Trade Liberalization, Urbanization and Nutrition Transition in Asian Countries

Abstract

diseases (DR-NCDs) around the developing world have been undergoing considerable shifts. India is reported to be facing an epidemic of diet-related non-communicable diseases [3]. The nutrition transition model was first proposed by Popkin BM [1], and since then the subject has drawn attention to nutritionists and heath specialists from many countries [4,5]. Directed by the advancement in agriculture, modern food science and technology and globalization of food system, the type and quantity of food consumed have changed dramatically both in developed and developing societies [6]. Asian countries likewise have witnessed considerable nutritional, demographic and epidemiological changes over past few decades marked by lower infant mortality rate, increased life expectancy, higher incidences of chronic non-communicable diseases (NCDs) [7]. The nutrition transition, in general, is characterized by a shift from a high proportion of locally grown staple grains, legumes, low animal based food, toward more varied diets comprising more refined, energy-dense, animal based and processed food which are generally high in sugar and fat and low in carbohydrate content. This shift in dietary habit, accompanied by reduced physical activity and leisure period lead to increase in overweight and obesity over time [8]. Once known as 'the diseases of affluence', developing countries in Asia such India, Bangladesh, Nepal is now facing a disproportionate burden of NCDs and an increasing number of households are affected concomitantly under nutrition and obesity [9]. Obesity and obesity induced diseases are gradually clustering among the poor communities in Asia and the number of overweight people has already outgrown that of undernourished people in some regions. Impact of trade liberalization and urbanization on nutrition transition Though some countries have seen the advantages of open trade regimes, most of the countries (especially the developing ones) are seem to be negatively affected by some highly controversial policies. Trade liberalization is believed to be associated with greater income inequality, unemployment, under employment and has facilitated availability of highly processed Abstract Objective: This paper describes few crucial determinants of nutrition transition in Asia such as liberalization of agrifood trade and urbanization. It also shows that the nutrition transition is concurrent with an epidemiological transition and proposes strategies to control the adverse effects of these events which have huge implications for the social and economic development. Design: This article reviews the already published literature on nutrition and epidemiological transition. Pubmed and Medline database were searched for articles published between 1985 to 2012 by using the terms of nutrition transition, impact of trade liberalization on health, urbanization in Asia, dietary transition in Asian countries, epidemiological transition in Asia. Research papers on nutrition transition in few non-Asian countries were also reviewed to show their policies on obesity, public health and nutrition. Conclusion: Asian countries are undergoing a rapid nutritional and epidemiological transition which has a huge impact on the rising prevalence of chronic non-communicable diseases like diabetes, obesity and other associated diseases. Policymakers should focus on formulating strategies to curb the incidence of these costly diseases at both community and national level to address the economic as well as the social implications of these diseases.