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Comment by Mvhsz | Hacker News Reader

Not sure why this is down voted, excerpt from the abstract shows that they view nutrition as the main reason for the gap.

> There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.

It's pretty widely accepted that nutrition trumps exercise in weight loss. I will say that my observations align with OP, urban lifestyles tend to be less sedentary then suburban/rural. But my observations could also be skewed by age differences, which presumably this study controlled for (didn't read the whole thing).

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Some anecdata:

I spend a decent amount of time in a small (~3k) town in the American west that's the largest place for about two hours in any direction. It has one grocery store. Prices and selection in this (non-chain) store are genuinely appalling. Fresh fruit and veg is expensive and generally low in quality. As a result, nobody but the occasional out-of-towner fisherman buys it, so there's no incentive to stock more/better stuff. It's kinda like a slightly scaled up version of the basket of brown bananas in the bodega: a desultory corner of the store where there's visible dust on the apples.

What do many folks buy instead? TV dinners. Lots of them. It's not uncommon to see a cart in the checkout line that's nothing but about twenty TV dinners, cheap beer and maybe a loaf or two of wonder bread. Not everyone lives like that, but it's common enough that it's rare for me to leave that store without feeling kinda sad.

So, yeah, food deserts aren't just an urban problem.

n.b. on reflection, a partial counterexample: the Walmart in the nearest larger (~20k) town, despite having more produce and similar goodies on offer, also does a very brisk trade in TV dinners. Access to nutrition is probably relevant, but there's got to also be broader cultural/economic/wellness issues at play.

How many Dollar Stores are in your town? Here is very interesting podcast outlining how Dollar Stores kill supermarkets that carry necessary products like produce.

https://www.npr.org/sections/money/2019/04/26/717665452/epis...

> It's pretty widely accepted that nutrition trumps exercise in weight loss.

I've lost and kept off about half my bodyweight, so I feel entitled to the opinion that that's horseshit dreamed up by marketing to tell people what they want to hear. There is one definitive way to lose weight, time tested and provably infallible: consume fewer calories than you expend.

Now certainly there are some factors involved in both sides of that equation that can be adjusted by what you eat, but take it from a food addict that weight loss is most definitely more about how much you eat.

I think we're in agreement... I use nutrition to mean "the calorie intake side of the equation".

I hear a lot of people use the word the same as I do. It's not that I'm arguing "100 calories of kale will effect your weight differently from 100 calories of powdered sugar" or any other fad-diet nonsense. But I would certainly argue that one of those options will lead to eating fewer calories over the course of a day.

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