Abstract
Many environmental factors contribute to the rise in prevalence of obesity in populations but one key driver is urbanization. Countries in Southeast (SE) Asia have undergone rapid changes in urbanization in recent decades. The aim of this study is to provide a systematic review of studies exploring the relationship between living in an urban or rural environment (urbanicity) and obesity in Southeast Asia. In particular, the review will investigate whether the associations are uniform across countries and ages, and by sex. The literature search was conducted up to June 2014 using five databases: EMBASE, PubMed, GlobalHealth, DigitalJournal and Open Grey. Forty-five articles representing eight of the eleven countries in SE Asia were included in the review. The review found a consistent positive association between urbanicity and obesity in countries of Southeast Asia, in all age groups and both genders. Regional differences between the associations are partly explained by gross national income (GNI). In countries with lower GNI per capita, the association between urbanicity and obesity was greater. Such findings have implications for policy makers. They imply that population level interventions need to be country or region specific, tailored to suit the current stage of economic development. In addition, less developed countries might be more vulnerable to the negative health impact of urbanization than more developed countries.
Highlights
The increasing prevalence of obesity is a phenomenon happening worldwide, with global prevalence almost doubling since 1980 [1]
Thirteen studies were from Malaysia, twelve from Vietnam, nine from Thailand, six from Indonesia, two from Laos, and one each from Philippines, Myanmar and Timor-Leste
Regional differences between the associations are partly explained by gross national income (GNI)
Summary
The increasing prevalence of obesity is a phenomenon happening worldwide, with global prevalence almost doubling since 1980 [1]. In Southeast Asia, like other parts of the world, obesity is considered one of the key risk factors for chronic and non-communicable disease [3, 4]. Its burden on health is reflected by the Global Burden of Disease project report [5]. In 1990, high BMI was ranked the 23rd most important risk factor for SE Asia, and by 2010 it was 9th [6]. Many environmental factors contribute to the rise in prevalence of obesity, but one key driver is urbanization [7]. It refers to the gradual increase in the proportion of people living in urban areas’’ [8]
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