According to a recent study, obesity is increasing more rapidly in the world's rural areas than in the cities. As part of the study, a team of researchers analysed the height and weight data of more than 112 million adults across urban and rural areas of 200 countries and territories between 1985 and 2017.

Height and weight can be used to calculate BMI, an internationally recognised scale which tells us whether an individual has a healthy weight for their height. The study, involving a network of more than 1000 researchers across the world, found that from 1985 to 2017, BMI rose by an average of 2.0 kg/m2 in women and 2.2 kg/m2 in men globally, equivalent to each person becoming 5-6 kg heavier.

More than half of the global rise over these 33 years was due to increases in BMI in rural areas. In some low- and middle-income countries, rural areas were responsible for over 80 per cent of the increase. The team found that since 1985, average BMI in rural areas has increased by 2.1 kg/m2 in both women and men. But in cities, the increase was 1.3 kg/m2 and 1.6 kg/m2 in women and men respectively.

Discussions around public health tend to focus more on the negative aspects of living in cities. In fact, cities provide a wealth of opportunities for better nutrition, more physical exercise and recreation, and overall improved health. These things are often harder to find in rural areas.

Meanwhile, rural areas in low- and middle-income countries have seen shifts towards higher incomes, better infrastructure, more mechanised agriculture and increased car use, all of which bring numerous health benefits, but also lead to lower energy expenditure and to more spending on food, which can be processed and low-quality when sufficient regulations are not in place. All these factors contribute to a faster increase in BMI in rural areas. As countries increase in wealth, the challenge for rural population changes from affording enough to eat, to affording good quality food.