Agriculture Reference
In-Depth Information
past were thought of as exclusively adult problems, including type 2 diabetes and
high blood pressure. These conditions begin taking their toll in terms of compli-
cations earlier in life, producing risk of early mortality. Second, children who are
overweight are at risk of becoming severely overweight adults (Ferraro et al. 2003).
And third, overweight children suffer from social stigma and emotional ill health in
many cultural environments.
The predictable obesity-driven chronic diseases—type 2 diabetes and atheroscle-
rotic heart disease the most visible and consequential—have major implications for
quality of life and for life expectancy. The risk of type 2 diabetes and of high blood
pressure increase steadily with rising body fatness. The vast majority of persons with
diabetes have type 2 diabetes, and of these, 90% are obese or overweight. Globally,
the Emerging Market Economy (former Soviet Union) countries had the highest
number of diabetics in 1995; by 2025, India and the Middle East will lead if current
trends continue (WHO, 2003).
Cardiovascular diseases (CVDs) are now the leading cause of death and disability
in most regions of the world (Reddy 2002a,b). Low- and middle-income countries
account for more than three quarters of all CVD deaths globally, with the large
majority of these attributable to coronary heart disease (CHD). Of great importance
is the fact that both type 2 diabetes and CHD are affecting adults at younger ages in
developing countries than they do in Europe and North America, with the greatest
risk in the age range 45 to 65; thus, the projection is for a major burden from deaths
among economically productive adults throughout the developing world (O'Dea and
Piers 2002, Reddy 2002a).
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Globally, problems of undernutrition persist in many countries and are actually wors-
ening in sub-Saharan Africa. The Millennium Development Goal to reduce hunger
by 50% by the year 2015 seems unattainable. At the same time, rising rates of over-
weight and obesity add to health care costs and reduced quality of life in the same
populations, creating a true double burden. In addition, overweight and obesity are
becoming increasingly concentrated among the poor, particularly in urban areas and
in the more economically developed countries. Thus, the burden of chronic disease
will increasingly fall on society's most disadvantaged, increasing health disparities
and compromising public health gains achieved through combating infectious dis-
eases and malnutrition (Hawkes et al. 2004).
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Health care costs associated with obesity-driven diseases are substantial. In devel-
oped countries, estimates are that obesity accounts for 2 to 7% of all medical care
costs (WHO 2003). In poorer countries, there has been less research on the topic,
but one analysis (Popkin 2006) estimates that the increasing costs of the shift toward
nutrition-related chronic disease will overwhelm the health care system of China
and slow its economic growth. It is clear that the proportion of the population who
are overweight or obese in many developed countries is now so large that there are
