Rural lifestyles drive the global obesity epidemic, report warns

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Rural lifestyles are a major driver of the global obesity epidemic, contradicting the commonly held view that growing waist-lines are an urban problem, experts have warned.

Rates of obesity have nearly tripled since 1975, with urbanisation often attributed as the cause.

But in a study of body-mass index (BMI) of more than 112 million adults published in Nature, researchers found that while obesity levels are creeping up everywhere, BMI has risen more rapidly in rural communities than among city dwellers.

“The results of this massive global study overturn commonly-held perceptions that more people living in cities is the main cause of the global rise in obesity,” said Majid Ezzati, senior author of the report and a professor at Imperial College’s School of Public Health.

“So this is entirely different to the current paradigm. This means that we need to rethink how we tackle this global health problem,” he added.

BMI is an internationally recognised index used to determine whether somebody is a healthy weight – a score between 19 and 25 on the scale is considered healthy.

Over three decades, the study found that 55 per cent of the increase in average BMI worldwide was driven by rural communities. Among both men and women living in the countryside, average BMI rose by 2.1 between 1985 and 2017 – but in cities, this rise was 1.3 in women and 1.6 among men.

The trend was even more pronounced in the majority of low and middle income countries, where 80 per cent of the rise in obesity levels was driven by people in rural communities.

Changing lifestyles are largely to blame, while the increased use of cars and the mechanisation of agriculture means rural lifestyles use significantly less energy than they did historically.

“Discussions around public health tend to focus more on the negative aspects of living in cities,” said Professor Ezzati. “In fact, cities provide a wealth of opportunities for better nutrition, more physical exercise and recreation, and overall improved health.

These things are often harder to find in rural areas,” he added.

But there was one exception to the trend – women in rural sub-Saharan Africa have lower BMI than their counterparts in cities.

This is largely because both domestic and agricultural life in many of these communities relies on manual labour – for instance walking miles to collect water.

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