This paper is only available as a PDF. To read, Please Download here.
Purpose
To compare recent changes in diet and physical activity with trends in body weight
and obesity prevalence, using large survey studies representative of the US population.
Materials and Methods: Secular-trends survey studies were made from databases of NHANES
II and III, USDA Nationwide Food Consumption Survey, Behavioral Risk Factor Survey
System, and Calorie Control Council Report providing data on obesity prevalence, body
mass index, calorie and fat intake, exercise-related physical activity, and consumption
of low-calorie food extracted from surveys for the adult US population and specific
subgroups.
Results
In the adult US population the prevalence of overweight rose from 25.4% from 1976
to 1980 to 33.3% from 1988 to 1991, a 31% increase. During the same period, average
fat intake, adjusted for total calories, dropped from 41.0% to 36.6%, an 11% decrease.
Average total daily calorie intake also tended to decrease, from 1,854 kcal to 1,785
kcal (−4%). Men and women had similar trends. Concurrently, there was a dramatic rise
in the percentage of the US population consuming low-calorie products, from 19% of
the population in 1978 to 76% in 1991. From 1986 to 1991 the prevalence of sedentary
lifestyle represented almost 60% of the US population, with no change over time.
Conclusions
Reduced fat and calorie intake and frequent use of low-calorie food products have
been associated with a paradoxical increase in the prevalence of obesity. These diverging
trends suggest that there has been a dramatic decrease in total physical activity
related energy expenditure. Efforts to increase the average American's total exercise-
and non-exercise-related physical activities may be essential for the prevention of
obesity.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Increasing prevalence of overweight among US adults: the National Health and Nutrition Examination Surveys, 1960 to 1991.JAMA. 1994; 272: 205-211
- Weight, weight change, and coronary heart disease in women: risk within the ‘normal’ weight range.JAMA. 1995; 273: 461-465
- Weight gain as a risk factor for clinical diabetes mellitus in women.Ann Intern Med. 1995; 122: 481-486
- Body weight and mortality among women.NEJM. 1995; 333: 677-685
- Nutritional problems growing out of new patterns of food consumption.Am J Pub Health. 1972; 62: 1194-1198
- Review of trends in food use in the United States, 1909 to 1980.J Am Diet Assoc. 1982; 81: 120-125
- Healthy People 2000; National Health Promotion and Disease Prevention Objectives.in: Publication PHS 91-50212. US Department of Health and Human Services, Washington, DC1991
- Physical activity as an index of heart attack risk in college alumni.Am J Epidemiol. 1978; 108: 161-175
- Leisure time physical activity, its relationship to coronary risk factors in a population-based sample. The Minnesota Heart Survey.Am J Epidemiol. 1985; 121: 570-579
- A meta-analysis of the factors affecting exerciseinduced changes in body mass, fat mass, and fat-free mass in males and females.Int J Obes. 1991; 5: 717-726
- Aerobic exercise and weight.Addict Behav. 1980; 5: 371-388
- The role of exercise in weight control.Exerc Sports Sci Rev. 1973; 1: 103-123
- Physical activity, body weight, and adiposity: an epidemiologic perspective.Exerc Sports Sci Rev. 1995; 23: 275-303
- Recreational physical activity and 10-year weight change in a US national cohort.Int J Obes. 1993; 17: 279-286
- Anthropometric reference data and prevalence of overweight, United States, 1976–80.Vital Health Stat. 1987; 11
- Food and nutrient intakes by individuals in the United States, 1 day, 1987–88.in: Nationwide Food Consumption Survey 1987–1988. Report No. 87+1. US Department of Agriculture, Washington, DC1993
- Effects of procedural differences between 1977 and 1987 in the Nationwide Food Consumption Survey on estimates of food and nutrient intakes: results of the USDA 1988 Bridging Study.in: Nationwide Food Consumption Survey 1987–1988. Report No. 87-M-1. US Department of Agriculture, Washington, DC1990
- Is dietary underreporting macronutrient-specific?.Eur J Clin Nutr. 1994; 48: 453-454
- Dietary fat and obesity: evidence from epidemiology.Eur J Clin Nutr. 1995; 49: 79-90
- Behavioral risk factor surveillance, 1986–1990.MMWR. 1991; 40: 1-23
- Prevalence of sedentary lifestyle: Behavioral Risk Factor Surveillance System, United States, 1991.MMWR. 1993; 29: 576-579
- The Use of Low-calorie Products in Americans.Calorie Control Council, Atlanta1995
- Patterns of weight change and their relation to diet in a cohort of healthy women.Am J Clin Nutr. 1990; 51: 1100-1105
- A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults.Am J Clin Nutr. 1992; 55: 818-828
- Energy and macronutrient intakes of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, Phase 1, 1988–91.Advance Data. 1994; 255: 1-23
- Trends in individual consumption of dietary fat in the United States, 1920–1984.Am J Clin Nutr. 1990; 52: 457-469
- Total energy intake of the US population: the third National Health and Nutrition Examination Survey, 1988–1991.Am J Clin Nutr. 1995; 62 (suppl): 1072S-1080S
- Correlates of over-and underreporting of energy intake in healthy older men and women.Am J Clin Nutr. 1994; 59: 1286-1290
- Underestimation of energy intake by 3-d records compared with energy intake to maintain body weight in 269 nonobese adults.Am J Clin Nutr. 1994; 60: 855-860
- Comparison of seven-day diet record with measured food intake of twenty-four subjects.Nutr Research. 1982; 2: 263-273
- Healthy People 2000; National Health Promotion and Disease Prevention Objectives.in: Publication PHSS 91-50212. US Department of Health and Human Services, Washington, DC1991
- Effect of weight reduction on resting energy expenditure, substrate utilization, and the thermic effect of food in moderately obese women.Am J Clin Nutr. 1992; 55: 924-933
- Use and storage of carbohydrate and fat.Am J Clin Nutr. 1995; 61 (suppl): 952-959S
- Fat and carbohydrate overfeeding in humans: different effects on energy storage.Am J Clin Nutr. 1995; 62: 19-29
- Healthy People 2000 at mid decade.JAMA. 1995; 273: 1123-1129
- Health promotion and disease prevention: United States, 1990.Vital Health Stat. 1993; 10
- Physical activity and public health.JAMA. 1995; 274 (Letter): 533
- On basketballs and heartbeats.Epidemiology. 1991; 2: 3-5
- Nutritional determinants of the insulin resistance syndrome.Int J Obesity. 1995; 19: S60-S68
- Obesity in Britain: gluttony or sloth?.BMJ. 1995; 311: 437-439
- Endurance training does not enhance total energy expenditure in healthy older persons.Am J Physiol. 1992; 263: 950-957
- Variety is still the spice of a healthful diet: a look at porposed revisions for the 1995 Dietary Guidelines for Americans.J Am Diet Assoc. 1995; 95: 1096-1098
- Measurement of physical activity to assess health effects in free-living populations.Med Sci Sports Exerc. 1993; 24: 60-70
- Outcomes of a field trial to improve children's dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH).JAMA. 1996; 275: 768-776
Article info
Publication history
Received in revised form:
November 22,
1996
Received:
May 10,
1996
Footnotes
**Supported by a grant from the Swiss National Fond.
Identification
Copyright
© 1997 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc.
