Abstract

ObjectiveWe investigated associations between changes in national food energy supply and in average population body weight.MethodsWe collected data from 24 high-, 27 middle- and 18 low-income countries on the average measured body weight from global databases, national health and nutrition survey reports and peer-reviewed papers. Changes in average body weight were derived from study pairs that were at least four years apart (various years, 1971–2010). Selected study pairs were considered to be representative of an adolescent or adult population, at national or subnational scale. Food energy supply data were retrieved from the Food and Agriculture Organization of the United Nations food balance sheets. We estimated the population energy requirements at survey time points using Institute of Medicine equations. Finally, we estimated the change in energy intake that could theoretically account for the observed change in average body weight using an experimentally-validated model.FindingsIn 56 countries, an increase in food energy supply was associated with an increase in average body weight. In 45 countries, the increase in food energy supply was higher than the model-predicted increase in energy intake. The association between change in food energy supply and change in body weight was statistically significant overall and for high-income countries (P < 0.001).ConclusionThe findings suggest that increases in food energy supply are sufficient to explain increases in average population body weight, especially in high-income countries. Policy efforts are needed to improve the healthiness of food systems and environments to reduce global obesity.

Highlights

  • Overweight and obesity have become major global public health problems

  • A model used to predict body-weight gain, assuming no change in physical activity, follows the simple rule that a sustained increase in energy intake of 100 kJ per day leads to a predicted increase of 1 kg body weight on average, with half of the weight gain being achieved in about one year and 95% in about three years.[9]

  • This is despite the fact that, in the United States, food waste has increased by approximately 50% since 1974, reaching about 5800 kJ per person per day in 2003.12 Here we test the hypothesis that an increase in food energy supply is sufficient to explain increasing population body weight, using data from 24 high-income, 27 middle-income and 18 low-income countries

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Summary

Introduction

The proportion of adults with a body mass index (BMI) of 25 kg/m2 or greater increased from 28.8% to 36.9% in men, and from 29.8% to 38.0% in women between 1980 and 2013.1 Urgent action from governments and the food industry is needed to curb the epidemic.[2] Action needs to be directed at the main drivers of the epidemic to meet the global target of halting the rise in obesity by 2025.3. The drivers of the obesity epidemic have been much debated.[4,5,6,7] An increased food energy supply and the globalization of the food supply, increasing the availability of obesogenic ultra-processed foods, are arguments for a predominant food system driver[5] of population weight gain. Increasing motorization and mechanization, time spent in front of small screens and a decrease in transport and occupational physical activity, point to reducing physical activity as a predominant driver[6,8] of the obesity epidemic. The oversupply of food energy is sufficient to drive the increase in energy intake and increases in body weight observed in the United Kingdom of Great Britain and Northern Ireland and the United States of America.[9,10,11] This is despite the fact that, in the United States, food waste has increased by approximately 50% since 1974, reaching about 5800 kJ per person per day in 2003.12 Here we test the hypothesis that an increase in food energy supply is sufficient to explain increasing population body weight, using data from 24 high-income, 27 middle-income and 18 low-income countries

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