Centre for Science, Athabasca University, Athabasca, AB T9S 3A3, Canada.
Nutrients. 2022 Oct 12;14(20):4253. doi: 10.3390/nu14204253.
The obesity epidemic appeared in the USA in 1976-1980 and then spread across Westernized countries. This paper examines the most likely causes of the epidemic in the USA. An explanation must be consistent with the emergence of the epidemic in both genders and in all age groups and ethnicities at about the same time, and with a steady rise in the prevalence of obesity until at least 2016. The cause is closely related to changes in the American diet. There is little association with changes in the intake of fat and carbohydrate. This paper presents the opinion that the factor most closely linked to the epidemic is ultra-processed foods (UPFs) (i.e., foods with a high content of calories, salt, sugar, and fat but with very little whole foods). Of particular importance is sugar intake, especially sugar-sweetened beverages (SSBs). There is strong evidence that consumption of SSBs leads to higher energy intake and more weight gain. A similar pattern is also seen with other UPFs. Factors that probably contributed to the increased intake of UPFs include their relatively low price and the increased popularity of fast-food restaurants. Other related topics discussed include: (1) the possible importance of Farm Bills implemented by the US Department of Agriculture; (2) areas where further research is needed; (3) health hazards linked to UPFs; and (4) the need for public health measures to reduce intake of UPFs.
肥胖症的流行于 1976-1980 年在美国出现，随后蔓延到西方国家。本文探讨了美国肥胖症流行的最可能原因。这种解释必须与在同一时间同时出现在男性和女性以及所有年龄组和种族中的流行现象以及肥胖症的患病率持续上升（至少到 2016 年）相一致。其原因与美国饮食的变化密切相关。与脂肪和碳水化合物摄入量的变化几乎没有关联。本文提出了一个观点，即与流行最密切相关的因素是超加工食品（UPFs）（即卡路里、盐、糖和脂肪含量高但全食物含量很少的食物）。特别重要的是糖的摄入量，尤其是含糖饮料（SSBs）。有强有力的证据表明，SSBs 的消费会导致能量摄入增加和体重增加。其他 UPFs 也出现了类似的模式。可能导致 UPF 摄入量增加的因素包括其相对较低的价格和快餐店的日益普及。本文还讨论了其他相关主题：（1）美国农业部实施的《农业法案》可能的重要性；（2）需要进一步研究的领域；（3）UPFs 带来的健康危害；以及（4）需要采取公共卫生措施来减少 UPFs 的摄入量。
