Industrialized societies are characterized by an abundant and palatable food supply and a decrease in physical activity at home, at work, and in transportation as a result of modern technology. The average American has a body mass index of 26.6 kg/m2, 20% above desirable body weight.1 Recent surveys show that the US population is getting heavier and the average energy intake has increased.2
Obesity—the result of either overnutrition (increased energy intake) or a sedentary life-style (decreased energy expenditure)—is characterized by a number of metabolic changes related to lipid metabolism. Obese individuals have elevated serum cholesterol and triglyceride and lower high-density lipoprotein concentrations. These changes increase one's risk for coronary heart disease. There are also changes in carbohydrate metabolism, such as hyperglycemia, hyperinsulinemia, insulin resistance, and decreased norepinephrine production. These findings are similar to the metabolic abnormalities found in persons with non-insulin-dependent diabetes mellitus. In overweight persons, the