CORRELATION IS NO CAUSATION: GYMNASIUM PROLIFERATION AND THE RISK OF OBESITY
Abstract
We read with interest the paper by Gearhardt et al. 1 examining the links between addictive substances and food-related problems. The authors interestingly suggest that foods and drugs of abuse may share analogous neurobiological and behavioural effects. In addition, they also suggest that the availability of a hyperpalatable food diet could explain a part of the rise in obesity prevalence. For example, they show that the number of McDonald's restaurants is correlated strongly with the obesity rate in France (r = 0.92). We would like to emphasize that, despite some face validity, no causal relationship should be drawn from this statistic, and it was probably not the intention of the authors to suggest so. As an example, we considered the correlation between the number of gymnasiums (data available from French administration 2) and obesity rate in France from 1997 to 2009 3 (Fig. 1). This correlation was within the same order of magnitude (r = 0.95, P = 0.001) as the one found by the authors between the number of McDonald's restaurants and the obesity rate described above. This finding is unlikely to support the hypothesis that reducing the number of gymnasiums could decrease the obesity rate, but rather suggest that any expanding commercial activity (e.g. fast foods, gymnasiums . . . ) will be correlated with the obesity rate. We nevertheless agree with the authors that the availability of highly processed food and fast foods may contribute to obesity, and therefore that public health interventions are required. Obesity rates and number of gymnasiums in France between 1997 and 2009. Numbers of gymnasium data were acquired from the French administration 2. All obesity data were acquired from the Obepi study 3
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The study cannot show that antidepressant use causes a lower likelihood of intubation or death.
“Second, our study cannot establish a causal relationship between antidepressant use and reduced risk of intubation or death [35].”
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Cites
Can food be addictive? Public health and policy implications
Gearhardt, A. N., Grilo, C. M., Dileone, R., Brownell, K. D., & Potenza, M. N. (2011) · Addiction · doi:10.1111/j.1360-0443.2010.03301.x · Cited by 395 · see citing works
Monitoring the Obesity Epidemic in France: The Obepi Surveys 1997–2006
Charles, M.-A. A., Eschwège, É., & Basdevant, A. (2008) · Obesity · doi:10.1038/oby.2008.285 · Cited by 226 · see citing works
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- Authors
- LE STRAT, Y., & HOERTEL, N.
- Affiliations
- Inserm (FR)
- Corresponding author
- HOERTEL, NICOLAS
- ORCID
- HOERTEL, NICOLAS
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2011-09-14
- Volume
- 106
- Issue
- 10
- Pages
- 1871-1872
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W1554030506
- Cited by
- 44
- References
- 2
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 4 · 2017: 1 · 2015: 3 · 2014: 4 · 2013: 3 · 2012: 1
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- obesity, gymnasium, correlation versus causation, hyperpalatable foods, fast food availability, food environment, processed foods, public health interventions, France
- MeSH terms
- Animals, Food, Humans, Obesity, Public Health, Public Policy, Behavior, Addictive, Marketing
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