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Unformatted text preview: Commentary Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases 1–3 Barry M Popkin ABSTRACT Global energy imbalances and related obesity levels are rapidly increasing. The world is rapidly shifting from a dietary period in which the higher-income countries are dominated by patterns of degenerative diseases (whereas the lower- and middle-income coun- tries are dominated by receding famine) to one in which the world is increasingly being dominated by degenerative diseases. This article documents the high levels of overweight and obesity found across higher- and lower-income countries and the global shift of this bur- den toward the poor and toward urban and rural populations. Dietary changes appear to be shifting universally toward a diet dominated by higher intakes of animal and partially hydrogenated fats and lower intakes of fiber. Activity patterns at work, at leisure, during travel, and in the home are equally shifting rapidly toward reduced energy expenditure. Large-scale decreases in food prices (eg, beef prices) have increased access to supermarkets, and the urbanization of both urban and rural areas is a key underlying factor. Limited documen- tationoftheextentoftheincreasedeffectsofthefastfoodandbottled soft drink industries on this nutrition shift is available, but some examples of the heterogeneity of the underlying changes are pre- sented. The challenge to global health is clear. Am J Clin Nutr 2006;84:289–98. KEY WORDS Nutrition transition, global obesity, edible oils, caloric sweeteners, physical inactivity WHAT IS THE NUTRITION TRANSITION? Humankind has faced major shifts in dietary and physical activity patterns and body composition since Paleolithic man emerged on Earth. Human diet and nutritional status have un- dergone a sequence of major shifts among characteristic states— defined as broad patterns of food use and corresponding nutrition-related disease. Over the past 3 centuries, the pace of dietary change appears to have accelerated to varying degrees in different regions of the world. The concept of the nutrition tran- sition focuses on large shifts in diet and activity patterns, espe- cially their structure and overall composition. These changes are reflected in nutritional outcomes, such as changes in average stature and body composition. Furthermore, dietary and activity pattern changes are paralleled by major changes in health status and by major demographic and socioeconomic changes. One needs to be concerned with food supply, which relates to agricultural systems and agricultural technology, as well as with the factors that affect the demand for and use of food. The latter include economic resources, demographic patterns, and various cultural and knowledge factors associated with food choice, dis- ease patterns, and sociologic considerations (eg, the role of women and family structure). Similarly, equally important changes affect how we move, work at home and in the market-...
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This note was uploaded on 07/08/2010 for the course PSYC 123 taught by Professor Kellybrownell during the Fall '08 term at Yale.
- Fall '08