Worldwide rise in obesity driven by country dwellers, study finds

Country folks have driven the recent global rise in obesity, a study published last week suggests.

This contradicts the predominant thinking that links being overweight with urban living.

“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 lead author Majid Ezzati of Imperial College of London’s School of Public Health. “This means that we need to rethink how we tackle this global health problem.”

The study, published in the peer-reviewed British journal Nature, looked at the body-mass-index data of more than 112 million adults in urban and rural areas of 200 countries and territories from 1985 to 2017. Body-mass-index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.

Researchers determined that BMI averages are rising for everyone; however, they were rising more quickly for people who lived in rural areas.

“Discussions around public health tend to focus more on the negative aspects of living in cities,” Ezzati said. “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.”

The study’s authors said rural dwellers tend to have lower income and thus less access to gyms or fitness facilities. In addition, healthier food is often costlier: “As countries increase in wealth, the challenge for rural populations changes from affording enough to eat, to affording good quality food,” Ezzati said.

The study is the most comprehensive analysis to date of how obesity is changing in rural and urban areas, according to Ezzati.

Among men, the study found that BMI increased in every country on Earth; some of the largest increases were in Peru, China, the Dominican Republic and the U.S. For women, BMI decreased slightly from 1985 to 2017 among women in 12 European countries and Singapore and Japan. At the other extreme, the biggest BMI increases were for women in Egypt and Honduras.

Also, for rural men, the biggest margins of rural over urban BMI were in Sweden, the Czech Republic, Ireland, Australia, Austria and the U.S. And rural women in central and eastern European countries were heavier than their urban counterparts by the biggest margin.

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