Summerbell, C.D. and Douthwaite, W. and Whittaker, V. and Ells, L.J. and Hillier, F. and Smith, S. and Kelly, S. and Edmunds, L.D. and Macdonald, I. (2009) 'The association between diet and physical activity and subsequent excess weight gain and obesity assessed at 5 years of age or older : a systematic review of the epidemiological evidence.', International journal of obesity., 33 (Supplement 3). S1-S92.
1 Introduction Obesity arises from a complex interplay between genetic susceptibility and behaviour, primarily relating to dietary habits and physical activity (Foresight, 2007). Evidence for specific behavioural factors that promote or protect against excess weight gain have been usefully reviewed (Wareham, 2007); (Jebb, 2007), and is more limited in children compared with adults (Rennie et al., 2005). A number of behavioural risk factors have been postulated, including TV viewing, diets with a high energy density, and fast foods. Most evidence is derived from cross sectional studies which can frequently produce conflicting results. Prospective studies with accurate measure of diet and physical activity exposures, and outcomes in terms of body fatness, are deemed to provide the more robust evidence on which to base interventions to achieve long-term behavioural change and prevent excess weight gain. The question to be answered by this comprehensive systematic review of the epidemiological evidence was ‘What is the association between food, food groups, nutrition and physical activity and subsequent excess weight gain and obesity in humans?’ Relevant exposures include patterns of diet; breastfeeding; food and drink; food preparation; dietary constituents; physical activity and inactivity; energy intake; energy density of diet; energy expenditure. Outcomes in adulthood and childhood have reported separately. Outcomes of interest included markers of weight gain; overweight; obesity; markers of body composition; markers of distribution of fat. The results of this review will provide evidence of association, but not causes, of subsequent excess weight gain and obesity. There is a degree of uncertainty inherent in epidemiological evidence, given that it is impossible to determine if there are uncontrolled variables, including genetic variations. The well known association between relatively high non caloric sweetner usage and subsequent weight gain is a useful reminder that, whilst an evidence based approach is critical to the process of scientific enquiry, consideration of evidence from other types of studies (mechanistic studies, intervention studies) and understanding the context of the evidence reviewed is essential if we are to provide policy makers, industry, service providers and the public with sensible recommendations.
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|Publisher Web site:||http://dx.doi.org/10.1038/ijo.2009.80|
|Record Created:||19 Jun 2009 12:50|
|Last Modified:||12 Jul 2013 12:05|
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