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 language | English |
|---|---|
| Pages (from-to) | 260-264 |
| Number of pages | 5 |
| Journal | Nature |
| Volume | 569 |
| DOIs | |
| Publication status | Published - 8 May 2019 |
Bibliographical note
'This article is licensed under a Creative CommonsAttribution 4.0 International License, which permits use, sharing,
adaptation, distribution and reproduction in any medium or
format, as long as you give appropriate credit to the original author(s) and the
source, provide a link to the Creative Commons license, and indicate if
changes were made. The images or other third party material in this article are
included in the article’s Creative Commons license, unless indicated otherwise
in a credit line to the material. If material is not included in the article’s
Creative Commons license and your intended use is not permitted by statutory
regulation or exceeds the permitted use, you will need to obtain permission
directly from the copyright holder.'
Keywords
- Epidemiology
- risk factors
- Obesity
- Rural areas
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Rising rural body-mass index is the main driver of the global obesity epidemic in adults. / NCD Risk Factor Collaboration (NCD-RisC); Bixby, Honor; Bentham, James; Zhou, Bin; Di Cesare, Mariachiara; Paciorek, Christopher J.; Bennett, James E.; Taddei, Cristina; Stevens, Gretchen A.; Rodriguez-Martinez, Andrea ; Carrillo-Larco, Rodrigo M.; Khang, Young-Ho; Sorić, Maroje; Gregg, Edward W.; Miranda, J. Jamie; Bhutta, Zulfiqar; Savin, Stefan; Sophiea, Marisa K.; Iurilli, Maria L.C.; Solomon, Bethlehem D.; Cowan, Melanie J.; Riley, Leanne M.; Danaei, Goodarz; Bovet, Pascal; Chirita-Emandi, Adela; Hambleton, Ian R.; Hayes, Alison J.; Ikeda, Nayu; Kengne, Andre; Laxmaiah, Avula; Li, Yanping; McGarvey, Stephen T.; Mostafa, Aya; Neovius, Martin; Starc, Gregor ; Zainuddin, Ahmad A.; Abarca-Gómez, Leandra ; Abdeen, Ziad A.; Abdrakhmanova, Shynar; Abdul Ghaffar, Suhaila; Hamid, Zargar Abdul; Abubakar Ghaffar, Jamila; Abu-Rmeileh, Niveen; Acosta-Cazares, Benjamin; Adams, Robert J.; Aekplakorn, Wichai; Afsana, Kaosar; Agdeppa, Imelda A.; Aguilar-Salinas, Carlos A.; Agyemang, Charles; Ahmad, Mohamad Hasnan; Ahmad, Noor Ani; Ahmadi, Naser; Ahmadvand, Alireza; Ahrens, Wolfgang; Ajlouni, Kamel ; Al Buhairan, Fadia S.; AlDhukair, Shahla ; Al-Hazzaa, Hazzaa M.; Ali, Mohamed M.; Ali, Osman; Alkerwi, Ala'a; Al-Othman, Amani Rashed; Al-Raddadi, Rajaa; Alvarez-Pedrerol, Mar; Aly, Eman; Amarapurkar, Deepak N.; Amouyel, Philippe; Amuzu, Antoinette; Andersen, Lars Bo; Anderssen, Sigmund A.; Ängquist, Lars H.; Anjana, Ranjit Mohan; Ansari-Moghaddam, Alireza; Aounallah-Skhiri, Hajer; Araújo, Joana ; Ariansen, Inger; Aris, Tahir; Arku, Raphael E.; Arlappa, Nimmathota; Aryal, Krishna K.; Aspelund, Thor; Assah, Felix K.; Assunção, Maria Cecília F. ; Aung, May Soe; Auvinen, Juha; Avdicová, Mária; Azevedo, Ana; Azizi, Fereidoun; Azmin, Mehrdad ; Babu, Bontha V.; Baharudin, Azli; Bahijri, Suhad ; Baker, Jennifer L.; Balakrishna, Nagalla; Bamoshmoosh, Mohamed ; Banach, Maciej; Bandosz, Piotr; Banegas, José R.; Barbagallo, Carlo M.; Barceló, Alberto; Barkat, Amina; Barros, Aluisio J. D. ; Barros, Mauro V.G.; Bata, Iqbal; Batieha, Anwar M.; Batista, Rosangela L.; Battakova, Zhamilya; Batyrbek, Assembekov; Baur, Louise A.; Beaglehole, Robert; Bel-Serrat, Silvia; Romdhane, Habiba Ben; Benedics, Judith ; Benet, Mikhail; Berkinbayev, Salim; Bernabe-Ortiz, Antonio; Bernotiene, Gailute; Bettiol, Heloisa; Bhagyalaxmi, Aroor; Bharadwaj, Sumit; Bi, Hongsheng ; Bi, Yufang; Biehl, Anna; Bika Lele, Elysée Claude ; Bikbov, Mukharram; Bista, Bihungum; Bjelica, Dusko J.; Bjerregaard, Peter; Bjertness, Espen; Bjertness, Marius B.; Björkelund, Cecilia; Blokstra, Anneke; Bo, Simona; Bobak, Martin; Boddy, Lynne M.; Boehm, Bernhard O.; Boeing, Heiner; Boggia, Jose G.; Boissonnet, Carlos P.; Bonaccio, Marialaura ; Bongard, Vanina; Bopp, Matthias; Borchini, Rossana; Borghs, Herman ; Braeckevelt, Lien; Braeckman, Lutgart; Bragt, Marjolijn C.E.; Brajkovich, Imperia; Branca, Francesco; Breckenkamp, Juergen; Breda, Joao; Brenner, Hermann; Brewster, Lizzy M.; Brian, Garry R.; Brinduse, Lacramioara; Bruno, Graziella; Bueno-de-Mesquita, H. Bas ; Bugge, Anna; Buoncristiano, Marta; Burazeri, Genc; Burns, Con; De León, Antonio Cabrera; Cacciottolo, Joseph; Cai, Hui; Cama, Tilema; Cameron, Christine; Camolas, José; Can, Gamze; Can, Günay; Cândido, Ana Paula C.; Cañete, Felicia; Capanzana, Mario V.; Capuano, Eduardo ; Capuano, Vincenzo; Cardoso, Viviane C.; Carlsson, Axel C.; Carmuega, Esteban ; Carvalho, Maria J.; Casanueva, Felipe F.; Casas, Juan-Pablo ; Caserta, Carmelo A.; Celikcan, Ertugrul ; Censi, Laura; Cesar, Juraci A. ; Chamukuttan, Snehalatha; Chan, Angelique W.; Chan, Queenie; Chaturvedi, Himanshu K.; Chaturvedi, Nishi; Che Abdul Rahim, Norsyamlina; Chen, Chien Jen; Chen, Fangfang; Chen, Huashuai; Chen, Shuohua; Chen, Zhengming; Cheng, Ching Yu; Cheng, Yiling J. ; Chetrit, Angela; Chikova-Iscener, Ekaterina ; Chiolero, Arnaud; Chiou, Shu-Ti; Chirlaque, María-Dolores ; Cho, Belong ; Cho, Yumi; Christensen, Kaare; Christofaro, Diego G. ; Chudek, Jerzy; Cifkova, Renata; Cilia, Michelle; Cinteza, Eliza ; Claessens, Frank; Clarke, Janine; Clays, Els; Concin, Hans; Confortin, Susana C.; Cooper, Cyrus; Coppinger, Tara C.; Costanzo, Simona; Cottel, Dominique; Cowell, Chris; Craig, Cora L.; Crampin, Amelia; Crujeiras, Ana B.; Cruz, Juan J.; Cucu, Alexandra; Cui, Liufu; Dallongeville, Jean; Damasceno, Albertino; Damsgaard, Camilla T.; Dankner, Rachel; Dantoft, Thomas M. ; D'Arrigo, Graziella; Dasgupta, Parasmani; Dastgiri, Saeed.
In: Nature, Vol. 569, 08.05.2019, p. 260-264.Research output: Contribution to journal › Letter › peer-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. Jamie
AU - Bhutta, Zulfiqar
AU - Savin, Stefan
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
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 - Hamid, Zargar Abdul
AU - Abubakar Ghaffar, Jamila
AU - Abu-Rmeileh, Niveen
AU - Acosta-Cazares, Benjamin
AU - Adams, Robert J.
AU - Aekplakorn, Wichai
AU - Afsana, Kaosar
AU - Agdeppa, Imelda A.
AU - Aguilar-Salinas, Carlos A.
AU - Agyemang, Charles
AU - Ahmad, Mohamad Hasnan
AU - Ahmad, Noor Ani
AU - Ahmadi, Naser
AU - Ahmadvand, Alireza
AU - Ahrens, Wolfgang
AU - Ajlouni, Kamel
AU - Al Buhairan, Fadia S.
AU - AlDhukair, Shahla
AU - Al-Hazzaa, Hazzaa M.
AU - Ali, Mohamed M.
AU - Ali, Osman
AU - Alkerwi, Ala'a
AU - Al-Othman, Amani Rashed
AU - Al-Raddadi, Rajaa
AU - Alvarez-Pedrerol, Mar
AU - Aly, Eman
AU - Amarapurkar, Deepak N.
AU - Amouyel, Philippe
AU - Amuzu, Antoinette
AU - Andersen, Lars Bo
AU - Anderssen, Sigmund A.
AU - Ängquist, Lars H.
AU - Anjana, Ranjit Mohan
AU - Ansari-Moghaddam, Alireza
AU - Aounallah-Skhiri, Hajer
AU - Araújo, Joana
AU - Ariansen, Inger
AU - Aris, Tahir
AU - Arku, Raphael E.
AU - Arlappa, Nimmathota
AU - Aryal, Krishna K.
AU - Aspelund, Thor
AU - Assah, Felix K.
AU - Assunção, Maria Cecília F.
AU - Aung, May Soe
AU - Auvinen, Juha
AU - Avdicová, Mária
AU - Azevedo, Ana
AU - Azizi, Fereidoun
AU - Azmin, Mehrdad
AU - Babu, Bontha V.
AU - Baharudin, Azli
AU - Bahijri, Suhad
AU - Baker, Jennifer L.
AU - Balakrishna, Nagalla
AU - Bamoshmoosh, Mohamed
AU - Banach, Maciej
AU - Bandosz, Piotr
AU - Banegas, José R.
AU - Barbagallo, Carlo M.
AU - Barceló, Alberto
AU - Barkat, Amina
AU - Barros, Aluisio J. D.
AU - Barros, Mauro V.G.
AU - Bata, Iqbal
AU - Batieha, Anwar M.
AU - Batista, Rosangela L.
AU - Battakova, Zhamilya
AU - Batyrbek, Assembekov
AU - Baur, Louise A.
AU - Beaglehole, Robert
AU - Bel-Serrat, Silvia
AU - Romdhane, Habiba Ben
AU - Benedics, Judith
AU - Benet, Mikhail
AU - Berkinbayev, Salim
AU - Bernabe-Ortiz, Antonio
AU - Bernotiene, Gailute
AU - Bettiol, Heloisa
AU - Bhagyalaxmi, Aroor
AU - Bharadwaj, Sumit
AU - Bi, Hongsheng
AU - Bi, Yufang
AU - Biehl, Anna
AU - Bika Lele, Elysée Claude
AU - Bikbov, Mukharram
AU - Bista, Bihungum
AU - Bjelica, Dusko J.
AU - Bjerregaard, Peter
AU - Bjertness, Espen
AU - Bjertness, Marius B.
AU - Björkelund, Cecilia
AU - Blokstra, Anneke
AU - Bo, Simona
AU - Bobak, Martin
AU - Boddy, Lynne M.
AU - Boehm, Bernhard O.
AU - Boeing, Heiner
AU - Boggia, Jose G.
AU - Boissonnet, Carlos P.
AU - Bonaccio, Marialaura
AU - Bongard, Vanina
AU - Bopp, Matthias
AU - Borchini, Rossana
AU - Borghs, Herman
AU - Braeckevelt, Lien
AU - Braeckman, Lutgart
AU - Bragt, Marjolijn C.E.
AU - Brajkovich, Imperia
AU - Branca, Francesco
AU - Breckenkamp, Juergen
AU - Breda, Joao
AU - Brenner, Hermann
AU - Brewster, Lizzy M.
AU - Brian, Garry R.
AU - Brinduse, Lacramioara
AU - Bruno, Graziella
AU - Bueno-de-Mesquita, H. Bas
AU - Bugge, Anna
AU - Buoncristiano, Marta
AU - Burazeri, Genc
AU - Burns, Con
AU - De León, Antonio Cabrera
AU - Cacciottolo, Joseph
AU - Cai, Hui
AU - Cama, Tilema
AU - Cameron, Christine
AU - Camolas, José
AU - Can, Gamze
AU - Can, Günay
AU - Cândido, Ana Paula C.
AU - Cañete, Felicia
AU - Capanzana, Mario V.
AU - Capuano, Eduardo
AU - Capuano, Vincenzo
AU - Cardoso, Viviane C.
AU - Carlsson, Axel C.
AU - Carmuega, Esteban
AU - Carvalho, Maria J.
AU - Casanueva, Felipe F.
AU - Casas, Juan-Pablo
AU - Caserta, Carmelo A.
AU - Celikcan, Ertugrul
AU - Censi, Laura
AU - Cesar, Juraci A.
AU - Chamukuttan, Snehalatha
AU - Chan, Angelique W.
AU - Chan, Queenie
AU - Chaturvedi, Himanshu K.
AU - Chaturvedi, Nishi
AU - Che Abdul Rahim, Norsyamlina
AU - Chen, Chien Jen
AU - Chen, Fangfang
AU - Chen, Huashuai
AU - Chen, Shuohua
AU - Chen, Zhengming
AU - Cheng, Ching Yu
AU - Cheng, Yiling J.
AU - Chetrit, Angela
AU - Chikova-Iscener, Ekaterina
AU - Chiolero, Arnaud
AU - Chiou, Shu-Ti
AU - Chirlaque, María-Dolores
AU - Cho, Belong
AU - Cho, Yumi
AU - Christensen, Kaare
AU - Christofaro, Diego G.
AU - Chudek, Jerzy
AU - Cifkova, Renata
AU - Cilia, Michelle
AU - Cinteza, Eliza
AU - Claessens, Frank
AU - Clarke, Janine
AU - Clays, Els
AU - Concin, Hans
AU - Confortin, Susana C.
AU - Cooper, Cyrus
AU - Coppinger, Tara C.
AU - Costanzo, Simona
AU - Cottel, Dominique
AU - Cowell, Chris
AU - Craig, Cora L.
AU - Crampin, Amelia
AU - Crujeiras, Ana B.
AU - Cruz, Juan J.
AU - Cucu, Alexandra
AU - Cui, Liufu
AU - Dallongeville, Jean
AU - Damasceno, Albertino
AU - Damsgaard, Camilla T.
AU - Dankner, Rachel
AU - Dantoft, Thomas M.
AU - D'Arrigo, Graziella
AU - Dasgupta, Parasmani
AU - Dastgiri, Saeed
N1 - 'This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.'
PY - 2019/5/8
Y1 - 2019/5/8
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.
KW - Epidemiology
KW - risk factors
KW - Obesity
KW - Rural areas
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
ER -