Obesity is rising at a faster rate in rural areas than cities, according to a new study of global trends in body-mass index (BMI).
From 1985 to 2017, BMI rose by an average of 2kg/m2 in women and 2.2kg/m2 in men globally, which is equivalent to each person becoming 5-6kg heavier, the report led by Imperial College London found.
Published in Nature scientific journal, the study saw researchers analyse the height and weight of more than 112 million adults across urban and rural areas of 200 countries between 1985 and 2017.
BMI is an internationally recognised scale which shows if an individual has a healthy weight for their height by comparing the two measures.
"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,” explained senior author, Professor Majid Ezzati of Imperial’s School of Public Health.
“Discussions around public health tend to focus more on the negative aspects of living in cities,” he added. “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.”
The team found significant differences between countries with high, middle and low incomes.
In high-income countries, BMI has generally been higher since 1985 in rural areas, especially concerning women.
Researchers cited disadvantages that those living outside cities face as to blame for this phenomenon, which include: lower income and education, limited availability of and the higher price of healthy foods, and fewer sports facilities.
Rural areas in low- and middle-income countries, on the other hand, have generally seen an increase in income, better infrastructure, more mechanised agriculture and increased car use.
While these bring numerous health benefits, they also mean lower energy expenditure and more spending on food, which can be processed and low-quality, according to the report.
These factors can, therefore, be considered as contributing to a more rapid increase in BMI, it added.
How did Europe fair on the global scale?
One trend researchers noticed that has remained largely unchanged since 1985 was that rural women in Central and Eastern European countries were heavier than their urban counterparts by the biggest margin — around 1 kg/m2 or more in Belarus, Czech Republic and Latvia.
The biggest margins of rural over urban BMI for men in European countries were in Sweden, the Czech Republic, Ireland, and Austria, all of which had rural BMIs over 0.35 kg/m2 higher than urban BMI.
In the ranking of highest mean BMIs of countries in Europe, when considering both men and women, Turkey came top (27.3kg/m2 for men, 28.9 kg/m2 for women), falling in 37th place out of the 200 countries included in the study.
Switzerland saw the lowest mean BMI (26.8kg/m2 for men, 23.8kg/m2 for women), which put the country in 170th place overall.
Here's a list of all the European countries included in the ranking along with the nations with the highest mean BMI (American Samoa) and lowest (Ethiopia) for comparison: