Diet and obesity

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Diet plays an important role in the genesis of obesity. Personal choices, food advertising, social customs and cultural influences, as well as food availability and pricing all play a role in determining what and how much an individual eats.

Contents

Dietary energy supply

Average per capita energy consumption of the world from 1961 to 2002 World Per Person Energy Consumption.png
Average per capita energy consumption of the world from 1961 to 2002

The dietary energy supply is the food available for human consumption, usually expressed in kilocalories per person per day. It gives an overestimate of the total amount of food consumed as it reflects both food consumed and food wasted. The per capita dietary energy supply varies markedly between different regions and countries. It has also changed significantly over time. [2] From the early 1970s to the late 1990s, the average calories available per person per day (the amount of food bought) has increased in all part of the world except Eastern Europe and parts of Africa. The United States had the highest availability with 3654 kilo calories per person in 1996. [3] This increased further in 2002 to 3770. [4] During the late 1990s, Europeans had 3394 kilo calories per person, in the developing areas of Asia there were 2648 kilo calories per person, and in sub-Sahara Africa people had 2176 kilo calories per person. [3] [5]

Average calorie consumption

USFood trends.gif
Change over time of the macronutrient composition of the US male diet
USFood trends2.gif
Change over time of the macronutrient composition of the US female diet
USDA chart showing the increase in soda consumption and the decrease in milk consumption from 1947 to 2001 Indicatorslongrun579.gif
USDA chart showing the increase in soda consumption and the decrease in milk consumption from 1947 to 2001

From 1971 to 2000, the average daily number of calories which women consumed in the United States increased by 335 calories per day (1542 calories in 1971 and 1877 calories in 2000). For men, the average increase was 168 calories per day (2450 calories in 1971 and 2618 calories in 2000). Most of these extra calories came from an increase in carbohydrate consumption, though there was also an increase in fat consumption over the same time period. [7] The increase in caloric consumption is attributed primarily to the "consumption of food away from home; increased energy consumption from salty snacks, soft drinks, and pizza; and increased portion sizes". [7] Other sources note that the consumption of soft drinks and other sweetened beverages now accounts for almost 25 percent of daily calories in young adults in America. [8] As these estimates are based on a person's recall, they may underestimate the amount of calories actually consumed. [7]

Fast food

As societies become increasingly reliant on energy-dense fast-food meals, the association between fast food consumption and obesity becomes more concerning. [9] In the United States, consumption of fast food meals has tripled and calorie intake from fast food has quadrupled between 1977 and 1995. [10] Consumption of sweetened drinks is also believed to be a major contributor to the rising rates of obesity. [11]

Portion size

A comparison of a typical 1984 cheeseburger (left) of 333 calories with a 2004 cheeseburger (right) of 590 calories as per the National Heart, Lung, and Blood Institute Cheeseburger portions.jpg
A comparison of a typical 1984 cheeseburger (left) of 333 calories with a 2004 cheeseburger (right) of 590 calories as per the National Heart, Lung, and Blood Institute

The portion size of many prepackage and restaurant foods has increased in both the United States and Denmark since the 1970s. [7] Fast food servings, for example, are 2 to 5 times larger than they were in the 1980s. Evidence has shown that larger portions of energy-dense foods lead to greater energy intake and thus to greater rates of obesity. [13] [14]

Meat consumption

A 2010 study published in the American Journal of Clinical Nutrition closely tracked 373,803 people over a period of 8 years across 10 countries. At its conclusion, the study reported that meat consumption (processed meat, red meat, & poultry) is positively associated with weight gain and increased abdominal obesity in men and women. [15] In response, the National Cattlemen's Beef Association countered that increased meat consumption may not be associated with fat gain. [16] However, a subsequent response controlled for just abdominal fat across a sample of 91,214 people found that even when controlling for calories and subjects with cancer or smoking cessation, meat consumption is linked with obesity. [17] Further population studies, reviews, and meta-analysis studies have corroborated the claim that greater meat consumption is linked to greater rates of obesity, [18] especially in regards to red meat and processed meat. [19]

Sugar consumption

Drinking more sugary beverages (including fruit juices, soft drinks, fruit drinks, sports drinks, energy and enhanced water drinks, sweetened iced tea, and lemonade) increases overall energy intake, and thus increases the risk of metabolic syndrome, obesity, and type 2 diabetes (see the pathophysiology of obesity). [20] [21] [22] [23] Children who consume more added sugar in foods and beverages have a higher risk of becoming overweight. [22] [23] By itself, sugar is not a factor causing obesity and metabolic syndrome, but rather – when over-consumed – is a component of unhealthy dietary behavior. [24] Adults who increase or decrease their free sugar intake increase or decrease their weight. [25]

Reviews indicate that governmental health policies should be implemented to discourage intake of sugar-sweetened beverages, and reduce the obesity in children and adults. Obesity has been rising in the 21st century. [20] [21] [22] [23] Other than adding excessive calories, the mechanisms by which high sugar consumption causes obesity are unclear because of limitations in clinical research involving uncontrolled factors, such as overall diet, physical activity, and sedentary lifestyle.[ clarification needed ] [20] [21] [26]

Ultraprocessed food consumption

Numerous large studies have demonstrated that eating ultraprocessed food has a positive dose-dependent relationship with both abdominal obesity and general obesity in both men and women. [27] Consuming a diet rich in unprocessed and minimally processed foods is linked with lower obesity risk and less chronic disease. These results are consistent among American, [28] Canadian, [29] Latin American, [30] British, [31] Australian, [32] French, [33] and Spaniard populations. [34]

Particular processing ingredients used in ultraprocessed foods have been linked with increasing the risk of obesity further. Intake of trans fat from industrial oils has been associated with increased abdominal obesity in men [35] and increased weight and waist circumference in women. [36] These associations were not attenuated when fat intake and calorie intake was accounted for. [37] [38]

Similarly, heavy consumption of fried food is linked to greater obesity risk on a population level. [39] On a more individual level, the relative risk of fried food consumption and increased weight gain seems to depend on genetic predisposition. [40]

Social policy and change

Prevalence of obesity in the adult population by region (2000 - 2016) Prevalence Of Obesity In The Adult Population By Region.svg
Prevalence of obesity in the adult population by region (2000 - 2016)
Prevalence of obesity in the adult population in 2016 Prevalence Of Obesity In The Adult Population (2016).svg
Prevalence of obesity in the adult population in 2016


New agricultural technologies have led to an overall reduction in the cost of food relative to household income, especially in high-income countries. In his popular book, "The Omnivore's Dilemma," the journalist Michael Pollan linked the subsidies offered to farmers of corn, soy, wheat, and rice through the U.S. farm bill to over-consumption of calories derived from these crops and to rising obesity rates. [41] While increased consumption of foods derived from these commodities is correlated with an increase in BMI (at the population level), no current research supports a causal relationship between farm subsidies and obesity. [42] From a policy perspective, the cost of sugar would actually decrease in the US if the commodity support programs in the farm bill were removed, largely due to the tariffs in the farm bill that restrict the importation of lower-cost sugar available on the global market. [43]

Participation by adults in the United States Department of Agriculture Supplemental Nutrition Assistance Program (i.e. Food Stamps) is positively associated with obesity, waist circumference, elevated fasting glucose, and metabolic syndrome. [44]

Metabolism

Evidence does not support the commonly expressed view that some obese people eat little yet gain weight due to a slow metabolism. On average obese people have a greater energy expenditure than normal weight or thin people and actually have higher basal metabolic rates. [45] [46] This is because it takes more energy to maintain an increased body mass. [47] Obese people also underreport how much food they consume compared to those of normal weight. [48] Tests of human subjects carried out in a calorimeter support this conclusion. [49]

See also

Related Research Articles

Dieting is the practice of eating food in a regulated way to decrease, maintain, or increase body weight, or to prevent and treat diseases such as diabetes and obesity. As weight loss depends on calorie intake, different kinds of calorie-reduced diets, such as those emphasising particular macronutrients, have been shown to be no more effective than one another. As weight regain is common, diet success is best predicted by long-term adherence. Regardless, the outcome of a diet can vary widely depending on the individual.

<span class="mw-page-title-main">Abdominal obesity</span> Excess fat around the stomach and abdomen

Abdominal obesity, also known as central obesity and truncal obesity, is the human condition of an excessive concentration of visceral fat around the stomach and abdomen to such an extent that it is likely to harm its bearer's health. Abdominal obesity has been strongly linked to cardiovascular disease, Alzheimer's disease, and other metabolic and vascular diseases.

<span class="mw-page-title-main">Obesity</span> Medical condition in which excess body fat harms health

Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classified as obese when their body mass index (BMI)—a person's weight divided by the square of the person's height—is over 30 kg/m2; the range 25–30 kg/m2 is defined as overweight. Some East Asian countries use lower values to calculate obesity. Obesity is a major cause of disability and is correlated with various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

<span class="mw-page-title-main">Sugar substitute</span> Sugarless food additive intended to provide a sweet taste

A sugar substitute is a food additive that provides a sweetness like that of sugar while containing significantly less food energy than sugar-based sweeteners, making it a zero-calorie or low-calorie sweetener. Artificial sweeteners may be derived through manufacturing of plant extracts or processed by chemical synthesis. Sugar substitute products are commercially available in various forms, such as small pills, powders, and packets.

<span class="mw-page-title-main">Low-carbohydrate diet</span> Diets restricting carbohydrate consumption

Low-carbohydrate diets restrict carbohydrate consumption relative to the average diet. Foods high in carbohydrates are limited, and replaced with foods containing a higher percentage of fat and protein, as well as low carbohydrate foods.

Calorie restriction is a dietary regimen that reduces the energy intake from foods and beverages without incurring malnutrition. The possible effect of calorie restriction on body weight management, longevity, and aging-associated diseases has been an active area of research.

<span class="mw-page-title-main">Healthy diet</span> Type of diet

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.

A fat tax is a tax or surcharge that is placed upon fattening food, beverages or on overweight individuals. It is considered an example of Pigovian taxation. A fat tax aims to discourage unhealthy diets and offset the economic costs of obesity.

<span class="mw-page-title-main">Very-low-calorie diet</span> Diet with very or extremely low daily food energy consumption

A very-low-calorie diet (VLCD), also known as semistarvation diet and crash diet, is a type of diet with very or extremely low daily food energy consumption. VLCDs are defined as a diet of 800 kilocalories (3,300 kJ) per day or less. Modern medically supervised VLCDs use total meal replacements, with regulated formulations in Europe and Canada which contain the recommended daily requirements for vitamins, minerals, trace elements, fatty acids, protein and electrolyte balance. Carbohydrates may be entirely absent, or substituted for a portion of the protein; this choice has important metabolic effects. Medically supervised VLCDs have specific therapeutic applications for rapid weight loss, such as in morbid obesity or before a bariatric surgery, using formulated, nutritionally complete liquid meals containing 800 kilocalories or less per day for a maximum of 12 weeks.

<span class="mw-page-title-main">Protein (nutrient)</span> Nutrient for the human body

Proteins are essential nutrients for the human body. They are one of the building blocks of body tissue and can also serve as a fuel source. As a fuel, proteins provide as much energy density as carbohydrates: 4 kcal per gram; in contrast, lipids provide 9 kcal per gram. The most important aspect and defining characteristic of protein from a nutritional standpoint is its amino acid composition.

A diabetic diet is a diet that is used by people with diabetes mellitus or high blood sugar to minimize symptoms and dangerous complications of long-term elevations in blood sugar.

<span class="mw-page-title-main">Western pattern diet</span> Modern dietary pattern

The Western pattern diet is a modern dietary pattern that is generally characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy and sweets, fried foods, industrially produced animal products, butter and other high-fat dairy products, eggs, potatoes, corn, and low intakes of fruits, vegetables, whole grains, pasture-raised animal products, fish, nuts, and seeds.

The Dietary Guidelines for Americans (DGA) provide nutritional advice for Americans who are healthy or who are at risk for chronic disease but do not currently have chronic disease. The Guidelines are published every five years by the US Department of Agriculture, together with the US Department of Health and Human Services. Notably, the most recent ninth edition for 2020–25 includes dietary guidelines for children from birth to 23 months. In addition to the Dietary Guidelines per se, there are additional tools for assessing diet and nutrition, including the Healthy Eating Index (HEI), which can be used to assess the quality of a given selection of foods in the context of the Dietary Guidelines. Also provided are additional explanations regarding customization of the Guidelines to individual eating preferences, application of the Guidelines during pregnancy and infancy, the USDA Nutrition Evidence Systematic Review, information about the Nutrition Communicators Network and the MyPlate initiative, information from the National Academies about redesigning the process by which the Dietary Guidelines for Americans are created, and information about dietary guidelines from other nations.

<span class="mw-page-title-main">Weight management</span> Techniques for maintaining body weight

Weight management refers to behaviors, techniques, and physiological processes that contribute to a person's ability to attain and maintain a healthy weight. Most weight management techniques encompass long-term lifestyle strategies that promote healthy eating and daily physical activity. Moreover, weight management involves developing meaningful ways to track weight over time and to identify the ideal body weights for different individuals.

<span class="mw-page-title-main">Robert Lustig</span> Endocrinologist, professor

Robert H. Lustig is an American pediatric endocrinologist. He is professor emeritus of pediatrics in the division of endocrinology at the University of California, San Francisco (UCSF), where he specialized in neuroendocrinology and childhood obesity. He is also director of UCSF's WATCH program, and president and co-founder of the non-profit Institute for Responsible Nutrition.

A number of lifestyle factors are known to be important to the development of type 2 diabetes including: obesity, physical activity, diet, stress, and urbanization. Excess body fat underlies 64% of cases of diabetes in men and 77% of cases in women. A number of dietary factors such as sugar sweetened drinks and the type of fat in the diet appear to play a role.

<span class="mw-page-title-main">Added sugar</span> Caloric sweeteners added to food and beverages

Added sugars or free sugars are sugar carbohydrates added to food and beverages at some point before their consumption. These include added carbohydrates, and more broadly, sugars naturally present in honey, syrup, fruit juices and fruit juice concentrates. They can take multiple chemical forms, including sucrose, glucose (dextrose), and fructose.

<span class="mw-page-title-main">Sweetened beverage</span> Type of beverage

Sugar-sweetened beverages (SSB) are any beverage with added sugar. They have been described as "liquid candy". Consumption of sugar-sweetened beverages have been linked to weight gain and an increased risk of cardiovascular disease mortality. According to the CDC, consumption of sweetened beverages is also associated with unhealthy behaviors like smoking, not getting enough sleep and exercise, and eating fast food often and not enough fruits regularly.

The Australian paradox is an observation of diverging trends in sugar consumption and obesity rates in Australia. The term was first used in a 2011 study published in Nutrients by Professor Jennie Brand-Miller, in which she and co-author Dr. Alan Barclay reported that, in Australia, "a substantial decline in refined sugars intake occurred over the same timeframe that obesity has increased."

<span class="mw-page-title-main">Frank Hu</span> Nutrition researcher

Frank B. Hu is a Chinese American nutrition and diabetes researcher. He is Chair of the Department of Nutrition and the Fredrick J. Stare Professor of Nutrition and Epidemiology at the Harvard T.H. Chan School of Public Health, and Professor of Medicine at the Harvard Medical School.

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