The advantages of living in urban areas for the healthy growth and development of children and adolescents are being lost in much of the world. This is confirmed by a report directed by Imperial College London (United Kingdom) and published in “Nature” that has analyzed the trends in height and body mass index (BMI) of 71 million children and adolescents (5 to 19 years of age). ) in urban and rural areas of 200 countries from 1990 to 2020 and in which 1,500 researchers and health professionals have participated.
During the 20th century, cities offered a multitude of opportunities for the training of the youngest people: better education, food, leisure and culture, and medical attention. All of this contributed to school-age children and adolescents living in cities being taller than their rural counterparts in the 20th century in almost all rich countries.
But the study now published in “Nature” indicates that this trend has been reversed, at least in Western countries.
Optimal growth and development in childhood and adolescence are crucial for lifelong health and well-being; and this is influenced by nutrition and the living environment at home, in the community and at school.
However, there are limited data comparing growth and development outcomes in urban and rural communities for this age group. Consequently, many policies and programs that aim to improve healthy growth and development at school ages have a narrow focus that often assumes that living in the city is a disadvantage.
IMC
The study assessed the children’s BMI, an indicator of whether they are at a healthy weight for their height. The researchers found that, on average, children living in cities had slightly higher BMIs than children in rural areas in 1990.
By 2020, the mean BMI increased in most countries, although more rapidly for urban children, except in sub-Saharan Africa and South Asia, where BMI increased faster in rural areas.
While height and BMI have increased worldwide since 1990, the work has seen that the degree of change between urban and rural areas varied widely across different low- and middle-income countries, while small differences between urban and rural areas remained stable in high-income countries.
Optimal growth and development in childhood and adolescence are crucial for lifelong health and well-being
And contrary to the widely held assumption that living in urban areas is the main driver of the obesity epidemic, the study has found that many high-income Western countries have had very little difference in height and BMI over time, with a minor difference between urban and rural BMI of one unit in 2020 (about 1.5 kg of weight for a 130 cm child).
“The issue is not so much whether children live in cities or urban areas, but where the poor live and whether governments are tackling growing inequalities with initiatives like supplemental income and free school meal programs,” says Majid Ezzati, lead author of the paper. study, and professor at the School of Public Health at Imperial College London.
The trend in sub-Saharan Africa is also cause for concern, the researchers say. Children living in rural areas have stagnated in height or even gotten shorter over the three decadespartly due to the nutritional and health crises that followed the structural adjustment policy in the 1980s.
Poor growth for school-age children and adolescents is linked to poor health throughout life
Majid Ezzati
Professor at Imperial College London School of Public Health
In addition, children in sub-Saharan Africa also gained weight more quickly in rural areas than in cities, meaning that in some countries they went from being underweight to gaining too much weight for healthy growth.
“This is a serious problem at all levels, from the individual to the regional. Poor growth for school-age children and adolescents is associated with poor health throughout life,” Ezzati points out.