Resting Energy Expenditure: From Cellular to Whole-Body Level, a Mechanistic Historical Perspective.

The basis of heat generated by the human body has been a source of speculation and research for more than 2,000 years. Basal heat production, now usually referred to as resting energy expenditure (REE), is currently recognized as deriving from biochemical reactions at subcellular and cellular levels that are expressed in the energy expended by the body's 78 organs and tissues. These organs and tissues, and the 11 systems to which they belong, influence body size and shape. Connecting these subcellular-/cellular-level reactions to organs and tissues, and then on to body size and shape, provides a comprehensive understanding of individual differences in REE, a contemporary topic of interest in obesity research and clinical practice. This review critically examines these linkages, their association with widely used statistical and physiological REE prediction formulas, and often-unappreciated aspects of measuring basal heat production in humans.

Neoliberal science, Chinese style: Making and managing the 'obesity epidemic'.

Science and Technology Studies has seen a growing interest in the commercialization of science. In this article, I track the role of corporations in the construction of the obesity epidemic, deemed one of the major public health threats of the century. Focusing on China, a rising superpower in the midst of rampant, state-directed neoliberalization, I unravel the process, mechanisms, and broad effects of the corporate invention of an obesity epidemic. Largely hidden from view, Western firms were central actors at every stage in the creation, definition, and governmental management of obesity as a Chinese disease. Two industry-funded global health entities and the exploitation of personal ties enabled actors to nudge the development of obesity science and policy along lines beneficial to large firms, while obscuring the nudging. From Big Pharma to Big Food and Big Soda, transnational companies have been profiting from the 'epidemic of Chinese obesity', while doing little to effectively treat or prevent it. The China case suggests how obesity might have been constituted an 'epidemic threat' in other parts of the world and underscores the need for global frameworks to guide the study of neoliberal science and policymaking.

Food security and nutrition in the Russian Federation - a health policy analysis.

BACKGROUND: In the Russian Federation (Russia), an elevated burden of premature mortality attributable to non-communicable diseases (NCDs) has been observed since the country's economic transition. NCDs are largely related to preventable risk factors such as unhealthy diets. OBJECTIVE: This health policy study's aim was to analyze past and current food production and nutritional trends in Russia and their policy implications for Russia's NCD burden. DESIGN: We examined food security and nutrition in Russia using an analytical framework of food availability, access to food, and consumption. RESULTS: Agricultural production declined during the period of economic transition, and nutritional habits changed from high-fat animal products to starches. However, per-capita energy consumption remained stable due to increased private expenditures on food and use of private land. Paradoxically, the prevalence of obesity still increased because of an excess consumption of unsaturated fat, sugar, and salt on one side, and insufficient intake of fruit and vegetables on the other. CONCLUSIONS: Policy and economic reforms in Russia were not accompanied by a food security crisis or macronutrient deprivation of the population. Yet, unhealthy diets in contemporary Russia contribute to the burden of NCDs and related avoidable mortality. Food and nutrition policies in Russia need to specifically address nutritional shortcomings and food-insecure vulnerable populations. Appropriate, evidence-informed food and nutrition policies might help address Russia's burden of NCDs on a population level.

Stigma and the addiction paradigm for obesity: lessons from 1950s America.

AIMS: To discuss an historical episode in which obesity was conceptualized as an addictive disorder and declared to be a major epidemic in the early postwar United States. This history illuminates past consequences of framing obesity as an addiction in ways that may inform constructive policy responses today. METHODS: Review of secondary and primary sources, including archival documents, relating to obesity in biomedical and popular thought of the 1940s and 1950s. RESULTS: In the United States in the late 1940s and 1950s, new medical thinking about obesity reinterpreted overweight and obesity as chiefly the consequence of addiction (understood in the then dominant psychodynamic theory as a psychological defect, oral fixation). This new conception was rapidly taken up in popular discourse and clinical practice, with adverse effects through amplification of weight stigma. Further, in the conservative political context, the addiction concept contributed to an ineffective policy response to the alarming new epidemiological evidence about obesity's consequences. Despite a lack of evidence for efficacy of the intervention, public health efforts focused on correcting individual eating behaviour among obese people by encouraging self-help in lay groups modelled, in part, on Alcoholics Anonymous. Population-level intervention was neglected. CONCLUSIONS: Current public health policy initiatives must be mindful of the risks of reframing obesity as an addiction. These include inadvertently reinforcing stigma, narrowing responses to those aiming to modify individual behaviour and biology and neglecting population policies aiming to reduce the consumption of energy-dense foods, as all occurred in the 1950s United States.

Investigating the historic long-term population health impact of the US National School Lunch Program.

OBJECTIVE: The present research aimed to compare historic participation in the US National School Lunch Program (NSLP) during childhood and subsequent prevalence of overweight and obesity among adults at the population level. DESIGN: Regression models examined cross-sectional, state- and age-based panel data constructed from multiple sources, including the Behavioural Risk Factor Surveillance System, US Congressional Record, US Census and the US Department of Agriculture. Models controlled for cohorts' racial/ethnic composition and state poverty rates. SUBJECTS: Adult-age cohorts (18-34, 35-49, 50-64 and 18-64 years) by US state over a 25-year period (1984-2008). SETTING: The cohorts' prevalence of overweight and obesity was compared with the cohorts' estimated NSLP participation during schooling (1925-2007; the NSLP began in 1946). RESULTS: Among adults aged 18-64 years, a one percentage-point increase in estimated NSLP participation during schooling between 1925 and 2007 was significantly associated with a 0·29 percentage-point increase in the cohort's later prevalence of overweight and obesity. Analysis of narrower age cohorts and different schooling periods produced mixed results. CONCLUSIONS: The NSLP might have influenced population health historically. Longitudinal analysis of individuals from studies now underway will likely facilitate more robust conclusions about the NSLP's long-term health impact based on more recent experiences.

Prêt-à-Manger: why the French have their cake and eat it, too.

Even if you weren't aware of the rising intensity of debates over food politics in recent years, the face-off between Sarah Palin and Michelle Obama probably caught your attention. One of Michelle Obama's most high profile acts as First Lady was to plant an organic food garden on the White House lawn­ironically later found to be contaminated by sewage-sludge-based fertilizer, rendering the lovingly grown vegetables off limits. The launch of the Obama Foodorama (the First Lady's foodie blog) and "Let's Move" (Obama's cause célèbre child anti-obesity campaign) soon followed. Palin's subsequent attacks on Obama's "interference" in personal food choices culminated in her visit to a Pennsylvania primary school, where Palin publicly proffered cookies to schoolchildren, in a presumed attempt to warn them of nanny state "food police."

Frequency of under- and overweight among children and adolescents during the economic transition in Poland.

The aim of this study is to examine the prevalence of underweight, overweight and obesity, using International Obesity Task Force (IOTF) criteria, in four cohorts of children and adolescents living in Poland in different economic eras: communist economy (1977/1978), crisis of the 1980s (1987/1988), political and economic transformation (1992/1994) and the free market economy (2002/2004). Analysis was conducted on a database including 10,934 records for children of the age 7-18 years. In Poland, in the last 26 years of economic and political transformations, the epidemic of obesity was not noticed but the growing incidence of children and adolescents with body mass deficit was observed (p<0.0001) (20.2% of girls in 2002/2004 vs. 11.0% in 1977/1978 and 12.1% of boys in 2002/2004 vs. 7.2% in 1977/1978). Lower parental education and a higher number of children in a family resulted in a higher prevalence of underweight (odds ratio [OR] fluctuated from 1.26 to 1.63). The social effects of the political transformation in Poland significantly affected families with low socio-economic status (SES), and especially more eco-sensitive boys. This result is opposite to the trends observed in Western countries and makes an important contribution to the current knowledge of the course of further changes in weight-to-height ratio at a global scale.

The impact of immigration on child health: experimental evidence from a migration lottery program.

This paper uses a unique survey designed by the authors to compare migrant children who enter New Zealand through a random ballot with children in the home country of Tonga whose families were unsuccessful participants in the same ballots. We find that migration increases height and reduces stunting of infants and toddlers, but also increases BMI and obesity among 3- to 5-yr-olds. These impacts are quite large even though the average migrant household has been in New Zealand for less than 1 yr. Additional results suggest that these impacts occur because of dietary change rather than direct income effects.

A socioecological framework to understand weight-related issues in Aboriginal children in Canada.

Obesity prevention efforts in Aboriginal (First Nations, Métis, or Inuit) communities in Canada should focus predominantly on children given their demographic significance and the accelerated time course of occurrence of type 2 diabetes mellitus in the Aboriginal population. A socioecological model to address childhood obesity in Aboriginal populations would focus on the numerous environments at different times in childhood that influence weight status, including prenatal, sociocultural, family, and community environments. Importantly, for Aboriginal children, obesity interventions need to also be situated within the context of a history of colonization and inequities in the social determinants of health. This review therefore advocates for the inclusion of a historical perspective and a life-course approach to obesity prevention in Aboriginal children in addition to developing interventions around the socioecological framework. We emphasize that childhood obesity prevention efforts should focus on promoting maternal health behaviours before and during pregnancy, and on breastfeeding and good infant and child nutrition in the postpartum and early childhood development periods. Ameliorating food insecurity by focusing on improving the sociodemographic risk factors for it, such as increasing income and educational attainment, are essential. More research is required to understand and measure obesogenic Aboriginal environments, to examine how altering specific environments modifies the foods that children eat and the activities that they do, and to examine how restoring and rebuilding cultural continuity in Aboriginal communities modifies the many determinants of obesity. This research needs to be done with the full participation of Aboriginal communities as partners in the research.

Secular declines in the association between obesity and mortality in the United States.

Recent research suggests that rising obesity will restrain future gains in US life expectancy and that obesity is an important contributor to the current shortfall in us longevity compared to other high-income countries. Estimates of the contribution of obesity to current and future national-level mortality patterns are sensitive to estimates of the magnitude of the association between obesity and mortality at the individual level. We assessed secular trends in the obesity/mortality association among cohorts of middle-aged adults between 1948 and 2006 using three long-running US data sources: the Framingham Heart Study, the National Health and Nutrition Examination Survey, and the National Health Interview Survey. We find substantial declines over time in the magnitude of the association between obesity and overall mortality and, in certain instances, cardiovascular-specific mortality. We conclude that estimates of the contribution of obesity to current national-level mortality patterns should take into account recent reductions in the magnitude of the obesity and mortality association.

Non-exercise physical activity in agricultural and urban people.

With evidence that urbanisation is associated with obesity, diabetes, hypertension and cardiovascular disease, this article compares daily physical activity between rural and urban dwellers. Specifically, it examines habitual daily activity levels, non-exercise activity thermogenesis (NEAT) and energy expenditure in agricultural and urban Jamaicans and urban North Americans. Ambulation was 60 per cent greater in rural Jamaicans than in the urban dwellers (4675 ± 2261 versus 2940 ± 1120 ambulation-attributed arbitrary units (AU)/day; P = 0.001). Levels of ambulation in lean urban Jamaicans were similar to those in lean urban North Americans, whereas obese urban dwellers walked less than their lean urban counterparts (2198 ± 516 versus 2793 ± 774 AU/day; P = 0.01). The data with respect to daily sitting mirrored the walking data; obese Americans sat for almost four hours more each day than rural Jamaicans (562 ± 78 versus 336 ± 68 minutes/day; P < 0.001). Urbanisation is associated with low levels of daily activity and NEAT.

A silver lining? The connection between gasoline prices and obesity.

I find evidence of a negative association between gasoline prices and body weight using a fixed effects model with several robustness checks. I also show that increases in gas prices are associated with additional walking and a reduction in the frequency with which people eat at restaurants, explaining their effect on weight. My estimates imply that 8% of the rise in obesity between 1979 and 2004 can be attributed to the concurrent drop in real gas prices, and that a permanent $1 increase in gasoline prices would reduce overweight and obesity in the United States by 7% and 10%.

The environmental account of obesity: a case for feminist skepticism.

There is an emerging consensus among public health advocates that combating obesity is best done by restructuring the environment rather than by stigmatizing individuals. Although feminist scholars have not been major participants in debates over antiobesity policy, recently there has been a move toward adopting the environmental account of obesity as a feminist solution because of its potential to respond to health inequalities along race, class, and gender lines. This article aims to trouble the embrace of the environmental approach by feminist scholars, however, and to resurrect and redirect feminist criticism toward attendant problems of moralism, backlash, and the surveillance and rehabilitation of poor women of color. Despite its overwhelming popularity among policy elites and health researchers, I argue that the environmental account of obesity is not likely to promote structural change and broad redistributions. Rather it makes problematic assumptions about the relationship between health and fat and about the efficacy of intervention strategies, masks moralism with health discourse, and legitimizes punitive, ineffective, and patronizing interventions.

Disparities in neighborhood food environments: implications of measurement strategies.

Public health researchers have begun to map the neighborhood "food environment" and examine its association with the risk of overweight and obesity. Some argue that "food deserts"­areas with little or no provision of fresh produce and other healthy food­may contribute to disparities in obesity, diabetes, and related health problems. While research on neighborhood food environments has taken advantage of more technically sophisticated ways to assess distance and density, in general, it has not considered how individual or neighborhood conditions might modify physical distance and thereby affect patterns of spatial accessibility. This study carried out a series of sensitivity analyses to illustrate the effects on the measurement of disparities in food environments of adjusting for cross-neighborhood variation in vehicle ownership rates, public transit access, and impediments to pedestrian travel, such as crime and poor traffic safety. The analysis used geographic information systems data for New York City supermarkets, fruit and vegetable markets, and farmers' markets and employed both kernel density and distance measures. We found that adjusting for vehicle ownership and crime tended to increase measured disparities in access to supermarkets by neighborhood race/ethnicity and income, while adjusting for public transit and traffic safety tended to narrow these disparities. Further, considering fruit and vegetable markets and farmers' markets, as well as supermarkets, increased the density of healthy food outlets, especially in neighborhoods with high concentrations of Hispanics, Asians, and foreign-born residents and in high-poverty neighborhoods.

Obesity and access to chain grocers.

Recent empirical work in the obesity literature has highlighted the role of the built environment and its potential influence in the increasing prevalence of obesity in adults and children. One feature of the built environment that has gained increasing attention is the role of access to chain grocers and their impact on body mass index (BMI). The assessment of the impacts of spatial access to chain grocers on BMI is complicated by two empirical regularities in the data. There is evidence that health outcomes such as BMI are clustered in space and that there is spatial dependence across individuals. In this article, we use an econometric model that takes into account the spatial dependence, and we allow the effect of access to differ for a person depending on whether he or she lives in a low-income community or peer group. We categorize this community using the characteristics of the people who immediately surround the individual rather than using census tracts. Using georeferenced survey data on adults in Marion County, Indiana, we find that the effect of improvements in chain grocer access on BMI varies depending on community characteristics.

Can religion help prevent obesity? Religious messages and the prevalence of being overweight or obese among Korean women in California.

This research examines the influence of messages from religious leaders and congregants on whether Korean women are overweight or obese. Data were drawn from telephone interviews with a probability sample (N = 591) of women of Korean descent living in California. Overweight or obese prevalence was measured using World Health Organization standards for Asians (BMI > 23). Respondents reported the frequency of messages discouraging "excessive eating" or encouraging "exercise" from religious leaders and congregants during a typical month. When conditioned on leaders' messages, the frequency of congregants' messages was associated with a significantly lower probability of being overweight or obese, although messages from either in the absence of the other were unassociated with being overweight or obese. At least for Korean women, religion may help prevent obesity via religious-based social mechanisms.

Social problem construction and national context: news reporting on "overweight" and "obesity" in the United States and France.

Drawing on analyses of American and French news reports on "overweight" and "obesity," this article examines how national context­including position in a global field of nation states, as well as different national politics and culture­shapes the framing of social problems. As has been shown in previous research, news reports from France­the economically dominated but culturally dominant nation of the two­discuss the United States more often than vice versa, typically in a negative way. Our contribution is to highlight the flexibility of anti-American rhetoric, which provides powerful ammunition for a variety of social problem frames. Specifically, depending on elite interests, French news reports may invoke anti-American rhetoric to reject a given phenomenon as a veritable public problem, or they may use such rhetoric to drum up concern over an issue. We further show how diverse cultural factors shape news reporting. Despite earlier work showing that a group-based discrimination frame is more common in the United States than in France, we find that the U.S. news sample is no more likely to discuss weight-based discrimination than the French news sample. We attribute this to specific barriers to this particular framing, namely the widespread view that body size is a behavior, akin to smoking, rather than an ascribed characteristic, like race. This discussion points, more generally, to some of the mechanisms limiting the diffusion of frames across social problems.

From gluttony to obesity: moral discourses on apoplexy and stroke.

Current UK medical guidance on the management of stroke includes advice on reducing behavioural factors that place people at risk of the disease. This paper explores the historical background to the construction of this risk; it starts by investigating the connections made between individual behaviours and the causation of apoplexy in the medical discourse during the 18(th) and 19(th) centuries described in English medical textbooks from the 1700s. In outlining the emergence of a biomedical discourse around apoplexy and stroke, we note how a number of judgemental and moral concerns are articulated particularly around diet and exercise. While different in emphasis and starting point these discourses have their echo in contemporary approaches to the prevention of stroke. We seek to show that many of the themes common in current health promotion and public health strategies can be seen as continuities of earlier concerns regarding people's health; albeit now operating against the backdrop of a somatic society rather than a broader sense of moral regulation. We also hope to show how the understanding and prevention of stroke feeds into the moral discourse of the 'obesity crisis' confronting the affluent nations of North America and Europe.

BMI distribution/social stratification in Swiss conscripts from 1875 to present.

BACKGROUND/OBJECTIVES: We aimed to extend the actual overweight discussion with new unbiased Swiss conscript data from 2005 to 2006, and to present for the first time Swiss data on body mass index (BMI) before 1950 and for the late-nineteenth century. SUBJECTS/METHODS: For this study, 19-year-old Swiss male conscripts (draft army; Cantons Bern, Zurich, Basel-Stadt and Basel-Land) from the census of 1875-1879, 1933-1939 and 2005-2006 (N=28 033; 2005-2006 census) were included. BMI distribution (World Health Organization (WHO) classification) and social stratification (International Labour Organization classification) were main outcome measures. RESULTS: Mean BMI of 19-year-old men in Switzerland increased in the 50 years between the 1870s and the 1930s by 0.80 kg/m(2) and between the 1930s and 2005 by 1.45 kg/m(2). The modern BMI sample is much more right skewed and s.d. is higher. Obesity prevalence (according to modern WHO classification) has increased by a factor of 105 from 1870s until present. Over 23% of our representative sample of Swiss men in 2005-2006 had a BMI of over 25 kg/m(2). In 2005-2006, contrary to the nineteenth century, unskilled workers had articulately higher BMI values at the 75th, 90th and 95th percentile than students; 12% of unskilled workers were obese against 2% of students. CONCLUSIONS: It thus seems that BMI relations between the upper and the lower end of the socio-economic strata changed inversely from the late-nineteenth century to 2005-2006. We further propose that the phenomenon of massive right-skewing BMI distribution between the 1930s and 2005-2006 affected the lower socio-economic strata to a far greater extent than the higher socio-economic group.