Prakash Shetty

Nutrition transition in India

OBJECTIVEnThe primary objective of this review is to examine the demographic and nutrition transition in India in relation to its contribution to the emerging epidemic of chronic non-communicable diseases in this country.nnnSETTINGnIndia, the country as a whole and its different states with a population exceeding 1 billion in 2001.nnnSUBJECTSnThe review examines demographic changes in the population with consequent effects on the population pyramid, the rapidity and rates of urbanisation with striking variations in chronic disease patterns and the trends in obesity between rural and urban communities, attempting to relate their prevalence with the diet and lifestyle changes accompanying them.nnnDESIGNnThe review is based largely on representative large-scale surveys in the country and other reliable documented data on population characteristics. It also includes a review of the published literature.nnnRESULTSnThe results indicate that the demographic changes, rates of urbanisation and changes in dietary patterns are contributing to the changing trends in chronic disease in India.nnnCONCLUSIONSnThere is clear evidence of a demographic, epidemiological and nutrition transition in India that is fuelling the epidemic of chronic diseases and obesity, particularly in the urban areas.

The nutrition transition to 2030. Why developing countries are likely to bear the major burden

Abstract Considerable increases in food consumption, shifts in consumption patterns and changes in the entire food system have occurred globally. These changes, initially limited to the industrialized world, are now being experienced at an even faster pace in many of the advanced economies of the developing world. The past evolution of this transition in nutrition and lifestyles is by now well documented. Based on FAOs outlook for global food and agriculture, this paper outlines the likely future changes in food consumption patterns and the global trajectory of the nutrition transition over the next 30 years. It presents the main drivers of the nutrition transition and examines their influence on the prospective changes in consumption patterns. The paper illustrates how the current burden of undernourishment and malnutrition in developing countries is likely to compound the adverse effects of the nutrition transition, notably the increasing prevalence of obesity and non-communicable diseases (NCDs); it shows how and where the current problem of undernutrition could create a growing future burden of overweight, obesity and NCDs and that both undernourishment and overnutrition are likely to co-exist for a long time in the vast majority of developing countries, creating a widespread double burden of malnutrition.

The principles, definition and dimensions of the new nutrition science

OBJECTIVEnTo specify the principles, definition and dimensions of the new nutrition science.nnnPURPOSEnTo identify nutrition, with its application in food and nutrition policy, as a science with great width and breadth of vision and scope, in order that it can fully contribute to the preservation, maintenance, development and sustenance of life on Earth.nnnMETHODnA brief overview shows that current conventional nutrition is defined as a biological science, although its governing and guiding principles are implicit only, and no generally agreed definition is evident. Following are agreements on the principles, definition and dimensions of the new nutrition science, made by the authors as participants at a workshop on this theme held on 5-8 April 2005 at the Schloss Rauischholzhausen, Justus-Liebig University, Giessen, Germany.nnnRESULTnNutrition science as here specified will retain its current classical identity as a biological science, within a broader and integrated conceptual framework, and will also be confirmed as a social and environmental science. As such it will be concerned with personal and population health, and with planetary health--the welfare and future of the whole physical and living world of which humans are a part.

Relationship between body composition and blood pressure in Bahraini adolescents.

The objective of the present study was to examine the relationship between body composition and blood pressure (BP) in Bahraini adolescents. A sample of 504 Bahraini schoolchildren aged 12-17 years (249 boys and 255 girls) was selected using a multi-stage stratified sampling procedure. BP measurements were performed on the students. Anthropometric data including weight, height, waist circumference (WC), hip circumference, and triceps, subscapular and medial calf skinfold thicknesses were also collected. BMI, percentage body fat, waist:hip (WHR), and subscapular:triceps skinfold ratio were calculated. Mean systolic BP and mean diastolic BP were higher in males than in females. Weight and height in boys and weight only in girls were significantly associated with systolic BP independent of age or percentage fat. Nearly 14 % of the adolescents were classified as having high BP. BMI and percentage body fat were significantly and positively associated with the risk of having high BP in the boys and girls. Adolescents with high WHR or WC, as indicators for central obesity, tended to have higher BP values. The results from the present study indicate that obesity influences the BP of Bahraini adolescents and that simple anthropometric measurements such as WHR and WC are useful in identifying children at risk of developing high BP. These findings together with the known tracking of BP from adolescence into adulthood underline the importance of establishing intervention programmes in order to prevent the development of childhood and adolescent obesity.

Introductory Lecture The Epidemiology and Determinants of Obesity in Developed and Developing Countries

Obesity is recognized as a serious problem in the industrialized and developed countries of the world. However, little attention is paid to the fact that obesity is becoming an increasing problem in developing countries too, with some countries showing increasing rates of obesity in the midst of the persisting occurrence of childhood malnutrition and stunting. As developing countries embrace the dominant western economic ways of development, industrialization and urbanization they contribute to improvements in living standards, with consequent dramatic changes in diets and lifestyles leading to weight gain and obesity which in turn poses a growing threat to the health. Overweight and obesity is associated with an increased likelihood of non-insulin dependent diabetes mellitus, hypertension, hyper-lipidaemia, and cardiovascular disease. It is also associated with increased rates of breast, colo-rectal and uterine cancer. Obesity is thus an important factor in the increasing morbidity and mortality due to chronic, non-communicable diseases (NCDs) and thereby contributes to premature mortality in the population. Thus, while the problem of undernutrition persists in much of the developing world, overweight and obesity and its related co-morbidities are posing an increasingly important public health problem both in the developed and developing world.

Anthropometric and body composition indicators of Bahraini adolescents

Background : Childhood and adolescent obesity tends to extend into adulthood and predisposes the individual to some chronic diseases in later life. Body composition is a good indicator for assessing obesity and nutritional status of people. Aim : To determine the anthropometric and body composition characteristics of Bahraini adolescents and to compare these measurements with previously published data on the same age group. Subjects of methods : Cross-sectional data on 506 Bahraini adolescents (249 boys and 257 girls) aged 12-17 years were collected in 2000. The sample was selected from intermediate and secondary schools using a multistage stratified sampling procedure. Anthropometric measurements, including weight, height, mid upper arm circumference, waist and hip circumference, triceps, subscapular and medial calf skinfold thickness, were performed on the adolescents. Body mass index (BMI), percent body fat, arm muscle circumference (AMC), arm muscle area (AMA), arm fat area (AFA), waist/hip ratio (WHR), and subscapular/triceps skinfold ratio (STR) were also calculated. Results : A sexual dimorphism that appears to be related to differential changes in body composition during puberty was observed. The findings showed that mean BMI, skinfold thickness and percent body fat were all higher than those reported in earlier studies on Bahraini adolescents of corresponding age range, indicating an increase in fat accumulation among the adolescent population. Bahraini adolescents were found to be shorter and of similar weight or even heavier than their Western counterparts, indicating a greater trend of obesity among Bahraini adolescents. Conclusion : A trend of greater obesity appears to have occurred in the Bahraini adolescents during the period between 1986 and 2000. These findings have important public health implications given recent evidence linking childhood and adolescent obesity to increased risk of obesity and morbidity in adulthood. Therefore, programmes to prevent the development of obesity in children and adolescents should be given a high priority.

Achieving the goal of halving global hunger by 2015

The FAO World Food Summit (WFS) in 1996 set the goal of halving the numbers of the global population suffering hunger by the year 2015, which was later incorporated into the UN Millennium Development Goals (MDG) that commit the international community to an expanded vision of development, and one that vigorously promotes human development as the key to sustaining social and economic progress in all countries. The two targets under the first MDG goal to eradicate poverty and hunger call for halving the proportion of individuals who suffer from poverty and from hunger by 2015. This commitment is another instance of the international community through the UN system yet again renewing its efforts and setting a target and a time frame to deal with the global problem of hunger, poverty and malnutrition. To date, the efforts to reduce global hunger in the developing world have fallen far short of the pace required to meet these targets. There has no doubt been some progress and several countries in the developing world have proved that success is possible. The economic and societal costs to developing countries of not taking decisive action, and thus failing to achieve a reduction in hunger and undernutrition, including micronutrient malnutrition costs, are that every year five million children lose their lives, 220 million disability-adjusted life years are lost as a result of childhood and maternal undernutrition and billions of dollars are lost in productivity and incomes in these countries. Alongside this perennial problem in developing societies are emerging new epidemics of diet-related diseases resulting from the profound demographic changes, urbanization and the economic transition that is transforming and globalizing the food systems in these countries. Thus, many developing countries are facing new and additional challenges of co-existing hunger alongside the emergence of other forms of malnutrition. Meeting the WFS and MDG targets of achieving the goal of halving global hunger is urgent, and the question that needs to be addressed is not whether the international community can achieve this goal in time but whether it can afford not to.