We were encouraged by the publication of the recent "call to action" by Manson et al1 regarding the growing epidemic of obesity. However, in presenting their proposal, most of their focus is on physical activity with limited reference to dietary intervention. While we agree that exercise is a necessary component in an overall strategy to combat obesity, we are concerned about the relative importance of exercise compared with diet as presented. A review of the diet, exercise, and obesity data demonstrates an increase in the prevalence of those engaged in the recommended levels of activity (25.4% vs 24.3%) and a decrease in those reporting no activity (30.7% vs 28.7%), albeit with an increase in those reporting insufficient activity (45.0% vs 45.9%).2 These minor changes in exercise rates occurred in the setting of a 61% increase in the prevalence of Americans with a body mass index (calculated as weight in kilograms divided by the square of height in meters) of 30.3
Galla JM, Cuffe MS. Key to Weight Loss—More Than Exercise? Arch Intern Med. 2004;164(18):. doi:10.1001/archinte.164.18.2066-a
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