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 Researchers examined data on height and weight collected from 2001
to 2016 for adults 20 and older and for youth ages 2 to 19. Severe
obesity rates were higher in rural areas for youth as well as for
men and women, while overall rates of obesity were higher only for
rural women, researchers report in JAMA.
In rural communities, severe obesity rates more than tripled for men
and more than doubled for women during the study period, while
climbing 29 percent among young people. Obesity rates in rural
areas, meanwhile, rose about 9 percent among children and teens and
about 36 percent for adults.
"A major finding that surprised us was this difference between
obesity and severe obesity," said Cynthia Ogden of the U.S. Centers
for Disease Control and Prevention in Hyattsville, Maryland.
"Severe obesity affects quality of life and has serious health
risks," including an increased risk of premature death and several
cancers, Ogden, lead author of the youth study and senior author of
the adult study, said by email.
About 10 percent of rural men had severe obesity in rural
communities by the end of the study period, compared with 4 percent
of urban men, the adult study found. Almost 14 percent of rural
women had severe obesity, compared with 8 percent of urban women.
Differences in education levels, smoking status, age, and racial
demographics in rural versus urban communities didn't appear to
explain the different rates of obesity and severe obesity among
adults.
More than 9 percent of rural youth had severe obesity by the end of
the study period, compared with about 5 percent of urban children
and teens.
Obesity and severe obesity were more common among black and Hispanic
youth than white children and teens, and also more likely to develop
in older youth and children from households headed by an adult with
limited education.
Children and teens are considered obese when their weight is higher
than 95 percent of other youth their same age and sex. They're
considered severely obese when their weight is 20 percent higher
than the cutoff for obesity.
For adults a body mass index (BMI) of at least 30 is considered
obese, and a BMI of at least 40 is classified as severely obese. (An
online BMI calculator for adults is available from the U.S. Centers
for Disease Control and Prevention, here: http://bit.ly/2ylWKJC.)
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One drawback of using BMI is that it doesn't distinguish between
muscle and fat. Therefore, obesity rates might not have been as high
as they appeared, particularly among the adults.
The studies also weren't controlled experiments designed to prove
whether or how certain aspects of rural life might obesity more
likely to develop.
"When looking at the global epidemic of obesity, we ironically often
blame urbanization as a factor due to urban centers having more fast
food locations, a pace of life where there is less emphasis on
family meals, and work environments that are not physically taxing,"
said Dr. Rekha Kumar of Weill Cornell Medicine's Comprehensive
Weight Control Center and NewYork-Presbyterian in New York City.
"We have passed that stage in the U.S. and measures are being taken
in some but not all urban areas to prevent obesity," Kumar, who
wasn't involved in the studies, said by email. "All (of) these
factors such as energy sparing technology, fast food, and desk jobs
have now reached rural areas as well in the U.S. so we are seeing an
escalation of the obesity epidemic."
No matter where people live, the key to preventing and reducing
obesity comes down to healthy eating and regular exercise, said
Ashlesha Datar, a researcher at the University of Southern
California in Los Angeles who wasn't involved in the studies.
"The only difference is that folks in rural areas are at a higher
risk and we need to figure out whether that is due to lack of
opportunities for pursuing healthy behaviors or other constraints,"
Datar said by email. "What might work for people in the cities might
not necessarily work for those in rural areas."
SOURCE: http://bit.ly/2th8uY4 and http://bit.ly/2ypKY0R JAMA, online
June 19, 2018.
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