Acabou de sair no NEJM: http://www.nejm.org/doi/full/10.1056/NEJMsa1208051
Myths, Presumptions, and Facts about Obesity
Krista Casazza, Ph.D., R.D., Kevin R. Fontaine, Ph.D., Arne Astrup, M.D., Ph.D., Leann L. Birch, Ph.D., Andrew W. Brown, Ph.D., Michelle M. Bohan Brown, Ph.D., Nefertiti Durant, M.D., M.P.H., Gareth Dutton, Ph.D., E. Michael Foster, Ph.D., Steven B. Heymsfield, M.D., Kerry McIver, M.S., Tapan Mehta, M.S., Nir Menachemi, Ph.D., P.K. Newby, Sc.D., M.P.H., Russell Pate, Ph.D., Barbara J. Rolls, Ph.D., Bisakha Sen, Ph.D., Daniel L. Smith, Jr., Ph.D., Diana M. Thomas, Ph.D., and David B. Allison, Ph.D.
N Engl J Med 2013; 368:446-454January 31, 2013DOI: 10.1056/NEJMsa1208051
Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information.
Using Internet searches of popular media and scientific literature, we identified, reviewed, and classified obesity-related myths and presumptions. We also examined facts that are well supported by evidence, with an emphasis on those that have practical implications for public health, policy, or clinical recommendations.
We identified seven obesity-related myths concerning the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals for weight loss, rapid weight loss, weight-loss readiness, physical-education classes, breast-feeding, and energy expended during sexual activity. We also identified six presumptions about the purported effects of regularly eating breakfast, early childhood experiences, eating fruits and vegetables, weight cycling, snacking, and the built (i.e., human-made) environment. Finally, we identified nine evidence-supported facts that are relevant for the formulation of sound public health, policy, or clinical recommendations.
False and scientifically unsupported beliefs about obesity are pervasive in both scientific literature and the popular press. (Funded by the National Institutes of Health.)
The views expressed in this article are those of the authors and do not necessarily represent the official views of the National Institutes of Health.
Supported in part by a grant (P30DK056336) from the National Institutes of Health.
DETALHES PARA A LISTA DE CONFLITOS DE INTERESSE:
Dr. Astrup reports receiving payment for board membership from the Global Dairy Platform, Kraft Foods, Knowledge Institute for Beer, McDonald’s Global Advisory Council, Arena Pharmaceuticals, Basic Research, Novo Nordisk, Pathway Genomics, Jenny Craig, and Vivus; receiving lecture fees from the Global Dairy Platform, Novo Nordisk, Danish Brewers Association, GlaxoSmithKline, Danish Dairy Association, International Dairy Foundation, European Dairy Foundation, and AstraZeneca; owning stock in Mobile Fitness; holding patents regarding the use of flaxseed mucilage or its active component for suppression of hunger and reduction of prospective consumption (patents EP1744772, WO2009033483-A1, EP2190303-A1, US2010261661-A1, and priority applications DK001319, DK001320, S971798P, and US971827P); holding patents regarding the use of an alginate for the preparation of an aqueous dietary product for the treatment or prevention of overweight and obesity (patent WO2011063809-A1 and priority application DK070227); and holding a patent regarding a method for regulating energy balance for body-weight management (patent WO2007062663-A1 and priority application DK001710). Drs. Brown and Bohan Brown report receiving grant support from the Coca-Cola Foundation through their institution. Dr. Mehta reports receiving grant support from Kraft Foods. Dr. Newby reports receiving grant support from General Mills Bell Institute of Health and Nutrition. Dr. Pate reports receiving consulting fees from Kraft Foods. Dr. Rolls reports having a licensing agreement for the Volumetrics trademark with Jenny Craig. Dr. Thomas reports receiving consulting fees from Jenny Craig. Dr. Allison reports serving as an unpaid board member for the International Life Sciences Institute of North America; receiving payment for board membership from Kraft Foods; receiving consulting fees from Vivus, Ulmer and Berne, Paul, Weiss, Rifkind, Wharton, Garrison, Chandler Chicco, Arena Pharmaceuticals, Pfizer, National Cattlemen’s Association, Mead Johnson Nutrition, Frontiers Foundation, Orexigen Therapeutics, and Jason Pharmaceuticals; receiving lecture fees from Porter Novelli and the Almond Board of California; receiving payment for manuscript preparation from Vivus; receiving travel reimbursement from International Life Sciences Institute of North America; receiving other support from the United Soybean Board and the Northarvest Bean Growers Association; receiving grant support through his institution from Wrigley, Kraft Foods, Coca-Cola, Vivus, Jason Pharmaceuticals, Aetna Foundation, and McNeil Nutritionals; and receiving other funding through his institution from the Coca-Cola Foundation, Coca-Cola, PepsiCo, Red Bull, World Sugar Research Organisation, Archer Daniels Midland, Mars, Eli Lilly and Company, and Merck. No other potential conflict of interest relevant to this article was reported.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
We thank Drs. Kyle Grimes and S. Louis Bridges for their suggestions on an earlier version of the manuscript.
From the Departments of Nutrition Sciences (K.C., M.M.B.B., D.L.S., D.B.A.), Health Behavior (K.R.F.), Pediatrics (N.D.), Medicine (G.D.), Health Care Organization and Policy (E.M.F., N.M., B.S.), and Biostatistics (T.M., D.B.A.) and the School of Public Health, Office of Energetics, Nutrition Obesity Research Center (A.W.B., D.B.A.), University of Alabama at Birmingham, Birmingham; the OPUS Center and the Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen (A.A.); the Departments of Development and Family Studies (L.L.B.) and Nutritional Sciences (B.J.R.), Pennsylvania State University, University Park; Pennington Biomedical Research Center, Baton Rouge, LA (S.B.H.); Children’s Physical Activity Research Group, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia (K.M., R.P.); the Departments of Pediatrics and Epidemiology, Program in Graduate Medical Nutrition Sciences, and Program in Gastronomy, Culinary Arts, and Wine Studies, Boston University, Boston (P.K.N.); and the Center for Quantitative Obesity Research, Montclair State University, Montclair, NJ (D.M.T.).
Address reprint requests to Dr. Allison at the University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL 35294, or at firstname.lastname@example.org.