Agriculture Reference
In-Depth Information
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An acceleration of the nutrition transition is being driven in part by a major change in
food distribution and marketing systems that accompanies urbanization in develop-
ing countries. Supermarkets are emerging in cities throughout the developing world.
This phenomenon occurred earliest in Latin America, where supermarkets' share
of retail food sold rose from 15% in 1990 to 60% in 2000 (Reardon and Berdegué
2002). The rise of supermarkets has the potential for major changes in the food
environment, making nonperishable foods available widely and vastly increasing the
number and variety of food items available to populations of consumers. They also
provide a distribution system that can be efficiently used by large corporations that
produce a large variety of processed food items. Trade policies have made it possible
for multinational corporations to market their products throughout the world, and
access to mass media (and thus direct exposure to advertising) has increased very
rapidly in the developing world, particularly in cities.
Thus, the combination of changes in population structure, rapid urbanization, and
global marketing of food products has produced changes in the energy balance equa-
tion for millions of people within a very short period of a few decades. These forces
will continue for some time to come, and with them will arrive increasing rates of
obesity and related diseases unless committed and targeted efforts are made on a
large scale to enable access to high-quality diets and adequate physical activity.
consequences of the obesIty ePIdemIc
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Rising rates of obesity in populations are of concern because obesity is intricately
associated with various diseases that compromise quality of life, predispose to
premature death, and place enormous cost burdens on health care systems. These
include type 2 diabetes (non-insulin-dependent diabetes mellitus), high blood pres-
sure, dyslipidemias, coronary heart disease, and certain types of cancers (breast,
endometrial, prostate, and colon). One analysis for the United States estimates that
compared to adults of normal weight, those who are severely obese (BMI > 40) have
7.4 times higher risk of diabetes, 6.4 times higher risk for high blood pressure, 2.7
times higher risk for asthma, almost twice the risk of high cholesterol levels, and
overall more than 4 times higher risk for overall fair or poor health (compared to
self-reported excellent, very good, or good health) (Mokdad et al. 2004). A recent
major analysis indicated that 30% or more of the global cancer burden could be
avoided by optimizing the quality of diets (American Institute for Cancer Research/
World Cancer Research Federation [AICR/WCRF] 2007). Deaths in the United
States attributable to poor diet and physical inactivity rose by 33% over the last 10
years, while deaths from other causes have declined. Estimates are that if current
trends continue, obesity will soon overtake tobacco as the leading preventable cause
of death in the United States.
Children who are overweight suffer from increased health problems in several
ways. First, many overweight children are developing health problems that in days
