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

(2019) NATURE. 569(7755). p.260-264
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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 cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3-6. Here we use 2,009population-based studies, with measurements of height and weight in more than 112million adults, to report national, regional and global trends in meanBMI 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% insome 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 citiesin 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.
Keywords
MIDDLE-INCOME COUNTRIES, PHYSICAL-ACTIVITY, SYSTEMATIC ANALYSIS, WORLDWIDE TRENDS, POOLED ANALYSIS, FOOD SYSTEM, URBAN, HEALTH, NUTRITION, WEIGHT

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Chicago
NCD risk Factor Collaboration (NCD-risC), the, Lutgart Braeckman, Gui De Backer, Dirk De Bacquer, Stefaan De Henauw, Els Clays, Delphine De Smedt, et al. 2019. “Rising Rural Body-mass Index Is the Main Driver of the Global Obesity Epidemic in Adults.” Nature 569 (7755): 260–264.
APA
NCD risk Factor Collaboration (NCD-risC), the, Braeckman, L., De Backer, G., De Bacquer, D., De Henauw, S., Clays, E., De Smedt, D., et al. (2019). Rising rural body-mass index is the main driver of the global obesity epidemic in adults. NATURE, 569(7755), 260–264.
Vancouver
1.
NCD risk Factor Collaboration (NCD-risC) the, Braeckman L, De Backer G, De Bacquer D, De Henauw S, Clays E, et al. Rising rural body-mass index is the main driver of the global obesity epidemic in adults. NATURE. 2019;569(7755):260–4.
MLA
NCD risk Factor Collaboration (NCD-risC), the et al. “Rising Rural Body-mass Index Is the Main Driver of the Global Obesity Epidemic in Adults.” NATURE 569.7755 (2019): 260–264. Print.
@article{8615889,
  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 cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3-6. Here we use 2,009population-based studies, with measurements of height and weight in more than 112million adults, to report national, regional and global trends in meanBMI 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\% insome 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 citiesin 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), the and Braeckman, Lutgart and De Backer, Gui and De Bacquer, Dirk and De Henauw, Stefaan and Clays, Els and De Smedt, Delphine and Kolsteren, Patrick and Lachat, Carl and Van Herck, Koen and Michels, Nathalie},
  issn         = {0028-0836},
  journal      = {NATURE},
  language     = {eng},
  number       = {7755},
  pages        = {260--264},
  title        = {Rising rural body-mass index is the main driver of the global obesity epidemic in adults},
  url          = {http://dx.doi.org/10.1038/s41586-019-1171-x},
  volume       = {569},
  year         = {2019},
}

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