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Obesity rates are rising faster in rural areas

A recent study of global trends in body-mass index (BMI) has revealed that rates of obesity are rising faster in rural areas compared to cities. A team led by Imperial College London analyzed height and weight data for more than 112 million adults across 200 countries between 1985 and 2017.

The study, which involved a network of more than 1,000 researchers, found that more than half of the average increase in BMI was due to gains in rural areas. In some low- and middle-income countries, rural areas contributed more than 80 percent of the BMI increase.

In 1985, urban men and women in over 75 percent of the countries had a higher BMI than those living in rural regions. Over the next three decades, the gap between urban and rural BMI shrank or even reversed in many of the countries.

“The results of this massive global study overturn commonly held perceptions that more people living in cities is the main cause of the global rise in obesity,” said study senior author Professor Majid Ezzati. “This means that we need to rethink how we tackle this global health problem.”

In high-income countries, BMI has been generally higher in rural areas since 1985, especially for women. The researchers said this may be due to disadvantages associated with living outside of cities, including lower income and education, limited availability and higher price of healthy foods, and fewer leisure and sports facilities.

A positive number shows a higher urban mean BMI, and a negative number a higher rural mean BMI.
Image Credit: Ezzati et al. Nature 2019

“Discussions around public health tend to focus more on the negative aspects of living in cities,” said Professor Ezzati. “In fact, cities provide a wealth of opportunities for better nutrition, more physical exercise and recreation, and overall improved health. These things are often harder to find in rural areas.”

At the same time, rural areas in low- and middle-income countries have shifted toward higher incomes, improved infrastructure, and increased car use. While all of these factors lead to numerous health benefits, they also lead to lower energy expenditure and to more spending on food.

“As countries increase in wealth, the challenge for rural populations changes from affording enough to eat, to affording good quality food,” said Professor Ezzati.

The study is published in the journal Nature.

By Chrissy Sexton, Staff Writer

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