Diminishing benefits of urban living for growth, development of children and adolescents: ICMR study

New Delhi: A study done by Indian Council of Medical Research (ICMR) on Body Mass Index (BMI) of children & adolescents (5-19 years) between 1990-2020 reveals diminishing height advantage of urban residents v/s rural residents in most regions, highlighting the complexity of factors influencing children health globally.

Researchers from three ICMR institutes--- National Institute of Medical Statistics, (NIMS), National Institute of Nutrition (NIN) and National Centre for Disease Informatics and Research (NCDIR) evaluated the data from 2,325 population-based studies, with measurements of height and weight from 71 million participants around 200 countries.

The study revealed that BMI differences between urban and rural children are diminishing. This indicated declining benefits of urban living for growth and development over the last 30 years in most regions across the world. The trend has now been published in the latest issue of Nature journal.

“We have analyzed the global data among the international group called NCD Risk Factor Collaboration (NCD-RisC). It has been shown that having low height and excessively low BMI increases the risk of morbidity and mortality, and low height impairs cognitive development and reduces educational performance and work productivity in later life. A high BMI in these ages increases the lifelong risk of overweight and obesity and several non-communicable diseases, and might contribute to poor educational outcomes,” Dr Himanshu Chaturvedi, Director General at ICMR-NIMS, one of the authors of the paper.

“The objective of this study was to understand the changes in the growth and development of children worldwide that happened in the last few decades. Over the years, physical work at diminished and mutiple health complications are being observed in people. This study trend will help us to work for policies and lifestyle changes,” he said.

As far as Indian scenario is concerned, we have to see the trends in South Asia. It showed that BMI of children and adolescents increased more in rural areas than in urban cities, leading to a closing of the urban–rural difference, said Dr Chaturvedi.

Similarly, for high-income countries and those in central and eastern Europe experienced a mix of increasing and decreasing urban BMI excess. The urban height advantage was larger in boys than girls in most countries.

“Several other factors may have had a secondary role in the observed trends in height and BMI and their difference in rural and urban areas. First, weight gain during childhood may reduce the age of puberty onset, which in turn may limit height gain during adolescence. Second, rural-to-urban migration. Finally, improvements in survival among children aged under 5 years in rural areas, particularly low-birthweight children, may have influenced the height and weight of those who survive beyond 5 years of age,” he said adding that these are the retrospective analysis, now every country should analyses their own data for better intervention so that country specific study can be undertaken.

ICMR scientists have suggested that there is a need to consider and evaluate how growth and development in these formative ages may be affected both by social and economic policies that influence household income and poverty and by programmes that affect nutrition, health services, infrastructure and living environments in rural and urban areas.

It said that there is a need to identify, implement and evaluate policies and programmes that improve growth and development outcomes in children. Factors like poverty, inflation, lack of nutrient rich food and changed which resulted from covid-19 pandemic and the war in Ukraine which may hinder further gains or even set back healthy growth and development in children and adolescents.