Reduced rate of fat oxidation: a metabolic pathway to obesity in the developing nations.

The purpose of this article is to document the metabolic and environmental factors associated with the increased frequency of obesity in the developing nations. While the prevalence of obesity in the developed countries is caused by the increased consumption of calorie-dense foods, in the developing nations, because obesity coexists with undernutrition, additional factors are necessary to account for it. The evidence suggests that an important contributing factor for obesity in the developing nations is a reduced fat oxidation and increased metabolism of carbohydrate that has been brought about by the chronic undernutrition experienced during prenatal and postnatal growth. This shift toward a preferential metabolic use of carbohydrate rather than of fat results in an increased deposition of body fat. This tendency, along with the general decrease of energy expenditure in physical activity associated with urbanization, and the culturally mediated acceptance of fatness leads to obesity among populations from the developing nations. A joint effect of these factors is that in the developing nations obesity is associated with short stature resulting from developmental undernutrition, while in the developed countries obesity is associated with tall stature. It is hoped that future research will address the mechanisms whereby undernutrition increases the tendency toward obesity. Understanding how to modify fat oxidation could affect our ability to prevent weight gain among undernourished populations of the developing nations. Therefore, future research on the interaction of undernutrition and the development of obesity is of prime importance for anthropology concerned with the origins of human variability. Copyright 2003 Wiley-Liss, Inc.