Traditional cooking fuels and type 2 diabetes in rural South India: insights from the TREND study

Traditional fuels including firewood, charcoal, or kerosene still remains a primary cooking fuel in rural India and the health impacts of such exposures in relation to T2D are not fully understood. Hence, this study investigates the association between traditional fuel use and prevalence of T2D in rural Tamil Nadu. Data were derived from the TREND study, a population-based cross-sectional survey conducted between 2018 and 2021 across 30 villages in Cheyyur Taluk, Tamil Nadu. A total of 13,877 adults aged ≥18 years with complete information on cooking fuel type and valid Oral Glucose Tolerance Test results were included. Participants were categorized as traditional fuel users (n = 13669) or clean fuel users(n = 208). Higher prevalence of T2D were observed among traditional fuel users (14.2% vs 12%; <i>p</i> < 0.001) and in the households who did not have a separate room for cooking (16.5% vs. 12.2%; <i>p</i> < 0.001) when compared to the clean fuel users and households with separate room for cooking. Traditional fuel use was associated with 80% higher odds of T2D among women (OR = 1.8; <i>p</i> < 0.05), independent of age, sex, family history, BMI, education and income. There is an urgent need for effective and sustained cleaner fuel adoption, improved kitchen ventilation in rural populations of India.