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

Presentation – user interfaces.

We conducted two usability studies that included a total of 49 participants ranging in age from 20 to 82. The goal of Study 1 was to learn whether there were differences in how older adults interact with the Web and whether changes in text size would affect performance. Users completed tasks on a prototype employee/retiree benefits site using various text sizes. We learned that older users (55 years or older) had significantly more difficulty using the Web site than younger users. Text size did not significantly affect performance in any age group. In Study 2 new participants performed the same tasks on a version of the site that was redesigned to address the usability problems encountered by older users in Study 1. The goal was to learn whether we could redesign the prototype to improve the performance of older adults. Performance improved significantly for both older and younger users