Rural communities become more obese than urban dwellers

Obesity is on the rise worldwide. An overall increase in body mass index, or body mass index (BMI) – a measure of a person's weight health – coincided with rapid urbanization, which led to the hypothesis that urbanization is the main cause of the global obesity epidemic.

Now, a new, large-scale report shows that the rise in global BMI comes from rural rather than urban residents. The discovery of contrasting theories theories that urban lifestyles contribute to the rise of obesity and suggests public health policies that emphasize the quality of food are needed.

"More than 55% of the increase in BMI around the world in men and women is due to the increase in rural populations, so it's totally contrary to the current paradigm." said Majid Ezzati, public health expert at Imperial College London. in the UK, who led the new research, said at a press briefing.

Rural increase

Ezzati and a network of more than 1,000 health scientists from around the world, known as the NCD Risk Factor Collaboration, examined more than 2,000 studies of 112 million adults in rural and urban areas. 1985 to 2017.

The team's analysis revealed that, overall, BMI increased more rapidly in rural areas than in urban areas, except in sub-Saharan Africa, where the trend reversed. More than half of the global rise in BMI comes from rural populations, researchers report today in the newspaper. Nature. In contrast, only 30% of the global increase in BMI occurred in urban populations.

Emerging trends

The researchers found that the most dramatic changes were occurring in the emerging economies of countries such as Chile, Malaysia and Turkey. In 1985, the rural populations of these localities had a low BMI, but by 2017 it had outpaced that of urban populations, especially women. These rural areas have become industrialized over the past three decades, bringing benefits such as running water and commercial fuel to communities, as well as cars and tractors for agriculture. Although these modern technologies bring health benefits, it also means that people are doing less physical work, now that they are no longer forced to fetch water or firewood. heating, said Ezzati.

The trend is similar in high-income industrialized countries such as the United States, Europe, and Japan, where researchers have found a higher BMI among women living in rural areas. According to researchers, the rise of rural BMI in these countries can come from infrastructure, access to food and different lifestyles.

"In the high-income world, much of the expense or energy activity currently comes from leisure – people running, going to the gym, swimming and playing sports – and these facilities are much more accessible in urban areas, "said Ezzati. I said. In contrast, people in rural areas are often further away from sports facilities and walking is rare as most people drive. Ezzati also noted that it is easier to eat healthier in cities, because fresh foods are more readily available in urban centers, and perhaps cheaper, than in rural areas where food deserts are more widespread.

Focusing only on growth rates, instead of the actual number of obese, may be confusing in some cases, but these data also seem to corroborate the researchers' findings. In some places, the total number of obese people in urban areas remains higher than the total in rural areas, although in most rich countries there are more obese people outside the cities.

Policy problem

The researchers found that the BMI of urban populations in sub-Saharan Africa was increasing faster than that of rural populations, in contrast to the increase in rural BMI in richer and less affluent countries.

"At the root of this problem, there is the problem of extremely rapid urbanization of sub-Saharan Africa, even before a significant economic growth," Ezzati said. "The benefits of the cities are not there and the rural areas still have poor results in terms of infrastructure and income, which has led to this opposite trend compared to everywhere else."

Wood remains the most common fuel in rural areas of Africa, for example, while in urban areas, people use more and more commercial fuel, which means they have to walk less for fuel. ;get. Similarly, city dwellers are connected to the water at home, while rural residents travel long distances to fetch water. In addition, cities in sub-Saharan Africa are overflowing with mediocre quality food. "There is a growing shortage of local markets that offer fresh food [to cities]"Ezzati said, noting an increase in processed carbohydrates and other foods leading to obesity in urban areas of sub-Saharan Africa.

Ezzati hopes that the team's research will prompt a rethinking of global nutrition policies for both undernutrition and overfeeding. The biggest challenge, he explains, is finding a way to make people not eat enough calories, but also to eat healthy calories.

"We are getting better at preventing people from eating unhealthy foods through regulation," said Ezzati, citing new legislation providing for taxes on sweetened beverages. "But … when the poor live more and more in rural areas and when they are no longer lacking in calories, how do we allow them to eat healthy?"