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Rising rural body-mass index is the main driver of the global obesity epidemic in adults

By May 1, 2019September 24th, 2020No Comments



NCD Risk Factor Collaboration (NCD-RisC)

Body-mass index (BMI) has increased steadily in most countries in parallel
with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the
most important drivers of the global rise in obesity3-6. Here we use 2,009 population-based studies, with measurements of height
and weight in more than 112 million adults, to report national, regional
and global trends in mean BMI segregated by place of residence (a rural or
urban area) from 1985 to 2017. We show that, contrary to the dominant
paradigm, more than 55% of the global rise in mean BMI from 1985 to
2017-and more than 80% in some low- and middle-income regions-was due to
increases in BMI in rural areas. This large contribution stems from the
fact that, with the exception of women in sub-Saharan Africa, BMI is
increasing at the same rate or faster in rural areas than in cities in low-
and middle-income regions. These trends have in turn resulted in a
closing-and in some countries reversal-of the gap in BMI between urban and
rural areas in low- and middle-income countries, especially for women. In
high-income and industrialized countries, we noted a persistently higher
rural BMI, especially for women. There is an urgent need for an integrated
approach to rural nutrition that enhances financial and physical access to
healthy foods, to avoid replacing the rural undernutrition disadvantage in
poor countries with a more general malnutrition disadvantage that entails
excessive consumption of low-quality calories.


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