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 inparallel with a rise in the proportion of the population who live incities1,2. This has led to a widely reported view that urbanization isone of the most important drivers of the global rise in obesity3–6.Here we use 2,009 population-based studies, with measurementsof height and weight in more than 112 million adults, to reportnational, regional and global trends in mean BMI segregated byplace of residence (a rural or urban area) from 1985 to 2017. Weshow that, contrary to the dominant paradigm, more than 55% ofthe global rise in mean BMI from 1985 to 2017—and more than80% in some low- and middle-income regions—was due to increasesin BMI in rural areas. This large contribution stems from the factthat, with the exception of women in sub-Saharan Africa, BMI isincreasing at the same rate or faster in rural areas than in cities inlow- and middle-income regions. These trends have in turn resultedin a closing—and in some countries reversal—of the gap in BMIbetween 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 nutritionthat enhances financial and physical access to healthy foods, to avoidreplacing the rural undernutrition disadvantage in poor countrieswith a more general malnutrition disadvantage that entails excessiveconsumption of low-quality calories.
Lingua originaleEnglish
pagine (da-a)260-264
Numero di pagine5
RivistaNature
Stato di pubblicazionePublished - 2019

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