Energy expenditure and obesity across the economic spectrum

Global economic development has been associated with an increased prevalence of obesity and related health problems. Increased caloric intake and reduced energy expenditure are both cited as development-related contributors to the obesity crisis, but their relative importance remains unresolved. Here, we examine energy expenditure and two measures of obesity (body fat percentage and body mass index, BMI) for 4,213 adults from 34 populations across six continents and a wide range of lifestyles and economies, including hunter-gatherer, pastoralist, farming, and industrialized populations. Economic development was positively associated with greater body mass, BMI, and body fat, but also with greater total, basal, and activity energy expenditure. Body size-adjusted total and basal energy expenditures both decreased approximately 6 to 11% with increasing economic development, but were highly variable among populations and did not correspond closely with lifestyle. Body size-adjusted total energy expenditure was negatively, but weakly, associated with measures of obesity, accounting for roughly one-tenth of the elevated body fat percentage and BMI associated with economic development. In contrast, estimated energy intake was greater in economically developed populations, and in populations with available data (n = 25), the percentage of ultraprocessed food in the diet was associated with body fat percentage, suggesting that dietary intake plays a far greater role than reduced energy expenditure in obesity related to economic development.

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Publication Details

Journal
Proceedings of the National Academy of Sciences
Published
2025-07-14
DOI
https://doi.org/10.1073/pnas.2420902122
Citations
17
Primary Topic
Obesity, Physical Activity, Diet
Type
article
Field-Weighted Citation Impact
31.94

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article

Energy expenditure and obesity across the economic spectrum

Annelies Goris, Melanie B. Gillingham, William R. Leonard, Mary H. Samuels et al.
17 citations
Proceedings of the National Academy of Sciences
Obesity, Physical Activity, Diet
31.94
article

Energy expenditure and obesity across the economic spectrum

Annelies Goris, Melanie B. Gillingham, William R. Leonard, Mary H. Samuels, Eric Stice, Nader Lessan, Wim G. van Gemert, Eric Matsiko, Søren Brage, J. Josh Snodgrass, A. Bonomi, Christel Larsson, Guy Plasqui, Samuel S. Urlacher, Hiroyuki Sagayama, Brian M. Wood, Stefan Gerardus Camps, Susan B. Roberts, William E. Kraus, Ricardo Uauy, Renaat Philippaerts, Mikael Fogelholm, Michael Gurven, Srishti Sinha, Rebecca Kuriyan, Lara Ruth Dugas, Estelle Victoria Lambert, Amanda McGrosky, David A. Raichlen, Jacob Plange‐Rhule, Kitty P. Kempen, Rik Heijligenberg, Barry W. Fudge, Sanjoy Deb, Asher Y. Rosinger, Kirsi Hannele Pietiläinen, Cornelia Loechl, Anine Christine Medin, John R. Speakman, E J Velthuis-te Wierik, Wantanee Kriengsinyos, Corby K. Martin, Lene Frost Andersen, Jeanine Verbunt, Regina C. Casper, William W. Wong, Rita J. G. van den Berg-Emons, Cara B. Ebbeling, Stefan Branth, Ross L. Prentice, Catherine Hambly, Ulf Ekelund, Nancy F. Butte, Jennifer Rood, Peter T. Katzmarzyk, Terrence Forrester, Éric Ravussin, Sai Krupa Das, Yosuke Yamada, Marie Löf, Ludo M. Van Etten, Leanne M. Redman, Maciej S. Buchowski, Daniel K. Cummings, Pascal Bovet, Amy H. Luke, Klaas R. Westerterp, Annemiek Joosen, Hans U. Jorgensen, Alice E. Dutman, Alexia J. Murphy‐Alford, Bruce M. Wolfe, Walter Churchill Willett, David S. Ludwig, Elisabet Rothenberg, Dale A. Schoeller, Xueying Zhang, Susan B. Racette, Rebecca M. Reynolds, Herman Pontzer, Kweku Bedu-Addo, Wilhelmine W. Verboeket-van de Venne, Sabine Schulz, Richard Cooper, Eric B. Rimm, Daphne Pannemans, Leonore Arab, Tamara Harris, Robert F. Kushner, Minna Tanskanen, N C De Bruin, Marian L. Neuhouser, Gerwin A. L. Meijer, Linda G. Bandini, M. McCloskey, Albert Stunkard, Amy F. Subar
article en
17 citations

Abstract

Global economic development has been associated with an increased prevalence of obesity and related health problems. Increased caloric intake and reduced energy expenditure are both cited as development-related contributors to the obesity crisis, but their relative importance remains unresolved. Here, we examine energy expenditure and two measures of obesity (body fat percentage and body mass index, BMI) for 4,213 adults from 34 populations across six continents and a wide range of lifestyles and economies, including hunter-gatherer, pastoralist, farming, and industrialized populations. Economic development was positively associated with greater body mass, BMI, and body fat, but also with greater total, basal, and activity energy expenditure. Body size-adjusted total and basal energy expenditures both decreased approximately 6 to 11% with increasing economic development, but were highly variable among populations and did not correspond closely with lifestyle. Body size-adjusted total energy expenditure was negatively, but weakly, associated with measures of obesity, accounting for roughly one-tenth of the elevated body fat percentage and BMI associated with economic development. In contrast, estimated energy intake was greater in economically developed populations, and in populations with available data (n = 25), the percentage of ultraprocessed food in the diet was associated with body fat percentage, suggesting that dietary intake plays a far greater role than reduced energy expenditure in obesity related to economic development.

Proceedings of the National Academy of SciencesVol. 122(29)
Pennington Biomedical Research Center (US), Dartmouth College (US), Northwestern University (US), Pennsylvania State University (US), Harvard University (US), University of the West Indies System (JM), St. John's University (US), University of Tsukuba (JP), Baylor University (US), University of Cape Town (ZA), Oregon Health & Science University (US), Elon University (US), Duke University (US), University of Oregon (US), Baylor College of Medicine (US), University of Oslo (NO), Chapman University (US), University of Aberdeen (GB), University of Agder (NO), Vanderbilt University (US), Tohoku University (JP), University of Cambridge (GB), Mahidol University (TH), Maastricht University Medical Centre (NL), Helsinki University Hospital (FI), California Southern University (US), University of California System (US), Kwame Nkrumah University of Science and Technology (GH), Karolinska Institutet (SE), Maastricht University (NL), Department of Public Health (AS), 490 BioTech (United States) (US), Fred Hutch Cancer Center (US), International Atomic Energy Agency (IT), University of the West Indies (BS), Center for Health, Exercise and Sport Sciences (RS), Jean Mayer Human Nutrition Research Center on Aging (US), Max Planck Institute for Evolutionary Anthropology (DE), Imperial College London Diabetes Centre (AE), Kwame Nkrumah University (ZM), Shenzhen Institutes of Advanced Technology (CN), Centre universitaire de médecine générale et santé publique, Lausanne (CH), Food & Nutrition (NL), The Queen's Medical Research Institute (GB), Clinical Nutrition Research Centre (SG), Imperial College London (GB), Anglia Ruskin University (GB), Arizona State University (US), University of Chile (CL), Norwegian School of Sport Sciences (NO), University of Glasgow (GB), Vanderbilt University Medical Center (US), Southern States University (US), Medical Research Council (GB), Stanford University (US), University of Edinburgh (GB)
National Science Foundation, University of Southern California, Northwestern University, Harvard University, Arizona State University, Baylor University, University of Washington, Dartmouth College, Helsingin ja Uudenmaan Sairaanhoitopiiri, University of Oregon, Imperial College London, University of Aberdeen, Universiteit Maastricht, Chinese Academy of Sciences, Karolinska Institutet, Mahidol University, International Atomic Energy Agency, Universitetet i Oslo, Göteborgs Universitet, Universidad de Chile, University of Tsukuba, University of Cape Town, Max-Planck-Institut für Evolutionäre Anthropologie, Universitetet i Agder, Directorate for Biological Sciences, Duke Global Health Institute, Duke University, Feinberg School of Medicine, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences
Openalex Percentile: Top 0%
Obesity, Physical Activity, Diet
31.94
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