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Part II. What is unique about the experience in lower-and middle-income less-industrialised countries compared with the very-highincome industrialised countries?

The shift in stages of the nutrition transition in the developing world differes from past experiences!

Published online by Cambridge University Press:  22 December 2006

Barry M Popkin*
Affiliation:
Carolina Population Center, University of North Carolina at Chapel Hill, CB # 8120 University Square, 123 West Franklin Street, Chapel Hill, NC 27516-3997, USA
*
*Corresponding author: Email popkin@unc.edu
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Abstract

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Objective:

This paper explores the unique nutrition transition shifts in diet and activity patterns from the period termed the receding famine pattern to the one dominated by nutrition-related non-communicable diseases (NR-NCDs). The paper examines the speed and timing of these changes; unique components, such as the issue of finding both under- and overnutrition in the same household; potential exacerbating biological relationships that contribute to differences in the rates of changes; and political issues.

Setting:

The focus is on lower-and middle-income countries of Asia, Africa, the Middle East and Latin America.

Results:

These changes are occurring at great speed and at earlier stages of these countries economic and social development. There are some unique issues that relate to body composition and potential genetic factors. The significance of the high number of persons exposed to heavy insults during pregnancy and infancy (foetalorigins hypothesis) and the subsequent rapid shifts in energy imbalance remains to be understood. Countries that are still addressing major concerns of undernutrition are not ready to address these NR-NCDs.

Conclusions:

The developing world needs to give far greater emphasis to addressing the prevention of the adverse health consequences of this shift to the nutrition transition stage of degenerative diseases.

Type
Research Article
Copyright
Copyright © CABI Publishing 2002

References

1Popkin, BM, Doak, C. The obesity epidemic is a worldwide phenomenon. Nutr. Rev. 1998; 56: 106–14.CrossRefGoogle ScholarPubMed
2Bell, C, Ge, K, Popkin, BM. Weight gain and its predictors in Chinese adults. Int. J. Obes. 2001; 25: 1079–86.CrossRefGoogle ScholarPubMed
3Monteiro, CA, Mondini, L, de Souza, ALM, Popkin, BM. The nutrition transition in Brazil. Eur. J. Clin. Nutr. 1995; 49: 105–13.Google ScholarPubMed
4Monteiro, CA, D'A Benicio, MH, Popkin, BM. Economic and cultural-educational predictors of overweight in urban and rural Brazilian women. Rev. Brasilian Nutr. Clin. 2000; 15(1): 253–60.Google Scholar
5Monteiro, CA, D'A Benicio, MH, Conde, WL, Popkin, BM. Shifting obesity trends in Brazil. Eur. J. Clin. Nutr. 2000; 54: 342–6.CrossRefGoogle ScholarPubMed
6Monteiro, CA, Conde, WL, Popkin, BM. Independent effects of income and education on the risk of obesity in the Brazilian adult population. J. Nutr. 2001; 131: 881S–6S.CrossRefGoogle ScholarPubMed
7Benjelloun, S. Nutritional transition in Morocco. Public Health Nutr. 2002; 5: 135–40.CrossRefGoogle ScholarPubMed
8Galal, OM. The nutrition transition in Egypt: obesity, undernutrition and the food consumption context. Public Health Nutr. 2002; 5: 141–8.CrossRefGoogle ScholarPubMed
9Ghassemi, H, Harrison, G, Mohammad, K, Balaa, ALN. An accelerated nutrition transition in Iran. Public Health Nutr. 2002; 5: 149–55.CrossRefGoogle ScholarPubMed
10Al-Isa, AN. Changes in body mass index (BMI) and prevalence of obesity among Kuwaitis 1980–1994. Int. J. Obes. 1997; 21: 1093–9.CrossRefGoogle ScholarPubMed
11Al-Isa, AN. Prevalence of obesity among adult Kuwaitis: a cross-sectional study. Int. J. Obes. 1995; 19: 431–3.Google ScholarPubMed
12Al-Nuaim, AR, Al-Rubeaan, K, Al-Mazrou, Y, Al-Attas, O, Al Daghari, N, Khoja, T. High prevalence of overweight and obesity in Saudi Arabia. Int. J. Obes. 1996; 20: 547–52.Google ScholarPubMed
13Al-Mannai, A, Dickerson, JWT, Morgan, JB, Khalfan, H. Obesity in Bahraini adults. J. Roy. Soc. Health 1996; 116: 3040.CrossRefGoogle ScholarPubMed
14Shetty, PS, James, WPT. BMI distribution in developed and developing countries. In: Body Mass Index: A Measure of Chronic Energy Deficiency in Adults. FAO Food and Nutrition Papers No. 56. Rome: Food and Agriculture Organization of the United Nations, 1994; Chapter 7.Google ScholarPubMed
15Ajlouni, K, Jaddou, H, Batieha, A. Obesity in Jordan. Int. J. Obes. 1998; 22: 624–8.CrossRefGoogle ScholarPubMed
16Medical Research Council, Department of Health and Macro International. South African Demographic and Health Survey 1998: Preliminary Report. Cape Town: South African Medical Research Council, 2000.Google Scholar
17Wang, Y, Monteiro, C, Popkin, BM. Trends of overweight and underweight in children and adolescents in the United States, Brazil, China and Russia. Am. J. Clin. Nutr. [in press].Google Scholar
18Jahns, L, Baturin, A, Popkin, BM. Post-soviet changes in diet and nutritional status of Russian children. 2001Google Scholar
19Guo, X, Mroz, TA, Popkin, BM, Zhai, F. Structural changes in the impact of income on food consumption in China 1989–93. Econ. Dev. Cult. 2000; 48: 737–60.CrossRefGoogle Scholar
20Drewnowski, A, Popkin, BM. The nutrition transition: new trends in the global diet. Nutr. Rev. 1997; 55: 3143.CrossRefGoogle ScholarPubMed
21Popkin, BM, Lu, B, Zhai, F. Understanding the nutrition transition: measuring rapid dietary changes in transitional countries' public health nutrition. Public Health Nutr. [in press].Google Scholar
22Drewnowski, A. Energy density, palatability, and satiety: implications for weight control. Nutr. Rev. 1998; 56: 347–53.CrossRefGoogle ScholarPubMed
23Bell, EA, Castellanos, VH, Pelkman, CL, Thorwart, ML, Rolls, BJ. Energy density of foods affects energy intake in normal weight women. Am. J. Clin. Nutr. 1998; 67: 412–20.CrossRefGoogle ScholarPubMed
24Popkin, BM. The nutrition transition and its health implications in lower income countries. Public Health Nutr. 1998; 1: 521.CrossRefGoogle ScholarPubMed
25Popkin, BM. Urbanization, lifestyle changes and the nutrition transition. World Dev. 1999; 27: 1905–16.CrossRefGoogle Scholar
26Paeratakul, S, Popkin, BM, Ge, K, Adair, LS, Stevens, J. Changes in diet and physical activity affect the body mass index of Chinese adults. Int. J. Obes. 1998; 22: 424–32.CrossRefGoogle ScholarPubMed
27Watkins, SC. The fertility transition: Europe and the Third World compared. Sociological Forum 1987; 2: 645–73.CrossRefGoogle Scholar
28Indian Institute of Population Sciences. National Family Health Study 1998–99. Mumbai, India: Indian Institute of Population Sciences, 2000; 1328.Google Scholar
29Griffiths, PL, Bentley, ME. The nutrition transition is underway in India. J. Nutr. 2001; 131(10): 2692–700.CrossRefGoogle ScholarPubMed
30Doak, C, Adair, LS, Monteiro, C, Popkin, BM. Overweight and underweight co-exists in Brazil China, and Russia. J. Nutr. 2000; 130: 2965–80.CrossRefGoogle Scholar
31Doak, C, Monteiro, C, Popkin, BM. Co-existing Overweight and Underweight within Households is Related to the Nutrition Transition. Chapel Hill, NC: University of North Carolina, 2001.Google Scholar
32Barker, DJP. Mothers, babies and disease in later life, 2nd ed. Edinburgh: Churchill Livingstone, 1998.Google Scholar
33Barker, DJP. Fetal Origins of Cardiovascular and Lung Disease. New York: Marcel Dekker, Inc., 2001.Google Scholar
34Deurenberg, P, Yap, M, Staveren, WA. Body mass index and percent body fat: a meta analysis among different ethnic groups. Int. J. Obes. 1998; 22(12): 1164–71.CrossRefGoogle ScholarPubMed
35International Diabetes Institute. The Asia–Pacific Perspective: Redefining Obesity and Its Treatment. Australia: Health Communications Australia Pty Limited, 2000.Google Scholar
36Bell, AC, Adair, LS, Popkin, BM. Ethnic differences in the association between body mass index and hypertension. Am. J. Epidemiol. [in press].Google Scholar
37Zimmet, PZ. Kelly West Lecture. Challenges in diabetes epidemiology – from west to the rest. Diabetes Care 1991; 15: 232–52.CrossRefGoogle Scholar
38Zimmet, PZ, McCarty, DJ, de Courten, MP. The global epidemiology of non-insulin-dependent diabetes mellitus and the metabolic syndrome. J. Diabetes Complic. 1997; 11(2): 60–8.CrossRefGoogle ScholarPubMed
39Bell, AC, Adair, LS, Popkin, BM. Clarifying the association between socioeconomic status and newly diagnosed hypertension within and between ethnic groups. Obes. Res. [in press].Google Scholar
40Adair, LS, Kuzawa, C, Borja, JR. Maternal energy stores and diet composition during pregnancy program adolescent blood pressure. Circulation 2001; 104: 1034–9.CrossRefGoogle ScholarPubMed
41Hoffman, DJ, Sawaya, AL, Coward, WA, Wright, A, Martins, PA, de Nascimento, C, Tucker, KL, Roberts, SB. Energy expenditure of stunted and nonstunted boys and girls living in the shantytowns of Sao Paulo. Brazil. Am. J. Clin. Nutr. 2000; 72: 1025–31.CrossRefGoogle ScholarPubMed
42Hoffman, DJ, Roberts, SB, Verreschi, I, Martins, PA, de Nascimento, C, Tucker, KL, Sawaya, AL. Regulation of energy intake may be impaired in nutritionally stunted children from the shantytowns of Sao Paulo. Brazil. J. Nutr. 2000; 130: 2265–70.Google ScholarPubMed
43Hoffman, DJ, Sawaya, AL, Verreschi, I, Tucker, KL, Roberts, SB. Why are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytowns children from Sao Paulo, Brazil. Am. J. Clin. Nutr. 2000; 72: 702–7.CrossRefGoogle ScholarPubMed
44Popkin, BM, Richards, MK, Monteiro, C. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J. Nutr. 1996; 126: 3009–16.CrossRefGoogle ScholarPubMed
45Uauy, R, Albala, C, Kain, J. Obesity trends in Latin America: transiting from under- to overweight. J. Nutr. 2001; 131: 893S–9S.CrossRefGoogle ScholarPubMed