Effect of Urbanization, Sedentary Lifestyle and Consumption Pattern on Obesity: An Evidence From India

Abstract

Once associated with the high-income countries, overweight and obesity has now become an emerging problem among the low- and middle-income countries. Overweight and obesity prevalence in India has almost doubled during the last decade (2005-15). Amongst all the factors that may lead to overweight and obesity, calorie-intense food consumption and low physical activity levels are major two factors which are associated with the rise in overnutrition problem. The consumption patterns and sedentary lifestyle among the urban areas make the urban population more susceptible to overweight and obesity.

Present study estimates the causal impact of urbanization on the Body Mass Index (BMI) of the population in India. Living in urban areas is likely to be correlated with the omitted or unobserved lifestyle related factors that determine BMI of individuals. This may lead to potential endogeneity in the relationship between the BMI of individuals and their place of residence in the form of Omitted Variable Bias. To examine the effect of living in urban areas on the BMI levels of individuals, we estimate a Two-Stage Least Squares (2SLS) model with instrument variable. A measure of road connectivity is used as an instrument for the place of residence. Further, to understand other potential factors that may govern the overweight and obesity status of individuals, we examine the effects of sedentary lifestyle and consumption pattern on the overweight and obesity status of the individuals by estimating a logistic regression model. The study considers individual level data from National Family Health Survey (NFHS) for the year 2015-16.

The results suggest that living in urban areas is associated with higher levels of BMI. The coefficient estimate of the urban residence for the IV-model is considerably higher as compared to the corresponding OLS estimate indicating that time variant omitted variables downwardly biased OLS estimates. Average BMI is found to be 1.7 kg/m2 units higher for the individuals living in the urban areas as compared to those living in the rural areas. Results obtained from estimation of a logistic regression model suggest that sedentary lifestyle increases the likelihood of being overweight or obese. More frequent television watching is associated with higher odds for being overweight or obese.

The study has implications in the policy framing especially in the context of urban planning. To put a restrain on the increasing overnutrition prevalence, it is important to have sufficient evidence on what factors affect overweight and obesity in India, and which section of the population is at a higher risk from overweight and obesity. Our study provides an evidence for such effects. It also has important implications for the health and nutrition policies. Future studies may investigate the effect of improved transportation and easy access of ready-to-eat food on the BMI levels for the urban population of India.

Note:
Funding Statement: Not applicable.

Declaration of Interests: No competing interests.

Keywords: body mass index, consumption pattern, overnutrition, sedentary lifestyle and urbanization.

JEL Classification: I12, R11