History of obesity. In Denmark.

“The origins of the obesity epidemic may be further back than we thought”

A recently published paper concluded that the rise of obesity began earlier than conventionally assumed. (See article summarizing study: The Origins of Obesity in Science.)

"This study revealed that continuous steady increases since the interwar period in the upper percentiles of the BMI distribution preceded the obesity epidemic, with an almost similar pattern in the children and the young men." (published paper)

I agree with some of the criticisms of the study and conclusions, such as population sample=1 (Denmark). Is this trend replicated in other countries? 

Another comment from a biostatistician that “slow and steady increases in obesity don’t necessarily indicate an earlier onset of the epidemic [of obesity]”. A proper data pool for that would require data before 1930’s. 

A statement from the original published paper confirms my observation over the years traveling this country: “The acceleration of the obesity epidemic has been stronger in rural and provincial areas than in densely populated urban areas, which was seen already in the beginning of the rise of prevalence in obesity in Danish young men during the 1960s.”

And, like anything involving human behavior, the contributions are multifactorial.

The high prevalence of obesity in people of all ages in rural Ohio was a shock when I moved there in late 2001. 

During a conversation on this subject with a man (late 20’s) that I was training, he commented that as agriculture became industrialized it required less physical activity by all family members. However, the culture of food and eating amongst farm families remained the same: calorically dense food, especially fats, and large portions during meals. 

Consequently, while activity levels decreased, the energy balance became very skewed towards a positive high caloric net balance. Which, over time, results in increased body mass.  

We can see an eventual similar trend in urban areas over time, albeit slower. My hypothesis is that most rural families used to grow their own food, meat and vegetables/grains. So they had an almost guaranteed supply of food and energy. 

Urban people had to purchase all their food (and still do). Purchasing power for food was based on their incomes and other debts (rent, etc). History worldwide has shown that wealthy people always have had almost unrestricted access to food. For many centuries, being overweight was a social sign of being affluent. 

It was only during the last half century when increasingly more people began moving from rural to urban communities. Industrial agriculture and food processing caused a large shift in the nutritional content and availability of food, and the culture of food. 

As Gary said that day, “People of Ohio still love their corn and pork, and there is plenty of it here. But now everyone has desk and ‘standing still’ jobs. And the kids don’t play as much; they’re glued to their phones and video games.”