Skip to main content

The Influence on Population Weight Gain and Obesity of the Macronutrient Composition and Energy Density of the Food Supply


Rates of overweight and obesity have increased dramatically in all regions of the world over the last few decades. Almost all of the world’s population now has ubiquitous access to low-cost, but highly-processed, energy-dense, nutrient-poor food products. These changes in the food supply, rather than decreases in physical activity, are most likely the primary driver of population weight gain and obesity. To-date, the majority of prevention efforts focus on personalised approaches targeting individuals. Population-wide food supply interventions addressing sodium and trans fat reduction have proven highly effective and comparable efforts are now required to target obesity. The evidence suggests that strategies focusing upon reducing the energy density and portion size of foods will be more effective than those targeting specific macronutrients. Government leadership, clearly specified targets, accountability and transparency will be the key to achieving the food supply changes required to address the global obesity epidemic.

This is a preview of subscription content, access via your institution.

Fig. 1


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.•

    Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014. doi:10.1016/S0140-6736(14)60460-8. This paper provides a comprehensive, up-to-date analysis of obesity trends over the past 30 years. Furthermore, this study highlights the significant burden of the obesity epidemic and the urgent need for public health intervention.

    Google Scholar 

  2. 2.

    Shiri R, Karppinen J, Leino-Arjas P, et al. The association between obesity and low back pain: a meta-analysis. Am J Epidemiol. 2010;171(2):135–54.

    Article  PubMed  Google Scholar 

  3. 3.

    Dixon JB. The effect of obesity on health outcomes. Mol Cell Endocrinol. 2010;316(2):104–8.

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    World Health Organisation. Global status report on non-communicable diseases 2010. Geneva, Switzerland: 2011.

  5. 5.

    World Health Organisation. Assessing national capacity for the prevention and control of non-communicable diseases: report of the 2010 global survey. Geneva, Switzerland: 2012.

  6. 6.

    Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095–128.

    Article  PubMed  Google Scholar 

  7. 7.

    Kac G, Perez-Escamilla R. Nutrition transition and obesity prevention through the life-course. Int J Obes Suppl. 2013;3(S1):S6–8.

    Article  Google Scholar 

  8. 8.

    Popkin BM, Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes Relat Metab Disord. 2004;28(S3):S2–9.

    Article  PubMed  Google Scholar 

  9. 9.

    Popkin BM. The nutrition transition: an overview of world patterns of change. Nutr Rev. 2004;62:S140–3.

    Article  PubMed  Google Scholar 

  10. 10.

    Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3–21.

    Article  PubMed Central  PubMed  Google Scholar 

  11. 11.

    Baker P, Friel S. Processed foods and the nutrition transition: evidence from Asia. Obes Rev. 2014;12(7):564–77.

  12. 12.

    National Heart Foundation of Australia. Rapid review of the evidence: effectiveness of food reformulation as a strategy to improve population health. Australia. 2012.

  13. 13.

    Monteiro C, Levy R, Claro R, et al. Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr. 2010;14(1):5–13.

    Article  Google Scholar 

  14. 14.

    Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804–14.

    Article  PubMed  Google Scholar 

  15. 15.

    Clark SE, Hawkes C, Murphy SM, et al. Exporting obesity: US farm and trade policy and the transformation of the Mexican consumer food environment. Int J Occup Environ Health. 2012;18(1):53–64.

    Article  PubMed  Google Scholar 

  16. 16.

    Thow AM, McGrady B. Protecting policy space for public health nutrition in an era of international investment agreements. Bull World Health Organ. 2014;92(2):139–45.

    Article  PubMed Central  PubMed  Google Scholar 

  17. 17.••

    Dwyer-Lindgren L, Freedman G, Engell RE, et al. Prevalence of physical activity and obesity in US counties, 2001-2011: a road map for action. Popul Health Metrics. 2013;11(1):7. This extensive report, with highly robust statistical analysis provides a turning point in the physical activity and obesity debate. Findings from this study help to pin-point key areas for the development of public health initiatives when addressing the obesity epidemic.

    Article  Google Scholar 

  18. 18.

    Swinburn B, Sacks G, Ravussin E. Increased food energy supply is more than sufficient to explain the US epidemic of obesity. Am J Clin Nutr. 2009;90(6):1453–6.

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Hall KD, Sacks G, Chandramohan D, et al. Quantification of the effect of energy imbalance on bodyweight. Lancet. 2011;378(9793):826–37.

    Article  PubMed  Google Scholar 

  20. 20.

    Luke A, Cooper RS. Physical activity does not influence obesity risk: time to clarify the public health message. Int J Epidemiol. 2013;42(6):1831–6.

    Article  PubMed  Google Scholar 

  21. 21.

    Hallal PC, Andersen LB, Bull FC, et al. Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet. 2012;380(9838):247–57.

    Article  PubMed  Google Scholar 

  22. 22.

    Hill JO. Understanding and addressing the epidemic of obesity: an energy balance perspective. Endocr Rev. 2006;27(7):750–61.

    Article  PubMed  Google Scholar 

  23. 23.

    Hill JO, Wyatt HR, Reed GW, et al. Obesity and the environment: where do we go from here? Science. 2003;299(5608):853–5.

    Article  CAS  PubMed  Google Scholar 

  24. 24.

    Swinburn BA, Sacks G, Lo S, et al. Estimating the changes in energy flux that characterize the rise in obesity prevalence. Am J Clin Nutr. 2009;89:1723–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. 25.

    United States Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta GA: 1996.

  26. 26.••

    Fogelholm M, Anderssen S, Gunnarsdottir I, et al. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review. Food and Nutrition Research. 2012; 56. This comprehensive systematic review is of great importance to public health when asssessing the food environment (primarily composition) in relation to weight gain and obesity. The extensive summarised details provided in this review regarding macronutrient and overall food consumption highlights key areas and action points for public health interventions.

  27. 27.

    Sacks FMMD, Bray GAMD, Carey VJP, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360(9):859–73.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. 28.

    Roush K. Diets vs. combinations of fat, protein, and carbohydrates. AJN Am J Nurs. 2009;109(11):64.

    Google Scholar 

  29. 29.

    Tsai AG, Wadden TA. Systematic review: an evaluation of major commercial weight loss programs in the United States. Ann Intern Med. 2005;142(1):56–66.

    Article  PubMed  Google Scholar 

  30. 30.

    Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes. 2006;1:11–25.

    Article  PubMed  Google Scholar 

  31. 31.

    Vandevijvere S, Monteiro C, Krebs‐Smith S, et al. Monitoring and benchmarking population diet quality globally: a step‐wise approach. Obes Rev. 2013;14(S1):135–49.

    Article  PubMed  Google Scholar 

  32. 32.

    Swinburn B, Sacks G, Vandevijvere S, et al. INFORMAS (International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support): overview and key principles. Obes Rev. 2013;14:1–12.

    Article  Google Scholar 

  33. 33.

    Swinburn B, Caterson I, Seidell JC, et al. Diet, nutrition and the prevention of excess weight gain and obesity. Public Health Nutr. 2004;7(1a):123–46.

    CAS  PubMed  Google Scholar 

  34. 34.

    Schutz Y. Macronutrients and energy balance in obesity. Metabolism. 1995;44(S3):7–11.

    Article  CAS  PubMed  Google Scholar 

  35. 35.

    Abete I, Astrup A, Martínez JA, et al. Obesity and the metabolic syndrome: role of different dietary macronutrient distribution patterns and specific nutritional components on weight loss and maintenance. Nutr Rev. 2010;68(4):214–31.

    Article  PubMed  Google Scholar 

  36. 36.

    Moubarac J, Martins A, Claro R, et al. Consumption of ultra-processed foods and likely impact on human health. Evidence from Canada. Public Health Nutr. 2012;16(12):2240–8.

    Article  PubMed  Google Scholar 

  37. 37.

    Monteiro C. Nutrition and health. The issue is not food, nor nutrients, so much as the processing (Invited commentary). Public Health Nutr. 2009;12(5):729–31.

    Article  PubMed  Google Scholar 

  38. 38.

    Popkin B. Global nutrition dynamics: the world in shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84:289–98.

    CAS  PubMed  Google Scholar 

  39. 39.

    Stuckler D, McKee M, Ebrahim S, et al. Manufacturing epidemics: the role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco. PLoS Med. 2012;9(6):e1001235.

  40. 40.

    Kearney J. Food consumption trends and drivers. Phil Trans R Soc B Biol Sci. 2010;365(1554):2793–807.

    Article  Google Scholar 

  41. 41.

    Kane G. What is the real cost of our food? Implications for the environment, society and public health nutrition. Public Health Nutr. 2011;15(2):268–76.

    Article  Google Scholar 

  42. 42.

    Drewnowski A. Obesity and the food environment: Dietary energy density and diet costs. Am J Prev Med. 2004;27(S3):154–62.

    Article  PubMed  Google Scholar 

  43. 43.

    Austin GL, Ogden LG, Hill JO. Trends in carbohydrate, fat, and protein intakes and association with energy intake in normal-weight, overweight, and obese individuals: 1971–2006. Am J Clin Nutr. 2011;93(4):836–43.

    Article  CAS  PubMed  Google Scholar 

  44. 44.

    Moubarac J-C, Batal M, Martins APB, et al. Processed and ultra-processed food products: consumption trends in Canada from 1938 to 2011. Can J Diet Pract Res. 2014;75(1):15–21.

    Article  PubMed  Google Scholar 

  45. 45.

    Seiden A, Hawley NL, Schulz D, et al. Long‐term trends in food availability, food prices, and obesity in Samoa. Am J Hum Biol. 2012;24(3):286–95.

    Article  PubMed Central  PubMed  Google Scholar 

  46. 46.

    Sheehy T, Sharma S. The nutrition transition in Barbados: trends in macronutrient supply from 1961 to 2003. Br J Nutr. 2010;104(08):1222–9.

    Article  CAS  PubMed  Google Scholar 

  47. 47.

    Golzarand M, Mirmiran P, Jessri M, et al. Dietary trends in the Middle East and North Africa: an ecological study (1961 to 2007). Public Health Nutr. 2012;15(10):1835–44.

    Article  PubMed  Google Scholar 

  48. 48.

    World Health Organisation. Diet, nutrition and the prevention of chronic diseases. Report of the Joint WHO/FAO Expert Consultation Geneva: 2003.

  49. 49.

    Alexandratos N, Bruinsma J. World agriculture towards 2030/2050: the 2012 revision. ESA Working paper Rome, FAO, 2012.

  50. 50.

    Australian Bureau of Statistics. Australian Health Survey: Nutrition First Results - Food and Nutrients, 2011-12. Canberra, Australia: 2014.

  51. 51.

    World Health Organisation. WHO Draft Guideline: sugars intake for adults and children. Geneva: World Health Organisation; 2014.

    Google Scholar 

  52. 52.

    Bray GA, Champagne CM. Beyond energy balance: there is more to obesity than kilocalories. J Am Diet Assoc. 2005;105(S5):17–23.

    Article  Google Scholar 

  53. 53.

    Hall KD. Mechanisms of metabolic fuel selection: modeling human metabolism and body-weight change. Eng Med Biol Mag IEEE. 2010;29(1):36–41.

    Article  Google Scholar 

  54. 54.

    Buchholz AC, Schoeller DA. Is a calorie a calorie? Am J Clin Nutr. 2004;79(5):899S–906.

    CAS  PubMed  Google Scholar 

  55. 55.

    Astrup A. Macronutrient balances and obesity: the role of diet and physical activity. Public Health Nutr. 1999;2(Supplement 3a):341–7.

    CAS  PubMed  Google Scholar 

  56. 56.

    Howarth NC, Saltzman E, Roberts S. Dietary fiber and weight regulation. Nutr Rev. 2001;59(5):129–39.

    Article  CAS  PubMed  Google Scholar 

  57. 57.

    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: Br Med J. 2013;346.

  58. 58.

    Grimes CA, Riddell LJ, Campbell KJ, et al. Dietary salt intake, sugar-sweetened beverage consumption, and obesity risk. Pediatrics. 2012.

  59. 59.

    Song WO, Wang Y, Chung CE, et al. Is obesity development associated with dietary sugar intake in the U.S.? Nutrition. 2012;28(11–12):1137–41.

    Article  CAS  PubMed  Google Scholar 

  60. 60.

    Williams P. Viewpoint. Sugar: is there a need for a dietary guideline in Australia? Aust J Nutr Diet. 2000;58:26–31.

    Google Scholar 

  61. 61.

    Bes-Rastrollo M, Schulze MB, Ruiz-Canela M, et al. Financial conflicts of interest and reporting bias regarding the association between sugar-sweetened beverages and weight gain: a systematic review of systematic reviews. PLoS Med. 2013;10(12):e1001578.

    Article  PubMed Central  PubMed  Google Scholar 

  62. 62.

    Malik VS, Pan A, Willett WC, et al. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98(4):1084–102.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  63. 63.

    de Ruyter JC, Olthof MR, Seidell JC, et al. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012;367(15):1397–406.

    Article  PubMed  Google Scholar 

  64. 64.

    Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006;84(2):274–88.

    PubMed Central  CAS  PubMed  Google Scholar 

  65. 65.

    Astrup A, Buemann B, Flint A, et al. Low-fat diets and energy balance: how does the evidence stand in 2002? Proc Nutr Soc. 2002;61(02):299–309.

    Article  PubMed  Google Scholar 

  66. 66.

    Hill JO, Melanson EL, Wyatt HT. Dietary fat intake and regulation of energy balance: implications for obesity. J Nutr. 2000;130(2):284.

    Google Scholar 

  67. 67.

    Crowe T, La Fontaine H, Gibbons C, et al. Energy density of foods and beverages in the Australian food supply: influence of macronutrients and comparison to dietary intake. Eur J Clin Nutr. 2004;58:1485–91.

    Article  CAS  PubMed  Google Scholar 

  68. 68.

    Stubbs J, Ferres S, Horgan G. Energy density of foods: effects on energy intake. Crit Rev Food Sci Nutr. 2000;40(6):481–515.

    Article  CAS  PubMed  Google Scholar 

  69. 69.

    Thomas JG, Doshi S, Crosby RD, et al. Ecological momentary assessment of obesogenic eating behavior: combining person-specific and environmental predictors. Obesity. 2011;19(8):1574–9.

    Article  PubMed  Google Scholar 

  70. 70.

    Murtaugh MA, Herrick JS, Sweeney C, et al. Diet composition and risk of overweight and obesity in women living in the southwestern United States. J Am Diet Assoc. 2007;107(8):1311–21.

    Article  CAS  PubMed  Google Scholar 

  71. 71.

    Kantor ED, Lampe JW, Kratz M, et al. Lifestyle factors and inflammation: associations by body mass index. PLoS ONE. 2013;8(7):e67833.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  72. 72.

    Muñoz-Pareja M, Guallar-Castillón P, Mesas AE, et al. Obesity-related eating behaviors are associated with higher food energy density and higher consumption of sugary and alcoholic beverages: a cross-sectional study. PLoS ONE. 2013;8(10):e77137.

    Article  PubMed Central  PubMed  Google Scholar 

  73. 73.

    Wang L, Lee I, Manson JE, et al. Alcohol consumption, weight gain, and risk of becoming overweight in middle-aged and older women. Arch Intern Med. 2010;170(5):453–61.

    Article  PubMed Central  PubMed  Google Scholar 

  74. 74.

    Schröder H, Morales-Molina J, Bermejo S, et al. Relationship of abdominal obesity with alcohol consumption at population scale. Eur J Nutr. 2007;46(7):369–76.

    Article  PubMed  Google Scholar 

  75. 75.

    Sayon‐Orea C, Martinez‐Gonzalez MA, Bes-Rastrollo M. Alcohol consumption and body weight: a systematic review. Nutr Rev. 2011;69(8):419–31.

    Article  PubMed  Google Scholar 

  76. 76.

    Flores M, Macias N, Rivera M, et al. Dietary patterns in Mexican adults are associated with risk of being overweight or obese. J Nutr. 2010;140(10):1869–73.

    Article  CAS  PubMed  Google Scholar 

  77. 77.

    Howarth NC, Murphy SP, Wilkens LR, et al. Dietary energy density is associated with overweight status among 5 ethnic groups in the multiethnic cohort study. J Nutr. 2006;136(8):2243–8.

    CAS  PubMed  Google Scholar 

  78. 78.

    Baldini M, Pasqui F, Bordoni A, et al. Is the Mediterranean lifestyle still a reality? Evaluation of food consumption and energy expenditure in Italian and Spanish university students. Public Health Nutr. 2009;12(02):148–55.

    Article  PubMed  Google Scholar 

  79. 79.

    Davey RC. The obesity epidemic: too much food for thought? Br J Sports Med. 2004;38(3):360–3.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  80. 80.

    Drewnowski A, Darmon N. The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr. 2005;82(1):265S–73.

    CAS  PubMed  Google Scholar 

  81. 81.

    Drewnowski A, Rolls B. How to modify the food environment. J Nutr. 2005;135:898–9.

    CAS  PubMed  Google Scholar 

  82. 82.

    Drewnowski A, Almiron-Roig E, Marmonier C, et al. Dietary energy density and body weight: is there a relationship? Nutr Rev. 2004;62(11):403–13.

    Article  PubMed  Google Scholar 

  83. 83.

    Vernarelli JA, Mitchell DC, Hartman TJ, et al. Dietary energy density is associated with body weight status and vegetable intake in US children. J Nutr. 2011;141(12):2204–10.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  84. 84.

    Matthiessen J, Fagt S, Biltoft-Jensen A, et al. Size makes a difference. Public Health Nutr. 2003;6(01):65–72.

    Article  PubMed  Google Scholar 

  85. 85.

    Nielsen SJ, Popkin BM. Patterns and trends in food portion sizes, 1977-1998. JAMA. 2003;289(4):450–3.

    Article  PubMed  Google Scholar 

  86. 86.

    Steenhuis IH, Leeuwis FH, Vermeer WM. Small, medium, large or supersize: trends in food portion sizes in The Netherlands. Public Health Nutr. 2010;13(06):852–7.

    Article  PubMed  Google Scholar 

  87. 87.

    Young LR, Nestle M. Reducing portion sizes to prevent obesity: a call to action. Am J Prev Med. 2012;43(5):565–8.

    Article  PubMed  Google Scholar 

  88. 88.

    Young L, Nestle M. Portion sizes and obesity: responses of fast-food companies. J Public Health Policy. 2007;28:238–48.

    Article  PubMed  Google Scholar 

  89. 89.

    Steenhuis I, Vermeer W. Portion size: review and framework for interventions. Int J Behav Nutr Phys Act. 2009;6(1):1–10.

    Article  Google Scholar 

  90. 90.

    Ledikwe JH, Ello-Martin JA, Rolls BJ. Portion Sizes and the Obesity Epidemic. J Nutr. 2005;135(4):905–9.

    CAS  PubMed  Google Scholar 

  91. 91.

    Ello-Martin J, Ledikwe J, Rolls B. The influence of food portion size and energy density on energy intake: implications for weight management. Am J Clin Nutr. 2005;82:S236–41.

    Google Scholar 

  92. 92.

    Rolls B, Roe L, Meengs J. Reductions in portion size and energy density of foods are additive and lead to sustained decreases in energy intake. Am J Clin Nutr. 2006;83:11–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  93. 93.

    Poelman MP, Steenhuis IH, de Vet E, et al. The development and evaluation of an internet-based intervention to increase awareness about food portion sizes: a randomized, controlled trial. J Nutr Educ Behav. 2013;45(6):701–7.

    Article  PubMed  Google Scholar 

  94. 94.

    Vermeer W, Steenhuis I, Poelman M. Small, medium, large or supersize? the development and evaluation of interventions targeted at portion size. Int J Obes. 2014;38:S13–8.

    Article  Google Scholar 

  95. 95.

    Murakami K, Miyake Y, Sasaki S, et al. An energy-dense diet is cross-sectionally associated with an increased risk of overweight in male children, but not in female children, male adolescents, or female adolescents in Japan: the Ryukyus Child Health Study. Nutr Res. 2012;32(7):486–94.

    Article  CAS  PubMed  Google Scholar 

  96. 96.

    Steyn NP, Nel JH, Parker W-A, et al. Dietary, social, and environmental determinants of obesity in Kenyan women. Scand J Public Health. 2011;39(1):88–97.

    Article  PubMed  Google Scholar 

  97. 97.

    Hawkes C, Jewell J, Allen K. A food policy package for healthy diets and the prevention of obesity and diet‐related non‐communicable diseases: the NOURISHING framework. Obes Rev. 2013;14(S2):159–68.

    Article  PubMed  Google Scholar 

  98. 98.

    World health Organisation. Global action plan for the prevention and control of non-communicable diseases 2013-2020. Geneva: World Health Organisation; 2013.

    Google Scholar 

  99. 99.

    World Cancer Research Fund. WCRF international food policy framework for healthy diets: NOURISHING - improve nutritional quality of the whole food supply London 2014. Available from: Accessed June 2014.

  100. 100.

    Pietinen P, Valsta LM, Hirvonen T, et al. Labelling the salt content in foods: a useful tool in reducing sodium intake in Finland. Public Health Nutr. 2008;11(04):335–40.

    Article  PubMed  Google Scholar 

  101. 101.

    Laatikainen T, Pietinen P, Valsta L, et al. Sodium in the Finnish diet: 20-year trends in urinary sodium excretion among the adult population. Eur J Clin Nutr. 2006;60(8):965–70.

    Article  CAS  PubMed  Google Scholar 

  102. 102.

    Puska P, Ståhl T. Health in all policies—the Finnish initiative: background, principles, and current issues. Annu Rev Public Health. 2010;31(1):315–28.

    Article  PubMed  Google Scholar 

  103. 103.

    Wyness LA, Butriss JL, Stanner SA. Reducing the population's sodium intake: the UK Food Standards Agency's salt reduction programme. Public Health Nutr. 2012;15(02):254–61.

    Article  PubMed  Google Scholar 

  104. 104.

    Webster J, Dunford E, Hawkes C, et al. Salt reduction initiatives around the world. J Hypertens. 2011;29:1043–50.

    Article  CAS  PubMed  Google Scholar 

  105. 105.

    Department of Health. Public health responsibility deal: calorie reduction pledge United Kingdom: Department of Health, Government of the United Kingdom; 2014. Accessed: available from:

  106. 106.

    Cobiac LJ, Vos T, Veerman JL. Cost-effectiveness of interventions to reduce dietary salt intake. Heart. 2010;96(23):1920–5.

    Article  PubMed  Google Scholar 

  107. 107.

    Bibbins-Domingo K, Chertow GM, Coxson PG, et al. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med. 2010;362(7):590–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  108. 108.

    Cappuccio FP, Capewell S, Lincoln P, et al. Policy options to reduce population salt intake. BMJ. 2011;343:4995.

    Article  Google Scholar 

  109. 109.

    Palar K, Sturm R. Potential societal savings from reduced sodium consumption in the US adult population. Am J Health Promot. 2009;24(1):49–57.

    Article  PubMed  Google Scholar 

  110. 110.

    Slining MM, Ng SW, Popkin BM. Food companies’ calorie-reduction pledges to improve U.S. diet. Am J Prev Med. 2013;44(2):174–84.

    Article  PubMed Central  PubMed  Google Scholar 

  111. 111.

    Department of Health. Industry engagement Australia: Australian Government Department of Health; 2009. Available from: Accessed Feb 2014.

  112. 112.

    Moodie R, Stuckler D, Monteiro C, et al. Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries. Lancet. 2013;381:670–9.

    Article  PubMed  Google Scholar 

Download references


Michelle Crino, Gary Sacks, Gary Swinburn and Bruce Neal are researchers within an NHMRC Centre for Research Excellence in Obesity Policy and Food Systems (APP1041020). Bruce Neal is supported by an Australian Research Council Future Fellowship (DP100100295) and a National Health and Medical Research Council of Australia Senior Research Fellowship (APP100311).

Compliance with Ethics Guidelines

Conflict of Interest

Michelle Crino has received scholarship money from Sanitarium Honours Scholarship 2011, and was in the Student Placement Program 2009 at Campbell Arnott’s.

Gary Sacks and Boyd Swinburn declare that they have no conflict of interest.

Stefanie Vandevijvere has received a Fellowship through the University of Auckland, and received travel/accommodations expenses covered or reimbursed for attending International conferences from Heart Foundation New Zealand, Maurice and Phyllis Paykel Trust New Zealand, and Auckland Medical Research Foundation.

Bruce Neal has received grant support from Australian Food and Grocery Council, and he interacts regularly on a non-financial basis with multiple large corporations in the Food Processing Industry and the Quick Service Restaurant industry in Australia and overseas in his efforts to improve the quality of the food supply.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information



Corresponding author

Correspondence to Michelle Crino.

Additional information

This article is part of the Topical Collection on Etiology of Obesity

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Crino, M., Sacks, G., Vandevijvere, S. et al. The Influence on Population Weight Gain and Obesity of the Macronutrient Composition and Energy Density of the Food Supply. Curr Obes Rep 4, 1–10 (2015).

Download citation


  • Obesity
  • Nutrition transition
  • Macronutrient composition
  • Energy density
  • Food supply
  • Ultra-processed food products