Foods, obesity, and diabetes-are all calories created equal?

Diet has become one of the top risk factors for poor health. The incidence of cardiometabolic disease in the United Sates, in Mexico, and in most countries is driven fundamentally by changes in diet quality. Weight gain has been typically framed as a problem of excess caloric intake, but, as reviewed in this paper, subtle changes in the quality of diet are associated with long-term weight gain. In order to successfully address obesity and diabetes, researchers and policy makers have to better understand how weight gain in the long term is modulated and to change the focus of research and public policy from one based on counting calories to one based on diet quality and its determinants at various levels.