Walking or cycling to work linked to healthier weight in India

June 11, 2013

People in India who walk or cycle to work are less likely to be overweight or obese, according to a study led by Christopher Millett from Imperial College London and the Public Health Foundation of India and colleagues. Their paper reporting the study, published in this week's PLOS Medicine, reveals that cyclists are also less likely to have diabetes or high blood pressure compared to people who take public or private transport to work.

These findings are important as they suggest that active travel could reduce rates of important risk factors for many chronic diseases, such as diabetes and cardiovascular disease, which are projected to rapidly increase dramatically in India and other low- and middle-income countries over the next two decades.

The researchers arrived at these conclusions by analysing physical activity and health information collected from almost 4,000 participants in the Indian Migration Study. They found that people living in rural areas were more likely to cycle to work than people living in towns and cities (68.3% versus 15.9%). Half of people who travelled to work by private transport were overweight, while the rate for those who took public transport was 38%. However, only a quarter of people who walked or cycled to work were overweight. The authors found similar patterns for rates of high blood pressure and diabetes.

The authors say: "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 [non-communicable diseases] in India. This should include greater investment in public transport and improving the safety and convenience of bicycling and walking in Indian towns and cities."

They add: "Specific measures to discourage car use should also be considered and could include carbon rationing, road pricing, car parking restrictions, and reduced speed limits."

In an accompanying Perspective article, Kavi Bhalla from the Johns Hopkins Bloomberg School of Public Health (uninvolved in the study), says: "While there is strong evidence from high income countries linking physical inactivity to major [non-communicable diseases] including coronary heart disease, type 2 diabetes, and breast and colon cancers, Millett and colleagues present important evidence from a rapidly developing economy."

Bhalla adds: "Promoting such policies that reverse growth of private motor vehicles and encourage active travel is critical to ensuring that we leave the next generation with a livable planet."
Research Article

Funding: This study was supported by a Wellcome Trust project grant GR070797MF. CM is supported by the Higher Education Funding Council for England and the National Institute for Health Research. CM's research in India is supported by a Wellcome Trust Capacity Strengthening Strategic Award to the Public Health Foundation of India and a consortium of UK universities. SA is supported by a Wellcome Trust Strategic Award Grant No Z/041825. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: AK has provided consultancy for McCain Foods, and the honoraria went entirely to charity. GDS is a member of the PLOS Medicine Editorial Board. All other authors have declared that no competing interests exist.

Citation: Millett C, Agrawal S, Sullivan R, Vaz M, Kurpad A, et al. (2013) Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study. PLoS Med 10(6): e1001459. doi:10.1371/journal.pmed.1001459




Christopher Millett
School of Public Health
Imperial College London
3rd Floor, Reynolds Building
St Dunstan's Road
London, London W6 8RP

Perspective Article

Funding: No specific funding was received to write this article.

Competing Interests: The author has declared that no competing interests exist.

Citation: Bhalla K (2013) The Health Effects of Motorization. PLoS Med 9(6): e1001458. doi:10.1371/journal.pmed.1001458




Kavi Bhalla
Assistant Professor
Johns Hopkins Bloomberg School of Public Health
Department of International Health, Johns Hopkins International Injury Research
615 N. Wolfe Street, E8642
Baltimore, MA 21205


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