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This Article Full Text (Publish Ahead of Print[PDF]) All Versions of this Article: 90/6/1453    most recent ajcn.2009.28595v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Swinburn, B. Articles by Ravussin, E. PubMed PubMed Citation Articles by Swinburn, B. Articles by Ravussin, E. Agricola Articles by Swinburn, B. Articles by Ravussin, E.

Increased food energy supply is more than sufficient to explain the US epidemic of obesity^1,2

¹ From Deakin University, Melbourne, Australia (BS and GS), and the Pennington Biomedical Research Center, Baton Rouge, LA (ER).

² Address correspondence to B Swinburn, WHO Collaborating Centre for Obesity Prevention, Deakin University, 221 Burwood Highway, Melbourne, Victoria 3125, Australia. E-mail: boyd.swinburn{at}deakin.edu.au.

ABSTRACT

Background: The major drivers of the obesity epidemic are much debated and have considerable policy importance for the population-wide prevention of obesity.

Objective: The objective was to determine the relative contributions of increased energy intake and reduced physical activity to the US obesity epidemic.

Design: We predicted the changes in weight from the changes in estimated energy intakes in US children and adults between the 1970s and 2000s. The increased US food energy supply (adjusted for wastage and assumed to be proportional to energy intake) was apportioned to children and adults and inserted into equations that relate energy intake to body weight derived from doubly labeled water studies. The weight increases predicted from the equations were compared with weight increases measured in representative US surveys over the same period.

Results: For children, the measured weight gain was 4.0 kg, and the predicted weight gain for the increased energy intake was identical at 4.0 kg. For adults, the measured weight gain was 8.6 kg, whereas the predicted weight gain was somewhat higher (10.8 kg).

Conclusions: Increased energy intake appears to be more than sufficient to explain weight gain in the US population. A reversal of the increase in energy intake of 2000 kJ/d (500 kcal/d) for adults and of 1500 kJ/d (350 kcal/d) for children would be needed for a reversal to the mean body weights of the 1970s. Alternatively, large compensatory increases in physical activity (eg, 110–150 min/d walking), or a combination of both, would achieve the same outcome. Population approaches to reducing obesity should emphasize a reduction in the drivers of increased energy intake.

Received for publication August 31, 2009. Accepted for publication September 16, 2009.