Skip to main content

Advertisement

Log in

Nutrition Transition and the Global Diabetes Epidemic

  • Lifestyle Management to Reduce Diabetes/Cardiovascular Risk (E Mayer-Davis and C Shay, Section Editors)
  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

Low- and middle-income countries (LMICs) face a rapid change in the nutrition transition toward increases in noncommunicable diseases. Underlying this transition are shifts in the agricultural system and the subsequent growth of the modern retail and food service sectors across all regions and countries, a change in technology affecting physical activity and inactivity, mass media access, urbanization, and penetration of modern food systems into all societies. The resulting major shifts in diet are toward increased refined carbohydrates, added sweeteners, edible oils, and animal-source foods and reduced legumes, other vegetables, and fruits. Most countries are seeing increases in body mass index (BMI), overweight, and waist circumference (WC), and an increased WC-BMI ratio appears to be emerging in many regions. The implications of these rapidly changing diets and body compositions include the prevalence and severity of diabetes in LMICs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. International Diabetes Federation. IDF Diabetes Atlas, 6th edn. Brussels, Belgium: International Diabetes Federation, 2013. http://www.idf.org/diabetesatlas.

  2. Caballero B, Popkin BM. The nutrition transition: diet and disease in the developing world. London: Academic Press; 2002.

    Google Scholar 

  3. Popkin BM. The nutrition transition and its health implications in lower-income countries. Public Health Nutr. 1998;1(1):5–21.

    Article  CAS  PubMed  Google Scholar 

  4. Popkin BM. The shift in stages of the nutrition transition in the developing world differs from past experiences! Public Health Nutr. 2002;5(1A):205–14.

    Article  PubMed  Google Scholar 

  5. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3–21. doi:10.1111/j.1753-4887.2011.00456.x. This is the author’s most recent detailed assessment of the overall shifts in diet, PA, and body composition and the developmental origins of health and disease.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Babu SC, Blom S. Building resilience for food and nutrition security. 2020 Conference Brief 6 2014.

  7. Anand SS, Hawkes C, de Souza RJ, Mente A, Dehghan M, Nugent R, et al. Global food consumption and its impact on cardiovascular disease requires global solutions with a focus on the globalized food system. J Am Coll Cardiol. 2015. This article, the product of a World Heart Association consensus conference, reviews changes in diets and the global agricultural and food systems. It discusses the systemic alterations all nations must make to address the resultant health problems and to prevent future increases in heart disease.

  8. Popkin B. Technology, transport, globalization and the nutrition transition. Food Policy. 2006;31(554):569.

    Google Scholar 

  9. Mendez MA, Popkin BM. Globalization, urbanization, and nutritional change in the developing world. Electron J Agric Dev Econ. 2005;1:220–41.

    Google Scholar 

  10. Popkin B, Bisgrove EZ. Urbanization and nutrition in low-income countries. Food Nutr Bull. 1988;10:3–23.

    Google Scholar 

  11. Ng SW, Popkin BM. Time use and physical activity: a shift away from movement across the globe. Obes Rev. 2012;13(8):659–80. doi:10.1111/j.1467-789X.2011.00982.x.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Dearth-Wesley T, Popkin B, Ng S. Estimated and forecasted trends in domain specific time-use and energy expenditure among adults in Russia. Int J Behav Nutr Phys Act. 2014;11:11. doi:10.1186/1479-5868-11-11.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Tudor-Locke C, Ainsworth BE, Popkin BM. Active commuting to school: an overlooked source of childrens’ physical activity? Sports Med. 2001;31(5):309–13.

    Article  CAS  PubMed  Google Scholar 

  14. Tudor-Locke C, Neff LJ, Ainsworth BE, Addy CL, Popkin BM. Omission of active commuting to school and the prevalence of children’s health-related physical activity levels: the Russian longitudinal monitoring study. Child Care Health Dev. 2002;28(6):507–12.

    Article  CAS  PubMed  Google Scholar 

  15. Tudor-Locke C, Ainsworth BE, Adair LS, Du S, Popkin BM. Physical activity and inactivity in Chinese school-aged youth: the China Health and Nutrition Survey. Int J Obes Relat Metab Disord. 2003;27(9):1093–9.

    Article  CAS  PubMed  Google Scholar 

  16. Tudor-Locke C, Ainsworth BE, Adair LS, Popkin BM. Objective physical activity of Filipino youth stratified for commuting mode to school. Med Sci Sports Exerc. 2003;35(3):465–71.

    Article  PubMed  Google Scholar 

  17. Tudor-Locke C, Ainsworth BE, Adair LS, Popkin BM. Physical activity in Filipino youth: the Cebu Longitudinal Health and Nutrition Survey. Int J Obes Relat Metab Disord. 2003;27(2):181–90.

    Article  CAS  PubMed  Google Scholar 

  18. Tudor-Locke C, Ainsworth BE, Adair LS, Du S, Lee N, Popkin BM. Cross-sectional comparison of physical activity and inactivity patterns in Chinese and Filipino youth. Child Care Health Dev. 2007;33(1):59–66. doi:10.1111/j.1365-2214.2006.00612.x.

    Article  CAS  PubMed  Google Scholar 

  19. Tudor-Locke C, Ainsworth BE, Popkin BM. Patterns of physical activity and overweight among 7-13-year-old Russian children: a 7-year nationally representative monitoring study. Res Q Exerc Sport. 2008;79(1):10–7.

    PubMed  Google Scholar 

  20. Popkin B, Drewnowski A. Dietary fats and the nutrition transition: new trends in the global diet. Nutr Rev. 1997;55:31–43.

    PubMed  Google Scholar 

  21. Wang Z, Zhai F, Du S, Popkin B. Dynamic shifts in Chinese eating behaviors. Asia Pac J Clin Nutr. 2008;17(1):123–30.

    PubMed  Google Scholar 

  22. Popkin BM, Nielsen SJ. The sweetening of the world’s diet. Obes Res. 2003;11(11):1325–32.

    Article  PubMed  Google Scholar 

  23. Ng SW, Slining MM, Popkin BM. Use of caloric and noncaloric sweeteners in US consumer packaged foods, 2005–2009. J Acad Nutr Diet. 2012;112(11):1828–34.e6.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Malik VS, Popkin BM, Bray GA, Despres JP, Willett WC, Hu FB. Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care. 2010;33(11):2477–83. doi:10.2337/dc10-1079.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Malik VS, Pan A, Willett WC, Hu FB. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98(4):1084–102. doi:10.3945/ajcn.113.058362.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Odegaard AO, Koh W-P, Arakawa K, Yu MC, Pereira MA. Soft drink and juice consumption and risk of physician-diagnosed incident type 2 diabetes: The Singapore Chinese Health Study. Am J Epidemiol. 2010;171(6):701–8. doi:10.1093/aje/kwp452.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Bazzano L, Li T, Joshipura K, Hu F. Intake of fruit, vegetables, and fruit juices and risk of diabetes in women. Diabetes Care. 2008;31(7):1311–7. doi:10.2337/dc08-0080.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Delgado CL. Rising consumption of meat and milk in developing countries has created a new food revolution. J Nutr. 2003;133(11 Suppl 2):3907S–10.

    CAS  PubMed  Google Scholar 

  29. Du S, Mroz TA, Zhai F, Popkin BM. Rapid income growth adversely affects diet quality in China—particularly for the poor! Soc Sci Med. 2004;59(7):1505–15.

    Article  PubMed  Google Scholar 

  30. Popkin BM, Du S. Dynamics of the nutrition transition toward the animal foods sector in China and its implications: a worried perspective. J Nutr. 2003;133(11 Suppl 2):3898S–906.

    CAS  PubMed  Google Scholar 

  31. Popkin BM, Keyou G, Zhai F, Guo X, Ma H, Zohoori N. The nutrition transition in China: a cross-sectional analysis. Eur J Clin Nutr. 1993;47(5):333–46.

    CAS  PubMed  Google Scholar 

  32. Du S, Lu B, Zhai F, Popkin BM. A new stage of the nutrition transition in China. Public Health Nutr. 2002;5(1A):169–74.

    Article  PubMed  Google Scholar 

  33. Popkin BM. The world is fat—the fads, trends, policies, and products that are fattening the human race. New York: Avery-Penguin Group; 2008.

    Google Scholar 

  34. 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(10):716–20. doi:10.1056/NEJM199609053351006.

    Article  CAS  PubMed  Google Scholar 

  35. Monteiro CA, Moubarac JC, Cannon G, Ng SW, Popkin B. Ultra-processed products are becoming dominant in the global food system. Obes Rev. 2013;14:21–8. doi:10.1111/obr.12107.

    Article  PubMed  Google Scholar 

  36. Monteiro CA, Levy RB, Claro RM, de Castro IR, Cannon G. Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr. 2011;14(1):5–13. doi:10.1017/S1368980010003241.

    Article  PubMed  Google Scholar 

  37. Lennerz BS, Alsop DC, Holsen LM, Stern E, Rojas R, Ebbeling CB, et al. Effects of dietary glycemic index on brain regions related to reward and craving in men. Am J Clin Nutr. 2013;98(3):641–7. doi:10.3945/ajcn.113.064113.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. U.S. Department of Health and Human Services and the US Department of Agriculture. Scientific report of the 2015 Dietary Guidelines Advisory Committee. Washington DC: Office of Disease Prevention and Health Promotion USDHHS; 2015. p. 2015.

    Google Scholar 

  39. Ludwig DS. Technology, diet, and the burden of chronic disease. JAMA. 2011;305(13):1352–3. doi:10.1001/jama.2011.380.

    Article  CAS  PubMed  Google Scholar 

  40. Popkin BM. Agricultural policies, food and public health. EMBO Rep. 2011;12(1):11–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63. doi:10.1016/S0140-6736(03)15268-3.

    Article  Google Scholar 

  42. Popkin BM, Slining MM. New dynamics in global obesity facing low- and middle-income countries. Obes Rev. 2013;14:11–20. doi:10.1111/obr.12102. This is an overview of the shifts in overweight, BMI distribution, WC, and WC-BMI ratio in LMICs.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Jaacks LM, Slining MM, Popkin BM. Recent trends in the prevalence of under- and overweight among adolescent girls in low- and middle-income countries. Pediatr Obes. 2015. doi:10.1111/ijpo.12000.

    PubMed  Google Scholar 

  44. Jaacks LM, Slining MM, Popkin BM. Recent underweight and overweight trends by rural–urban residence among women in low- and middle-income countries. J Nutr. 2015. doi:10.3945/jn.114.203562. This presents the only data for LMICs on trends in overweight and obesity in adolescents.

    Google Scholar 

  45. Albrecht SS, Barquera S, Popkin BM. Exploring secular changes in the association between BMI and waist circumference in Mexican-Origin and white women: a comparison of Mexico and the United States. Am J Hum Biol. 2014;26(5):627–34. doi:10.1002/ajhb.22573.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Albrecht SS, Gordon-Larsen P, Stern D, Popkin BM. Is waist circumference per body mass index rising differentially across the US, England, China, and Mexico? Eur J Clin Nutr. 2015. doi:10.1038/ejcn.2015.71.

  47. Stern D, Smith LP, Zhang B, Gordon-Larsen P, Popkin BM. Changes in waist circumference relative to body mass index in Chinese adults, 1993–2009. Int J Obes. 2014;38(12):1503–10. doi:10.1038/ijo.2014.74.

    Article  CAS  Google Scholar 

  48. Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444(7121):881–7. doi:10.1038/nature05488.

    Article  CAS  PubMed  Google Scholar 

  49. Ross R, Despres JP. Abdominal obesity, insulin resistance, and the metabolic syndrome: contribution of physical activity/exercise. Obesity. 2009;17 Suppl 3:S1–2. doi:10.1038/oby.2009.381.

    Article  CAS  PubMed  Google Scholar 

  50. Després J-P, Lemieux I, Bergeron J, Pibarot P, Mathieu P, Larose E, et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol. 2008;28(6):1039–49. doi:10.1161/atvbaha.107.159228.

    Article  PubMed  Google Scholar 

  51. Barquera S, Campos I, Rivera J. Mexico attempts to tackle obesity: the process, results, push backs and future challenges. Obes Rev. 2013;14:69–78. doi:10.1111/obr.12096.

    Article  PubMed  Google Scholar 

  52. Corvalán C, Reyes M, Garmendia M, Uauy R. Structural responses to the obesity and non-communicable diseases epidemic: the Chilean Law of Food Labeling and Advertising. Obes Rev. 2013;14:79–87. doi:10.1111/obr.12099.

    Article  PubMed  Google Scholar 

  53. Foo LL, Vijaya K, Sloan RA, Ling A. Obesity prevention and management: Singapore’s experience. Obes Rev. 2013;14:106–13. doi:10.1111/obr.12092.

    Article  PubMed  Google Scholar 

  54. Coitinho D, Monteiro C, Popkin B. What Brazil is doing to promote healthy diets and active lifestyles. Public Health Nutr. 2002;5(1A):263–7.

    Article  PubMed  Google Scholar 

  55. Jaime P, da Silva A, Gentil P, Claro R, Monteiro C. Brazilian obesity prevention and control initiatives Brazil: Brazilian obesity prevention and control initiatives. Obes Rev. 2013;14 Suppl 2:88–95.

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Barry M. Popkin declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Barry M. Popkin.

Additional information

This article is part of the Topical Collection on Lifestyle Management to Reduce Diabetes/Cardiovascular Risk

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Popkin, B.M. Nutrition Transition and the Global Diabetes Epidemic. Curr Diab Rep 15, 64 (2015). https://doi.org/10.1007/s11892-015-0631-4

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11892-015-0631-4

Keywords

Navigation