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

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journal contribution
posted on 17.05.2019, 14:35 by NCD Risk Factor Collaboration (NCD-RisC), Oonagh MarkeyOonagh Markey
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. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity. 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.

Funding

Wellcome Trust. H.B. was supported by a Medical Research Council Doctoral Training Partnership Studentship, J.B. by a Royal Society Research Grant, and M.D.C. by an Academy of Medical Sciences Springboard Award.

History

School

  • Sport, Exercise and Health Sciences

Published in

Nature

Volume

569

Issue

7755

Pages

260 - 264

Citation

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), pp.260-264.

Publisher

Nature Research (part of Springer Nature)

Version

VoR (Version of Record)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/ by/4.0/

Acceptance date

30/03/2019

Publication date

2019-05-08

Notes

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

ISSN

0028-0836

eISSN

1476-4687

Language

en

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