Sources of Major Global Dietary Shifts
• Global increases in:
–
–
–
–
Caloric sweetener use, especially in beverages
animal source foods
refined carbohydrates, ultra refined foods
snacking, away-from-home eating, precooked food
• Global decreases in:
–
–
legumes, vegetables, fruits in most LMIC countries
food preparation time
• Only in Low and middle income world: increased
edible oil use and food frying. Probably the largest shift
in the 1980-2012 period of any major food group.
“close to 2 billion people overweight”
Women Aged 19-49. Regional Population-Weighted Percent Underweight,
Overweight, and Annualized Change–1990’s 2000’s, Rural/Urban
Rural
Urban
Underweight
East Asia
and Pacific
-0.19
0
1.13
1
-1
Percentage
Popkin and Slining, Obesity Reviews Oct 2013
0.23
Sub-Saharan
Africa
-0.24
2
0.37
South Asia
0.01
1
0.86
Middle East and
North Africa
0.01
0.06
0
-0.10
Latin America and
the Caribbean
-0.22
0.31
Sub-Saharan
Africa
-0.16
0.44
Central Asia
0.98
South Asia
-0.57
East Asia
and Pacific
-0.05
Middle East and
North Africa
0.10
Overweight
-0.06
0.21
Latin America and
the Caribbean
-0.24
Underweight
0.90
Central Asia
0.01
-1
Overweight
0
1
0.58
-1
0
1
Annualized Change in the Prevalence of Overweight and Underweight 1990's-2000's Sorted by GNP per capita*
Rural
Urban
Country (GDP)
-0.37
-0.17
-0.07
-0.08
-0.25
-0.07
-0.60
-0.50
-0.33
-0.07
-0.41
-0.36
-0.17
-0.33
-0.27
-0.80
-0.43
-0.30
-0.11
-0.29
-0.17
-0.22
-1.64
-0.27
-0.30
-0.36
-0.67
-0.22
-0.93
-0.83
-0.02
Mexico (3116)
Brazil (3087)
Turkey (2784)
0.00
Namibia (1661)
Kazakhstan (1647) -1.00
0.00
Jordan (1268)
Peru (1213)
Colombia (1213)
Morocco (1033)
0.36
Dominican Rep. (983)
Cameroon (916)
0.00
Cote d'Ivoire (862)
Guatemala (857)
Zimbabwe (839)
0.19
Senegal (789)
0.22
Egypt (759)
0.00
Bolivia (731)
Armenia (637)
0.20
Indonesia (621)
Haiti (478)
Guinea (463)
Zambia (418)
Ghana (398)
Benin (387)
India (374)
Kenya
(366)
0.07
Rwanda (359)
Burkina Faso (333)
Lesotho (330)
-0.40
0.00
Niger (319)
China (314)
Nigeria (292)
-1.11
Chad (289)
0.00
Bangladesh (286)
Mali (279)
0.55 Madagascar (273)
Cambodia (266)
Ethiopia (250)
Nicaragua (245)
Uganda (243)
0.00
Malawi (200)
Nepal (190)
Mozambique (182)
-0.17
Tanzania (172)
0.00
Vietnam (98)
-1.75-1.25-0.75-0.25 0.25 0.75
Underweight
Percentage
Popkin and Slining, Obesity Reviews Oct 2013
Country (GDP)
1.36
0.91
0.70
0.57
-0.32
-0.19
-0.20
1.33
0.88
0.93
0.18
-0.07
3.40
-0.60
0.50
1.75
2.67
-0.67
0.69
0.33
1.31
1.79
0.60
1.22
0.73
0.17
0.40
1.13
0.50
0.29
0.80
0.50
0.11
-0.06
-0.07
-0.04
-0.18
-0.20
-0.33
-0.30
-0.22
-0.21
-0.02
0.29
0.90
-0.67
-1.50
0.13
0.45
0.82
0.27
0.40
0.18
1.00
0.56
0.56
0.87
-1.00
-0.45
-0.27
-0.36
-0.33
-0.17
-0.47
-0.50
0.53
0.23
-3 -2 -1 1 2
Overweight
-0.83
3
4
Mexico (3116)
Brazil (3087)
Turkey (2784)
Namibia (1661)
0.14
Kazakhstan (1647) -2.00
0.25
Jordan (1268)
0.00
Peru (1213)
0.00
Colombia (1213)
Morocco (1033)
0.18
-0.27
Dominican Rep. (983)
Cameroon (916)
0.00
Cote d'Ivoire (862)
0.25
Guatemala (857)
Zimbabwe (839)
0.13
Senegal (789)
0.39
-0.06
Egypt (759)
Bolivia (731)
Armenia (637)
0.40
Indonesia (621)
Haiti (478)
Guinea (463)
0.33
Zambia (418)
Ghana (398)
Benin (387)
India (374)
0.14
Kenya (366)
0.20
Rwanda (359)
0.00
Burkina Faso (333)
Lesotho (330)
0.20
-0.20
Niger (319)
China (314)
Nigeria (292)
Chad (289)
Bangladesh (286)
Mali (279)
Madagascar (273)
Cambodia (266)
0.20
Ethiopia (250)
Nicaragua (245)
Uganda (243)
0.00
Malawi (200)
Nepal (190)
Mozambique (182)
Tanzania (172)
0.00
Vietnam (98)
-1.75-1.25-0.75-0.25 0.25 0.75
Underweight
Percentage
1.40
0.44
0.40
0.29
0.75
1.00
0.67
2.60
1.67
1.00
1.33
0.06
0.63
1.21
0.00
0.40
0.73
0.00
0.73
1.07
1.50
0.14
1.13
0.10
0.17
0.79
0.45
0.44
0.75
0.73
1.27
0.64
0.60
0.36
2.33
0.88
0.61
1.33
1.50
1.05
0.40
-4 -3 -2 -1 1 2 3 4
Overweight
based on nationally representative surveys of women aged 19-49 (n=815,609). Underweight is BMI 18.5<. Overweight BMI ≥25
South Korea
• Prior to WTO, closed off from trade, taught all
women getting married to cook with traditional
methods[very high vegetable intake, low fat].
• Very low overweight/obesity relative to GNP
• After WTO, starting to see major diet shifts toward
more processed, packaged foods and beverages,
increased overweight
“close to 2 billion people overweight”
Mexico—short history leading to
recent events
• 2000’s: started looking not only at undernutrition but overweight and
obesity (Bellagio paper-nutr. Transition)
• Beverage panel-Min of Health 2008, major support medical societies
• Gov’t developed national agreement health nutrition
• Min Educ and Health—with industry and academia fighting got
major school food/beverage guidelines 2011
• 2012 front of package labeling panel
• Marketing industry self-regulation
• Lost several 20% SSB tax votes prior to bloomberg funding and
major civil society push across the country forced conservative gov’t
to push for smaller 10% SSB tax, added unexpectedly by Min of
Finance 8% junk food tax. Start Jan. 2014
“close to 2 billion people overweight”
Key issues related to the future
• Accelerated overweight, BMI and waist circumference shifts in
LMIC’s
• LMIC’s are leading in large-scale regulatory changes now with rapid
shifts being see.
• Retail sector growth enormous-convenience stores and
supermarkets and mega markets in LMIC’s: good and bad sides
• Nature of agriculture is being driven by retailers, many shifts. E.g
documented for Bangladesh, India and China for huge shifts from
farmer to middle man to processors now very much integrated
directly into agrobusinesses, retailers,etc
• Obesogenic environment: the LMIC environment makes that of the
US and UK look healthy in many cases
“close to 2 billion people overweight”