Epidemiologic evidence

Following the results of a survey by an expert group [5] of the global prevalence of obesity, the WHO has now declared obesity to be one of the major international health problems. The situation continues to worsen; for example, the prevalence of overweight and obesity in England has doubled over the past 10-15 years [5]. In this same period energy consumption, estimated on a national level, has been seen to be decreasing. This must mean that energy expenditure by physical exercise has diminished or, more accurately, that physical inactivity has been increasing. This is probably caused by a combination of the widespread availability of mechanized transportation, which requires no muscular activity, the increase in physically inactive jobs and production methods, and the increase in inactive leisure activities, such as watching television. The latter is a particular problem in children, where many age groups spend up to 5-6 h/day in front of the television [6]. The significance of these observations is, however, rather uncertain, as watching television is frequently associated with snacking, an indisputable contributor to the generation of obesity.

Because of the difficulties of assessment described above, most observations on physical inactivity are circumstantial. The available information does, however, suggest that physical inactivity is an important ingredient in the pathogenesis of the current obesity epidemic. If this interpretation is correct then the diminished physical inactivity is, of course, a highly important target priority in both prevention and therapy of obesity and its complications.

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