Rising rural body-mass index is the main driver of the global obesity epidemic in adults

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.Peer reviewe

A social and ecological assessment of tropical land uses at multiple scales: the Sustainable Amazon Network

Science has a critical role to play in guiding more sustainable development trajectories. Here, we present the Sustainable Amazon Network (Rede Amazonia Sustentavel, RAS): a multidisciplinary research initiative involving more than 30 partner organizations working to assess both social and ecological dimensions of land-use sustainability in eastern Brazilian Amazonia. The research approach adopted by RAS offers three advantages for addressing land-use sustainability problems: (i) the collection of synchronized and co-located ecological and socioeconomic data across broad gradients of past and present human use; (ii) a nested sampling design to aid comparison of ecological and socioeconomic conditions associated with different land uses across local, landscape and regional scales; and (iii) a strong engagement with a wide variety of actors and non-research institutions. Here, we elaborate on these key features, and identify the ways in which RAS can help in highlighting those problems in most urgent need of attention, and in guiding improvements in land-use sustainability in Amazonia and elsewhere in the tropics. We also discuss some of the practical lessons, limitations and realities faced during the development of the RAS initiative so far.Keywords: Social–ecological systems, Tropical forests, Land use, Interdisciplinary research, Sustainability, Trade-off

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Rastreio do diabetes mellitus: fundamental na prevenção da Doença Renal Crônica

Introdução: O Diabetes Mellitus (DM), um problema de saúde pública, é apontado pela literatura como importante fator de risco para progressão da Doença Renal Crônica (DRC). A nefropatia diabética, uma das principais complicações microvasculares do DM, corresponde à maior causa de insuficiência renal terminal em todo o mundo

Rastreio da doença renal crônica na comunidade – Juiz de Fora, MG - Brasil

Introdução: No Brasil, a incidência e a prevalência da Doença Renal Crônica (DRC) estão em curva ascendente, o que se deve principalmente ao envelhecimento populacional associado ao aumento exponencial da hipertensão arterial sistêmica (HAS) e da diabetes mellitus (DM). Sendo assim, a DRC é questão preocupante para a saúde pública

Análise multitemporal do desmatamento na Área de Preservação Ambiental da Chapada do Araripe, PE

The study was conducted in the Araripe plasterer pole located at Piaui, Pernambuco and Ceara border, Brazil, with an area of approximately 10,000 km2. The region is experiencing an accelerated degradation process due to improper management of natural resources. Extensive areas of native forests are being cleared and used for energy production for the gypsum industry. In 1997, it was created the Araripe Environmental Protection Area (APA), in order to reduce and mitigate environmental degradation processes. The purpose of this APA was not to stop the activity in that region, but to adapt it in a sustainable manner, since the plaster pole is over an area of high vulnerability to desertification processes. The inappropriate use of natural resources in this region may intensify the environmental problems and accelerate the desertification process. Thus, the aim of this paper is to monitor the environmental degradation in the APA region during a period of 16 years, and evaluate if this region is been preserved since APA creation. To achieve the proposed aim we mapped deforestation and natural forest from 1990 to 2006 (one image every four years) using Landsat TM 5. We applied the Linear Spectral Mixing Model and we did a band ration between the resulting vegetation and soil bands which allowed a better identification of deforested areas. The results show that the deforestation had decreased since the APA creation and thus had a positive effect on the preservation of this vulnerable area.Pages: 6896-690