Preventing the global burden of type 2 diabetes by improving the quality of staple foods: The Global Nutrition and Epidemiologic Transition Initiative

Abstract

Type 2 diabetes has reached epidemic proportions globally, affecting low‐ and high‐income countries. Two main contributors have been the epidemiological transition and concomitant adverse changes in diet. We aimed to depict the current state of diabetes in light of the ongoing epidemiological and nutrition transition, and to posit that a key factor has been a shift in the type and processing of staple foods, using data from 10 countries participating in the Global Nutrition and Epidemiologic Transition Initiative (GNET), a collaborative effort aiming to reduce diabetes by improving the quality of traditional foods through culturally‐appropriate interventions. We depicted the epidemiological transition using median age, life expectancy, overall death rate and cause of death, and the nutrition transition using data from food balance sheets. Main staple foods (rice, roots, tubers, wheat, corn, legumes) differed by country, with most countries undergoing a shift in principal contributors to energy in the past 60 years. A notable example was the opposing trend in percent energy from rice (positive) vs. legumes (inverse). GNET countries with pilot data have documented barriers and motivators to increase intake of high‐quality traditional foods. In summary, global research efforts to identify and promote intake of culturally‐acceptable high‐quality staple foods could play a key role in diabetes prevention.