Energy balance and weight gain -
International Society for Developmental Origins of Health and Disease. Tie HT, Xia YY, Zeng YS, Zhang Y, Dai CL, Guo JJ et al Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: a meta-analysis. Arch Gynecol Obstet 2 — Norris SA, Osmond C, Gigante D, Kuzawa CW, Ramakrishnan L, Lee NR et al Size at birth, weight gain in infancy and childhood, and adult diabetes risk in five low- or middle-income country birth cohorts.
Diabetes Care 35 1 — Adair LS, Martorell R, Stein AD, Hallal PC, Sachdev HS, Prabhakaran D et al Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter? Am J Clin Nutr 89 5 — de Beer M, Vrijkotte TG, Fall CH, van Eijsden M, Osmond C, Gemke RJ Associations of infant feeding and timing of linear growth and relative weight gain during early life with childhood body composition.
Int J Obes Lond 39 4 — Papadimitriou A Timing of adiposity rebound and prevalence of obesity. J Pediatr 2 Weng SF, Redsell SA, Swift JA, Yang M, Glazebrook CP Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy.
Arch Dis Child 97 12 — Pearce J, Taylor MA, Langley-Evans SC Timing of the introduction of complementary feeding and risk of childhood obesity: a systematic review.
Int J Obesity 37 10 — Wilson SM, Sato AF Stress and paediatric obesity: what we know and where to go Stress.
Health London 30 2 — Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Gortmaker SL, Long MW, Resch SC, Ward ZJ, Cradock AL, Barrett JL et al Cost effectiveness of childhood obesity interventions: evidence and methods for CHOICES.
Am J Prev Med 49 1 — Pan American Health Organization Recommendations from a Pan American Health Organization Expert Consultation on the Marketing of Food and Non-Alcoholic Beverages to Children in the Americas.
PAHO, Washington, D. Jenkin G, Madhvani N, Signal L, Bowers S A systematic review of persuasive marketing techniques to promote food to children on television. Obes Rev 15 4 — Hawkes C Regulating and litigating in the public interest: regulating food marketing to young people worldwide: trends and policy drivers.
Am J Public Health 97 11 — Wang YWY, Wilson RF, Bleich S, Cheskin L, Weston C, Showell N, Fawole O, Lau B, Segal J Childhood obesity prevention programs: comparative effectiveness review and meta-analysis internet: agency for healthcare research and quality US ; Contract No.
USDA Nutrition Evidence Library NEL Dietary patterns systematic review. UK Scientific Advisory Committee on Nutrition The influence of maternal, fetal and child nutrition on development of chronic disease in later life.
Emmett PM, Jones LR Diet, growth, and obesity development throughout childhood in the Avon Longitudinal Study of Parents and Children.
Nutr Rev 73 Suppl 3 — Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L et al Maternal and child undernutrition: consequences for adult health and human capital. Yang Z, Huffman SL Nutrition in pregnancy and early childhood and associations with obesity in developing countries.
Matern Child Nutr 9 Suppl 1 — Michels KB, Willett WC, Graubard BI, Vaidya RL, Cantwell MM, Sansbury LB et al A longitudinal study of infant feeding and obesity throughout life course.
Int J Obes Lond 31 7 — Ramirez-Silva I, Rivera JA, Trejo-Valdivia B, Martorell R, Stein AD, Romieu I et al Breastfeeding status at age 3 months is associated with adiposity and cardiometabolic markers at age 4 years in Mexican children.
J Nutr 6 — Download references. Nutrition and Metabolism Section, International Agency for Research on Cancer, cours Albert Thomas, , Lyon Cedex 08, France.
Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico. Micalis Institute, MGP MetagenoPolis, INRA, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France. Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, CRC, University hospital Malmö, Malmö, Sweden.
Faculty of Agricultural and Food Science, American University of Beirut, Beirut, Lebanon. Department of Nutrition and the Nutrition Research Institute, The University of North Carolina, Chapel Hill, USA.
Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany. Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK.
Nutrition Policy and Scientific Advice NPU , Department of Nutrition for Health and Development NHD , World Health Organization WHO , Geneva, Switzerland. Office of the Associate Director, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA.
Faculty of Earth and Life Sciences, Department of Health Sciences, University Amsterdam, Amsterdam, The Netherlands. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, Joint Appointments, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, USA.
NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. Institute of Nutrition, Mahidol University Salaya, Nakhon Pathom, Thailand. World Cancer Research Fund International, London, UK.
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Correspondence to Isabelle Romieu. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.
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Download PDF. Abstract Purpose The aim of this paper is to review the evidence of the association between energy balance and obesity. Methods In December , the International Agency for Research on Cancer IARC , Lyon, France convened a Working Group of international experts to review the evidence regarding energy balance and obesity, with a focus on Low and Middle Income Countries LMIC.
Results The global epidemic of obesity and the double burden, in LMICs, of malnutrition coexistence of undernutrition and overnutrition are both related to poor quality diet and unbalanced energy intake. Conclusion Energy intake that exceeds energy expenditure is the main driver of weight gain.
Obesity and Weight Control: Is There Light at the End of the Tunnel? Article 15 May Mediterranean Diet and Obesity-related Disorders: What is the Evidence? Article Open access 30 September The role of the Mediterranean diet on weight loss and obesity-related diseases Article 23 August Use our pre-submission checklist Avoid common mistakes on your manuscript.
Introduction Obesity is defined as a state of excess adiposity that presents a risk to health such as increased risk of chronic diseases including cancer [ 1 — 3 ] and is the consequence of sustained positive energy balance over time.
The International Agency for Research on Cancer IARC of the World Health Organization WHO convened a Working Group Meeting in December to review evidence regarding energy balance and obesity, with a focus on Low and Middle Income Countries LMIC , and to tackle the following scientific questions: 1.
What are the factors that modulate these associations? Table 1 List of topics presented during the working group meeting Full size table. Full size image. Determinants of energy balance: what the evidence tells us With recognition that overweight and obesity are major risk factors for cancer, cardiovascular disease, diabetes, and many other health conditions, the difference between energy intake and expenditure, frequently referred to as energy balance, has become of great interest because of its direct relation to long-term gain or loss of adipose tissue and alterations in metabolic pathways.
Measurements of adiposity Several measures for overweight and obesity have been used in epidemiological studies [ 3 ]; however, it is important to be aware that such measures are imperfect markers of the internal physiological processes that are the actual determinants of cancer development.
Energy intake and energy expenditure Energy balance is the result of equilibrium between energy intake and energy expenditure. Understanding nutritional determinants of obesity Many factors relating to foods and beverages have been shown to influence amounts consumed or energy balance over the short to medium term, such as energy density and portion size [ 36 , 37 ], although the effect of energy density over the longer term is unclear.
Foods and dietary patterns One factor that has been suggested as being obesogenic is a high energy density of foods i. Understanding weight loss In weight loss trials, low carbohydrate interventions led to significantly greater weight loss than did low-fat interventions when the intensity of intervention was similar [ 60 ].
Factors that modulate the association between dietary intake and obesity Physical activity Long-term observational studies fairly consistently show an association between physical activity and weight maintenance, and a position paper from the American College of Sports Medicine ACSM stated that — min per week of moderate intensity physical activity is effective to prevent weight gain [ 62 ].
Genetic and epigenetic factors The patterns and distributions of obesity within and between ethnically diverse populations living in similar and contrasting environments suggest that some ethnic groups are more susceptible than others to obesity [ 70 ].
Microbiota In a healthy symbiotic state, the colonic microbiota interacts with our food, in particular dietary fiber, allowing energy harvest from indigestible dietary compounds. Determinants of childhood obesity Many factors have contributed to the increase in the prevalence of obesity in children including unhealthy dietary patterns with high consumption of fast foods and highly processed food [ 85 ], of sugar sweetened beverages [ 86 ], lack of PA, an increase in sedentary behaviors e.
Prevention of obesity Numerous policy options to prevent obesity have been explored, and evidence is sufficient to conclude that many are cost effective. The obesity-cancer link: what are the underlying mechanisms?
Conclusions and recommendations The global epidemic of obesity and the double burden of malnutrition are both related to poor quality diet; therefore, improvement in diet quality can address both phenomena.
Update on the Obesity Epidemic: After the Sudden Rise, Is the Upward Trajectory Beginning to Flatten? Article Open access 02 October Ultra-processed Food and Obesity: What Is the Evidence? Article Open access 31 January Ultra-processed foods, adiposity and risk of head and neck cancer and oesophageal adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition study: a mediation analysis Article Open access 22 November References Anderson AS, Key TJ, Norat T, Scoccianti C, Cecchini M, Berrino F et al.
Food, nutrition, and physical activity: a global perspective Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C et al Global, regional, and national prevalence of overweight and obesity in children and adults during — a systematic analysis for the Global Burden of Disease Study Lancet — Article PubMed PubMed Central Google Scholar de Onis M, Blossner M, Borghi E Global prevalence and trends of overweight and obesity among preschool children.
Am J Clin Nutr 92 5 — Article PubMed Google Scholar Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA et al Child and adolescent obesity: part of a bigger picture.
Lancet — Article PubMed PubMed Central Google Scholar Wabitsch M, Moss A, Kromeyer-Hauschild K Unexpected plateauing of childhood obesity rates in developed countries. BMC Med Article PubMed PubMed Central Google Scholar Wang YF, Baker JL, Hil JO, Dietz WH Controversies regarding reported trends: has the obesity epidemic leveled off in the United States?
World Bank, Washington DC Google Scholar Darnton-Hill I, Nishida C, James WP A life course approach to diet, nutrition and the prevention of chronic diseases. Public Health Nutr 7 1a — Article CAS PubMed Google Scholar James P et al UN SCN, Geneva Moubarac JC, Martins AP, Claro RM, Levy RB, Cannon G, Monteiro CA Consumption of ultra-processed foods and likely impact on human health.
Public Health Nutr 16 12 — Article PubMed Google Scholar Monteiro CA, Levy RB, Claro RM, de Castro IR, Cannon G Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr 14 1 :5—13 Article PubMed Google Scholar Baker P, Friel S Processed foods and the nutrition transition: evidence from Asia.
Obes Rev 15 7 — Article CAS PubMed Google Scholar Barquera S, Pedroza-Tobias A, Medina C Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease.
Curr Opin Lipidol 27 4 — Article CAS PubMed PubMed Central Google Scholar International Food Policy Research Institute Washington, DC Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K et al Body fatness and cancer—viewpoint of the IARC Working Group.
N Engl J Med 8 — Article PubMed Google Scholar Hanahan D, Weinberg RA Hallmarks of cancer: the next generation. Cell 5 — Article CAS PubMed Google Scholar Bonomini F, Rodella LF, Rezzani R Metabolic syndrome, aging and involvement of oxidative stress.
Aging disease 6 2 — Article PubMed PubMed Central Google Scholar Hursting SD, Berger NA Energy balance, host-related factors, and cancer progression. J Clin Oncol 28 26 — Article PubMed PubMed Central Google Scholar Renehan AG, Roberts DL, Dive C Obesity and cancer: pathophysiological and biological mechanisms.
Arch Physiol Biochem 1 —83 Article CAS PubMed Google Scholar Sun Q, van Dam RM, Spiegelman D, Heymsfield SB, Willett WC, Hu FB Comparison of dual-energy X-ray absorptiometric and anthropometric measures of adiposity in relation to adiposity-related biologic factors.
Am J Epidemiol 12 — Article PubMed PubMed Central Google Scholar World Health Organization Waist circumference and waist-hip ratio: a report of a WHO expert consultation van der Kooy K, Leenen R, Seidell JC, Deurenberg P, Droop A, Bakker CJ Waist-hip ratio is a poor predictor of changes in visceral fat.
Am J Clin Nutr 57 3 — PubMed Google Scholar Willett W. Oxford University Press, New York, pp — Heymsfield SB, Lohman TG, Wang Z, Going SB Human body composition. Champaign McCrory MA, Gomez TD, Bernauer EM, Mole PA Evaluation of a new air displacement plethysmograph for measuring human body composition.
Med Sci Sports Exerc 27 12 — Article CAS PubMed Google Scholar Glickman SG, Marn CS, Supiano MA, Dengel DR Validity and reliability of dual-energy X-ray absorptiometry for the assessment of abdominal adiposity. J Appl Physiol 97 2 — Article Google Scholar Bandera EV, Maskarinec G, Romieu I, John EM Racial and ethnic disparities in the impact of obesity on breast cancer risk and survival: a global perspective.
Adv Nutr 6 6 — Article CAS PubMed PubMed Central Google Scholar Scientific Advisory Committee on Nutrition Dietary reference values for energy.
The Stationery Office, London Google Scholar Hall KD, Sacks G, Chandramohan D, Chow CC, Wang YC, Gortmaker SL et al Quantification of the effect of energy imbalance on bodyweight.
Lancet — Article PubMed Google Scholar Healy GN, Wijndaele K, Dunstan DW, Shaw JE, Salmon J, Zimmet PZ et al Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study AusDiab.
Diabetes Care 31 2 — Article PubMed Google Scholar Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J et al Accuracy of body mass index in diagnosing obesity in the adult general population. Int J Obes Lond 32 6 — Article CAS Google Scholar Ello-Martin JA, Ledikwe JH, Rolls BJ The influence of food portion size and energy density on energy intake: implications for weight management.
Am J Clin Nutr 82 1 Suppl S— S Prentice AM Manipulation of dietary fat and energy density and subsequent effects on substrate flux and food intake. Am J Clin Nutr 67 3 Suppl S— S Fogelholm M, Anderssen S, Gunnarsdottir I, Lahti-Koski M Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review.
Food Nutr Res 56 Salas-Salvado J, Bullo M, Babio N, Martinez-Gonzalez MA, Ibarrola-Jurado N, Basora J et al Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial.
Diabetes Care 34 1 —19 Article PubMed Google Scholar Jaworowska A, Blackham T, Davies IG, Stevenson L Nutritional challenges and health implications of takeaway and fast food. Nutr Rev 71 5 — Article PubMed Google Scholar Schroder H, Fito M, Covas MI Association of fast food consumption with energy intake, diet quality, body mass index and the risk of obesity in a representative Mediterranean population.
Br J Nutr 98 6 — Article CAS PubMed Google Scholar Pereira MA, Kartashov AI, Ebbeling CB, Van Horn L, Slattery ML, Jacobs DR Jr. Lancet —42 Article PubMed Google Scholar Alkerwi A, Crichton GE, Hebert JR Consumption of ready-made meals and increased risk of obesity: findings from the observation of cardiovascular risk factors in Luxembourg ORISCAV-LUX study.
Br J Nutr 1—8 Kant AK, Whitley MI, Graubard BI Away from home meals: associations with biomarkers of chronic disease and dietary intake in American adults, NHANES — Int J Obes Lond 39 5 — Article CAS Google Scholar Chajes V, Biessy C, Ferrari P, Romieu I, Freisling H, Huybrechts I et al Plasma elaidic acid level as biomarker of industrial trans fatty acids and risk of weight change: report from the EPIC study.
PloS one 10 2 :e Article PubMed PubMed Central Google Scholar Han E, Powell LM Consumption patterns of sugar-sweetened beverages in the United States. J Acad Nutr Dietetics 1 —53 Article Google Scholar Basu S, McKee M, Galea G, Stuckler D Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross-national analysis of 75 countries.
Am J Public Health 11 — Article PubMed PubMed Central Google Scholar Malik VS, Pan A, Willett WC, Hu FB Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr 98 4 — Article CAS PubMed PubMed Central Google Scholar Te Morenga L, Mallard S, Mann J Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies.
BMJ e Article Google Scholar Rouhani MH, Salehi-Abargouei A, Surkan PJ, Azadbakht L Is there a relationship between red or processed meat intake and obesity? Obes Rev 15 9 — Article CAS PubMed Google Scholar Fung TT, Pan A, Hou T, Chiuve SE, Tobias DK, Mozaffarian D et al Long-term change in diet quality is associated with body weight change in men and women.
J Nutr 8 — Article CAS PubMed PubMed Central Google Scholar Romaguera D, Norat T, Vergnaud AC, Mouw T, May AM, Agudo A et al Mediterranean dietary patterns and prospective weight change in participants of the EPIC-PANACEA project. Am J Clin Nutr 92 4 — Article CAS PubMed Google Scholar Funtikova AN, Benitez-Arciniega AA, Gomez SF, Fito M, Elosua R, Schroder H Mediterranean diet impact on changes in abdominal fat and year incidence of abdominal obesity in a Spanish population.
Br J Nutr 8 — Article CAS PubMed Google Scholar Buckland G, Bach A, Serra-Majem L Obesity and the Mediterranean diet: a systematic review of observational and intervention studies.
Obes Rev Off J Int Assoc Study Obes 9 6 — Article CAS Google Scholar Richter LM, Victora CG, Hallal PC, Adair LS, Bhargava SK, Fall CH et al Cohort profile: the consortium of health-orientated research in transitioning societies.
Int J Epidemiol Romieu I, Escamilla-Nunez MC, Sanchez-Zamorano LM, Lopez-Ridaura R, Torres-Mejia G, Yunes EM et al The association between body shape silhouette and dietary pattern among Mexican women.
Public Health Nutr 15 1 — Article PubMed Google Scholar Scientific Advisory Committee on Nutrition Carbohydrates and health. The Stationery Office, London Google Scholar Mirza NM, Palmer MG, Sinclair KB, McCarter R, He J, Ebbeling CB et al Effects of a low glycemic load or a low-fat dietary intervention on body weight in obese Hispanic American children and adolescents: a randomized controlled trial.
Am J Clin Nutr 97 2 — Article CAS PubMed Google Scholar Tobias DK, Chen M, Manson JE, Ludwig DS, Willett W, Hu FB Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. Endocrinol 3 12 — Google Scholar Hu T, Mills KT, Yao L, Demanelis K, Eloustaz M, Yancy WS Jr.
Am J Epidemiol Suppl 7 :S44—S54 Article PubMed PubMed Central Google Scholar Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK et al American College of Sports Medicine Position Stand. Med Sci Sports Exerc 41 2 — Article PubMed Google Scholar Thorogood A, Mottillo S, Shimony A, Filion KB, Joseph L, Genest J et al Isolated aerobic exercise and weight loss: a systematic review and meta-analysis of randomized controlled trials.
Am J Med 8 — Article PubMed Google Scholar Miller CT, Fraser SF, Levinger I, Straznicky NE, Dixon JB, Reynolds J et al The effects of exercise training in addition to energy restriction on functional capacities and body composition in obese adults during weight loss: a systematic review.
PloS one 8 11 :e Article PubMed PubMed Central Google Scholar Ismail I, Keating SE, Baker MK, Johnson NA A systematic review and meta-analysis of the effect of aerobic vs. PLoS One 8 12 :e Article PubMed PubMed Central Google Scholar Hu FB, Li TY, Colditz GA, Willett WC, Manson JE Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women.
Jama 14 — Article PubMed Google Scholar Liao Y, Liao J, Durand CP, Dunton GF Which type of sedentary behaviour intervention is more effective at reducing body mass index in children?
Obes Rev Off J Int Assoc Study Obesity 15 3 — Article CAS Google Scholar Blundell JE, Gibbons C, Caudwell P, Finlayson G, Hopkins M Appetite control and energy balance: impact of exercise.
ObesRev 16 Suppl 1 —76 Google Scholar Franks PW, Ravussin E, Hanson RL, Harper IT, Allison DB, Knowler WC et al Habitual physical activity in children: the role of genes and the environment. Am J Clin Nutr 82 4 — CAS PubMed Google Scholar Locke AE, Kahali B, Berndt SI, Justice AE, Pers TH, Day FR et al Genetic studies of body mass index yield new insights for obesity biology.
Nature — Article CAS PubMed PubMed Central Google Scholar Ahmad S, Varga TV, Franks PW Gene x environment interactions in obesity: the state of the evidence. Hum Hered 75 2—4 — Article PubMed Google Scholar Kilpelainen TO, Qi L, Brage S, Sharp SJ, Sonestedt E, Demerath E et al Physical activity attenuates the influence of FTO variants on obesity risk: a meta-analysis of , adults and 19, children.
PLoS Med 8 11 :e Article PubMed PubMed Central Google Scholar Qi Q, Chu AY, Kang JH, Jensen MK, Curhan GC, Pasquale LR et al Sugar-sweetened beverages and genetic risk of obesity. Diabetologia 57 3 — Article CAS PubMed Google Scholar Nettleton JA, Follis JL, Ngwa JS, Smith CE, Ahmad S, Tanaka T et al Gene x dietary pattern interactions in obesity: analysis of up to 68, adults of European ancestry.
Hum Mol Genet 24 16 — Article CAS PubMed PubMed Central Google Scholar van Dijk SJ, Tellam RL, Morrison JL, Muhlhausler BS, Molloy PL Recent developments on the role of epigenetics in obesity and metabolic disease. Clinical Epigenetics 7 1 Article PubMed PubMed Central Google Scholar Chambers JC, Loh M, Lehne B, Drong A, Kriebel J, Motta V et al.
Lancet Diabetes Endocrinol 3 7 — Dick KJ, Nelson CP, Tsaprouni L, Sandling JK, Aïssi D, Wahl S et al. Curr Opin Microbiol 16 3 — Article CAS PubMed Google Scholar Vangay P, Ward T, Gerber JS, Knights D Antibiotics, pediatric dysbiosis, and disease.
Cell Host Microbe 17 5 — Article CAS PubMed Google Scholar Le Chatelier E, Nielsen T, Qin J, Prifti E, Hildebrand F, Falony G et al Richness of human gut microbiome correlates with metabolic markers.
Nature — Article CAS PubMed Google Scholar Dao MC, Everard A, Aron-Wisnewsky J, Sokolovska N, Prifti E, Verger EO et al Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology. Gut 65 3 — Article CAS PubMed Google Scholar Kong LC, Holmes BA, Cotillard A, Habi-Rachedi F, Brazeilles R, Gougis S et al Dietary patterns differently associate with inflammation and gut microbiota in overweight and obese subjects.
PLoS One 9 10 :e Article PubMed PubMed Central Google Scholar Lobstein T, Baur L, Uauy R, TaskForce IIO Obesity in children and young people: a crisis in public health. Obes Rev 5 Suppl 1 :4— Article PubMed Google Scholar Perez-Morales E, Bacardi-Gascon M, Jimenez-Cruz A Sugar-sweetened beverage intake before 6 years of age and weight or BMI status among older children; systematic review of prospective studies.
JAMA 16 — Article CAS PubMed Google Scholar Fatima Y, Doi SAR, Mamun AA Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis.
Obes Rev 16 2 — Article CAS PubMed Google Scholar Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA et al Child and adolescent obesity: part of a bigger picture.
Lancet WHO Global strategy on diet, physical activity and health—what are the causes? World Health Organization ISDOHaD. International Society for Developmental Origins of Health and Disease Tie HT, Xia YY, Zeng YS, Zhang Y, Dai CL, Guo JJ et al Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: a meta-analysis.
Arch Gynecol Obstet 2 — Article PubMed Google Scholar Norris SA, Osmond C, Gigante D, Kuzawa CW, Ramakrishnan L, Lee NR et al Size at birth, weight gain in infancy and childhood, and adult diabetes risk in five low- or middle-income country birth cohorts.
Diabetes Care 35 1 —79 Article PubMed Google Scholar Adair LS, Martorell R, Stein AD, Hallal PC, Sachdev HS, Prabhakaran D et al Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter?
Am J Clin Nutr 89 5 — Article CAS PubMed PubMed Central Google Scholar de Beer M, Vrijkotte TG, Fall CH, van Eijsden M, Osmond C, Gemke RJ Associations of infant feeding and timing of linear growth and relative weight gain during early life with childhood body composition. Int J Obes Lond 39 4 — Article Google Scholar Papadimitriou A Timing of adiposity rebound and prevalence of obesity.
J Pediatr 2 Article PubMed Google Scholar Weng SF, Redsell SA, Swift JA, Yang M, Glazebrook CP Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy.
Arch Dis Child 97 12 — Article PubMed PubMed Central Google Scholar Pearce J, Taylor MA, Langley-Evans SC Timing of the introduction of complementary feeding and risk of childhood obesity: a systematic review.
Int J Obesity 37 10 — Article CAS Google Scholar Wilson SM, Sato AF Stress and paediatric obesity: what we know and where to go Stress. You'll have either a positive energy balance, a negative energy balance, or a perfect balance. If losing weight is your goal and your energy equation was either balanced or positive, don't worry.
If you found that your balance was negative, but the total falls short of the calorie goal, that's okay too. There are three different ways to change your number and lose weight successfully. There are only three ways to change your energy balance.
In short, you have to either reduce your caloric intake, increase your energy output, or combine the two options to achieve the calorie deficit needed for weight loss. The right method for you depends on your health history, your lifestyle, and your personal preferences.
If you can't exercise or if you absolutely hate to exercise, you can reduce your caloric intake by to calories per day to lose weight. Once the weight is gone, however, people who choose this option may have a hard time keeping the weight off.
As you slim down, your metabolism changes. That means that your energy output number decreases and you have to decrease your energy input even more to reach energy balance. In short, you have to eat less.
For many people, eating less is not reasonable or sustainable for the long-term. You can also change your energy balance by exercising more. For most people, it would require an intense exercise session that lasts 45 minutes or more.
And you'd need to do it every day. Even fit, athletic exercisers need easy workout days or days off to recover and refuel. Unless you are in a job that involves regular physical movement, this option may not be the most reasonable and it may put you at risk for injury. Making small adjustments to both your caloric intake and your physical activity is generally recommended as the most reasonable and sustainable method of weight loss.
Using this method, you can burn a few hundred extra calories with a workout and cut back calories by eliminating dessert or high-calorie snacks to reach your goal.
It is also the best way to maintain your weight after you've slimmed down. To lose one pound per week, experts generally recommend an energy deficit of calories per week.
If you choose the combined method to change your energy balance, you can play around with the numbers to see what works best. Here's an example:. Roger has a positive energy balance of calories. In this state, he will gain weight. To lose weight, he needs a negative balance of roughly calories per day or calories per week.
To reach his goal, Roger chooses to make modest changes to his diet to decrease his caloric intake by calories per day. Then, he will add physical activity to burn more calories. His goal is to burn an extra calories by walking or biking to work. On the weekends, he'll hike to burn calories per day.
Updated Energy Balance Plan for Roger. With a negative energy balance of calories per day, Roger will have a total calorie deficit of calories per week and will lose roughly one pound per week on this plan. Our working hypothesis is that the biological regulation of energy balance is optimum at a high level of energy flux i.
We have been influenced by the work of Jean Mayer and colleagues 20 , who suggested this in the s and thought that there may a threshold of physical activity below which energy balance regulation is least sensitive.
He suggested that individuals who had high levels of energy expenditure due to high levels of physical activity were better at regulating energy intake with energy expenditure than those with low levels of energy expenditure due to low levels of physical activity.
Bell et al. They reported that resting metabolic rate RMR is higher at high vs. low energy flux, and the difference may be due to differences in sympathetic nervous system activity. We continue to pursue the idea that our biological regulation of energy balance is most sensitive when regulation occurs at a high energy flux.
The two ways to increase energy flux are to become more physically active or to become obese. Both serve to increase total energy expenditure, allowing energy balance to be regulated at a higher level.
Although it is theoretically possible to maintain energy balance at a low energy flux, in practice, it may be very difficult for most people to maintain the level of food restriction necessary to do this. If it is easier to maintain energy balance at a high energy flux, this is an important consideration in the treatment of obesity.
The only way to reduce obesity and maintain a high energy flux is to substitute increased physical activity for the lost body weight. Finally, there are other important biological constraints that should be considered in the regulation of energy balance. It is clear that humans have a preference for sweet tastes and perhaps for high-energy dense foods There does not seem to be a strong biological drive to promote energy restriction or to promote physical activity Our biology is strongly aimed at promoting energy intake and protecting against weight loss.
Environmental factors that facilitate energy intake and discourage physical activity do not appear to be biologically opposed. The reason why the entire population is not obese is probably because some people are able to oppose these environmental factors with conscious efforts to avoid overeating and engage in regular physical activity.
We cannot attribute the obesity epidemic solely to our biology. We must also examine the role of our behavior patterns. Our diet and physical activity patterns are the source of day to day variations in energy balance.
The state of positive energy balance that started the obesity epidemic must have resulted from changes in behavior. Experts debate about the extent to which changes in diet vs.
changes in physical activity produced the obesity epidemic. Although there is some indication that energy intake has increased and physical activity has declined over the past few decades, it is surprisingly difficult to accurately quantify these changes. Our information about energy intake comes from self-reported food intake which is problematic in determining total energy intake Furthermore, it is difficult to separate cause from effect between energy intake and obesity.
For example, energy intake in the NHANES surveys aligns well with body weight. The jump in body weight and obesity seen from NHANES II to NHANES III was mirrored by a jump in average energy intake Was this causal in weight gain or simply the result of the increase in weight in the population?
Similarly, it is difficult to quantify the role of declines in physical activity in contributing to weight gain over the past decades.
Adequate measures of physical activity have not always been available. For example, leisure time physical activity has remained relatively constant since 26 , but the patterns before then are not clear. Most experts speculate that technological changes have reduced lifestyle physical activity 23 , Unfortunately, it is only recently that researchers have begun to measure lifestyle physical activity.
The best indication that this change may be significant comes from assessment of walking in a group of Amish individuals who have not adopted most technological changes occurring during the 20th century.
Researchers found that Amish men walk 18, steps per day and women 14, steps per day In comparison, we found that in Colorado, the average male takes steps per day, and the average female takes steps per day From the limited data available, it appears that energy intake has increased and physical activity has decreased more than enough to explain the increase in the weight of the population.
One of the most controversial areas of obesity research is the role of diet composition on body weight. We have, again, approached this issue from an energy balance point of view by trying to understand the impact of diet composition on energy intake, energy expenditure, and efficiency of energy storage.
Flatt 29 provided a theoretical basis for how diet composition could impact body weight regulation. Flatt argued that achieving energy balance is largely a matter of achieving substrate balance and particularly fat balance. There is little functional capacity for storage of additional protein or carbohydrate in the body, but capacity for fat storage is essentially unlimited.
It is important that protein and carbohydrate balance be regulated acutely, and the body developed effective means for oxidizing excesses of these nutrients. Fat balance can be regulated over the long term because fat can be brought in and out of storage as needed.
Thus, the way the body reachieves energy balance after a perturbation e. Our work has shown that the impact of diet composition will differ depending on whether subjects are in energy balance or whether they are in positive or negative energy balance.
There seems to be similar body weight and body fat loss with high- and low-fat diets when total energy intake was fixed at a level below energy requirements 30 — However, there are several reports of differences in weight loss with high- and low-fat diets when energy intake was not fixed 33 — 35 , suggesting that diet composition may affect satiety or hunger during dieting.
Nordmann et al. Diet composition can impact body weight in individuals who are in energy balance. Astrup et al. Reducing dietary fat without food restriction affects both energy intake and energy expenditure in small ways.
Voluntary intake is consistently lower with low-fat vs. high-fat diets 38 , Because carbohydrate produces more thermic effect than fat, reducing dietary fat and increasing dietary carbohydrate would also be expected to produce a slight increase in the thermic effect of food If lowering dietary fat composition produces slight decreases in energy intake and slight increases in energy expenditure, the result should be that energy balance is reestablished with a slightly lower body weight and body fat content.
During positive energy balance, diet composition can have a big effect on energy balance. We demonstrated that excess energy is efficiently stored in the body regardless of its source, but that excess energy from dietary fat is stored with a greater efficiency than excess energy from carbohydrate.
We demonstrated this with an overfeeding study where subjects were overfed high-fat and high-carbohydrate diets for 14 d each Subjects were studied in a whole room calorimeter that allowed determination of energy expenditure and substrate balances over time.
Carbohydrate overfeeding produced progressive increases in carbohydrate oxidation and in total energy expenditure over the 14 d. The energy storage was due more to declining fat oxidation than to de novo lipogenesis.
The excess energy from dietary fat was stored efficiently without noticeable effects on substrate oxidation or energy expenditure. In summary, our work suggests that gradual increases in dietary fat may have played a role in the weight gain of the population and that reductions in dietary fat would be one way to produce small, but important, reductions in the average weight of the population.
Some critics point out that previous public health efforts to lower dietary fat levels in the population have not been effective in lowering the body weight of the population However, such efforts were not effective in actually lowering dietary fat. Although the percentage of fat in the diet decreased from the late s to early s, this was only because total energy intake increased.
The actual amount of fat in grams consumed per day did not decline. Rather than lowering dietary fat, we simply added more carbohydrate on top of a high-fat diet. Our work also suggests that there is little effect of lowering dietary fat during negative energy balance.
Thus, it is not surprising that low-fat diets have not been found to lead to greater weight loss than higher-fat diets. There is recent interest in how the protein content of the diet impacts body weight 42 , but there is insufficient research at present to understand the impact of these diets on energy balance.
Similarly, the impact of high vs. low glycemic diets on energy balance is still unclear and very controversial 43 , There is considerable evidence that the energy density of the diet can impact energy intake, at least over the short term. Energy density is defined as kilocalories per weight of food.
Over the short term, humans eat a constant volume of food at meals 45 , 46 so that total energy intake increases with energy density of the diet. Some of the effect of high-fat diets on energy intake is likely due to the higher energy density of high-fat diets However, high levels of dietary fat may increase energy intake independently of energy density Portion size is another factor that can influence total energy intake.
Rolls and colleagues 47 have consistently demonstrated that energy intake increases as the portion size of the food offered increases. Other factors, such as increased variety of food, low cost, and accessibility also may increase energy intake The role of added sugars in energy balance and body weight is highly controversial.
Epidemiological data suggest an inverse relationship between carbohydrate content of the diet and weight However, the impact of dietary sugar may depend on whether it replaces other calories or simply adds to them.
We previously found that adding excess carbohydrate to a mixed diet results in the storage of most of the excess carbohydrate.
This occurs because carbohydrate oxidation is increased and fat oxidation is decreased, creating a situation of positive fat balance and positive energy balance Much added sugar in the diet of Americans comes from beverages.
There has been speculation that energy intake from beverages may be regulated differently than energy in foods in a way to contribute to positive energy balance If the sugar in beverages adds, rather than replaces, other calories, dietary sugar could be a factor contributing to positive energy balance.
Declining levels of physical activity in the population would likely decrease energy expenditure and, if not matched by a decline in energy intake, produce positive energy balance and weight gain Reductions in physical activity would produce an obvious decline in the energy expended in physical activity, but might also produce small declines in RMR 21 and in the thermic effect of food There is very strong epidemiological data suggesting that moderate to high levels of physical activity protect against weight gain and obesity 54 , We have reviewed these data on several occasions, demonstrating that the impact of physical activity on energy balance is to make it less likely that positive energy balance and weight gain will occur 56 , A controversial issue in this area is how much physical activity should be recommended for prevention of weight gain, weight loss, and prevention of weight regain after weight loss.
Our work suggests that very small increases in physical activity may prevent weight gain 58 , whereas very large increases are necessary to avoid weight regain after weight loss We have also argued that the impact of diet and physical activity together on energy balance must be considered.
Whether the fat content of the diet, for example, produces positive fat and energy balance depends on the level of physical activity. Because regular physical activity increases fat oxidation and total energy expenditure, a physically active person should be able to eat a higher-fat diet without the risk of positive energy balance and weight gain.
Several studies have shown that increased physical activity protects against high-fat diets in producing positive energy balance 60 , Kelly Brownell was one of the first to call attention to the power of the external environment in promoting excessive energy intake and obesity We provided a theoretical foundation for how the environment could affect energy balance in two papers in Science 23 , We pointed out the many ways that both the food and physical activity environment has changed over time in a way to encourage overeating and to discourage physical activity.
The impact of the environment on energy balance seems to be unidirectional and promotes positive rather than negative energy balance.
Although we believe that there are biological systems that attempt to maintain energy balance, the ability of such systems to defend body weight in the face of increasing unidirectional environmental pressures is limited.
Hill et al. The fact that obesity rates have gradually increased since the s might suggest that people with a high metabolic susceptibility experienced weight gain first as the environment became more obesigenic i.
However, as the influence of the environment on energy balance becomes stronger, more and more people are unable to biologically oppose the environmental influences and are experiencing weight gain.
It is tempting to try to identify one or two environmental factors that are most responsible for weight gain in the population.
For example, Bray et al. However, we believe that it is impossible to attribute the influences of the environment on energy balance to one or two—or five factors; rather it has been small changes in numerous environmental factors 23 , 58 , Our current food supply now is one that is high in fat, energy dense, and high in sugar.
Food is inexpensive and available in large portions. Food is heavily advertised, and it has become acceptable to have food everywhere. These are factors that are known to promote energy intake in a way that does not elicit strong biological opposition.
Our physical activity environment has changed largely due to technological advances that make it unnecessary to be physically active in our daily lives. Most occupations no longer involve physical activity, and we rarely need to be physically active for transportation. The development of television, DVDs, computers, the internet, and video games has filled our leisure time with sedentary rather than physically active pursuits.
The way we build our communities promotes driving and not walking. The major challenge becomes to identify the factors in the environment that can be changed to help reverse the population weight gain. Our challenge is to use our understanding of the regulation of energy balance to develop strategies to address the obesity epidemic.
Figure 3 , which is modified from the work of Dr. Stephan Rossner 66 , can be used to consider two different approaches to reversing the obesity epidemic—treatment and prevention. The dotted line in Fig.
The gradual weight gain of the population and rates of obesity will likely continue, perhaps until everyone is obese. One strategy would be to prevent positive energy balance and stop the gradual weight gain of the population.
Another strategy is to treat obesity in those already affected. This involves producing negative energy balance to produce weight loss followed by achieving energy balance permanently at a lowered body weight. Possible strategies for addressing the obesity epidemic. Bouchard, 63 with permission from CRC Press.
One strategy for reducing obesity rates is to treat obesity and overweight. Many overweight and obese individuals have tried to lose weight, and most have been successful to some degree.
However, few succeed in long-term maintenance of weight loss. Our work suggests that a big reason for the high failure rate in obesity treatment is the failure to see weight loss maintenance as a separate process from weight loss.
From an energy balance point of view, weight loss involves a temporary period of negative energy balance, whereas weight loss maintenance involves a permanent period of achieving energy balance at a new level.
For practical purposes, food restriction is the primary driver of weight loss, and any diet that results in eating fewer calories will produce weight loss. Although it is possible to lose weight with physical activity alone 67 , 68 , it is difficult for most people to do enough to achieve a degree of negative energy balance that would result in significant weight loss.
This is also why adding physical activity to food restriction produces only a minimal additional amount of weight loss The difference in weight loss under these conditions is most likely due to the impact of the diet on hunger and satiety. When total calories are fixed in a hypocaloric diet, weight loss does not vary significantly by diet composition 30 — Dansinger et al.
However, attrition was high in all groups. The problem is that weight tends to be regained in most people regardless of the composition of the diet used for weight loss.
For example, the greater initial weight loss of low- vs. high-carbohydrate diets is not maintained at 1 yr 33 — Most people who lose weight, regardless of the diet used to lose the weight, regain it over the next 1—3 yr The exact success rate in treating obesity is difficult to identify and depends on definitions of success.
Although we have a great deal of research about factors that contribute to weight loss, we have surprisingly little research to understand the factors that contribute to weight loss maintenance.
We study weight loss maintenance using our rodent model of dietary obesity and using information from the National Weight Control Registry NWCR.
In , Dr. Rena Wing and I started the NWCR to recruit and study a group of people who had succeeded at long-term weight loss maintenance. Individuals are eligible to enter the NWCR if they have maintained a weight loss of at least 30 pounds for at least 1 yr.
Individuals self-report their weight loss to enter the NWCR and provide information to us, largely, by completing questionnaires about weight loss and weight loss maintenance. Currently, we are following over individuals in the NWCR.
These individuals are maintaining an average weight loss of over 70 pounds for an average period of almost 6 yr. Over the past decade, we have described characteristics of these successful weight loss maintainers 59 , 74 — Although this is not a prospective study of weight loss maintenance, we have identified many common characteristics of these individuals that provide interesting hypotheses about successful weight loss maintenance.
We have found surprisingly few similarities in how NWCR participants report losing their weight. Conversely, many similarities are seen in the behaviors and strategies used to maintain weight loss.
The four that stand out are: Eating a moderately low-fat, high-carbohydrate diet. This is consistent with our previous work suggesting that low-fat diets should be better than high-fat diets in preventing positive energy balance.
Consistent self-monitoring of body weight, food intake, and physical activity. NWCR participants continue to periodically keep diet and physical activity records. This is consistent with other reports that self-monitoring facilitates long-term success in weight management Eating breakfast every day.
This is consistent with a growing body of data showing that eating breakfast facilitates maintenance of a healthy body weight Very high levels of physical activity. Others have reported that high levels of physical activity are important for long-term weight loss maintenance 80 — Weight loss is about negative energy balance, and there are many ways to produce this.
Negative energy balance is a temporary state that cannot be easily maintained for long periods of time. Weight loss maintenance is about achieving energy balance, but at a new lower body weight.
It requires diet and physical activity patterns that can be maintained indefinitely. The challenge is not just achieving energy balance, but achieving it at a lower body weight.
This is a challenge because energy requirements decline with weight loss. Holly Wyatt and I developed the concept of the energy gap in an attempt to individualize strategies for weight loss maintenance Fig.
The energy gap is the difference between energy requirements before and after weight loss RMR decreases with decreasing body mass. The thermic effect of food decreases with total energy intake. The energy cost of physical activity is related to body mass and declines with weight loss.
Although there is a debate about whether the drop in energy requirements might actually be larger than expected from the loss of body weight 85 , it is clear that energy expenditure is lower after weight loss than before, and this presents a challenge in achieving energy balance after weight loss.
Most people do not distinguish between weight loss and weight loss maintenance. They try to achieve energy balance after weight loss by maintaining their lower energy intake. A typical energy gap for a weight loss of 40 pounds would be — kcal. There are two ways to address the energy gap—reduce energy intake or increase physical activity.
It is not difficult to maintain this amount of food restriction temporarily, but the challenge is doing it permanently. Food restriction can be an effective temporary strategy, but it is rarely an effective long-term strategy for many people.
It is opposed by our biology that stimulates us to eat 86 and is, perhaps, accompanied by other metabolic changes that we identified in our weight-reduced animal model 15 — Similarly, food restriction is vigorously opposed by an environment that encourages eating.
It is no surprise that few people can consistently fight their biology and their environment to sustain energy restriction. When they fail, they rapidly regain their weight, just like our weight-reduced rats.
The second way of addressing the energy gap is to increase physical activity. There are several advantages to this strategy. Presumably, intake before weight loss was at a level that could be maintained long term. It is certainly possible that an individual may combine strategies to address the energy gap by reducing energy intake some and increasing energy expenditure some more.
We believe that those who rely more on increasing physical activity than food restriction to address the energy gap will be more successful in long-term weight loss maintenance.
In addition to allowing a higher energy intake during weight loss maintenance, there are at least two other ways that high levels of physical activity may facilitate weight loss maintenance. First, high levels of physical activity may compensate for changes in metabolism caused by established obesity.
If obesity affects humans in the way it affects rats, weight-reduced humans may have a strong metabolic drive to regain weight. We have examined possible metabolic effects of obesity in individuals in the NWCR. We find that RMR in NWCR participants is not different than lean or obese controls However, RMR was measured while they were performing their usual daily physical activity regimen and might be lower if measured under chronic sedentary conditions.
As another example, we find one of the metabolic characteristics of weight-reduced rats that may predispose them to weight regain is a lower than anticipated leptin level 15 — A recent study suggested that giving leptin to weight-reduced humans may be more effective to prevent weight gain than to produce weight loss A second way that physical activity may help with weight loss maintenance is by maintaining a high energy flux.
Weight loss produces a decline in energy requirements, and achieving energy balance by food restriction results in achieving energy balance at a lower flux. By increasing physical activity, energy flux can continue to be maintained at a high level, which may be where biological regulatory systems are most sensitive.
An important question is whether it is any easier for people to maintain an increase in physical activity of — kcal than it is for them to maintain an energy restriction of the same amount.
In truth, it is difficult to produce and maintain increases in physical activity in most people. We still have to find better ways to get people to increase physical activity, but the available data suggest that this strategy has a greater potential for success than energy restriction.
Similarly, increasing physical activity is the only strategy found at least partially to prevent weight regain in our weight-reduced animal model Other strategies such as drugs or surgery may partially fill the energy gap. For example, a drug that reduces hunger or increases energy expenditure would help fill the energy gap and require less voluntary food restriction or intentional increase in physical activity.
In summary, the challenge for obesity treatment is not losing weight but keeping it off. There are many ways to produce weight loss, but permanent weight loss maintenance may require a very high level of physical activity.
An alternative strategy to obesity treatment is prevention of excessive weight gain. This strategy does not require producing negative energy balance but rather only requires preventing positive energy balance. This strategy would represent a very long-term approach to addressing the obesity epidemic and is based on the notion that it is easier and more feasible to prevent weight gain than to produce and maintain substantial weight loss.
The first goal with this strategy would be to stop obesity rates from increasing, and gradually, over generations, to reduce levels to those seen before We provided a theoretical basis for this strategy in our second Science paper We estimated the degree of positive energy balance that is producing the gradual weight gain of the population.
Brown et al. If the gradual weight gain of the population is due to a small degree of positive energy balance, it should be possible to stop it with a small changes strategy that involves small decreases in energy intake and small increases in energy expenditure.
Such a strategy makes sense from an energy balance point of view. Making small decreases in energy intake would serve to reduce the positive energy balance, not produce negative energy balance. This should not produce strong biological compensatory decreases in energy intake of the kind that are seen with substantial food restriction.
Similarly, there is no evidence that small increases in physical activity produce compensatory increases in energy intake in relatively sedentary individuals
Balancw balance is a Energy balance and weight gain concept in weight control, Endrgy on the relationship between calorie intake and expenditure. Put simply, Nutrient absorption mechanism about balabce calories gsin consume versus balabce calories Energy balance and weight gain burn, and it significantly impacts your body weight. Energy balance is essential for overall weight control and plays a pivotal role in the daily management of blood sugar levels for individuals with Type 1 diabetes. Striking the right balance between calorie intake and expenditure is vital to achieving and sustaining a healthy weight and maintaining stable blood sugar levels in this population. Our website uses cookies.
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