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Rising rural body-mass index is the main driver of the global obesity epidemic in adults
Imperial College London, London, UK.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Epidemiology.ORCID iD: 0000-0003-2335-8542
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.ORCID iD: 0000-0003-1949-6299
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.ORCID iD: 0000-0003-2247-8454
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Number of Authors: 11522019 (English)In: Nature, ISSN 0028-0836, E-ISSN 1476-4687, Vol. 569, no 7755, p. 260-264Article in journal, Letter (Other academic) Published
Abstract [en]

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. 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.

Place, publisher, year, edition, pages
2019. Vol. 569, no 7755, p. 260-264
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
International Health; Nutrition
Identifiers
URN: urn:nbn:se:uu:diva-383181DOI: 10.1038/s41586-019-1171-xISI: 000467473600049PubMedID: 31068725OAI: oai:DiVA.org:uu-383181DiVA, id: diva2:1315010
Funder
Wellcome trust
Note

NCD Risk Factor Collaboration (NCD-RisC)

For a complete list of all 1155 authors see https://doi.org/10.1038/s41586-019-1171-x

Available from: 2019-05-10 Created: 2019-05-10 Last updated: 2019-06-19Bibliographically approved

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Lind, LarsLytsy, PerSundström, JohanYngve, Agneta

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