Rising rural body-mass index is the main driver of the global obesity epidemic in adults
Rising rural body-mass index is the main driver of the global obesity epidemic in adults
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DOI：
10.1038/s41586-019-1171-x
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发表时间：
2019-05-09
期刊：
影响因子：
64.8
通讯作者：
Ezzati, Majid
中科院分区：
文献类型：
--
作者：
Bixby, Honor;Bentham, James;Ezzati, Majid
在大多数国家，随着城市人口比例的上升，体重指数（BMI）也在稳步上升。（1，2）这导致了一种广泛报道的观点，即城市化是全球肥胖症上升的最重要驱动因素之一（3-6）。在这里，我们使用了2，009项基于人口的研究，测量了超过1.12亿成年人的身高和体重，报告了1985年至2017年按居住地（农村或城市地区）划分的平均BMI的国家，地区和全球趋势。我们发现，与主流范式相反，从1985年到2017年，全球平均BMI上升的55%以上-在一些低收入和中等收入地区超过80%-是由于农村地区BMI的增加。这一巨大贡献是因为，除撒哈拉以南非洲的妇女外，低收入和中等收入区域农村地区的体重指数增长速度与城市相同或更快。这些趋势反过来又导致低收入和中等收入国家城市和农村地区的BMI差距缩小，在一些国家甚至出现逆转，尤其是女性。在高收入和工业化国家，我们注意到农村BMI持续较高，尤其是女性。迫切需要对农村营养问题采取综合办法，以增加获得健康食品的财力和实际机会，避免贫穷国家农村营养不良的不利条件被更普遍的营养不良的不利条件所取代，这种不利条件会导致过度消费低质量的卡路里。
Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI 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% in some 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 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.