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. 2017 Mar;28(3):247-258.
doi: 10.1007/s10552-017-0869-z. Epub 2017 Feb 17.

Energy balance and obesity: what are the main drivers?

Isabelle Romieu  1 , Laure Dossus  2 , Simón Barquera  3 , Hervé M Blottière  4 , Paul W Franks  5 , Marc Gunter  2 , Nahla Hwalla  6 , Stephen D Hursting  7 , Michael Leitzmann  8 , Barrie Margetts  9 , Chizuru Nishida  10 , Nancy Potischman  11 , Jacob Seidell  12 , Magdalena Stepien  2 , Youfa Wang  13 , Klaas Westerterp  14 , Pattanee Winichagoon  15 , Martin Wiseman  16 , Walter C Willett  17 ; IARC working group on Energy Balance and Obesity
Affiliations

Energy balance and obesity: what are the main drivers?

Isabelle Romieu et al. Cancer Causes Control. 2017 Mar.

Abstract

Purpose: The aim of this paper is to review the evidence of the association between energy balance and obesity.

Methods: In December 2015, the International Agency for Research on Cancer (IARC), Lyon, France convened a Working Group of international experts to review the evidence regarding energy balance and obesity, with a focus on Low and Middle Income Countries (LMIC).

Results: The global epidemic of obesity and the double burden, in LMICs, of malnutrition (coexistence of undernutrition and overnutrition) are both related to poor quality diet and unbalanced energy intake. Dietary patterns consistent with a traditional Mediterranean diet and other measures of diet quality can contribute to long-term weight control. Limiting consumption of sugar-sweetened beverages has a particularly important role in weight control. Genetic factors alone cannot explain the global epidemic of obesity. However, genetic, epigenetic factors and the microbiota could influence individual responses to diet and physical activity.

Conclusion: Energy intake that exceeds energy expenditure is the main driver of weight gain. The quality of the diet may exert its effect on energy balance through complex hormonal and neurological pathways that influence satiety and possibly through other mechanisms. The food environment, marketing of unhealthy foods and urbanization, and reduction in sedentary behaviors and physical activity play important roles. Most of the evidence comes from High Income Countries and more research is needed in LMICs.

Keywords: Diet; Energy balance; Energy expenditure; Energy intake; Obesity; Satiety.

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Fig. 1
Fig. 1
Prevalence of obesity, ages 18+, both sexes, 2014 (age-standardized estimates)—source: WHO
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