The interaction between obesity and diabetes

Abstract

Between 1980 and 1990 there was an unprecedented increase in body weight and prevalence of obesity in the United States. The mean weight of adults. 20 through 74 years of age increased 3.6 kg, whereas mean height increased less than 1 cm. The increase occurred in both sexes, all races, and all age strata except women over 60 years of age. The increase in weight is plausibly explained by an increase in caloric intake. Any accompanying reduction in energy expenditure would have augmented the effect of increased calories, but it appears that leisure time physical activity did not decline in adults Although smoking cessation is associated with excess weight gain, the growing number of ex-smokers can account for only a fraction of the population's increase in body weight There is a strong relationship between relative body weight and risk of non-insulin-dependent diabetes mellitus (NIDDM). A relationship also exists between physical activity and risk of NIDDM, but it is not well defined (in terms of a relationship between type, frequency, and intensity of exercise). Given the increase in body weight across the population, together with the fact that physical activity has been constant or decreased, an increase in risk for NIDDM would be expected. No firm evidence of an increase in incidence or prevalence of NIDDM has emerged from the National Health Interview Surveys that were conducted annually. Possible explanations for this discrepancy are considered.