Energy Use and Obesity in Industrialized Communities
Becoming a “Westernized” country is often linked with obesity and the chronic health conditions associated with it, including diabetes, heart disease, and cancer. The importance of increased calorie intake and decreased energy usage hasn’t really been evaluated.
Generally speaking, weight gain is a consequence of eating and absorbing more calories than are burned. The theory by public health organizations is an imbalance of physical activity to calorie intake.
Industrialized communities tend to be less active than farming and foraging populations. Daily exercise has also decreased within industrialized communities over the past few decades as economic progress has risen. A decline in activity doesn’t always align with a decrease in total energy expenditure when comparing populations.
Long-term energy balance is reflected by body composition. Previous research has shown that total energy expenditure is consistent and stable within adults, even when activity levels vary.
A recent study finds that daily energy use is higher in developed populations, and energy use isn’t reduced in more industrialized populations. This challenges the claim that a dip in physical activity contributes to obesity with economic progress. The results suggest that dietary intake plays a greater role than reduced energy expenditure in the higher prevalence of obesity associated with economic growth.
In this study, two measures of obesity (BMI and percent body fat) and energy expenditure were evaluated in over 4,200 adults between 18 and 60 years old from 34 populations across six continents, with a wide range of lifestyles and economies. These included hunter-gatherer, pastoralist, farming, and industrialized populations
Economic progress was positively linked with higher body mass, BMI, and body fat, in addition to greater total, basal, and activity energy expenditure. With increasing economic development, body size-adjusted total and basal energy expenditures both declined by 6 to 11%. These were highly variable between populations and didn’t align closely with lifestyle.
Body size-adjusted total energy expense was weakly negatively linked with measures of obesity, making up about one-tenth of the increased body fat percentage and BMI linked with economic growth.
However, estimated energy intake was higher in economically developed populations. In those with data available (n = 25), the percentage of ultra-processed food consumed was linked with body fat percentage. This suggests that food consumption plays a much bigger role than decreased energy usage in obesity as it relates to economic development.
Results indicated that countries with higher human development indices (HDI)- a measure of education, longevity, and wealth, had higher rates of obesity, particularly in women. BMI and body fat were also higher with age. This category also consistently had a higher body fat percentage than hunter-gatherer, agropastoralist, horticulturalist, and low HDI populations.
Despite energy expenditure remaining somewhat constant, increased BMI, and percent body fat appear to be attributed to an increased consumption of high-calorie, highly palatable ultra-processed food in more industrialized populations. In short, you can’t outrun a bad diet.
To prevent further unwanted gains, advise your clients to:
Avoid sugar-sweetened beverages, which are directly associated with unwanted weight gain.
Skip fast food. No drive-through, Door Dash, or Uber Eats.
Keep ultra-processed foods out of your home (and car).
Pay attention to hunger cues. Ask yourself- “What’s eating me, that’s making me eat?”
Stay active across your lifespan. Find physical activity you enjoy.
Include both cardiovascular exercise and strength training.
Limit (or avoid) alcohol. It provides empty calories but minimal health effects.
Reduce high-fat foods such as chips, high-calorie desserts, fried foods, fatty cuts of meat and pork, full-fat dairy products, and processed red meat.
Add more high-fiber foods to meals, including beans, lentils, whole grains, fruits, and vegetables.
Take an exercise “snack” during the day in place of grabbing food. Do some push-ups, jumping jacks, or a 60-second plank.
Lisa Andrews, MEd, RD, LD
Reference:
McGrosky, A. Luke, et. al., and The IAEA DLW Database Consortium, Energy expenditure and obesity across the economic spectrum, Proc. Natl. Acad. Sci. U.S.A. 122 (29) e2420902122, https://doi.org/10.1073/pnas.2420902122 (2025).
