Sedentary lifestyle and not caloric intake¹ may be to blame for increased obesity² in the US, according to a new analysis of data from the National Health and Nutrition Examination Survey (NHANES). A study published in The American Journal of Medicine reveals that in the past 20 years there has been a sharp decrease in physical exercise and an increase in average body mass index (BMI), while caloric intake has remained steady. Investigators⁴ theorized that a nationwide drop in leisure-time physical activity, especially among young women, may be responsible for the upward trend in obesity rates. By analyzing⁵ NHANES data from the last 20 years, researchers from Stanford University discovered that the number of US adult women who reported no physical activity jumped from 19.1% in 1994 to 51.7% in 2010. For men, the number increased from 11.4% in 1994 to 43.5% in 2010. During the period, average BMI has increased across the board, with the most dramatic rise found among young women ages 18-39.

 

"These changes have occurred in the context of substantial increases in the proportion of adults reporting no leisure-time physical activity, but in the absence of any significant population-level changes in average daily caloric intake," explains lead investigator³ Uri Ladabaum, MD, MS, Associate Professor of Medicine (Gastroenterology and Hepatology), Stanford University School of Medicine. "At the population level, we found a significant association between the level of leisure-time physical activity, but not daily caloric intake, and the increases in both BMI and waist circumference⁶."

 

The study looked at the escalation⁷（增加，扩大） of obesity in terms of both exercise and caloric intake. While investigators did not examine what types of foods were consumed, they did observe that total daily calorie, fat, carbohydrate⁸, and protein consumption have not changed significantly over the last 20 years, yet the obesity rate among Americans is continuing to rise.

 

Researchers also tracked the rise in abdominal⁹（腹部的） obesity, which is an independent indicator¹⁰ of mortality even among people with normal BMIs. Abdominal obesity is defined by waist circumference of 88 cm (34.65 in) or greater for women and 102 cm (40.16 in) or greater for men. Data showed that average waist circumference increased by 0.37% per year for women and 0.27% per year for men. Just like the rise in average BMIs, the group most affected¹¹ by increased rates of abdominal obesity was women.

 

"The prevalence of abdominal obesity has increased among normal-weight women and overweight women and men," observes Dr. Ladabaum. "It remains¹² controversial whether overweight alone increases mortality risk, but the trends in abdominal obesity among the overweight are concerning in light of the risks associated with increased waist circumference（腰围） independent of BMI."

 

When Ladabaum et al grouped respondents to the most recent NHANES survey by race/ethnicity and age, they found that more than 50% of the workforce-aged adults in eight demographic subgroups reported no leisure-time physical activity. The following chart displays the results and highlights the differences between the 1994 survey results and those collected in 2010 (albeit, with slightly different survey methods). According to this data, women, and black and Mexican-American women in particular, showed the greatest decreases in reported exercise.

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