Obesity on the rise in rural areas too

More than half of the global rise over 33 years is due to the increase in BMI in rural areas, says scientist

Obesity and being overweight are not problems that only the affluent classes in urban areas face. There is an increasing ‘globesity’ (global obesity epidemic) triggered by the rising overweight/obesity cases in rural areas too, says a recent study spearheaded by Imperial College, London, and for which Indian data was furnished by the Hyderabad based ICMR- National Institute of Nutrition (ICMR-NIN).

The study published in the renowned scientific journal Nature has revealed that the body mass index (BMI), a measure of overweight and obesity, of the rural population has been rising at a faster rate compared to the cities in the middle-income countries like India. These trends across countries have resulted in rural-urban convergence in terms of BMI.

Researchers studied the BMI of more than 112 million adults across urban and rural areas of 200 countries, involving a network of more than 1,000 researchers across the globe. It was found that from 1985 to 2017, the BMI rose by an average of 2.0 kg/m2 in women and 2.2 kg/m2 in men, equivalent to each person becoming 5-6 kg heavier.

In rural areas, the BMI increased by 2.1 kg/m2 in both men and women. But in cities, the increase was only 1.3 kg/m2 and 1.6 kg/m2 in women and men, respectively. “More than half of the global rise over these 33 years was due to the increase in BMI in rural areas,” says A. Laxmaiah, scientist and head of public health nutrition division, ICMR-NIN. “In some low and middle-income countries, rural areas are responsible for over 80% of the increase,” he adds.

Data related to 1.2 lakh people from India revealed that the mean BMI was 16.5 kg/m2 among rural men and women during 1975-79, which increased to 18.5kg/m2 in 2012. The increase in BMI was more in the States of Kerala (+3.8 kg/m2), West Bengal (+2.6 kg/m2) and Andhra Pradesh (+2.6 kg/m2), while a lower increase (0.7 to 0.8 kg/m2) was observed in Madhya Pradesh and Uttar Pradesh. The mean increase in BMI observed was 2.0 kg/m2 over a period of 32 years, which has led to increase in the prevalence of overweight from 2% to 12% among men and from 4% (1975) to 16% (2012) among women in rural India. “Consumption of low-quality calories in foods such as fruits, vegetables, nuts and milk is the major driver of overweight and obesity and also stunting and anaemia in India. It’s time to focus on nutrition security to stop the increasing disease burden in India,” said R. Hemalatha, director of ICMR-NIN.

Rural areas have seen a shift towards higher income, better infrastructure and more mechanised agriculture, all of which bring numerous health benefits, but also lead to lower energy expenditure and more spending on low quality processed food. All these factors contribute to faster increase in overweight/obesity in the rural areas.

Professor Majid Ezzati of Imperial’s School of Public Health was cited to have said that the results of this massive global study overturn the commonly-held perceptions that more people living in cities is the main cause for the global rise in obesity.