They would be very gratefully received,

The rapid rise in excess weight among adults is largely due to changes in diet, with the spread of the so-called energy-dense, nutrient-poor ‘Western’ diet, as well as reductions in physical activity. There may also be a third factor involved in low-income populations. Young children (foetal or infants) subject to undernutrition may undergo permanent metabolic changes which leave them at higher risk of excess weight in the face of relativity higher energy intake in later life (this is known as the ‘early origin’ hypothesis). This can be triggered by a relatively small increase in calories; it can occur due to relatively small increases in incomes, or even no increase at all as energy-dense foods become the cheapest sources of dietary energy. The hypothesis provides a plausible explanation for high levels of adult overweight in low-income communities and households in which there are also undernourished individuals. In my sample, one fifth of girls and almost a quarter of boys were stunted and/or thin, and almost 19% of households contained under- and over-nourished individuals. In other words there may be a direct link from undernutrition in early life to later obesity, and excess weight will continue to increase as long as undernutrition persists among young children due to the poor health and nutrition of pregnant women, early termination of exclusive breastfeeding, poor weaning practices, lack of clean drinking water and adequate sanitation, high loads of intestinal parasites and infectious disease, and so on.

The repercussions for developing countries are huge. Excess weight leads to chronic disease. I’ve referred to overweight as well as obesity because the risk of chronic disease starts to rise at BMIs of 25 (the definition of overweight, not obesity), or even lower. The dual burden of chronic and infectious disease creates huge costs for health systems, and new policy responses must be found to deal with undernutrition and overnutrition simultaneously in the same communities, and sometimes the same households.

Who should act, and in what way is up for debate: in some respects, many middle income countries have the financial resources and the technical expertise to tackle these problems – Brazil has pioneered a number of innovative programmes and policies. But I strongly believe that the development community can’t afford to ignore the approaching pandemic of excess weight; it is a symptom of a broken, pro-growth development model and a perverse food system which is about profit not health and well-being – a food system in which agriculture, food production, marketing and distribution are controlled by a few large corporations, in which governments subsidise the production of commodities for industrial use and export rather than the production of food for domestic markets, in which markets for industrialised food products are created by aggressive advertising, and those same products distributed via the massive spread of ‘the supermarket’. Despite being rural, the population in my sample is almost 100% dependent on purchased foodstuffs; domestic food production has been wiped out as the sugar mills take over every last bit of land to plant their crop. The situation is common to many areas in which land ownership is concentrated in the hands of a few corporations.

I have done some research into the issue a couple of years ago and found that the amount of money spent on treating diseases related to obesity cost countries sometimes more than the amounts they receive in ODA.
http://www.eadi.org/fileadmin/Documents/Events/General_Conference/2008/Poverty/EADI_-_CNCDs_and_MDGs_-_JWitt_2008.pdf

It is better to look more closely at various signs of growth skepticism whether it is real or not.

Those who believe in or advocate both social change & economic growth should proceed with caution because obesity or any other health factor is a tricky subject that may mean a sign that growth skepticism does exists in (some) people’s minds.

It is time to take action on this.

Duncan: Fascinating Nathalie, thanks. Your policy list is intriguing – half of it (public education, lifestyles etc) could apply to the UK government, but not the other half (small farmers, urban agriculture). And Brazil has to deal with this new problem as the same time as reducing its remaining levels of poverty.

Obesity is one of the the main health concerns people have talked about so much, so why did they hide the truth about the notions of so-called “local” food culture to be imposed upon those who differently need food for various dietary reasons?

Can the obese people need special kinds of diet & exercise as attempts to avoid the stigma behind the notion? I think it is unfair to talk about it while trying to understand about how different kinds of food to make up a balanced diet on a daily basis.

Do not forget what the doctors need to let the “obese” people do the exercise, especially under special supervision to lessen the chances of being discriminated upon by those who aren’t fat at all. The negative sentiments would arouse misunderstanding on various issues affecting people’s health.

I shall find out more later on the signs of growth skepticism in both food and health.

You read that right.

A wasting disease is when you can eat all you want of your regular diet (e.g. white rice) and still not fill a nutritional deficiency (e.g. Vitamin B) so you come down with, say, beri-beri.

Now it’s true, a person might become obese in a well-nourished population through overindulgence and sloth.

But where obesity is endemic, you will find that the population has multiple, chronic nutritional but “sub-lethal” nutrient deficiencies. It exists on low-quality staple foods, usually US-dumped. When you have nutrient deficiencies, your body may be ’starving’ slowly even as you eat more and more low-quality food.

American Indians have some of the worst rates of obesity in the US. In many tribes the staple food is frybread – government suplus flour fried in government surplus corn oil. Fillers like that mean no one will ever die of a caloric deficiency. And enriched flour will keep the classical wasting diseases away.

But if that’s not a kind of malnutrition, I’ll be damned.

People eat badly because they are poor.

I think charities would have a hard time explaining why they are focussing on a problem that affects only the richest people in poor countries along with poorer people in richer countries.

Is this something that can be left to the countries themselves as well as organisations such as WHO? As the problem is growing in richer countries they will be doing research and until obesity rates start falling here I doubt we even have very much to offer.