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This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3 , 4 , 5 , 6. Here we use 2, population-based studies, with measurements of height and weight in more than million adults, to report national, regional and global trends in mean BMI segregated by place of residence a rural or urban area from to 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.
Being underweight or overweight can lead to adverse health outcomes. BMI—a measure of underweight and overweight—is rising in most countries 2. It is commonly stated that urbanization is one of the most important drivers of the worldwide rise in BMI because diet and lifestyle in cities lead to adiposity 3 , 4 , 5 , 6. However, such statements are typically based on cross-sectional comparisons in one or a small number of countries. Only a few studies have analysed how BMI is changing over time in rural and urban areas.
The few studies that covered more than one country 7 , 8 , 9 , 10 , 11 , 12 used at most a few dozen data sources and hence could not systematically estimate trends, and focused primarily on women of child-bearing age. Data on how BMI in rural and urban populations is changing are needed to plan interventions that address underweight and overweight. Here, we report on mean BMI in rural and urban areas of countries and territories from to We used 2, population-based studies of human anthropometry conducted in countries Extended Data Fig.