Comparing Obesity Trends in Rural Versus Urban Peru from 1991 to 2005
Background: The changes in diet and physical activity in populations over time has been described as the nutrition transition. It is currently thought that many developing nations are in a transition from the receding famine to the degenerative disease profile as these nations adopt “western diets” and the people become more sedentary. The literature has shown a unique relationship between Gross National Income (GNI) per capita and obesity. At or above a GNI per capita of $2500 (US), prevalence of obesity increase among lower socioeconomic status (SES) groups and falls in upper SES groups. Methods: To examine this transition in one country, data were analyzed from Peru. The data were obtained from the United States Agency for International Development’s Demographic Health Surveys administered from 1991 to 2008. During this time Peru’s GNI per capita increased from $1090 to $3990. For the analysis, all non pregnant women aged 15 to 49 who had body mass index (BMI) measurements taken during the survey were included. Prevalence ratios of underweight, normal weight, overweight, and obesity were compared for place of residence (urban or rural) and educational attainment for all four surveys completed during those years (1991-2, 1996, 2000, and 2004-5). Food consumption patterns in children from the same household were examined for surveys completed in 2000 and 2004. Results and Discussion: Over the survey period (1991-2005), average BMI measurements and obesity prevalence increased in all women in Peru from 8-12%. However, both average BMI and prevalence of obesity increased more rapidly in rural women. In terms of educational attainment, a proxy for SES, obesity was highest among urban women with higher educational attainment initially. However, it increased among other educational attainment groups over time. For rural women, obesity was highest among those with lower educational attainment over time. The consumption of oils, fats, and butters increased from 2000 to 2004 in both urban and rural children with the greatest increase among rural children. Based on the results, it appears that there is evidence of increased prevalence of obesity in rural compared to urban women in Peru from 1991-2005 suggestive of the nutrition transition from receding famine to degenerative disease. The more rapid increase in both BMI and obesity in rural women may be the result of increased access to different food products such as oils, fats and butters and increased consumption in rural areas. More research should be done to further clarify factors affecting this transition and the public health community and the government should examine and attempt to prevent further increase in obesity in Peru.