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India’s latest round of family health survey has offered contrasting views on body weight, with urban residents far more likely to suffer from obesity than those in rural areas who are more prone to being underweight.

This presents a complex scenario for policymakers with deficiency diseases such as anaemia more common in rural areas while a greater number of those in cities suffer from hypertension, according to the latest round of National Family Health Survey (NFHS 2019-21).

Obesity, in general, is on the rise, the survey found. Every fourth adult is overweight or obese, with more men and women now exceeding normal body weight index (BMI) compared to five years ago. The last round of the survey was held in 2015-16. Women in cities and towns are the worst affected demographic group, with one in three being overweight or obese.

Plump cities, skinny villages
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Plump cities, skinny villages

Rising body weight is a trend in both cities and villages. Up to 20% rural women are either obese or overweight, compared to 15% in 2015-16.

However, as the country becomes more food-secure, the share of underweight adults has declined by 3-4 percentage points, among both men and women. Rural women are the most underweight group, with 21% still reporting below-normal BMI.

Disease Divide
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Disease Divide

This urban-rural divide along body weight is also reflected in disease prevalence. Anaemia, a blood disorder that most often happens from nutritional deficiencies, is more common in rural than urban India. The share of anaemic population is higher in both rural women (59%) and men (27%), respectively, than their urban peers (54% and 20%)

On the contrary, the prevalence of lifestyle diseases such as high blood sugar and hypertension that are caused by lack of physical activity, unhealthy eating habits or consumption of alcohol or tobacco is relatively higher among urban populations. Up to 27% urban men, the worst affected group, suffer from elevated blood pressure or are taking medicine to control their blood pressure, compared to 23% rural men, the survey found. This is interesting as the consumption of tobacco and alcohol is considerably higher among rural populations than urban, the NFHS data showed.

High blood sugar and hypertension are more widespread in some of the high-income states such as Tamil Nadu and Kerala, whereas the populations in low-income states such as Rajasthan, Assam and Bihar suffer the least from these diseases.

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