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The Nutrition Transition and the Double Burden of Malnutrition

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Nutritional Health

Part of the book series: Nutrition and Health ((NH))

Abstract

The nutrition transition is characterized by a dietary shift from traditional foods to modern, globalized foods marked by excessive intakes of sodium, sugar, and saturated fat. The latter dietary pattern is associated with obesity and chronic disease. An incomplete passage through the nutrition transition makes populations vulnerable to a double burden of malnutrition in which problems of nutrient deficiencies associated with traditional food systems remain unresolved or are even exacerbated, while novel problems related to nutrient excesses appear. Economic development, urbanization, and globalization are major drivers of these dietary shifts. While these can have positive impacts on diets, they also create inequalities that make certain populations more vulnerable to the double burden of malnutrition. The nutrition transition is now mostly observed in low- and middle-income countries. However, it also affects particular populations in high-income countries, such as Indigenous Peoples in Canada. Around the world, Indigenous populations safeguard health-promoting food traditions and are key to constructing healthier food systems.

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References

  1. Popkin BM. Nutritional patterns and transitions. Popul Dev Rev. 1993;19:138.

    Article  Google Scholar 

  2. HLPE. Nutrition and food systems. A report by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security. Rome: FAO; 2017. http://www.fao.org/3/a-i7846e.pdf. Accessed 17 Sept 2021.

  3. Omram AR. The epidemiologic transition: a theory of the epidemiology of population change. Bull World Health Organ. 2001;79:161–70.

    Google Scholar 

  4. Popkin BM, Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes. 2004;28:S2–9.

    Article  Google Scholar 

  5. Popkin BM. The nutrition transition is speeding up: a global perspective. In: Temple N, Wilson T, Jacobs Jr DR, editors. Nutritional health: strategies for disease prevention. 3rd ed. New York: Humana Press; 2012. p. 85–99.

    Chapter  Google Scholar 

  6. NCD Risk Factor Collaboration. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016;387:1377–96.

    Article  Google Scholar 

  7. World Health Organization. Obesity and overweight fact sheet. World Health Organization; 2021. http://www.who.int/mediacentre/factsheets/fs311/en. Accessed 17 Sept 2021.

  8. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70:3–21.

    Article  PubMed  Google Scholar 

  9. Monteiro CA, Conde WL, Lu B, Popkin BM. Obesity and inequities in health in the developing world. Int J Obes. 2004;28:1181–6.

    Article  CAS  Google Scholar 

  10. Barquera S, Pedroza-Tobias A, Medina C. Cardiovascular diseases in mega-countries: the challenges of the nutrition, physical activity and epidemiologic transitions, and the double burden of disease. Curr Opin Lipidol. 2016;27:329–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Atun R, Davies JI, Gale EA, Bärnighausen T, Beran D, Kengne AP, et al. Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol. 2017;5:622–67.

    Article  PubMed  Google Scholar 

  12. World Health Organization. Global report on diabetes: executive summary. Geneva: World Health Organization; 2016.

    Google Scholar 

  13. International Food Policy Research Institute. Global nutrition report 2016; from promise to impact: ending malnutrition by 2030. Washington, DC: International Food Policy Research Institute; 2016. https://doi.org/10.2499/9780896295841. Accessed 17 Sept 2021.

    Book  Google Scholar 

  14. Doak CM, Adair LS, Monteiro C, Popkin BM. Overweight and underweight coexist within households in Brazil, China and Russia. J Nutr. 2000;130:2965–71.

    Article  CAS  PubMed  Google Scholar 

  15. Ramirez-Zea M, Kroker-Lobos MF, Close-Fernandez R, Kanter R. The double burden of malnutrition in indigenous and nonindigenous Guatemalan populations. Am J Clin Nutr. 2014;100:1644S–51S.

    Article  CAS  PubMed  Google Scholar 

  16. Jones AD, Acharya Y, Galway LP. Urbanicity gradients are associated with the household-and individual-level double burden of malnutrition in sub-Saharan Africa. J Nutr. 2016;146:1257–67.

    Article  CAS  PubMed  Google Scholar 

  17. Stein AD, Thompson AM, Waters A. Childhood growth and chronic disease: evidence from countries undergoing the nutrition transition. Matern Child Nutr. 2005;1:177–84.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371:340–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Yang Z, Huffman SL. Nutrition in pregnancy and early childhood and associations with obesity in developing countries. Matern Child Nutr. 2013;9:105–19.

    Article  PubMed  Google Scholar 

  20. Hales CN, Barker DJ. The thrifty phenotype hypothesis: type 2 diabetes. Br Med Bull. 2001;60:5–20.

    Article  CAS  PubMed  Google Scholar 

  21. Popkin BM. Nutrition transition and the global diabetes epidemic. Curr Diab Rep. 2015;15:64.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Rosset P. The “tortilla crisis” in Mexico. Campesina; 2007. https://viacampesina.org/en/the-qtortilla-crisisq-in-mexico. Accessed 17 Sept 2021.

  23. Hawkes C, Chopra M, Friel S. Globalization, trade, and the nutrition transition. In: Labonte R, Schrecker T, Packer C, Runnels V, editors. Globalization and health: pathways, evidence and policy; 2009. p. 257–284.

    Google Scholar 

  24. Oths KS, Carolo A, Dos Santos JE. Social status and food preference in southern Brazil. Ecol Food Nutr. 2003;42:303–24.

    Article  PubMed  Google Scholar 

  25. Menezes F. Food sovereignty: a vital requirement for food security in the context of globalization. Development. 2001;44:29–33.

    Article  Google Scholar 

  26. Kelly B, Jacoby E. Public health nutrition special issue on ultra-processed foods. Public Health Nutr. 2018;21:1–4.

    Article  PubMed  Google Scholar 

  27. Monteiro CA, Cannon G, Moubarac J-C, Levy RB, Louzada MLC, Jaime PC. The UN decade of nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutr. 2018;21:5–17.

    Article  PubMed  Google Scholar 

  28. Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84:289–98.

    Article  CAS  PubMed  Google Scholar 

  29. Monteiro CA, Levy RB, Claro RM, de Castro IR, Cannon G. A new classification of foods based on the extent and purpose of their processing. Cad Saude Publica. 2010;26:2039–49.

    Article  PubMed  Google Scholar 

  30. Welch R, Mitchell P. Food processing: a century of change. Br Med Bull. 2000;56:1–17.

    Article  CAS  PubMed  Google Scholar 

  31. Baraldi LG, Steele EM, Canella DS, Monteiro CA. Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study. BMJ Open. 2018;8:e020574.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Rauber F, da Costa Louzada ML, Steele EM, Millett C, Monteiro CA, Levy RB. Ultra-processed food consumption and chronic non-communicable diseases-related dietary nutrient profile in the UK (2008–2014). Nutrients. 2018;10:587.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Nardocci M, Polsky JY, Moubarac J-C. Consumption of ultra-processed foods is associated with obesity, diabetes and hypertension in Canadian adults. Can J Public Health. 2021;112:421–9.

    Article  PubMed  Google Scholar 

  34. PAHO. Ultra-processed food and drink products in Latin America: trends, impact on obesity, policy implications. Washington, DC: Pan American Health Organization; 2015.

    Google Scholar 

  35. Sproesser G, Ruby MB, Arbit N, Akotia CS, dos Santos Alvarenga M, Bhangaokar R, et al. Understanding traditional and modern eating: the TEP10 framework. BMC Public Health. 2019;19:1–14.

    Article  Google Scholar 

  36. Tumin R, Anderson SE. Television, home-cooked meals, and family meal frequency: associations with adult obesity. J Acad Nutr Diet. 2017;117:937–45.

    Article  PubMed  Google Scholar 

  37. Fertig AR, Loth KA, Trofholz AC, Tate AD, Miner M, Neumark-Sztainer D, et al. Compared to pre-prepared meals, fully and partly home-cooked meals in diverse families with young children are more likely to include nutritious ingredients. J Acad Nutr Diet. 2019;119:818–30.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Kuhnlein HV, Erasmus B, Spigelski D, editors. Indigenous peoples’ food systems: the many dimensions of culture, diversity and environment for nutrition and health. Rome: Food and Agriculture Organization of the United Nations; 2009.

    Google Scholar 

  39. Wells JC, Sawaya AL, Wibaek R, Mwangome M, Poullas MS, Yajnik CS, et al. The double burden of malnutrition: aetiological pathways and consequences for health. Lancet. 2020;395:75–88.

    Article  PubMed  Google Scholar 

  40. Wong C, Zalilah M, Chua E, Norhasmah S, Chin Y, Nur’Asyura AS. Double-burden of malnutrition among the indigenous peoples (Orang Asli) of Peninsular Malaysia. BMC Public Health. 2015;15:1–9.

    Article  Google Scholar 

  41. Lee M-J, Popkin BM, Kim S. The unique aspects of the nutrition transition in South Korea: the retention of healthful elements in their traditional diet. Public Health Nutr. 2002;5:197–203.

    Article  CAS  PubMed  Google Scholar 

  42. Padulosi S, Thompson J, Rudebjer P. Fighting poverty, hunger and malnutrition with neglected and underutilized species (NUS): needs, challenges and the way forward. Rome: Bioversity International; 2013. https://www.bioversityinternational.org/fileadmin/_migrated/uploads/tx_news/Fighting_poverty__hunger_and_malnutrition_with_neglected_and_underutilized_species__NUS__1671.pdf. Accessed 17 Sept 2021.

    Google Scholar 

  43. Receveur O, Boulay M, Kuhnlein HV. Decreasing traditional food use affects diet quality for adult Dene/Métis in 16 communities of the Canadian Northwest Territories. J Nutr. 1997;127:2179–86.

    Article  CAS  PubMed  Google Scholar 

  44. FAO, IFAD, UNICEF, WFP and WHO. The state of food security and nutrition in the world 2020. Transforming food systems for affordable healthy diets. Rome: FAO; 2020.

    Google Scholar 

  45. Freire WB, Ramírez M, Belmont P. Tomo I: Encuesta Nacional de Salud y Nutrición de la población ecuatoriana de cero a 59 años, ENSANUT-ECU 2012. Rev Latinoam Políticas Acción Pública. 2015;2:117.

    Google Scholar 

  46. INEC. Anuario de estadísticas vitales, nacimientos y defunciones 2014. Ecuador: Instituto Nacional de Estadística y Censos; 2014. https://www.ecuadorencifras.gob.ec/documentos/web-inec/Poblacion_y_Demografia/Nacimientos_Defunciones/Publicaciones/Anuario_Nacimientos_y_Defunciones_2014.pdf. Accessed 17 Sept 2021.

    Google Scholar 

  47. Fundación Heifer Ecuador. Acuerdo comercial multipartes Ecuador-Unión Europea: ¿Negociación de un TLC? Posibles impactos en el sector rural. Quito, Ecuador: Fundación Heifer Ecuador; 2014.

    Google Scholar 

  48. Bernstein A. Emerging patterns in overweight and obesity in Ecuador. Rev Panam Salud Pública. 2008;24:71–4.

    Article  PubMed  Google Scholar 

  49. Deaconu A, Ekomer MG, Batal M. Promoting traditional foods for human and environmental health: lessons from agroecology and indigenous communities in Ecuador. BMC Nutr. 2021;7:1.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Gross J, Montero CG, Berti PR, Hammer M. Moving forward, looking back: on the frontlines of dietary shift in rural Ecuador. Íconos-Rev Cienc Soc. 2016:49–70.

    Google Scholar 

  51. Deaconu A, Berti PR, Cole DC, Mercille G, Batal M. Agroecology and nutritional health: a comparison of agroecological farmers and their neighbors in the Ecuadorian highlands. Food Policy. 2021;101:102034.

    Article  Google Scholar 

  52. Monteiro CA, Cannon G, Moubarac J-C, Martins APB, Martins CA, Garzillo J, et al. Dietary guidelines to nourish humanity and the planet in the twenty-first century. A blueprint from Brazil. Public Health Nutr. 2015;18:2311–22.

    Article  PubMed  Google Scholar 

  53. Deaconu A, Berti PR, Cole DC, Mercille G, Batal M. Market foods, own production, and the social economy: how food acquisition sources influence nutrient intake among Ecuadorian farmers and the role of agroecology in supporting healthy diets. Sustainability. 2021;13:4410.

    Article  Google Scholar 

  54. Drewnowski A, Popkin BM. The nutrition transition: new trends in the global diet. Nutr Rev. 1997;55:31–43.

    Article  CAS  PubMed  Google Scholar 

  55. Kuhnlein HV, Receveur O. Dietary change and traditional food systems of indigenous peoples. Annu Rev Nutr. 1996;16:417–42.

    Article  CAS  PubMed  Google Scholar 

  56. Roy B. Sang sucré, pouvoirs codés, médecine amère: diabète et processus de construction identitaire: les dimensions socio-politiques du diabète chez les Innus de Pessamit. Presses Université Laval; 2002.

    Google Scholar 

  57. Sheikh N, Egeland GM, Johnson-Down L, Kuhnlein HV. Changing dietary patterns and body mass index over time in Canadian Inuit communities. Int J Circumpolar Health. 2011;70:511–9.

    Article  PubMed  Google Scholar 

  58. Batal M, Chan HM, Fediuk K, Ing A, Berti P, Sadik T, et al. Importance of the traditional food systems for First Nations adults living on reserves in Canada. Can J Public Health. 2021;112:20–8.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Ford JD. Vulnerability of Inuit food systems to food insecurity as a consequence of climate change: a case study from Igloolik, Nunavut. Reg Environ Change. 2009;9:83–100.

    Article  Google Scholar 

  60. Laberge Gaudin V, Receveur O, Girard F, Potvin L. Facilitators and barriers to traditional food consumption in the Cree community of Mistissini, Northern Quebec. Ecol Food Nutr. 2015;54:663–92.

    Article  PubMed  Google Scholar 

  61. Batal M, Chan HM, Fediuk K, Berti P, Sadik T, Johnson-Down L. Comparison of measures of diet quality using 24-hour recall data of First Nations adults living on reserves in Canada. Can J Public Health. 2021;112:41–51.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Batal M, Johnson-Down L, Moubarac J-C, Ing A, Fediuk K, Sadik T, et al. Quantifying associations of the dietary share of ultra-processed foods with overall diet quality in First Nations peoples in the Canadian provinces of British Columbia, Alberta, Manitoba and Ontario. Public Health Nutr. 2018;21:103–13.

    Article  PubMed  Google Scholar 

  63. Chan HM, Fediuk K, Batal M, Sadik T, Tikhonov C, Ing A, et al. The First Nations Food, Nutrition and Environment Study (2008–2018)—rationale, design, methods and lessons learned. Can J Public Health. 2021;112:8–19.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Batal M, Chan HM, Fediuk K, Ing A, Berti P, Sadik T, et al. Associations of health status and diabetes among First Nations Peoples living on-reserve in Canada. Can J Public Health. 2021;112:154–67.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Batal M, Chan HM, Fediuk K, Berti PR, Mercille G, Sadik T, et al. First Nations households living on-reserve experience food insecurity: prevalence and predictors among ninety-two First Nations communities across Canada. Can J Public Health. 2021;112:52–63.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Blanchet R, Willows N, Johnson S, Okanagan Nation Salmon Reintroduction Initiatives, Batal M. Traditional food, health, and diet quality in Syilx Okanagan adults in British Columbia, Canada. Nutrients. 2020;12:927.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Blanchet R, Batal M, Johnson-Down L, Johnson S, Willows N. An indigenous food sovereignty initiative is positively associated with well-being and cultural connectedness in a survey of Syilx Okanagan adults in British Columbia, Canada. BMC Public Health. 2021;21:1–12.

    Article  Google Scholar 

  68. World Health Organization. Double-duty actions for nutrition: policy brief. Geneva: World Health Organization; 2017. https://www.who.int/publications/i/item/WHO-NMH-NHD-17.2. Accessed 17 Sept 2021.

    Google Scholar 

  69. Hawkes C. Global nutrition report 2017: nourishing the SDGs. Development Initiatives; 2017.

    Google Scholar 

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Authors and Affiliations

  1. Faculty of Medicine, Nutrition Department, Université de Montréal, Montréal, QC, Canada

    Malek Batal, Ana Deaconu & Lara Steinhouse

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  1. Malek Batal
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  2. Ana Deaconu
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  3. Lara Steinhouse
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Correspondence to Malek Batal .

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Editors and Affiliations

  1. Centre for Science, Athabasca University, Athabasca, AB, Canada

    Norman J. Temple

  2. Department of Biology, Winona State University, Winona, MN, USA

    Ted Wilson

  3. Division of Epidemiology and Community Health, University of Minnesota School of Public Health, MINNEAPOLIS, MN, USA

    David R. Jacobs, Jr.

  4. Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA

    George A. Bray

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Batal, M., Deaconu, A., Steinhouse, L. (2023). The Nutrition Transition and the Double Burden of Malnutrition. In: Temple, N.J., Wilson, T., Jacobs, Jr., D.R., Bray, G.A. (eds) Nutritional Health. Nutrition and Health. Humana, Cham. https://doi.org/10.1007/978-3-031-24663-0_3

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  • DOI: https://doi.org/10.1007/978-3-031-24663-0_3

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