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

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.