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Obesity Facts: Rural Australians Are Worse Off Than City Slickers

It's well-documented that obesity threatens the lives of billions of people around the world, but blaming city-living for this spike has been debunked in a major study.

The scientific community has routinely linked the three-decades-long rise in obesity levels around the world to sedentary, city-based lifestyles.

They were wrong, according to a new study published in the Nature journal on Wednesday, which found those living in rural areas have a bigger battle against the bulge.

Leveraging data on 112 million people from 1985 through 2017, it disproves a major assumption about which lifestyles are driving Body Mass Index (BMIs) to unprecedented levels.

Over the period of the study, average weight rose by five to six kilograms  -- and the bulk of it is due to BMI gains in rural areas (BMI is a height-to-weight ratio that is a popular measure of obesity).

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The study was a huge undertaking, with 1000 researchers analysing 2,009 obesity studies to disprove these stereotypes.

“In the world as a whole, BMI has been going up faster in rural areas than in urban areas,” study co-author Majid Ezzati, an expert in global environmental health at Imperial College London, told reporters.

A healthy BMI for both male and female adults is 18.5 to 24.9. Overweight is a BMI of 25 to 29.9, while obesity is a BMI of 30 and above. (However, BMI is not considered a clear-cut indication of health.)

The study found that while global averages are creeping up for everyone -- it's faster for rural residents.

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Ezzati and his colleagues found that 55 percent of the global rise in BMI can be attributed to people living in rural areas of the world.

Broken down by sex, 60 percent of the rise in BMI in women and 57 percent in men is linked to rural living.

There has been a very widely stated assumption, widely stated by academics, by the media, and by our policy organisations that urbanisation is the main driver of the obesity epidemic, Ezzati said.

Health specialists assumed that because residents of cities have greater access to highly processed food, work in offices and get around in cars and on buses, they must be driving the worldwide rise in obesity.

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Ezzati said it’s not just about encouraging exercise or limiting the amount of calories people eat. An increasingly important factor is improving access to nutritional food.

“What we really need is getting people not to just eat enough calories, but to eat healthy calories,” he said.

Esszati said as countries get richer, the people living in rural areas end up with less and less access to good nutrition, and their BMIs pay the price over time.

“For those of you who live in especially larger, high-income countries, places like the United States or Australia the whole idea of rural food deserts may actually be familiar to you,” he said.

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The Heart Foundation's Heart Health General Manager Bill Stavreski said Australia's obesity rates are among the worst on the world stage.

"The average Australian compared to 30 years ago is now, for men, eight kilograms heavier and, for women, six kilograms heavier -- and that's actually higher than the international average," he said.

Stavreski said 90 percent of Australians are not eating enough vegetables and around one in two are not eating enough fruit.

"We feature up the top of world lists and these are certainly not the lists we want to be at the top," he said.

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Stavreski said Australians in some rural areas have difficulty accessing good produce.

The scientists found that it’s actually easier to eat healthy in cities because fresh food is available at lower cost and there are also more possibilities for sports and leisure.

There's also the rural side to the food stereotype to consider, said Barry Popkin, food science researcher and professor of nutrition at the University of North Carolina.

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"The general preconceived notion is that in rural areas, you live off the land, your farm or do manual labour, you eat food from your own garden," Popkin, who reviewed the paper said.

Contact the author alattouf@networkten.com.au