Globalisation, nutrition and health

Abstract

The global extent of epidemiological and nutritional transition is evidenced by the increasing prevalence of ‘diseases of affluence’ and of obesity in ‘poor’ countries. Circumstantial evidence of increasing food availability preference for high-fat foods and reduced physical work due to mechanisation of labour suggests that the causes of obesity are largely environmental. In countries making economic progress the ‘shift’ in high prevalence of obesity and cardiovascular disease from high- to low-income groups appears to follow previous experience in the West. The causal link between obesity and non-communicable disease depends on the patterns of both fat distribution (central vs peripheral) and weight gain. Fetal programming whereby perturbation in fetal nutrition or hormonal status produces adverse effects in later life might be important. Godfrey & Barker focused on fetal exposures demonstrating a causal link between intrauterine growth retardation and later coronary heart disease hypertension and type 2 diabetes mellitus. Evidence that infant feeding method and early cholesterol status might also influence adult health has recently been reviewed. Fears that these epidemics are accelerating fuel speculation that the effects of adverse fetal programming will be more severe when life-style changes rapidly. (excerpt)