title: Obesity as malnutrition: the role of capitalism in the obesity global epidemic.
abstract: The global obesity epidemic remains poorly understood, partly because it has emerged alongside persisting under-nutrition in many populations. At an abstract level, obesity develops from exposure to the "obesogenic niche," comprising diverse factors predisposing to weight gain. This article first explores how susceptibility to the obesogenic niche is influenced by developmental and life-history experience. Human growth is sensitive to early-life ecological conditions, under the transducing effect of maternal phenotype. Such plasticity is associated with subsequent variability in body composition and metabolism, impacting susceptibility to the obesogenic niche, albeit with heterogeneity across populations. Both nutritional constraint and nutritional excess during early life are associated with variability in relevant molecular pathways. The article then considers the fundamental contribution of capitalist economics to population under-nutrition and over-nutrition. Historically, capitalism contributed to the under-nutrition of many populations through demand for cheap labor. As the limiting factor for economic growth switched to consumption, capitalism has increasingly driven consumer behavior inducing widespread over-nutrition. In populations undergoing nutritional transition, many individuals encounter both under- and over-nutrition within the life course, elevating both susceptibility and exposure to the obesogenic niche. The interactions between global economic forces and nutritional shifts are distributed across generations, and are strongly transduced by maternal effects. The structural connections between undernourished and overnourished worldwide and between under- and over-nutrition within individual life-courses highlight the central role of capitalist economics in the global obesity epidemic. Prevention policies targeting individual behavior have proved ineffective and economic policies are arguably the optimal target for intervention.
authors.affiliation: Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom. Jonathan.Wells@ucl.ac.uk
authors.forename: Jonathan C K
authors.initials: JC
authors.lastname: Wells
mesh_terms: D030861:Capitalism; D002149:Energy Intake; D006803:Human Development; D006801:Humans; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D044343:Overnutrition / Q000150:complications / Q000453:epidemiology / Q000209:etiology*; D011634:Public Health