Modeling the Epidemiologic Transition: Energy Expenditure, Obesity and Diabetes

As populations get more secure access to food and emerge from intergenerational undernutrition, they go rapidly to the opposite extreme of explosive obesity and its accompanying pathologies, diabetes, hypertension and cardiovascular disease. 80% of the burden of disease attributable to these chronic diseases rests on low and low middle income countries, the ones least economically able to provide the required costly curative medical care. Global public health has placed a premium on learning how to prevent the epidemics in the first place. Key to achieving this is a thorough understanding of what causes the weight gain in the first place. It is intuitively obvious that we gain weight if we take in more energy from food than we put out in activity. But the detailed understanding of all the factors that lead to increases in intake and reductions in output of energy both vary across populations and differ in specific detail. UWI SODECO is one of five collaborating research centres that have won a grant from the US National Institutes of Health to investigate the pathways to obesity and co-morbidities, Modeling the Epidemiologic Transition Study (METS). This is a population based study that is designed to test the relationship between physical activity (PA) and body weight, diabetes, and cardiovascular disease (CVD) risk in 5 populations of African origin living in the Seychelles, South Africa, Ghana, Jamaica and the US (suburban Chicago). These are sites which represent populations at different stages of the epidemiologic transition. When completed in 2016, METS will provide insight into the relative contributions of physical activity and dietary intake to overweight/obesity, age-related weight gain, diabetes and hypertension in five population samples of young adults at different stages of economic development. These data is useful for the development of empirically-based public health policy aimed at the prevention of obesity and associated chronic diseases.