Trends in nutrition, lifestyle, and metabolic disease in the United States from 1900 onwards

The growing ‘epidemic’ of metabolic disease may be a consequence of a typical Western lifestyle, consisting of excessive fat and sugar intake and a lack of physical exercise. Some animal studies have provided insights into the mechanisms of metabolic syndrome and obesity and the influence of dietary composition, however there are still unclarities regarding the effects of diet and lifestyle factors on the development of metabolic disease in humans. In this study, we investigated long-term trends in diet, lifestyle, and metabolic disease in the United States. Data on the included variables was collected from published literature as well as publicly available data, covering as many years as possible from 1900 onwards. We found that intake of all macronutrients and added sugar has increased but has started to plateau or decrease in more recent years. Exercise, urbanization, and life expectancy have also risen. However, besides some evidence of urbanization and life expectancy correlating with metabolic disease prevalence, we did not see a clear association between most of the dietary factors and the steeply rising prevalence of metabolic disease. We propose that to gain traction on the issue of metabolic disease in our current society, it is necessary to continue research into (new aspects of) our diet, and to include other (external) factors. These may be related to the gut microbiota, including antibiotics use and epigenetics. [Display omitted] •Nutrition and exercise are understood to be the main causes of metabolic disease.•Intake of protein, fat, carbohydrates and added sugar increased since 1900.•Exercise, life expectancy and urbanization have all risen as well.•Metabolic disease prevalence rises disproportionally to diet and lifestyle trends.•More research is required on other contributing factors or combinations thereof.