7.6 How are diets changing globally?

7.6.1 What is the nutrition transition?

The nutrition transition is a term used to characterise the shift in dietary consumption and energy expenditure that coincides with economic, demographic, and epidemiological (shift from infectious to non communicable diseases) changes. It generally refers to the transition taking place in developing countries from traditional diets high in cereal and fibre to Western pattern diets high in sugars, fat (especially saturated), and animal-source food. The nutrition transition tends to go hand in hand with other lifestyle changes.

The nutrition transition and trends in developing countries

Developed country eating habits are already at stage 2.

Many developing countries are rapidly moving from stage 1 (end of famine) to stage 2 (overconsumption).

The transition from traditional diets to energy-dense Western-style diets has been a key contributor to the obesity epidemic in low- and middle-income countries (see later in this chapter).

The challenge is to move, globally to stage 3 – towards diets that both healthy and environmentally sustainable.

7.6.2 What are the trends?

Eating habits are changing

People are eating more food overall

In particular more animal products

This leads to increased energy intake

Decrease in plant-based foods in most regions

Chapter 4 discusses these changes and future projections in more detail.

The growth in consumption of animal products (and with it processed meats) is not limited to developed countries. The 2014 ODI report on future diets shows the historical shift towards increased food consumption in general, but in many cases there is also an increase in the proportion meat contributes to eating patterns. Consumption of cereals, pulses, roots and tubers has generally declined.

Consumption of processed foods has increased globally

The 2015 Global Nutrition Report shows a rise in consumption of processed foods across multiple different types of food system.

In the food systems of high and increasingly middle income countries processed foods are common and affordable. People in these countries consume “80–90 kilograms per person per year of energy-dense, ultraprocessed foods, with added salt, refined sugars, and low amounts of essential micronutrients”. International Food Policy Research Institute (2015) Global Nutrition Report 2015: Actions and Accountability to Advance Nutrition and Sustainable Development. Washington, DC. (http://globalnutritionreport.org/).

Populations in emerging economies and more rural food systems consume “20–30 kilograms of ultraprocessed foods per person each year, but this is growing faster than in developed countries”.

Obesity and diet-related non-communicable diseases are an increasing problem in developing countries: China as an example

China is an example of a country undergoing a transformation in its food system. During economic development, urbanisation and industrialisation, diets have changed and lifestyles have become more sedentary. As diets transition (more meat, more processed foods, more fats and sugars, fewer vegetables and legumes) new diet-related health challenges are emerging.

Adult and childhood obesity levels are increasing even though undernutrition does persist in some rural areas.

Adults:

  • 28.5% men and 25.5% women overweight / obese
  • 10% diabetic + 15% prediabetic

Children:

  • 13% overweight or obese, 15% prediabetic
  • 1/3 have at least one cardiometabolic risk factor

National trends in obesity are associated with economic development, but mediated by cultural and contextual factors

While there is a general trend towards increases in the prevalence of obesity with economic development, this is not always the case. Other factors such as culture and religion influence eating habits. Cultural beliefs and attitudes towards for example food and exercise interact with other environmental factors and socio-structural dynamics and this can create a predisposition towards overweight. See for example http://www.ttdinhduong.org/tailieudinhduong/22.pdf (Sobal, J. (2002) Social and Chapter 21: Cultural Influences on Obesity, International Textbook of Obesity) and this report from NHS National Obesity Observatory http://www.noo.org.uk/uploads/doc/vid_9851_Obesity_ethnicity.pdf