The myth of energy balance: Is food really making children fat?

Abstract

BackgroundLittle research tested the direct effect of energy intake and expenditure to study the causal links between shifts in diet and the increase in childhood obesity in developing world.ObjectiveTo examine the unique patterns of energy imbalance in China.MethodsThe 1991–2000 nationwide China Health and Nutrition Survey (CHNS) data and quantile regression models (QRM) were used to assess the differential effects of energy intake on weight changes in children (2–18 y) across the weight distribution.ResultsThe children's mean body weight (kg) increased 20% between1991–2000, from 30 (95% confidence internal (CI): 29.6, 30.5) to 35.9 (95% CI: 35.5, 36.4). However, the average daily total energy intake (kcal) declined from 2037 (95% CI: 2013, 2062) in 1991 to 1929 (95% CI: 1903, 1956) in 2000. Our model prediction suggested evident gaps between observed and energy intake predicted body weight (2–5 kg lower of observed mean body weight than predicted mean body weight across all age‐gender groups). QRM estimates examining the 50%, 85%, and 95% percentiles of the BMI (kg/m2) distribution suggest an insignificant effect of total energy intake on weight changes in children on the upper tail of the BMI distributions.ConclusionsOur results suggest food intake along is not the primary driver of the rising childhood obesity epidemic in China.Grant Funding Source: NIH/NICHD (U54 HD070725‐01)