A global study examining energy expenditure and obesity across 34 populations reveals that economic development is strongly associated with increased body fat and BMI, but not because of a decline in physical activity. Contrary to long-standing assumptions, populations in developed economies display higher total and activity energy expenditures, largely due to greater fat-free mass. However, when adjusting for body size, the difference in energy expenditure between low- and high-development populations is small and does not significantly account for the rise in obesity.
Instead, the findings point to dietary factors – especially increased caloric intake and consumption of ultraprocessed foods-as the dominant contributors to obesity in economically developed regions. In populations where diet data were available, the percentage of ultraprocessed foods in the diet was a strong predictor of higher body fat percentage, even when controlling for physical activity, age, sex, and socioeconomic status.
This evidence suggests that public health strategies should focus more on regulating food environments and reducing the availability and consumption of obesogenic foods, rather than attributing obesity trends to sedentary lifestyles alone. While physical activity remains essential for overall health, diet quality plays a far more influential role in the obesity epidemic linked to global economic development.
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