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

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

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3–6 . 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.

0028-0836
260-264
Bennett, James E.
fb1f8649-2f9e-47e4-8361-605cca88b427
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Fall, Caroline H.
7171a105-34f5-4131-89d7-1aa639893b18
Hill, Allan G.
5b17aa71-0c14-4fbf-8bc9-807c8294d4ae
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
NCD Risk Factor Collaboration (NCD-RisC)
Bennett, James E.
fb1f8649-2f9e-47e4-8361-605cca88b427
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Fall, Caroline H.
7171a105-34f5-4131-89d7-1aa639893b18
Hill, Allan G.
5b17aa71-0c14-4fbf-8bc9-807c8294d4ae
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81

NCD Risk Factor Collaboration (NCD-RisC) (2019) Rising rural body-mass index is the main driver of the global obesity epidemic in adults. Nature, 569 (7755), 260-264. (doi:10.1038/s41586-019-1171-x).

Record type: Article

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 cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3–6 . 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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Accepted/In Press date: 30 March 2019
e-pub ahead of print date: 8 May 2019
Published date: 9 May 2019

Identifiers

Local EPrints ID: 431250
URI: http://eprints.soton.ac.uk/id/eprint/431250
ISSN: 0028-0836
PURE UUID: 5c3fc3e9-305f-425b-b732-798c65696a46
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for Caroline H. Fall: ORCID iD orcid.org/0000-0003-4402-5552
ORCID for Allan G. Hill: ORCID iD orcid.org/0000-0002-4418-0379
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655

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Date deposited: 28 May 2019 16:30
Last modified: 18 Feb 2021 17:16

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