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

NCD Risk Factor Collaboration (NCD-RisC)

Research output: Contribution to journalLetterResearchpeer-review

5 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)260-264
Number of pages5
JournalNature
Volume569
Issue number7755
DOIs
StatePublished - 9 May 2019

Fingerprint

Body Mass Index
Obesity
Malnutrition
Urbanization
Africa South of the Sahara
Developed Countries
Weights and Measures
Food
Population

Cite this

NCD Risk Factor Collaboration (NCD-RisC). / Rising rural body-mass index is the main driver of the global obesity epidemic in adults. In: Nature. 2019 ; Vol. 569, No. 7755. pp. 260-264.
@article{831f99db1621409ab98629b6ea949119,
title = "Rising rural body-mass index is the main driver of the global obesity epidemic in adults",
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.",
author = "{NCD Risk Factor Collaboration (NCD-RisC)} and Honor Bixby and James Bentham and Bin Zhou and {Di Cesare}, Mariachiara and Paciorek, {Christopher J.} and Bennett, {James E.} and Cristina Taddei and Stevens, {Gretchen A.} and Andrea Rodriguez-Martinez and Carrillo-Larco, {Rodrigo M.} and Khang, {Young Ho} and Maroje Sorić and Gregg, {Edward W.} and Miranda, {J. Jaime} and Bhutta, {Zulfiqar A.} and Young-Ho Khang and Sophiea, {Marisa K.} and Iurilli, {Maria L.C.} and Solomon, {Bethlehem D.} and Cowan, {Melanie J.} and Riley, {Leanne M.} and Goodarz Danaei and Pascal Bovet and Adela Chirita-Emandi and Hambleton, {Ian R.} and Hayes, {Alison J.} and Nayu Ikeda and Kengne, {Andre P.} and Avula Laxmaiah and Yanping Li and McGarvey, {Stephen T.} and Aya Mostafa and Martin Neovius and Gregor Starc and Zainuddin, {Ahmad A.} and Leandra Abarca-G{\'o}mez and Abdeen, {Ziad A.} and Shynar Abdrakhmanova and Suhaila Abdul Ghaffar and Zargar Abdul Hamid and Jamila Abubakar Garba and Abu-Rmeileh, {Niveen M.} and Benjamin Acosta-Cazares and Adams, {Robert J.} and Wichai Aekplakorn and Kaosar Afsana and Agdeppa, {Imelda A.} and Aguilar-Salinas, {Carlos A.} and Belong Cho and Moon, {Jin Soo}",
year = "2019",
month = "5",
day = "9",
doi = "10.1038/s41586-019-1171-x",
language = "English",
volume = "569",
pages = "260--264",
journal = "Nature",
issn = "0028-0836",
publisher = "Nature Publishing Group",
number = "7755",

}

Rising rural body-mass index is the main driver of the global obesity epidemic in adults. / NCD Risk Factor Collaboration (NCD-RisC).

In: Nature, Vol. 569, No. 7755, 09.05.2019, p. 260-264.

Research output: Contribution to journalLetterResearchpeer-review

TY - JOUR

T1 - Rising rural body-mass index is the main driver of the global obesity epidemic in adults

AU - NCD Risk Factor Collaboration (NCD-RisC)

AU - Bixby, Honor

AU - Bentham, James

AU - Zhou, Bin

AU - Di Cesare, Mariachiara

AU - Paciorek, Christopher J.

AU - Bennett, James E.

AU - Taddei, Cristina

AU - Stevens, Gretchen A.

AU - Rodriguez-Martinez, Andrea

AU - Carrillo-Larco, Rodrigo M.

AU - Khang, Young Ho

AU - Sorić, Maroje

AU - Gregg, Edward W.

AU - Miranda, J. Jaime

AU - Bhutta, Zulfiqar A.

AU - Khang, Young-Ho

AU - Sophiea, Marisa K.

AU - Iurilli, Maria L.C.

AU - Solomon, Bethlehem D.

AU - Cowan, Melanie J.

AU - Riley, Leanne M.

AU - Danaei, Goodarz

AU - Bovet, Pascal

AU - Chirita-Emandi, Adela

AU - Hambleton, Ian R.

AU - Hayes, Alison J.

AU - Ikeda, Nayu

AU - Kengne, Andre P.

AU - Laxmaiah, Avula

AU - Li, Yanping

AU - McGarvey, Stephen T.

AU - Mostafa, Aya

AU - Neovius, Martin

AU - Starc, Gregor

AU - Zainuddin, Ahmad A.

AU - Abarca-Gómez, Leandra

AU - Abdeen, Ziad A.

AU - Abdrakhmanova, Shynar

AU - Abdul Ghaffar, Suhaila

AU - Abdul Hamid, Zargar

AU - Abubakar Garba, Jamila

AU - Abu-Rmeileh, Niveen M.

AU - Acosta-Cazares, Benjamin

AU - Adams, Robert J.

AU - Aekplakorn, Wichai

AU - Afsana, Kaosar

AU - Agdeppa, Imelda A.

AU - Aguilar-Salinas, Carlos A.

AU - Cho, Belong

AU - Moon, Jin Soo

PY - 2019/5/9

Y1 - 2019/5/9

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85065577280&partnerID=8YFLogxK

U2 - 10.1038/s41586-019-1171-x

DO - 10.1038/s41586-019-1171-x

M3 - Letter

VL - 569

SP - 260

EP - 264

JO - Nature

JF - Nature

SN - 0028-0836

IS - 7755

ER -