Global nutrition transition and the pandemic of obesity in developing countries

Popkin, Barry M; Adair, Linda S; Ng, Shu Wen

doi:10.1111/j.1753-4887.2011.00456.x

Cited by 4,313Obesity, Physical Activity, DietGlobal Public Health Policies and EpidemiologyNutrition, Health, and Society Studies

Global nutrition transition and the pandemic of obesity in developing countries

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Popkin, Barry M, Adair, Linda S, Ng, Shu Wen·2012·Nutrition Reviews

DOI 10.1111/j.1753-4887.2011.00456.xPMC PMC3257829

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Abstract

Decades ago, discussion of an impending global pandemic of obesity was thought of as heresy. But in the 1970s, diets began to shift towards increased reliance upon processed foods, increased away-from-home food intake, and increased use of edible oils and sugar-sweetened beverages. Reductions in physical activity and increases in sedentary behavior began to be seen as well. The negative effects of these changes began to be recognized in the early 1990s, primarily in low- and middle-income populations, but they did not become clearly acknowledged until diabetes, hypertension, and obesity began to dominate the globe. Now, rapid increases in the rates of obesity and overweight are widely documented, from urban and rural areas in the poorest countries of sub-Saharan Africa and South Asia to populations in countries with higher income levels. Concurrent rapid shifts in diet and activity are well documented as well. An array of large-scale programmatic and policy measures are being explored in a few countries; however, few countries are engaged in serious efforts to prevent the serious dietary challenges being faced.

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The nutrition transition has affected the global distribution of the burden of obesity, diabetes, and untreated caries in permanent teeth.
“The nutrition transition has affected the global distribution of the burden of obesity (Popkin et al. 2012), diabetes (Popkin 2015), and untreated caries in permanent teeth (Moynihan and Petersen 2004)”
From Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study (2020) · cites this paper as Popkin et al. 2012
LMICs now bear a double burden of undernutrition and overnutrition.
“More recently, there has been an epidemiological transition in LMICs, since these countries now bear a double burden of undernutrition and overnutrition.77,78”
From Nutrition in adolescents: physiology, metabolism, and nutritional needs (2017) · cites this paper as [78]
The nutrition transition in developing nations beginning in the 1970s is typified by replacement of traditional carbohydrates with processed starches and sugars that have a higher GL.
“the “nutrition transition” in developing nations beginning in the 1970s (coincident with the low-fat diet era in the United States and Europe) is typified by replacement of traditional carbohydrates with processed starches and sugars that have a higher GL (160).”
From The carbohydrate-insulin model: A physiological perspective on the obesity pandemic (2021) · cites this paper as [160]
The prevalence of obesity is growing fast in developing countries, with experts calling for an increase in vegetable intake and higher quality, nutritious foods.
“Although these findings are not directly generalizable to the developing world, VASP may find acceptance in developing markets where large clusters of price-conscious consumers are likely to exist and the prevalence of obesity is growing fast, with experts calling for increase in vegetable intake and higher quality, nutritious foods (Popkin et al., 2012).”
From Completing the food waste management loop: Is there market potential for value-added surplus products (VASP)? (2020) · cites this paper as Popkin et al., 2012
The younger populations of middle-income countries may be more likely than their elders to forego traditional foods for newer ones.
“The younger populations of middle-income countries may be more likely than their elders to forego traditional foods for newer ones 12 .”
From Ultra‐processed foods and the nutrition transition: global, regional and national trends, food systems transformations and political economy drivers (2020) · cites this paper as [12]

Supermarkets act predominantly as new distribution channels for durable processed foods in the early stages of market growth, before offering a wider variety including fresh foods (and out-competing traditional wet markets) in later stages.
“Supermarkets act predominantly as new distribution channels for durable processed foods in the early stages of market growth, before offering a wider variety including fresh foods (and out-competing traditional wet markets) in later stages 12,157,159,160 .”
From Ultra‐processed foods and the nutrition transition: global, regional and national trends, food systems transformations and political economy drivers (2020) · cites this paper as [12]
These unhealthy diets are facilitated by modern food environments.
“These unhealthy diets are facilitated by modern food environments, a problem that is likely to become more widespread as food environments in LMIC shift to resemble those of HIC (5,7,8).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [8]
The problem of unhealthy diets facilitated by modern food environments is likely to become more widespread as food environments in LMIC shift to resemble those of HIC.
“These unhealthy diets are facilitated by modern food environments, a problem that is likely to become more widespread as food environments in LMIC shift to resemble those of HIC (5,7,8).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [8]
The consumption of legumes declined in the US from 1960 and into the 1980's, with reduced consumption patterns observed globally.
“The consumption of legumes declined in the US from 1960 and into the 1980’s, with reduced consumption patterns observed globally (8).”
From Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System (2015) · cites this paper as [8]

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Infant Feeding and Later Obesity Risk
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Drinking to our health: can beverage companies cut calories while maintaining profits?
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Golden Arches East: McDonald's in East Asia
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Losing the War Against Obesity: The Need for a Developmental Perspective
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[5]Monteiro C The big issue is ultra-processing Journal of the World Public Health Nutrition Association 2010
[100]Wartella EA Lichtenstein AH Boon CS Examination of Front-of-Package Nutrition Rating Systems and Symbols: Phase 1 Report Washington DC National Academy Press 2010 24983042
[122]Popkin BM Siega-Riz AM Haines PS A comparison of dietary trends among racial and socioeconomic groups in the United States N Engl J Med 1996 335 716 720 8703172

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Authors: Popkin, B. M., Adair, L. S., & Ng, S. W.
Affiliations: University of North Carolina at Chapel Hill (US)
Corresponding author: Popkin, Barry M
ORCID: Popkin, Barry M
Adair, Linda S
Ng, Shu Wen
Venue: Nutrition Reviews
Publisher: Oxford University Press (OUP)
Published: 2012-01
Volume: 70
Issue: 1
Pages: 3-21
ISSN: 0029-6643 (ISSN-L)
DOI: 10.1111/j.1753-4887.2011.00456.x
PMC: PMC3257829
OpenAlex: W2120445700
Semantic Scholar: 6f8af2fb4bba0c808e8c07094d2d4bb1fc8edcd9
Cited by: 4,313
References: 155
Citations by year: 2026: 205 · 2025: 274 · 2024: 278 · 2023: 333 · 2022: 383 · 2021: 374 · 2020: 451 · 2019: 353 · 2018: 340 · 2017: 338 · 2016: 285 · 2015: 266 · 2014: 218 · 2013: 144 · 2012: 63
FWCI: 34.51
Type: journal article
Language: en
Open access: green
europepmc.org
Locations: Nutrition Reviews (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (2r24hd050924-06)
National Institute of Diabetes and Digestive and Kidney Diseases (DK-056350, P30DK056350)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD 38700, R01HD030880, R24 HD-050924, R01HD038700, R01 HD 30880)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
Life Sciences › Agricultural and Biological Sciences › Food Science › Nutrition, Health, and Society Studies
Keywords: nutrition transition, obesity epidemic, developing countries, low- and middle-income countries, processed foods, sugar-sweetened beverages, edible oils, sedentary behavior, physical inactivity, obesity prevention policy, sub-Saharan Africa, South Asia
MeSH terms: Developing Countries, Diet, Feeding Behavior, Health Policy, Humans, Nutritional Status, Obesity, Socioeconomic Factors, Exercise, Metabolic Syndrome, Fast Foods

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Global nutrition transition and the pandemic of obesity in developing countries

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