WASHINGTON (CBS WASHINGTON) — City slickers are skinnier than their country-bumpkin counterparts.

A national study in the Journal of Rural Health of over 8,800 Americans showed that country folks were nearly one-fifth more likely to be obese compared to those living in cities.

“The rates of obesity were much higher than previously reported based on self-report, with 39 percent of rural Americans being obese compared to 33 percent of urban Americans,” study lead author Christie Befort, an assistant professor in the Department of Preventive Medicine at the University of Kansas Medical Center in Kansas City, Kan., told ABC News.

It’s also important to understand the root causes of rural obesity. The researchers point to two factors — diet and physical isolation.

The study found that the overall diet of country people is much higher in fat.

“There is very little awareness and concern about how preparation contributes to calories in the food,” said study author Christie Befort – who has family roots in Kansas.

While country diets remain high in fat, rural residents also face challenges to buying healthy food.

“There is some perception that rural areas have better access to fresh vegetables because of farming,” Dr. Joseph A. Skelton of Wake Forest Baptist Health — Brenner’s Children’s Hospital in Winston-Salem, N.C., told ABC News. He was not involved in the study. “Many farms practice mono-agriculture, such as corn, and may not get access to a wide variety of vegetables.”

There are many studies to show that rural Americans have worse shopping access to healthy food choices, added Barry M. Popkin, professor of nutrition at the School of Public Health at the University of North Carolina at Chapel Hill.

In addition to the lack of access to healthy food, rural dwellers face barriers to healthy living because of their physical isolation.

“It’s tough to get to a gym if you live outside of a town without one,” said Befort, “Physical activity is now needed to compensate for diet and technology. That requires cultural change because rural areas typically don’t have a culture of physical activity as leisure time.”

According to the study, almost 70 million or one-quarter of Americans call rural areas home, according to the study. Rural residents face greater challenges to living healthy lives. As rural communities continue to dwindle in size, rural health issues are often overlooked. This study reminds us that obesity is another challenge that rural Americans face.

“Rural America is fatter than urban America,” said Popkin, “We’ve ignored rural America in public thinking. We do know this is a population with major needs.”

This study defined obesity as a body mass index equal to or greater than 30 kg/m2. To figure out your body mass index, click here to use a calculator from the Centers for Disease Control and Prevention.


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