Trends in obesity and energy supply in the WHO MONICA Project

Silventoinen, Karri; Sans, Susana; Tolonen, Hanna; Monterde, David; Kuulasmaa, Kari; Kesteloot, Hugo; Tuomilehto, Jaakko

doi:10.1038/sj.ijo.0802614

Cited by 226 publications

(167 citation statements)

References 31 publications

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“…The lack of unfavourable trends in overweight and obesity in Italy may, therefore, at least in part be attributed to the type of 'Mediterranean diet' (Trichopoulou et al, 2005), and to the absence of a systematic increase in portion size. The WHO Monica project, analysing 10-year trends of total energy supply from several countries worldwide, showed that, in Italy, per capita total energy intake remained approximately stable between 1986 and 1994, whereas it increased by more than 200 kcal/capita/day in the USA and in several Western European countries (Harnack et al, 2000;Silventoinen et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…Over the last few decades, overweight has been increasing in several developed, but also developing, countries, including the USA Flegal et al, 2002Flegal et al, , 2004aFreedman et al, 2002;Manson and Bassuk, 2003;Chopra and DarntonHill, 2004;Olshansky et al, 2005), Canada (Katzmarzyk, 2002), the Pacific countries (WHO, 2003), Australia, China and several Western European countries (Silventoinen et al, 2004), including Spain (Rodriguez Artalejo et al, 2002;Martinez et al, 2004), Great Britain (Rennie and Jebb, 2005) and Denmark (Bendixen et al, 2004). Overweight is the single major cause of disease and death showing systematic unfavourable trends over the last few decades (Chopra and Darnton-Hill, 2004;Olshansky et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

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Overweight and obesity in Italian adults 2004, and an overview of trends since 1983

Gallus

Colombo²,

Scarpino³

et al. 2006

Eur J Clin Nutr

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Objective: Overweight has been increasing in several developed countries over the last few decades. No update information on the issue is available for Italy. Design and setting: We conducted a computer assisted personal in-house interview survey in March-April 2004, on a sample of 2932 Italian individuals (1407 men and 1525 women) aged 18 years or over, representative of the general adult Italian population. Information on weight and height was self-reported. Results: Overall, 3.4% of the Italian adult population were underweight (o18.5 kg/m 2 , 0.9% of men and 5.8% of women), 31.3% were overweight (25.0-29.9 kg/m 2 , 38.4% of men, 24.7% of women), and 8.2% were obese (X30.0 kg/m 2 , 7.4% of men and 8.9% of women). Overweight or obesity was reported by 14.2% of subjects aged 18-24 years (20.6% of men and 7.6% of women). The highest proportions of overweight and obese subjects were in the 45-64 year age group for men (51.4% overweight, 10.0% obese) and in the X65 year age group for women (38.8% overweight, 13.8% obese). Age-and sex-standardised prevalence of overweight or obesity was 36.0% for more educated subjects, and 54.0% for less educated ones. It was 32.3% in northern, 44.3% in central and 47.0% in southern Italy. Overweight increased from 1983 to the early 1990s, and levelled off thereafter. Prevalence of obesity remained around 8-9% across the last 20 years. Conclusions: Trends of overweight and obesity in Italy are more favourable than in several developed countries. Still, approximately 15 million of Italian adults are overweight and 4 million obese.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Overweight and obesity in Italian adults 2004, and an overview of trends since 1983

Gallus

Colombo²,

Scarpino³

et al. 2006

Eur J Clin Nutr

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“…1,2 Earlier studies have documented an association between sedentary behavior and obesity, 3 as well as an inverse relationship between habitual physical activity and obesity. 4,5 Sedentary lifestyle is a strong predictor of obesity, 6 and physical activity is considered important in the prevention of weight gain.…”

Section: Introductionmentioning

confidence: 99%

Physical activity reduces the influence of genetic effects on BMI and waist circumference: a study in young adult twins

et al. 2008

Self Cite

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Objective: Both obesity and exercise behavior are influenced by genetic and environmental factors. However, whether obesity and physical inactivity share the same genetic vs environmental etiology has rarely been studied. We therefore analyzed these complex relationships, and also examined whether physical activity modifies the degree of genetic influence on body mass index (BMI) and waist circumference (WC). Methods: The FinnTwin16 Study is a population-based, longitudinal study of five consecutive birth cohorts (1975)(1976)(1977)(1978)(1979) of Finnish twins. Data on height, weight, WC and physical activity of 4343 subjects at the average age of 25 (range, 22-27 years) years were obtained by a questionnaire and self-measurement of WC. Quantitative genetic analyses based on linear structural equations were carried out by the Mx statistical package. The modifying effect of physical activity on genetic and environmental influences was analyzed using gene-environment interaction models. Results: The overall heritability estimates were 79% in males and 78% in females for BMI, 56 and 71% for WC and 55 and 54% for physical activity, respectively. There was an inverse relationship between physical activity and WC in males (r ¼ À0.12) and females (r ¼ À0.18), and between physical activity and BMI in females (r ¼ À0.12). Physical activity significantly modified the heritability of BMI and WC, with a high level of physical activity decreasing the additive genetic component in BMI and WC. Conclusions: Physically active subjects were leaner than sedentary ones, and physical activity reduced the influence of genetic factors to develop high BMI and WC. This suggests that the individuals at greatest genetic risk for obesity would benefit the most from physical activity.

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“…22 Differences in trends of total energy supply per capita between countries explained 41% of the variation of trends in mean BMI. 23 However, daily energy demands can be measured directly using a method called the doubly labelled water (DLW) technique. 24,25 When this method was used to compare self-reported energy intakes with energy expenditure, it became clear that energy intake was often considerably underestimated, due to a combination of underrecording and temporary undereating.…”

Section: Introductionmentioning

confidence: 99%

Physical activity energy expenditure has not declined since the 1980s and matches energy expenditures of wild mammals

2008

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Objective: Obesity results from protracted energy imbalance. Whether this comprises excessive energy intake, lowered physical activity or both, remains disputed. Design: Physical activity energy expenditure, evaluated in three different ways from daily energy expenditure (DEE) measured using doubly labelled water, was examined for trends over time. Data included subjects in Europe (Maastricht, the Netherlands) and North America extending back to the 1980s. These data were compared with measures from the third world, and measures made on wild terrestrial mammals. Results: Physical activity expenditure in Europe (residual of the regression of DEE on basal energy expenditure (BEE)) has slightly but significantly increased since the 1980s. There was no trend over time in physical activity level (PAL ¼ DEE/BEE), or in the residual variance in DEE once mass, sex and age were accounted for. This latter index of physical activity expenditure also significantly increased over time in North America. DEE of individuals in Europe and North America was not significantly different from individuals measured in the third world. In wild terrestrial mammals, DEE mostly depended on body mass and ambient temperature. Predicted DEE for a 78 kg mammal living at 20 1C was 9.2 MJ per day (95% CI: 7.9-12.9 MJ per day), not significantly different from the measured DEE of modern humans (around 10.2-12.6 MJ per day). Conclusion: As physical activity expenditure has not declined over the same period that obesity rates have increased dramatically, and daily energy expenditure of modern man is in line with energy expenditure in wild mammals, it is unlikely that decreased expenditure has fuelled the obesity epidemic.

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Trends in obesity and energy supply in the WHO MONICA Project

Cited by 226 publications

References 31 publications

Overweight and obesity in Italian adults 2004, and an overview of trends since 1983

Overweight and obesity in Italian adults 2004, and an overview of trends since 1983

Physical activity reduces the influence of genetic effects on BMI and waist circumference: a study in young adult twins

Physical activity energy expenditure has not declined since the 1980s and matches energy expenditures of wild mammals

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