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Need for tailored strategies to combat unhealthy lifestyles among the poor and the rich: the PURE study

Hotline I - Late Breaking Trials on Prevention of Heart Failure

Munich, Germany – 26 August 2012: Healthy foods such as fruits and vegetables, proteins and non-saturated fats are consumed more often by the wealthy while poorer people consume more carbohydrates, concludes a new study involving people from 17 countries.

Risk Factors and Prevention

Results from the Prospective Urban Rural Epidemiology (PURE) study were reported here today by Professor Salim Yusuf of the Population Health Research Institute, McMaster University and Hamilton Health Sciences, in Hamilton, Canada and principal investigator of the study. The study,
involving 154,000 individuals from 628 communities, investigated the patterns of diet, physical activity and smoking.

Results showed that, with increasing country gross domestic product (GDP), there was increased consumption of fruits and vegetables, higher percentage energy from total fats and proteins, but lower percent energy from carbohydrates.

The study found that individuals who were poor, or from poorer countries, were more active, chiefly because of higher energy expenditure in jobs, at home, and during transportation. The markedly lower level of obligatory physical activity was not compensated for by higher levels of recreational physical activity in richer countries or richer individuals.

Those who were better off and those in richer countries quit smoking much more often, so that the rate of smoking was lower in wealthier individuals and wealthier countries.

However, the differences in diet, physical activity and smoking between wealthy and poor households were less marked among those living in urban areas than those living in rural areas.
“Policies to prevent cardiovascular disease need to focus on different aspects of lifestyle among the rich versus the poor and between rich and poor countries," said Professor Yusuf. "In particular, healthy foods need to become more affordable."
The study was conducted in 17 countries and co-ordinated worldwide by the PHRI (Population Health Research Institute) and supported by the Canadian Institutes of Health Research, the Indian Council of Medical Research, several other peer review organizations and pharmaceutical companies.

“These results provide new insights into the need to customise prevention policies differently for the rich and the poor and for countries at different economic levels,” said Professor David Wood from the University of London, UK and an expert in cardiovascular disease prevention.


This press release accompanies both a presentation and an ESC press conference at the ESC Congress 2012. Edited by the ESC from material supplied by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology. The content of the press release has been approved by the investigator.

Refers to session: Hot Line I: Late Breaking Trials on Prevention to Heart Failure

Refers to press conference:  Hotline I - Late Breaking Trials on Prevention of Heart Failure

Notes to editor

About the European Society of Cardiology
The European Society of Cardiology (ESC) represents more than 75,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.

About ESC Congress 2012
ESC Congress 2012 will take place from 25 to 29 August at the Messe München centre in Munich, Germany. Information on the scientific programme is available here. More information on ESC Congress 2012 is available from the ESC Press Office or contact us at