| doreen T |
Sun, May-12-19 06:34 |
Global obesity rising faster in rural areas than cities, study finds
https://www.cbc.ca/news/health/obes...urban-1.5128238
Thomson Reuters · Posted: May 08, 2019 4:24 PM ET
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Commonly held perception that obesity is a city problem could now be overturned
Global rates of obesity among people who live in the countryside are rising faster than those among city dwellers, in part due to greater access in urban areas to healthier foods and places to exercise, researchers said on Wednesday.
In a study of 33 years of trends in body mass index (BMI) across 200 countries and territories, the scientists found that people worldwide are getting heavier — with average weight rising by five to six kilograms (11 to 13 pounds) over the period of the study — and that most of the rise is due to gains in BMI in rural areas.
"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 Majid Ezzati, a professor at Imperial College London who co-led the work.
He said the findings showed "that we need to rethink how we tackle this global health problem."
The study, published in the journal Nature on Wednesday, analyzed height and weight data from around 112 million adults across urban and rural areas of 200 countries and territories between 1985 and 2017.
BMI is an internationally recognized scale that gives an indication of whether someone is a healthy weight. BMI is calculated by dividing a person's weight in kilograms by their height in metres squared, and a BMI of between 19 to 25 is considered healthy.
The study found that between 1985 and 2017, average rural BMI increased by 2.1 in women and men. In cities, however, the gain was 1.3 and 1.6 in women and men, respectively.
The researchers described "striking changes" in the geography of BMI. In 1985, urban men and women in more than three quarters of the countries studied had higher BMIs than their rural counterparts. But 30 years later, the BMI gap between urban and rural dwellers in many countries had shrunk dramatically, or even reversed.
This may be due to some disadvantages for people living in the countryside, the researchers said, including lower levels of income and education, limited availability and higher costs of healthy foods, and fewer sports facilities.
Ezzati said that while discussions about public health often focus on negative aspects of city living, these findings show there are some benefits.
"Cities provide a wealth of opportunities for better nutrition, more physical exercise and recreation, and overall improved health," he said. "These things are often harder to find in rural areas."
The proportion of overweight and obese adults in the rural parts of many low- and middle-income countries is also rising more quickly than in cites.
"Rural areas in these countries have begun to resemble urban areas," Barry Popkin, an expert on global public health at the University of North Carolina, said in a journal commentary.
"Modern food supply is now available in combination with cheap, mechanized devices for farming and transport," he said. "Ultra-processed foods are also becoming part of the diets of poor people."
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link to original study in Nature .. Rising rural body-mass index is the main driver of the global obesity epidemic in adults
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Abstract
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 obesity3,4,5,6. 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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