Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

The nutrition transition: worldwide obesity dynamics and their determinants

International Journal of Obesity volume 28, pages S2–S9 (2004)Cite this article

Abstract

OBJECTIVE: This paper explores the major changes in diet and physical activity patterns around the world and focuses on shifts in obesity.

DESIGN: Review of results focusing on large-scale surveys and nationally representative studies of diet, activity, and obesity among adults and children.

SUBJECTS: Youth and adults from a range of countries around the world.

MEASUREMENTS: The International Obesity Task Force guidelines for defining overweight and obesity are used for youth and the body mass index ≥25 kg/m2 and 30 cutoffs are used, respectively, for adults.

RESULTS: The nutrition transition patterns are examined from the time period termed the receding famine pattern to one dominated by nutrition-related noncommunicable diseases (NR-NCDs). The speed of dietary and activity pattern shifts is great, particularly in the developing world, resulting in major shifts in obesity on a worldwide basis. Data limitations force us to examine data on obesity trends in adults to provide a broader sense of changes in obesity over time, and then to examine the relatively fewer studies on youth. Specifically, this work provides a sense of change both in the United States, Europe, and the lower- and middle-income countries of Asia, Africa, the Middle East, and Latin America.

CONCLUSION: The paper shows that changes are occurring at great speed and at earlier stages of the economic and social development of each country. The burden of obesity is shifting towards the poor.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

References

  1. Popkin BM . The shift in stages of the nutrition transition in the developing world differs from past experiences!. Public Health Nutr 2002; 5: 205–214.

    Article  PubMed  Google Scholar 

  2. Omran AR . The epidemiologic transition: a theory of the epidemiology of population change'. Milbank Mem Fund Q 1971; 49: 509–538.

    Article  CAS  PubMed  Google Scholar 

  3. Olshansky SJ, Ault AB . The fourth stage of the epidemiologic transition: the age of delayed degenerative diseases'. Milbank Mem Fund Q 1986; 64: 355–391.

    Article  CAS  Google Scholar 

  4. Manton KG, Soldo BJ . Dynamics of health changes in the oldest old: new perspective and evidence'. Milbank Mem Fund Q 1985; 63: 206–285.

    Article  CAS  Google Scholar 

  5. Crimmins EM, Saito Y, Ingegneri D . Changes in life expectancy and disability-free life expectancy in the United States. Popul Dev Rev 1989; 15: 235–267.

    Article  Google Scholar 

  6. Popkin BM . The nutrition transition in low-income countries: an emerging crises. Nutr Rev 1994; 52: 285–298.

    Article  CAS  PubMed  Google Scholar 

  7. Popkin BM . An overview on the nutrition transition and its health implications: the Bellagio meeting. Public Health Nutr 2002; 5: 93–103.

    Article  PubMed  Google Scholar 

  8. 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: 3898S–3906S.

    Article  CAS  PubMed  Google Scholar 

  9. US Department of Agriculture. World Agricultural Supply and Demand Estimates (WASDE-315). Table: Vegetable Oil Consumption Balance Sheets (in million metric tons), FAS Online. USDA: Washington, DC; 1997.

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

    Article  Google Scholar 

  11. Du S, Lu B, Zhai F, Popkin BM . The nutrition transition in China: a new stage of the Chinese diet. In: Caballero B, Popkin BM (eds) The Nutrition Transition: Diet and Disease in the Developing World. Academic Press: London; 2002. pp 205–222.

    Chapter  Google Scholar 

  12. Galloway JH . Sugar. In: Kiple KF, Ornelas KC (eds) The Cambridge World History of Food, Vol. I. Cambridge University Press: New York; 2000.

    Google Scholar 

  13. Mintz S . Time, sugar, and sweetness. In: Counihan C, Van Esterik P (eds). Food and Culture: A Reader. Routledge: New York; 1977.

    Google Scholar 

  14. Popkin BM, Nielsen SJ . The sweetening of the world's diet. Obes Res 2003; 11: 1325–1332.

    Article  PubMed  Google Scholar 

  15. Mendez M, Popkin BM . Globalization, urbanization and nutritional change in the developing world. Electron J AgricDev Econ, (in press).

  16. Delgado CL . Rising consumption of meat and milk in developing countries has created a new food revolution. J Nutr 2003; 133: 3907S–3910S.

    Article  CAS  PubMed  Google Scholar 

  17. Delgado CL, Rosegrant MW, Steinfeld H, Ehui SK, Courbois C . Livestock to 2020: The Next Food Revolution. International Food Policy Research Institute; Food and Agriculture Organization of the United Nations (FAO); International Livestock Research Institute (ILRI): Washington DC, Rome, Nairobi, Kenya; 1999.

    Google Scholar 

  18. French S, Story M, Neumark-Sztainer D, Fulkerson JA, Hannan P . Fast food restaurant use among adolescents: associations with nutrient intake, food choice, and behavioral and psychosocial variables. Int J Obes Relat Metab 2001; 25: 1823–1833.

    Article  CAS  Google Scholar 

  19. Nielsen S, Siega-Riz A, Popkin BM . Trends in energy intake in the US between 1977 and 1996: similar shifts seen across age groups. Obes Res 2002; 10: 370–378.

    Article  PubMed  Google Scholar 

  20. Nielsen S, Siega-Riz A, Popkin BM . Trends in food locations and sources among adolescents and young adults. Prev Med 2002; 35: 107–113.

    Article  PubMed  Google Scholar 

  21. Haines P, Hama M, Guilkey DK, Popkin BM . Weekend eating in the United States is linked with greater energy, fat and alcohol intake. Obes Res 2003; 11: 945–949.

    Article  PubMed  Google Scholar 

  22. Jeffery R, Utter J . The changing environment and population obesity in the United States. Obes Res 2003; 11: 12S–22S.

    Article  PubMed  Google Scholar 

  23. Nielsen S, Popkin BM . Patterns and trends in portion sizes, 1977–1998. JAMA 2003; 289: 450–453.

    Article  PubMed  Google Scholar 

  24. Young LR, Nestle M . The contribution of expanding portion sizes to the US obesity epidemic. Am J Public Health 2002; 92: 246–249.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Bray GA, Nielsen SJ, Popkin BM . Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr 2004; 79: 537–543.

    Article  CAS  PubMed  Google Scholar 

  26. Guthrie J, Lin B, Frazao E . Role of food prepared away from home in the American diet, 1977–78 versus 1994–96: changes and consequences. J Nutr Educ Behav 2002; 34: 140–150.

    Article  PubMed  Google Scholar 

  27. Paeratakul S, Ferdinand DP, Champagne CM, Ryan DH, Bray GA . Fast-food consumption among US adults and children: dietary and nutrient intake profile. J Am Diet Assoc 2003; 103: 1332–1338.

    Article  PubMed  Google Scholar 

  28. Bowman SA, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS . Effects of fast-food consumption on energy intake and diet quality among children in a National Household Survey. Pediatrics 2004; 113: 112–118.

    Article  PubMed  Google Scholar 

  29. McCrory M, Fuss P, Hays NP, Vinken AG, Greenberg AS, Roberts SB . Overeating in America: association between restaurant food consumption and body fatness in healthy men and women ages 19 to 80. Obes Res 1999; 7: 564–571.

    Article  CAS  PubMed  Google Scholar 

  30. French S, Harnack L, Jeffery RW . Fast food restaurant use among women in the Pound of Prevention study: dietary, behavioral and demographic correlates. Int J Obes Relat Metab Disord 2000; 24: 1353–1359.

    Article  CAS  PubMed  Google Scholar 

  31. Ma Y, Bertone E, Stanek EJ, Reed GW, Hebert JR, Cohen NL, Merriam PA, Ockene IS . Association between eating patterns and obesity in a free-living adult population. Am J Epidemiol 2003; 158: 85–92.

    Article  PubMed  Google Scholar 

  32. Nicklas T, Yang S, Baranowski T, Zakeri I, Berenson G . Eating patterns and obesity in children: the Bogalusa Heart Study. Am J Prev Med 2003; 25: 9–16.

    Article  PubMed  Google Scholar 

  33. Thompson O, Ballew C, Resnicow K, Must A, Bandini LG, Cyr H, Dietz WH . Food purchased away from home as a predictor of change in BMI z-scores among girls. Int J Obes Relat Metab 2003; 28: 282–289.

    Article  Google Scholar 

  34. Popkin BM . Urbanization, lifestyle changes and the nutrition transition. World Development 1999; 27: 1905–1916.

    Article  Google Scholar 

  35. Bell AC, Ge K, Popkin BM . The road to obesity or the path to prevention? Motorized transportation and obesity in China. Obes Res 2002; 10: 277–283.

    Article  PubMed  Google Scholar 

  36. Roberts DF, Foehr UG . Kids and Media in America. Cambridge University Press: Cambridge; 2004.

    Google Scholar 

  37. Levin S, Ainsworth BE, Kwok CW, Addy CL, Popkin BM . Patterns of physical activity among Russian youth: the Russian Longitudinal Monitoring Survey. Eur J Public Health 1999; 9: 166–173.

    Article  Google Scholar 

  38. Tudor-Locke C, Ainsworth BE, Popkin BM . Active commuting to school: an overlooked source of children's physical activity? Sports Med 2001; 31: 309–313.

    Article  CAS  PubMed  Google Scholar 

  39. Tudor-Locke C, Ainsworth BA, Adair LS, Popkin BM . Physical activity in Filipino youth: the Cebu Longitudinal Health and Nutrition Survey. Int J Obes Relat Metab 2003; 27: 181–190.

    Article  CAS  Google Scholar 

  40. Tudor-Locke C, Ainsworth BE, Adair LS, Du S, Popkin BM . Comparison of Physical Activity and Inactivity Patterns in Chinese and Filipino Youth 2004 (in press).

  41. Rivera JA, Barquera S, Campirano F, Campos I, Safdie M, Tovar V . Epidemiological and nutritional transition in Mexico: rapid increase of non-communicable chronic diseases and obesity. Public Health Nutr 2002; 5: 113–122.

    Article  PubMed  Google Scholar 

  42. Monteiro CA, Conde WL, Lu B, Popkin BM . Is Obesity Fuelling Inequities in Health in the Developing World? University of North Carolina Manuscript: Chapel Hill, NC; 2004.

    Google Scholar 

  43. Mendez MA, Monteiro CA, Popkin BM . Overweight Now Exceeds Underweight Among Women in Most Developing Countries! University of North Carolina Manuscript: Chapel Hill, NC; 2004.

    Google Scholar 

  44. Wang Y, Monteiro C, Popkin BM . Trends of overweight and underweight in children and adolescents in the United States, Brazil, China, and Russia. Am J Clin Nutr 2002; 75: 971–977.

    Article  CAS  PubMed  Google Scholar 

  45. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Lobstein T, Frelut M-L . Prevalence of overweight among children in Europe. Obes Rev 2003; 4: 195–200.

    Article  CAS  PubMed  Google Scholar 

  47. Guillame M, Lissau I . Epidemiology. In: Burniat W, Cole T, Lissau I, Poskitt EME (eds) Child and Adolescent Obesity: Causes and Consequences, Prevention and Management. Cambridge University Press: Cambridge; 2002. pp 28–49.

    Chapter  Google Scholar 

  48. 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: 1505–1515.

    Article  PubMed  Google Scholar 

  49. Guo X, Mroz TA, Popkin BM, Zhai F . Structural changes in the impact of income on food consumption in China, 1989–1993. Econ Dev Cultural Change 2000; 48: 737–760.

    Article  Google Scholar 

  50. McTigue KM, Garrett JM, Popkin BM . The natural history of obesity: weight change in a large US longitudinal survey. Ann Intern Med 2002; 136: 857–864.

    Article  PubMed  Google Scholar 

  51. Gordon-Larsen P, Adair LS, Nelson MC, Popkin BM . Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health. Am J Clin Nutr 2004; 80: 569–575.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    B M Popkin & P Gordon-Larsen

Authors
  1. B M Popkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P Gordon-Larsen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B M Popkin.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Popkin, B., Gordon-Larsen, P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obes 28 (Suppl 3), S2–S9 (2004). https://doi.org/10.1038/sj.ijo.0802804

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802804

Keywords

  • youth obesity
  • nutrition transition
  • obesity trend

Search

Advanced search

Quick links