Macronutrient Intake and Obesity

Obesity is a global pandemic that is increasing throughout most of the world. Increases in obesity are not restricted to highly industrialized countries, but have been observed in newly developed and developing countries as well. Obesity is associated with increased risk for non-insulin dependent diabetes mellitus, coronary artery disease, and some types of cancer. Tragically, eliminating food shortages in developing countries may result in substituting heart disease, diabetes, and cancer for malnutrition. There are many approaches to reducing obesity, including dietary modification, surgical interventions, and drug therapies. However, only dietary modification has the potential to be effective on a global scale. Public health measures in the United States have sought to reduce obesity by reducing the intake of dietary fat. While these efforts have succeeded in reducing dietary fat, obesity has continued to increase, suggesting that moderate fat reduction may not be effective. Other proposed diets include low-carbohydrate diets, low glycemic index diets, and very low fat diets. While all of these diets may be effective for some people, they are not satisfactory for public health policy. In fact, the ratio of fat to carbohydrate may not be as important as previously believed. Humans may be well suited to adapt to diets as varied as a high carbohydrate tropical diet consisting mostly of fruits to the high fat Eskimo diet consisting largely of animal foods. Either extreme may be healthful if providing adequate, but not excessive, energy and adequate amounts of micronutrients. Public health measures may need to focuss on reducing the overconsumption of inexpensive and convenient foods.