Large-scale interventions and programmes addressing nutrition-related chronic diseases and obesity: examples from 14 countries.

Abstract

Developing countries are clearly facing a double burden of disease. The prevalences of overweight and obesity are rising among adults simultaneously with high rates of undernutrition among children 1‐7 . Consequently, nutrition-related chronic diseases, such as cardiovascular disease and diabetes, are emerging as concerns in developing countries 8 . These concerns are combined with the continued need to address undernutrition and infectious disease. Overweight and obesity are increasing in Chile among low-income groups and poor communities 9 . There is a triple burden of disease in South Africa, described by Vorster 10 . These are poverty-related infectious diseases, including HIV/AIDS, violence-related injuries and an increase in lifestyle-related non-communicable diseases. The burden of obesity and cardiovascular disease in the more developed regions of Brazil is also emerging among the poor 11 . As nutrition-related chronic diseases become more prevalent, limited resources will be further strained by the simultaneous cost of addressing infectious disease and undernutrition, while treating nutrition-related chronic diseases. Early prevention is essential in order to prevent the epidemic. As Reddy 8 states in this supplement, prevention is a necessary, cost-effective means of avoiding the high social, biological and economic costs of a treatment-based approach to nutrition-related chronic diseases. Thus, as a part of this meeting, we considered programmes in developing countries that have sought to intervene early to prevent obesity and nutrition-related chronic diseases.