6–15.4), 14.3% (95% CI 12.2–16.4), and 6.2% (95% CI 5.0–7.4), respectively. Findings for women showed similar patterns. Rural men had lower blood pressure, lipids, and fasting blood glucose than urban and migrant men, whereas no differences were seen in women. Among migrant men, but not women, there was weak evidence for a lower prevalence of both diabetes and obesity among more recent (≤10 y) migrants. Conclusions Migration into urban areas is associated with increases in obesity, which drive other risk factor changes. Migrants have adopted modes of life that put them at similar risk to the urban population. Gender differences in some risk factors by place of origin are unexpected and require further exploration. Please see later in the article for the Editors' Summary Shah Ebrahim and colleagues examine the distribution of obesity, diabetes, and other cardiovascular risk factors among urban migrant factory workers in India, together with their rural siblings. The investigators identify patterns of change of cardiovascular risk factors associated with urban migration.

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    DOAJ
    Article . 2010
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    PLoS Medicine
    Article . 2010 . Peer-reviewed
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    PLoS Medicine
    Article . 2010
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      PLoS Medicine
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    Authors: Cummins, Steven; Smith, Dianna M; Taylor, Mathew; Dawson, John; +3 Authors

    AbstractObjectiveNeighbourhood differences in access to fresh fruit and vegetables may explain social inequalities in diet. Investigations have focused on variations in cost and availability as barriers to the purchase and consumption of fresh produce; investigations of quality have been neglected. Here we investigate whether produce quality systematically varies by food store type, rural–urban location and neighbourhood deprivation in a selection of communities across Scotland.DesignCross-sectional survey of twelve fresh fruit and vegetable items in 288 food stores in ten communities across Scotland. Communities were selected to reflect a range of urban–rural settings and a food retail census was conducted in each location. The quality of twelve fruit and vegetable items within each food store was evaluated. Data from the Scottish Executive were used to characterise each small area by deprivation and urban–rural classification.SettingScotland.ResultsQuality of fruit and vegetables within the surveyed stores was high. Medium-sized stores, stores in small town and rural areas, and stores in more affluent areas tended to have the highest-quality fresh fruit and vegetables. Stores where food is secondary, stores in urban settings and stores in more deprived areas tended have the lowest-quality fresh produce. Although differences in quality were not always statistically significant, patterns were consistent for the majority of fruit and vegetable items.ConclusionsThe study provides evidence that variations in food quality may plausibly be a micro-environmental mediating variable in food purchase and consumption and help partially explain neighbourhood differences in food consumption patterns.

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    Public Health Nutrition
    Article . 2009 . Peer-reviewed
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