Global epidemiology of obesity, vegetarian dietary patterns, and noncommunicable disease in Asian Indians
Pramil N. SinghKristen N. ArthurMichael J. OrlichWesley JamesAnil J PurtyJayakaran S. JobSujatha RajaramJoan Sabaté
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Asian Indian
Nutrition Transition
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The objective of this narrative review is to examine the nutrition transition and its consequences when populations in Africa modernize as a result of socio-economic development, urbanization, and acculturation. The focus is on the changes in dietary patterns and nutrient intakes during the nutrition transition, the determinants and consequences of these changes as well as possible new approaches in public health nutrition policies, interventions and research needed to steer the nutrition transition into a more positive direction in Africa. The review indicates that non-communicable, nutrition-related diseases have emerged in sub-Saharan Africa at a faster rate and at a lower economic level than in industrialized countries, before the battle against under-nutrition has been won. There is a putative epigenetic link between under- and over-nutrition, explaining the double burden of nutrition-related diseases in Africa. It is concluded that it is possible to steer the nutrition transition into a more positive direction, provided that some basic principles in planning public health promotion strategies, policies and interventions are followed. It is suggested that sub-Saharan African countries join forces to study the nutrition transition and implemented interventions on epidemiological, clinical and molecular (genetic) level for better prevention of both under- and over-nutrition.
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Globally, obesity rates are continuing to increase and countries in the midst of modernization are most vulnerable. Developing nations are undergoing a health transition alongside rapid economic modernization. The nation of Vanuatu, like other Pacific island countries, is experiencing such a transition marked by decreased cases of infectious disease and increased incidence of chronic and non-communicable diseases. Aneityum is a small and sparsely populated island in Vanuatu and is behind more developed islands in its transition. This present study is the latest in a multi-year project examining health in Vanuatu as it undergoes a health transition with an increased prevalence of chronic disease, namely cardiovascular diseases and type 2 diabetes. In this study, we sought to continue tracking the population health on Aneityum, to analyze health differences between men and women, and to compare findings to previous data in Vanuatu. In July and August of 2023, adult males [n=41] and females [n=62] were surveyed and had their anthropometric measurements taken on Aneityum in Vanuatu. Mean anthropometric measurements (body mass index, body fat percentage, waist circumference) continued to be significantly greater among women than men (P-value < 0.05). Women exhibited higher rates of obesity in all metrics than in previous studies while men remained relatively unchanged. While men still have lower obesity rates compared to those from Efate in 2011, the women of Aneityum have reached similar levels as their counterparts from a decade ago. There is debate whether Ni-Vanuatu populations are more accurately measured by WHO or Asian-Pacific BMI cutoffs. When Asian-Pacific BMI guidelines are applied, male obesity rate rises 4.87% and the female obesity rate rises 17.74%, indicating drastically worse population health than previously thought. Potential explanations for the disparity in obesity rates between males and females include sex-associated fat distribution patterns, social inequality, and cultural habits. This paper provides valuable insights into the state of Vanuatu's health in its transitional period and a greater understanding of the interplay between sex and health.
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Accelerating epidemiological transition and concurrent shifts in diet, activity and body composition are universal trends, especially in middle‐ and lower‐income countries. A unique nutrition transition has occurred in the Republic of Korea, a country that modernized earlier than most Asian countries. This analysis attempts to describe the nutrition transition in the Republic of Korea, focusing on specific features that other countries may follow to retain the healthy elements of their traditional diets. The analysis uses secondary data on economics, dietary intake, anthropometry and causes of death, including a series of comparable nationally representative dietary surveys (the National Nutrition Survey). The structure of the economy of the Republic of Korea, along with dietary and disease patterns, began an accelerated shift in the 1970s. Major dietary change included a large increase in the consumption of animal food products and a fall in total cereal intake. Uniquely, the amount and the rate of increase in fat intake have remained very low. The Republic of Korea also has a relatively low prevalence of obesity compared with other Asian countries with similar or much lower incomes. The nutrition transition in the Republic of Korea is unique. National efforts to retain elements of the traditional diet are thought to have shaped this unique transition in the Republic of Korea in the midst of rapid economic growth and introduction of western culture.
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Bangladesh is going through an epidemiological transition with large reductions in mortality due to acute, infectious, and parasitic diseases and increases in non-communicable, degenerative, and chronic diseases over the last 20 years. There is also evidence of an adult nutritional transition with increases in pre-obesity and obesity particularly in urban areas. However a high percentage of the population of Bangladesh remain undernourished and economically poor and ultra-poor development programmes indicate that improving their nutritional status might not be achievable as a bi-product of the development programme. Bangladesh like many developing countries has many burdens of under and over-nutrition, high levels of infectious diseases as well as growing levels of non-communicable diseases.
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Aim: The major aim of this review is to assess the nutrition transition in Uttrakhand toward, to its contribution to the emerging epidemic of chronic non-communicable diseases. Subjects: The review examines the basic shift in eating preferences mainly attributable to shift in agriculture practices after the green revolution and urbanisation. Furthermore, the remarkable shift in the occupation structure in the state from farmers towards employment and services implies a reduction in energy expenditure. One consequence of nutrition transition has been decline in under nutrition accompanied by over nutrition leading to obesity and other NCD’s.It basically attempting to relate the diet and lifestyle changes accompanying NCDs. Methods: The review is based largely on various reliable documented data on population characteristics. The information is based on various review and documented report and data of the published literature. Results: The results shows that the demographic changes, rates of urbanization and changes in dietary patterns are contributing factors that are leading to nutrition transitions and NCDs in hills. The major consequence of nutrition transition has been the decline in the rate of under nutrition accompanied by over nutrition leading to obesity and other degenerative diseases. Conclusions: There are clear evidences of a demographic, epidemiological and nutrition transition in Uttrakhand. There is no single solution to the problem. A multidisciplinary approach is required to solve the present problem related to food and nutrition.
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The double burden of undernutrition and overnutriton in developing countries is a public health challenge Developing countries are undergoing various types of transitions. The epidemiological transition makes them face a double burden of communicable and non-communicable diseases. Similarly, demographic and socioeconomic transitions are also occurring in these countries. Earlier developing countries had a high prevalence of undernutrition, but this era of transition has also brought a double burden of undernutrition and overnutrition in these countries. Shukla et al in their descriptive study of body mass index (BMI) in western India in this issue of the journal have demonstrated this burden.1 BMI, also known as Quetelet's index, relates height to weight and is measured by the formula—weight (kg)/height (m)2. It has been recommended to use this index as it is difficult to measure fat mass under field conditions. For different grades of overweight among adults, an expert committee of the World Health Oranisation has recommended three cut off points of 25, 30, and 40. While interpreting these cut off points, the following points should be kept in mind2:
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Abstract Issue/problem In the last decades, the number of deaths from non-communicable diseases in developing countries has risen to those observed in developed countries. Description of the problem Nutritional research in developing countries has primarily focused on under-nutrition, particularly among vulnerable population subgroups such as women and children. However, while economic growth has a significant social impact at population level, there is suggestive evidence of an ongoing nutritional transition leading to concurrent under- and over-nutrition in the population. Results The ongoing nutritional transition in these settings has been mostly linked to the rapid process of urbanisation and westernization. Data from several developing countries suggest that improvements in developmental indicators is accompanied by higher availability of highly processed poorly nutritious foods. Regarding socioeconomic factors, results demonstrated that better education and better living standards were associated with higher odds of overweight/obesity after adjusting for confounders, including urban vs. rural setting. This is likely a consequence of the ongoing nutritional and epidemiological transition occurring in these settings. In fact, developing countries have not yet reached the same phase of nutritional transition as an economically affluent country, and while high-calorie diets comprising fast-food are the more economically affordable option in the latter, such diets are still reserved for the more affluent individuals in some developing countries, where economic growth has only just begun to allow affluent individuals to afford fast-food. Conclusions Understanding the underlying ecological and socioeconomic roots of both extremes of the nutritional status is vital to design successful public health interventions.
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“Nutrition transition” describes the shifts in dietary consumption and energy expenditure influenced by economic, demographic, and epidemiological changes at a population level. This phenomenon has been associated with rising obesity rates worldwide, especially in developed countries. In Brazil, the historical analysis of temporal trends between malnutrition and obesity characterized the nutrition transition in the country and interweaved it with the formulation and implementation of public food and nutrition policies. Such analysis is crucial for understanding certain principles in each context. Thus, this review contextualized the consolidation of obesity as a critical health and public policy issue in Brazil. Our review suggested that the country may still be at the initial stage of care for obesity, and more efforts are needed to contain the advance of the disease in Brazil.
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The prevalence of type 2 diabetes has been reaching epidemic proportions across the globe, affecting low/middle-income and developed countries. Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet. We aimed to depict the current state of type 2 diabetes worldwide in light of the undergoing epidemiologic and nutrition transition, and to posit that a key factor in the nutrition transition has been the shift in the type and processing of staple foods, from less processed traditional foods to highly refined and processed carbohydrate sources.
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The present report summarises the symposium ‘Nutrition Transition and the Global Burden of Type 2 Diabetes’ and a workshop on strategies for dietary interventions to prevent type 2 diabetes held by the Global Nutrition and Epidemiologic Transition Initiative, Boston, MA, USA in November 2011. The objectives of this event were to bring attention to the global epidemic of type 2 diabetes in light of the ongoing nutrition transition worldwide, especially in low- and middle-income countries, and to highlight the present evidence on key dietary risk factors contributing to the global diabetes burden. The meeting put forward ideas for further research on this topic and discussed practical recommendations to design and implement culturally appropriate dietary interventions with a focus on improving carbohydrate quality to help alleviate this growing health problem.
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