Energy expenditure and obesity across the economic spectrum
Abstract
Global economic development has been associated with an increased prevalence of obesity and related health problems. Increased caloric intake and reduced energy expenditure are both cited as development-related contributors to the obesity crisis, but their relative importance remains unresolved. Here, we examine energy expenditure and two measures of obesity (body fat percentage and body mass index, BMI) for 4,213 adults from 34 populations across six continents and a wide range of lifestyles and economies, including hunter-gatherer, pastoralist, farming, and industrialized populations. Economic development was positively associated with greater body mass, BMI, and body fat, but also with greater total, basal, and activity energy expenditure. Body size–adjusted total and basal energy expenditures both decreased approximately 6 to 11% with increasing economic development, but were highly variable among populations and did not correspond closely with lifestyle. Body size–adjusted total energy expenditure was negatively, but weakly, associated with measures of obesity, accounting for roughly one-tenth of the elevated body fat percentage and BMI associated with economic development. In contrast, estimated energy intake was greater in economically developed populations, and in populations with available data (n = 25), the percentage of ultraprocessed food in the diet was associated with body fat percentage, suggesting that dietary intake plays a far greater role than reduced energy expenditure in obesity related to economic development.
Article Details
Journal Info
Proceedings of the National Academy of Sciences
National Academy of Sciences
Authors (97)
Amanda McGrosky
Department of Biology, Elon University
Amy Luke
Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University
Leonore Arab
David Geffen School of Medicine, University of California
Kweku Bedu-Addo
Department of Physiology, Kwame Nkrumah University of Science and Technology
Alberto G. Bonomi
Phillips Research
Pascal Bovet
Soren Brage
Medical Research Council Epidemiology Unit, University of Cambridge
Maciej S. Buchowski
Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University
Nancy Butte
Department of Pediatrics, Baylor College of Medicine
Stefan G. Camps
Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research and National University Health System
Regina Casper
Psychiatry and Behavioral Sciences, Stanford University
Daniel K. Cummings
Economic Science Institute, Argyros School of Business and Economics, Chapman University
Sai Krupa Das
Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University
Sanjoy Deb
Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University
Lara R. Dugas
Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University
Ulf Ekelund
Terrence Forrester
Solutions for Developing Countries, University of the West Indies, Mona
Barry W. Fudge
University of Glasgow
Melanie Gillingham
Department of Molecular and Medical Genetics, Oregon Health and Science University
Annelies H. Goris
OnePlanet Research Center
Michael Gurven
Department of Anthropology, University of California
Catherine Hambly
Institute of Biological and Environmental Sciences, University of Aberdeen
Annemiek Joosen
Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre
Peter T. Katzmarzyk
Kitty P. Kempen
Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre
William E. Kraus
Wantanee Kriengsinyos
Institute of Nutrition, Mahidol University
Rebecca Kuriyan
Division of Nutrition, St. John’s Research Institute
Robert F. Kushner
Department of Medicine and Medical Education, Feinberg School of Medicine, Northwestern University
Estelle V. Lambert
Health through Physical Activity, Lifestyle and Sport Research Centre, Division of Exercise Science and Sports Medicine, Faculty of Health Sciences, University of Cape Town
Christel L. Larsson
Department of Food and Nutrition and Sport Science, University of Gothenburg
William R. Leonard
Department of Medicine and Medical Education, Feinberg School of Medicine, Northwestern University
Nader Lessan
Imperial College London Diabetes Centre
Marie Löf
Department of Medicine, Karolinska Institutet 141 83
Corby K. Martin
Pennington Biomedical Research Center
Anine C. Medin
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo
Marian L. Neuhouser
Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington
Kirsi H. Pietilainen
Healthy Weight Hub, Helsinki University Central Hospital
Guy Plasqui
Department of Nutrition and Movement Sciences, Maastricht University
Ross L. Prentice
Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington
Susan B. Racette
College of Health Solutions, Arizona State University
David A. Raichlen
Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California
Eric Ravussin
Pennington Biomedical Research Center
Leanne Redman
Pennington Biomedical Research Center
Rebecca M. Reynolds
Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh
Eric B. Rimm
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University
Susan Roberts
Geisel School of Medicine, Dartmouth College
Asher Y. Rosinger
Department of Biobehavioral Health, Pennsylvania State University
Mary H. Samuels
Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University
Srishti Sinha
Division of Nutrition, St. John’s Research Institute
J. Josh Snodgrass
Department of Anthropology, University of Oregon
Eric Stice
Psychiatry and Behavioral Sciences, Stanford University
Samuel S. Urlacher
Department of Anthropology, Baylor University
Jeanine A. Verbunt
Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre
Bruce Wolfe
Oregon Health and Science University
Brian Wood
Department of Anthropology, University of California
Xueying Zhang
Department of Medicinal Chemistry
Alexia J. Murphy-Alford
Nutritional and Health-Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency
Cornelia J. Loechl
Nutritional and Health-Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency
Jennifer Rood
Pennington Biomedical Research Center
Hiroyuki Sagayama
Faculty of Health and Sport Sciences, University of Tsukuba
Dale A. Schoeller
Biotech Center and Nutritional Sciences, University of Wisconsin
Klaas R. Westerterp
Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre
William W. Wong
Department of Pediatrics, Baylor College of Medicine
Yosuke Yamada
Department of Sports and Health Sciences, Graduate School of Biomedical Engineering, Tohoku University
John R. Speakman
Institute of Biological and Environmental Sciences, University of Aberdeen
Herman Pontzer
Department of Evolutionary Anthropology, Duke University
Lene F. Andersen
Linda Bandini
Stephan Branth
Niels C. De Bruin
Richard Cooper
Alice E. Dutman
Cara B. Ebbeling
Mikael Fogelholm
Tamara Harris
Rik Heijligenberg
Hans U. Jorgensen
David S. Ludwig
Eric Matsiko
Margaret McCloskey
Gerwin A. Meijer
Daphne L. Pannemans
Renaat M. Philippaerts
Jacob Plange-Rhule
Elisabet M. Rothenberg
Sabine Schulz
Albert Stunkard
Amy Subar
Minna Tanskanen
Ricardo Uauy
Institute of Nutrition and Food Technology, University of Chile
Rita Van den Berg-Emons
Ludo M. van Etten
Wim G. Van Gemert
Erica J. Velthuis-te Wierik
Wilhelmine W. Verboeket-van de Venne
Walter C. Willett