Review

International Journal of Obesity (2006) 30, 1585–1594. doi:10.1038/sj.ijo.0803326; published online 27 June 2006

Putative contributors to the secular increase in obesity: exploring the roads less traveled

S W Keith1,2, D T Redden2, P T Katzmarzyk3,4, M M Boggiano5, E C Hanlon6, R M Benca6, D Ruden7, A Pietrobelli8, J L Barger9,10, K R Fontaine11, C Wang12, L J Aronne13, S M Wright13, M Baskin14, N V Dhurandhar15, M C Lijoi16, C M Grilo17, M DeLuca7, A O Westfall2 and D B Allison1,2,3

  1. 1Section on Statistical Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
  2. 2Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
  3. 3Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada
  4. 4School of Physical and Health Education, Queen's University, Kingston, Ontario, Canada
  5. 5Formerly MM Hagan, Department of Psychology, Behavioral Neuroscience Division, University of Alabama at Birmingham, Birmingham, AL, USA
  6. 6Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
  7. 7Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
  8. 8Paediatric Unit, Verona University Medical School, Verona, Italy
  9. 9Wisconsin Primate Research Center, University of Wisconsin-Madison, Madison, WI, USA
  10. 10Department of Medicine, University of Wisconsin Medical School, Madison, WI, USA
  11. 11Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
  12. 12Department of Epidemiology and Clinical Investigation Sciences, University of Louisville, Louisville, KY, USA
  13. 13Comprehensive Weight Control Program Weill Medical College of Cornell University, New York, NY, USA
  14. 14Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
  15. 15Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
  16. 16Department of Nutrition and Food Science, Wayne State University, Detroit, MI, USA
  17. 17Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

Correspondence: Dr DB Allison, Department of Biostatistics, Ryals Public Health Building, 1665 University Boulevard, University of Alabama at Birmingham, UAB Station, Birmingham, AL 35294-0022, USA. E-mail: dallison@uab.edu

Received 11 October 2005; Revised 13 February 2006; Accepted 23 February 2006; Published online 27 June 2006.

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Abstract

Objective:

 

To investigate plausible contributors to the obesity epidemic beyond the two most commonly suggested factors, reduced physical activity and food marketing practices.

Design:

 

A narrative review of data and published materials that provide evidence of the role of additional putative factors in contributing to the increasing prevalence of obesity.

Data:

 

Information was drawn from ecological and epidemiological studies of humans, animal studies and studies addressing physiological mechanisms, when available.

Results:

 

For at least 10 putative additional explanations for the increased prevalence of obesity over the recent decades, we found supportive (although not conclusive) evidence that in many cases is as compelling as the evidence for more commonly discussed putative explanations.

Conclusion:

 

Undue attention has been devoted to reduced physical activity and food marketing practices as postulated causes for increases in the prevalence of obesity, leading to neglect of other plausible mechanisms and well-intentioned, but potentially ill-founded proposals for reducing obesity rates.

Keywords:

additional explanations, prevalence of obesity, obesity epidemic, body mass index, food marketing, physical activity

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