Energy balance

Both overall and abdominal obesity have deleterious effects on insulin sensitivity and insulin secretion and are risk predictors of impaired glucose tolerance and clinical type 2 diabetes (reviewed in Feskens 1992; Virtanen & Aro 1994; Costacou & Mayer-Davis 2003). Already a small, sustained decrease in weight improves insulin sensitivity and decreases the risk of type 2 diabetes (Tuomilehto et al. 2001; Diabetes Prevention Program Research Group 2002). The putative effects of dietary factors other than energy overload (such as fibre, glycaemic load, proportion of fat, type of dietary fatty acids) in the aetiology of overall and abdominal obesity remain to be settled.

Overweight and obesity have during the recent decades increased alarmingly in various populations worldwide, also among children and adolescents (e.g. Kautiainen et al. 2002; Jolliffe 2004).

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