Nutrition transition is the shift in dietary consumption and energy expenditure that coincides with economic, demographic, and epidemiological changes. Specifically the term is used for the transition of developing countries from traditional diets high in cereal and fiber to more Western-pattern diets high in sugars, fat, and animal-source food.
Historical framework The nutrition transition model was first proposed in 1993 by Barry Popkin, and is the most cited framework in literature regarding the nutrition transition, although it has been subject to some criticism for being overly simplified. Popkin posits that two other historic transitions affect and are affected by nutritional transition. The first is the demographic transition, whereby a pattern of high fertility and high mortality transforms to one of low fertility and low mortality. Secondly, an epidemiological transition occurs, wherein a shift from a pattern of high prevalence of infectious diseases associated with malnutrition, and with periodic famine and poor environmental sanitation, to a pattern of high prevalence of chronic and degenerative diseases associated with urban-industrial lifestyles is shown. These concurrent and dynamically influenced transitions share an emphasis on the ways in which populations move from one pattern to the next. Popkin used five broad patterns to help summarize the nutrition transition model. While these patterns largely appear chronological, they are not restricted to certain periods of human history and still characterize certain geographic and socioeconomic subpopulations. The first pattern is that of collecting food, a characterization of hunter-gatherers, whose diets were high in carbohydrates and low in fat, especially saturated fat. The second pattern is defined by famine, a marked scarcity and reduced variation of the food supply. The third pattern is one of receding famine. Fruits, vegetables, and animal protein consumption increases, and starchy staples become less important in the diet. The fourth pattern is one of degenerative diseases onset by a diet high in total fat, cholesterol, sugar, and other refined carbohydrates and low in polyunsaturated fatty acids and fiber. This pattern is often accompanied by an increasingly sedentary lifestyle. The fifth pattern, and most recently emerging pattern, is characterized by a behavioral change reflective of a desire to prevent or delay degenerative diseases. Recent and rapid changes seen in developing countries from the second and third pattern to the fourth is the common focus of nutrition transition research and desire for policy that would emphasize a healthier overall diet characterizes the shift from the fourth to the fifth pattern. The nutritional transition, like the demographic and epidemiological transitions, shows a change in human dietary and activity patterns over time, affecting overall nutritional status. The nutritional transition argues that the previous periods in the transition continue in certain geographic and socio-economic subpopulations at different times. Pattern 1: Collecting food Hunter gatherer diet, high in carbohydrates and fibre, low in fat. Activity patterns are very high with little obesity. Pattern 2: Famine Diet becomes less varied as people settle with periods of acute scarcity. Towards the end of this phase variation increases, but social stratification intensifies, with the most impoverished and women and children suffering the brunt of the burden of food scarcity. Pattern 3: Receding Famine Increase in animal proteins and fruits and vegetables. Activity patterns shift to include more leisure activities. Current climate changes are effecting movement out of the famine and receding famine period. Pattern 4: Nutritional-related NCD Diet becomes high in fat, cholesterol, sugar and other refined foods. This is accompanied by a continued shift to a sedentary lifestyle, which increases the prevalence of obesity and degenerative diseases. This matches on with the final phase of the epidemiological transition. Pattern 5: Behaviour change In response to the shifts happening in pattern 4, behaviours pushed by governments, the health system or individuals are expected to prevent or delay the degenerative diseases.
Relation to economic development The nutrition transition has much of its roots in economic factors related to the development of a nation or subpopulations within a nation. It was once believed that current nutrition transition was endemic only to industrialized nations like the United States, but increasing research has indicated that not only is nutrition transition occurring most rapidly in low- and middle-income developing countries, the stress of its effects stands to burden the poorest populations of these countries the most as well. This shift is attributable to many causes. Globalization has played a large role in altering the access and availability of foods in formerly undeveloped nations. Demographic shifts from rural to urban areas are central to this as well as the liberalization of food markets, global food marketing, and the emergence of transnational food companies in developing countries. All these forces of globalization are creating lifestyle changes that contribute to the nutrition transition. Technological advancements are making previously arduous labor less difficult and thus altering energy expenditure that would have helped offset the caloric increases in the diet. Daily tasks and leisure are also affected by technological advancements and contributing to greater rates of inactivity. The aforementioned increases in calorie are due to increased consumption of edible oils, animal-source foods, caloric sweeteners, accompanied by reduced consumption of grains and fruits and vegetables. These changes play into human biological preferences seen across the world. Socioeconomic factors also play an important role as do cultural values tied to appearance and status.
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