North america is an obese dragon11/20/2023 ![]() Factors that probably contributed to the increased intake of UPFs include their relatively low price and the increased popularity of fast-food restaurants. A similar pattern is also seen with other UPFs. There is strong evidence that consumption of SSBs leads to higher energy intake and more weight gain. Of particular importance is sugar intake, especially sugar-sweetened beverages (SSBs). This paper presents the opinion that the factor most closely linked to the epidemic is ultra-processed foods (UPFs) (i.e., foods with a high content of calories, salt, sugar, and fat but with very little whole foods). There is little association with changes in the intake of fat and carbohydrate. The cause is closely related to changes in the American diet. An explanation must be consistent with the emergence of the epidemic in both genders and in all age groups and ethnicities at about the same time, and with a steady rise in the prevalence of obesity until at least 2016. This paper examines the most likely causes of the epidemic in the USA. The obesity epidemic appeared in the USA in 1976–1980 and then spread across Westernized countries.
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