Abstract
Obesity can only be caused by increased energy intake, reduced energy expenditure, or both. It seems obvious that reduced energy expended on physical activity must have fuelled the global epidemic of paediatric obesity. However, the origin of obesity is more complex than it seems,1 and systematic reviews have failed to establish that low physical activity causes obesity.2,3 In today's Lancet, Sue Kimm and co-workers4 report that changes in physical activity in late childhood and adolescence are related to changes in measures of body fatness in US girls followed up for 9–10 years.
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