Population Health Research Institute
Study List

PURE (Ongoing)
Prospective Urban and Rural Epidemiological Study

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The Prospective Urban and Rural Epidemiological (PURE) study, investigates the impact of urbanization and economic status on obesity in low- and middle-income countries. Covering an exhaustive assessment of societal, nutritional and lifestyle changes which accompany urbanization and economic development, the PURE study is helping to understand how modernization, urbanization and globalization increase obesity and other risk factors for CVD and diabetes. Utilizing standardized data collection in both rural and urban communities from countries representing low-, middle- and high-income regions of the world, and involving 400,000 combined participants worldwide, PURE is the largest study of its kind.

Study Design: Observational Study.

Intervention: N/A.

Length of Study: 10 years

# of Participants: 155,000

Patient Populations: Cardiovascular Disease among populations of varying ethnic groups and environmental settings.


Available upon study completion.

Main Publications (for a full listing of publications, please visit the 'Media and Publications' section)

PURE Concept Paper, Int J Epidemiol. 2009 Mar 4: Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: a review.  Chow CK, Lock K, Teo K, Subramanian S, McKee M, Yusuf S

PURE Design Paper, Am Heart J. 2009 Jul;158(1):1-7.e1: The Prospective Urban Rural Epidemiology (PURE) study: examining the impact of societal influences on chronic non-communicable diseases in low-, middle-, and high-income countries. Teo K, Chow CK, Vaz M, Rangarajan S, Yusuf S; PURE Investigators-Writing Group

EPOCH Pilot paper - PLoS One. 2010 Dec 10;5(12):e14294

EPOCH Pilot - Cigarette pack labelling in 12 countries at different levels of economic development: J Public Health Policy. 2011 May;32(2):146-64

EPOCH Reliability paper – PLoS One 2012Sep 7(9):e44410

Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): Lancet. 2011 Oct 1;378(9798):1231-43

Prevalence of a Healthy Lifestyle among Individuals with Cardiovascular Disease in High, Middle and Low income Countries. The PURE Study: JAMA, April 17, 2013—Vol 309, No. 15 1613

Development of a semi-quantitative food frequency questionnaire for use in United Arab Emirates and Kuwait based on local foods: Nutrition Journal 2005, 4:18

Nutrient estimation from an FFQ developed for a black Zimbabwean population: Nutrition Journal 2005, 4:37

Food composition database development for between country comparisons: Nutrition Journal 2006, 5:2

Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in South India: Methodological issues: Asia Pac J Clin Nutr 2008;17(1):178-185

Refinement and validation of an FFQ developed to estimate macro- and micronutrient intakes in a south Indian population: Public Health Nutrition 2008: 12(1), 12–18

Development, reproducibility and validity of the food frequency questionnaire in the Poland arm of the PURE study: Journal of Human Nutrition and Dietetics

Development and validation of a quantitative food frequency questionnaire among rural and urban dwelling adults in Colombia: J Nutr Educ Behav. Nov/Dec 2012; Vol 44:6

Validation of a Semi-Quantitative Food Frequency Questionnaire for Argentinean Adults: PLoS May 2012, Vol 7:5

Relative validity of an FFQ to estimate daily food and nutrient intakes for Chilean adults: Public Health Nutrition Aug 2012

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