Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study

Christopher Millett*, Sutapa Agrawal, Ruth Sullivan, Mario Vaz, Anura Kurpad, A. V. Bharathi, Dorairaj Prabhakaran, Kolli Srinath Reddy, Sanjay Kinra, George Davey Smith, Shah Ebrahim, Indian Migration Study Grp

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

78 Citations (Scopus)


Background: Increasing 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 Findings: Cross-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%; p

Conclusions: Walking 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.

Original languageEnglish
Article number1001459
Number of pages12
JournalPLoS Medicine
Issue number6
Publication statusPublished - Jun 2013


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