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Global nutrition transition and the pandemic of obesity in developing countries.

ABSTRACT: Decades ago, discussion of an impending global pandemic of obesity was thought of as heresy. But in the 1970s, diets began to shift towards increased reliance upon processed foods, increased away-from-home food intake, and increased use of edible oils and sugar-sweetened beverages. Reductions in physical activity and increases in sedentary behavior began to be seen as well. The negative effects of these changes began to be recognized in the early 1990s, primarily in low- and middle-income populations, but they did not become clearly acknowledged until diabetes, hypertension, and obesity began to dominate the globe. Now, rapid increases in the rates of obesity and overweight are widely documented, from urban and rural areas in the poorest countries of sub-Saharan Africa and South Asia to populations in countries with higher income levels. Concurrent rapid shifts in diet and activity are well documented as well. An array of large-scale programmatic and policy measures are being explored in a few countries; however, few countries are engaged in serious efforts to prevent the serious dietary challenges being faced.

SUBMITTER: Popkin BM

PROVIDER: S-EPMC3257829 | biostudies-literature | 2012 Jan

REPOSITORIES: biostudies-literature

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Global nutrition transition and the pandemic of obesity in developing countries.

Popkin Barry M BM Adair Linda S LS Ng Shu Wen SW

Nutrition reviews 20120101 1

Decades ago, discussion of an impending global pandemic of obesity was thought of as heresy. But in the 1970s, diets began to shift towards increased reliance upon processed foods, increased away-from-home food intake, and increased use of edible oils and sugar-sweetened beverages. Reductions in physical activity and increases in sedentary behavior began to be seen as well. The negative effects of these changes began to be recognized in the early 1990s, primarily in low- and middle-income popula ...[more]

PMID: 22221213

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Project description:UnlabelledNutrition transition necessitates low and middle-income countries (LAMICs) to scale up their efforts in addressing the burdens of undernutrition and overweight/obesity. Magnitudes of undernutrition and overweight are high in LAMICs, but no study has reviewed the existence of nutrition policies to address it. No evidence is also available on the effect of nutrition policies and governance on the undernutrition and overweight/obesity patterns in such countries. We conducted a policy review to examine the presence and associations of nutrition policies and governance with the children's nutrition statuses in LAMICs.MethodsWe reviewed nutrition policies, nutrition governance, and the trends of nutrition status from LAMICs. We retrieved data on the policies from the global database on the implementation of nutrition actions (GINA). We also retrieved data on the trends of nutrition status and nutrition governance from the nutrition landscape information system (NLiS), and on LAMICs from the World Bank database. We then analyzed the data both descriptively and by using a mixed effects model with random-intercept by country.ResultsOf the 139 LAMICs reviewed, only 39.6% had policies to address both undernutrition and overweight/obesity. A higher proportion of low-income countries (LICs) had policies to address undernutrition compared to that of middle-income countries (MICs) (86.1% vs. 63.1%, p = 0.002), and a low proportion of both had policy to address overweight. Having a nutrition policy that addresses undernutrition was not associated with better nutrition status outcomes. Strong nutrition governance in LAMICS was associated with low magnitudes of stunting (beta = -4.958, p = 0.015); wasting (beta = -5.418, p = 0.003); and underweight (beta = -6.452, p = 0.001).ConclusionDespite high magnitudes of undernutrition and overweight/obesity in LAMICs, only about one third of them had nutrition policies to address such nutrition transition. Having strong nutrition governance may help to bring down the magnitudes of undernutrition in LAMICs.

Project description:The global prevalence of obesity has increased substantially over the past 40 years, from less than 1% in 1975, to 6-8% in 2016, among girls and boys, and from 3% to 11% among men and from 6% to 15% among women over the same time period. Our aim was to consolidate the evidence on the epidemiology of obesity into a conceptual model of the so-called obesity transition. We used illustrative examples from the 30 most populous countries, representing 77·5% of the world's population to propose a four stage model. Stage 1 of the obesity transition is characterised by a higher prevalence of obesity in women than in men, in those with higher socioeconomic status than in those with lower socioeconomic status, and in adults than in children. Many countries in south Asia and sub-Saharan Africa are presently in this stage. In countries in stage 2 of the transition, there has been a large increase in the prevalence among adults, a smaller increase among children, and a narrowing of the gap between sexes and in socioeconomic differences among women. Many Latin American and Middle Eastern countries are presently at this stage. High-income east Asian countries are also at this stage, albeit with a much lower prevalence of obesity. In stage 3 of the transition, the prevalence of obesity among those with lower socioeconomic status surpasses that of those with higher socioeconomic status, and plateaus in prevalence can be observed in women with high socioeconomic status and in children. Most European countries are presently at this stage. There are too few signs of countries entering into the proposed fourth stage of the transition, during which obesity prevalence declines, to establish demographic patterns. This conceptual model is intended to provide guidance to researchers and policy makers in identifying the current stage of the obesity transition in a population, anticipating subpopulations that will develop obesity in the future, and enacting proactive measures to attenuate the transition, taking into consideration local contextual factors.

Project description:IntroductionNutrition transition has emerged as an important concept in health research used to describe shifts in dietary consumption and energy expenditure that coincide with economic, demographic and epidemiological changes at a population level. Better understanding of the shifts in dietary patterns across populations and their drivers could possibly hold the key to prevention of diet-related disease risk. An increasing number of studies have reported on nutrition transition in populations around the world, however, global evidence has not been summarised.ObjectiveThis scoping review is aimed to identify, explore and map the literature on nutrition transition with a specific focus on dietary changes in populations across the world. The review would allow better clarification around the concept of nutrition transition, classification of published studies and provide a framework for further research.Methods and analysisThe scoping review will be designed based on the methodology by Arksey and O'Malley, refined by Levac et al. and developed in conjunction with guidance on conducting systematic scoping reviews by Peters et al. The main research question addressed by the scoping review will be: 'What is the evidence on nutrition transition defined based on dietary changes reported in general adult population across the world?' Electronic databases (PubMed, ScienceDirect and Web of Science), grey literature sources and the reference lists of key studies will be searched to identify studies appropriate for inclusion in the review. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be abstracted into tables and logically organised according to items addressed in the specific research questions.Ethics and disseminationDissemination of results will be sought through a peer-reviewed publication, conference presentations and stakeholder meetings. The data used are from publicly available secondary sources, so no ethical review would be required for this study.

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Global nutrition transition and the pandemic of obesity in developing countries.

Publications

Global nutrition transition and the pandemic of obesity in developing countries.

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