The epidemic of obesity and overweight that plagues the planet is breeding with the people, as suggested by the largest study to date on the world body mass index. The research, signed by more than a thousand scientists, has analyzed the weight and height of more than 112 million people in virtually all countries between 1985 and 2017. The results show that the body mass index has increased an equivalent amount to make each person fat about six kilograms. More than 55% of this increase is due to overweight and obesity in rural areas. In some poor or middle-income countries, this percentage reaches 80%.
"We have seen the opposite of the paradigm," said epidemiologist Majid Ezzati, one of the main authors, at a press conference. For decades, the scientific community has thought that the global epidemic of obesity and the growth of cities went hand in hand. The data show another reality. "In high-income countries, it is actually easier, in many aspects, to eat healthily in cities, because there are fresh foods available and perhaps cheaper, and there are also more sports facilities," reflected Ezzati, of the Imperial College of London.
The authors ask "to prevent rural malnutrition in poor countries from being replaced by malnutrition"
The study, published this Wednesday in the magazine Nature, reveals that the body mass index has increased on average 2.1 kilograms per square meter since 1985 in rural areas, both in women and men. However, in the cities that increase has been reduced to 1.3 in women and 1.6 in men. The body mass index is calculated by dividing the weight in kilograms by the height in meters squared.
The epidemiologist Napoleón Pérez, co-author of the work, stresses that, beyond global trends, we must look at the fine print in each country. "In some Western countries, like Spain, the difference between rural and urban areas is almost ridiculous," says Pérez, from the University of Málaga. In a dozen European countries, in fact, the body mass index of women has not risen, but has fallen slightly since 1985. Spain, Portugal, Greece, Italy and France are among these countries with less female overweight.
In Honduras and Egypt, on the other hand, women have gained a worrying five kilograms per square meter. As for men, their body mass index has increased in all countries, with peaks of more than 3.1 kilograms per square meter in Peru, China, the Dominican Republic and the United States.
The authors of the work believe that it is "urgent" to facilitate access to healthy foods, "to prevent rural malnutrition in poor countries being replaced by malnutrition with excessive consumption of low quality calories." In 2016, the World Organization of Health called for all countries in the world to implement a tax of 20% on sugary drinks, linked to the global epidemic of obesity and diabetes.
"30 years ago, rural municipalities were very rural, but now many are mini-cities," says Miguel Ángel Martínez.
The epidemiologist Napoleón Pérez applauds measures such as the announced front labeling Nutriscore, a kind of traffic light that will distinguish between healthy and harmful foods at a glance. "And we must regulate advertising aimed at children to the maximum. That are not cajoled by things that can not be called or food, "rivets Perez.
The new study finds shocking differences between countries. Women living in rural Bangladesh are an exception to the general trend. Its body mass index is just 17.7 kilograms per square meter, compared to 35.4 registered in urban women of American Samoa, a territory of the South Pacific linked to the United States. As for men, the inhabitants of the rural areas of Ethiopia have the lowest record, with 18.4 kilograms per square meter, compared to the maximum of 34.6 observed, again, in American Samoa.
The statistician Miguel Ángel Martínez Beneito is skeptical with the conclusions of the new work. "Perhaps obesity is not increasing in rural areas, but rural municipalities are becoming less rural," says the researcher, of the Foundation for the Promotion of Health and Biomedical Research of the Valencian Community. "30 years ago, the rural municipalities were very rural, with a shortage of means, with hunger. But now many are mini-cities with a few thousand people and similar media, "he says.
For Antonio Cabrera, an epidemiologist at the University of La Laguna and co-author of the work, the results send a political message. "The rural world in almost all the planet already has money to buy food, it is no longer malnourished, it is malnourished, international aid programs have to concentrate on fighting against malnutrition, not against malnutrition," he reflects.