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Trends in obesity and energy supply in the WHO MONICA Project

International Journal of Obesity volume 28, pages 710–718 (2004)Cite this article

Abstract

OBJECTIVE: To examine the relationship between secular trends in energy supply and body mass index (BMI) among several countries.

DESIGN: Aggregate level analyses of annually reported country food data against anthropometric data collected in independent cross-sectional samples from 34 populations in 21 countries from the early 1980s to the mid-1990s.

SUBJECTS: Population randomly selected participants aged 35–64 y.

MEASUREMENTS: BMI data were obtained from the WHO MONICA Project. Food energy supply data were derived from the Food Balance Sheet of the Food and Agriculture Organization of the United Nations.

RESULTS: Mean BMI as well as the prevalence of overweight (BMI ≥25 kg/m2) increased in virtually all Western European countries, Australia, the USA, and China. Decreasing trends in BMI were seen in Central and Eastern European countries. Increasing trends in total energy supply per capita were found in most high-income countries and China while decreasing trends existed in Eastern European countries. Between country differences in temporal trends of total energy supply per capita explained 41% of the variation of trends in mean BMI; the effect was similar upon the prevalence of overweight and obesity. Trends in percent of energy supply from total fat per capita had a slight effect on the trends in mean BMI (+7% increment in R2) when the total energy supply per capita was adjusted for, while energy supply from total sweeteners per capita had no additional effect.

CONCLUSION: Increasing energy supply is closely associated with the increase of overweight and obesity in western countries. This emphasizes the importance of dietary issues when coping with the obesity epidemic.

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Acknowledgements

The MONICA Centres are funded predominantly by regional and national governments, research councils, and research charities. Coordination is the responsibility of the World Health Organization (WHO), assisted by local fund raising for congresses and workshops. WHO also supports the MONICA Data Centre (MDC) in Helsinki. Not covered by this general description is the ongoing generous support of the MDC by the National Public Health Institute of Finland, and a contribution to WHO from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA for support of the MDC and the Quality Control Centre for Event Registration in Dundee. The completion of the MONICA Project is generously assisted through a Concerted Action Grant from the European Community. Likewise appreciated are grants from ASTRA Hässle AB, Sweden, Hoechst AG, Germany, Hoffmann-La Roche AG, Switzerland, the Institut de Recherches Internationales Servier (IRIS), France, and Merck & Co. Inc., NJ, USA, to support data analysis and preparation of publications. This work has been also supported by Academy of Finland (Grants #46558 and #53585).

Author information

Author notes

  1. K Silventoinen, S Sans, H Tolonen, D Monterde, K Kuulasmaa, H Kesteloot and J Tuomilehto: Participating centres of the WHO MONICA Project listed in the appendix

Authors and Affiliations

  1. Department of Public Health, University of Helsinki, Finland

    K Silventoinen & J Tuomilehto

  2. Division of Epidemiology, School of Public Health, University of Minnesota, USA

    K Silventoinen

  3. Department of Health and Social Security, Institute of Health Studies, Barcelona, Spain

    S Sans

  4. Department of Epidemiology and Health Promotion, National Public Health Institute, Finland

    H Tolonen, K Kuulasmaa & J Tuomilehto

  5. Saint Paul's Hospital Research Institute, Barcelona, Spain

    D Monterde

  6. Department of Epidemiology, University of Leuven, Belgium

    H Kesteloot

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  1. K Silventoinen
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  4. D Monterde
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  5. K Kuulasmaa
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  7. J Tuomilehto
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Corresponding author

Correspondence to K Silventoinen.

Appendix

Appendix

Participating centres of the WHO MONICA Project

Australia—University of Western Australia, Nedlands: MST Hobbs, K Jamrozik, PL Thompson, BK Armstrong; University of Newcastle, Newcastle: A Dobson, S Leeder, H Alexander, R Heller.

Belgium—Ghent State University, Ghent: G De Backer, I De Craene, F van Onsem, L van Parys, S De Henauw, D De Bacquer.

China—Beijing Heart, Lung and Blood Vessel Research Institute, Beijing: Wu Zhaosu, Wu Yingkai, Yao Chonghua, Zhang Ruisong.

Czech Republic—Institute for Clinical and Experimental Medicine, Prague: Z Škodová, Z Píša, L Berka, Z Cícha, J Cerovská, R Emrová, M Hoke, M Hronkova, J Pikhartová, R Poledne, P Vojtíšek, J Vorlicek, E Wiesner, D Grafnetter.

Denmark—Centre of Preventive Medicine (The Glostrup Population Studies) Copenhagen University: M Schroll, M Kirchhoff, A Sjol, K Korsgaard Thomsen, M Madsen, TJ Joergensen.

Finland—National Public Health Institute, Helsinki: J Tuomilehto, P Puska, A Nissinen, E Vartiainen, H Korhonen, P Jousilahti, P Pietinen.

France—National Institute of Health and Medical Research (INSERM U258) Paris: P Ducimetiere, JL Richard, A Bingham, T Lang; National Institute of Health and Medical Research, Toulouse: J Ferrieres, JP Cambou, JB Ruidavets, MP Branchu, V Delmas, P Rodier; Department of Epidemiology and Public Health, INSERM U508, Pasteur Institute, Lille: P Amouyel, D Cottel, MC Nuttens, N Marécaux, J Dallongeville, J-L Salomez, M Montaye1, C Steclebout.

Germany—Bremen Institute for Prevention Research and Social Medicine, Bremen: E Greiser, B Herman, G Stüdemann; GSF-Institute for Epidemiology, Munich and Institute for Epidemiology and Social Medicine, University of Münster: U Keil, J Stieber, A Döring, B Filipiak, U Härtel, HW Hense; Centre for Epidemiology & Health Research, Berlin: W Barth, L Heinemann, A Assmann, S Böthig, G Voigt, S Brasche, D Quietzsch, E Classen.

Iceland—Heart Preventive Clinic, Reykjavik: U Agnarsson, II Gudmundsdottir, N Sigfusson, I Stefansdottir, Th Thorsteinsson, H Sigvaldason; Institute of Cardiology, Regional Hospital, Udine: D Vanuzzo, GA Feruglio, L Pilotto, GB Cignacco, M Scarpa, R Marini, G Zilio, M Spanghero, G Zanatta; Research Centre on Chronic Degenerative Diseases of the University of Milan: GC Cesana, M Ferrario, R Sega, P Mocarelli, G De Vito, F Valagussa.

Lithuania—Kaunas Medical Academy, Institute of Cardiology: J Bluzhas, S Domarkiene, A Tamosiunas, R Reklaitiene.

New Zealand—University of Auckland: R Beaglehole, RT Jackson, R Bonita, AW Stewart, D Mahon, W Bingley.

Poland—Institute of Public Health, Collegium Medicum, Jagiellonian University, Kraków: A Pajak, J Sznajd, E Kawalec, T Pazucha, M Malczewska, I Mórawska; National Institute of Cardiology, Warsaw, Department of Cardiovascular Epidemiology and Prevention: S Rywik, G Broda, A Waoekiewicz, E Sygnowska, B Jasinski, P Kurjata.

Russian Federation—National Research Centre for Preventive Medicine, Moscow: T Varlamova, A Britov, V Konstantinov, T Timofeeva, A Alexandri, O Konstantinova; Institute of Internal Medicine, Novosibirsk: Yu P Nikitin, S Malyutina.

Spain—Institute of Health Studies, Department of Health and Social Security, Barcelona: S Sans, I Balaguer-Vintró, Ll Balañá, G Paluzie, D Ruiz.

Sweden—Göteborg University, The Cardiovascular Institute: L Wilhelmsen, A Rosengren, S Johansson, A Dotevall, G Lappas; Kalix Hospital, Department of Medicine: V Lundberg, E Jägare-Westerberg; Kiruna Hospital, Department of Medicine: T Messner; Umeå University Hospital, Department of Medicine: K Asplund, B Stegmayr.

Switzerland—Institute of Social and Preventive Medicine, University of Lausanne: M Rickenbach, V Wietlisbach, D Hausser, B Tullen, F Paccaud; Institute of Social and Preventive Medicine, University of Zurich: F Gutzwiller, Department of Social Affairs, Cantonal Health Office of Ticino: F Barazzoni, F Mainieri, G Domenighetti.

United Kingdom—The Queen's University of Belfast, Northern Ireland: AE Evans, EE McCrum, T Falconer, S Cashman, C Patterson, M Kerr, D O’Reilly, A Scott, M McConville, I McMillan; University of Dundee, Scotland: H Tunstall-Pedoe, WCS Smith, R Tavendale, I Crombie, C Brown, M Shewry, M-K Hannah; Royal Infirmary, Glasgow, Scotland: C Morrison.

USA—Stanford Center for Research in Disease Prevention, Stanford University, California: SP Fortmann, A Varady, MA Winkleby, D Jatulis, M Hull.

Yugoslavia—Novi Sad Health Centre: M Planojevic, D Jakovljevic, A Svircevic, M Mirilov, T Strasser.

MONICA Management Centre—World Health Organization, Geneva: S Mendis, I Martin, I Gyarfas, Z Pisa, SRA Dodu, S Böthig, MJ Watson, M Hill.

MONICA Data Centre—National Public Health Institute, Helsinki, Finland: K Kuulasmaa, J Tuomilehto, A Molarius, E Ruokokoski, V Moltchanov, H Tolonen; MONICA Steering Committee: J Tuomilehto (Chair), H Wolf (Publications Coordinator), A Dobson, S Sans, H Tunstall-Pedoe, S Mendis (WHO, Geneva), K Kuulasmaa (KTL, Helsinki, Finland); Previous Steering Committee Members: P Amouyel, K Asplund, R Beaglehole, A Evans, M Ferrario, SP Fortmann, F Gutzwiller, M Hobbs, U Keil, A Menotti, A Pajak, P Puska, SL Rywik, and former Chiefs of CVD/HQ, Geneva (listed above), A Shatchkute (WHO, Copenhagen), V Zaitsev (WHO, Copenhagen); Former Consultants: FH Epstein (Zürich, Switzerland), M Feinleib (Bethesda, USA), MJ Karvonen (Helsinki, Finland), Z Pisa (Prague, Czech Republic), RJ Prineas (Minneapolis, USA), OD Williams (Birmingham, AL, USA);

Former Consultants: MJ Karvonen (Helsinki, Finland), RJ Prineas (Minneapolis, USA), M Feinleib (Bethesda, USA), FH Epstein (Zürich, Switzerland), Z Pisa (Prague, Czech Republic), OD Williams (Birmingham, AL, USA).

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Silventoinen, K., Sans, S., Tolonen, H. et al. Trends in obesity and energy supply in the WHO MONICA Project. Int J Obes 28, 710–718 (2004). https://doi.org/10.1038/sj.ijo.0802614

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