Trends in obesity and energy supply in the WHO MONICA Project.

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 > or =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.