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Reducing the global burden of type 2 diabetes by improving the quality of staple foods: The Global Nutrition and Epidemiologic Transition Initiative.

Mattei J, Malik V, Wedick NM, Hu FB, Spiegelman D, Willett WC, Campos H, Global Nutrition Epidemiologic Transition Initiati - Global Health (2015)

Bottom Line: Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet.We depicted the epidemiologic transition using demographic and mortality data from the World Health Organization, and the nutrition transition using data from the Food and Agriculture Organization food balance sheets.These efforts may be valuable in shaping future research, community interventions, and public health and nutritional policies.

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. jmattei@hsph.harvard.edu.

ABSTRACT

Background: The prevalence of type 2 diabetes has been reaching epidemic proportions across the globe, affecting low/middle-income and developed countries. Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet. We aimed to depict the current state of type 2 diabetes worldwide in light of the undergoing epidemiologic and nutrition transition, and to posit that a key factor in the nutrition transition has been the shift in the type and processing of staple foods, from less processed traditional foods to highly refined and processed carbohydrate sources.

Discussion: We showed data from 11 countries participating in the Global Nutrition and Epidemiologic Transition Initiative, a collaborative effort across countries at various stages of the nutrition-epidemiologic transition whose mission is to reduce diabetes by improving the quality of staple foods through culturally-appropriate interventions. We depicted the epidemiologic transition using demographic and mortality data from the World Health Organization, and the nutrition transition using data from the Food and Agriculture Organization food balance sheets. Main staple foods (maize, rice, wheat, pulses, and roots) differed by country, with most countries undergoing a shift in principal contributors to energy consumption from grains in the past 50 years. Notably, rice and wheat products accounted for over half of the contribution to energy consumption from staple grains, while the trends for contribution from roots and pulses generally decreased in most countries. Global Nutrition and Epidemiologic Transition Initiative countries with pilot data have documented key barriers and motivators to increase intake of high-quality staple foods. Global research efforts to identify and promote intake of culturally-acceptable high-quality staple foods could be crucial in preventing diabetes. These efforts may be valuable in shaping future research, community interventions, and public health and nutritional policies.

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Related in: MedlinePlus

Epidemiologic transition in twelve countries, by 5-year period from 1950–2010. Data obtained from United Nations World Population Prospects: The 2012 Revision. Crude death rate reflects the number of deaths over a given period divided by the person-years lived by the population over that period. Life expectancy is the average number of years of life expected by a hypothetical cohort of individuals who would be subject during all their lives to the mortality rates of a given period. Median age is the age that divides the population in two parts of equal size. Tanzania includes Zanzibar. Data for China do not include Hong Kong and Macao, Special Administrative Regions (SAR) of China, and Taiwan Province of China. Malaysia includes Sabah and Sarawak
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Fig1: Epidemiologic transition in twelve countries, by 5-year period from 1950–2010. Data obtained from United Nations World Population Prospects: The 2012 Revision. Crude death rate reflects the number of deaths over a given period divided by the person-years lived by the population over that period. Life expectancy is the average number of years of life expected by a hypothetical cohort of individuals who would be subject during all their lives to the mortality rates of a given period. Median age is the age that divides the population in two parts of equal size. Tanzania includes Zanzibar. Data for China do not include Hong Kong and Macao, Special Administrative Regions (SAR) of China, and Taiwan Province of China. Malaysia includes Sabah and Sarawak

Mentions: We depict the epidemiologic transition by contrasting the shift in mortality and population demographics from 1950 to 2010 (Fig. 1) [18]. The general trend has been a steep increase in life expectancy, alongside even steeper declines in crude overall death rates. In most countries, median age has increased slightly, suggesting an older demographic composition. However, distinct characteristics are observed for countries across stages of economic development. For example, in LMIC such as Nigeria, Tanzania, and Kenya, life expectancy remains low despite a dramatic decrease in the crude death rate. These countries also have a younger population based on median age. We classify these countries as being in ‘early transition’. India and China also show dramatic decreases in overall mortality, but with stronger economic growth and improvements in health care, their life expectancies and median age are higher than in lower income countries. Thus, we categorize India and China as countries ‘ongoing transition’, along with Malaysia, Brazil, and Mexico, which have also experienced increases in life expectancy over the same timeframe. Finally, Costa Rica, Kuwait and the US, including the territory of Puerto Rico, are considered ‘transitioned countries’. These higher income countries have a less steep increase in life expectancy, and the decrease in death rate has stalled or even reversed in recent years.Fig. 1


Reducing the global burden of type 2 diabetes by improving the quality of staple foods: The Global Nutrition and Epidemiologic Transition Initiative.

Mattei J, Malik V, Wedick NM, Hu FB, Spiegelman D, Willett WC, Campos H, Global Nutrition Epidemiologic Transition Initiati - Global Health (2015)

Epidemiologic transition in twelve countries, by 5-year period from 1950–2010. Data obtained from United Nations World Population Prospects: The 2012 Revision. Crude death rate reflects the number of deaths over a given period divided by the person-years lived by the population over that period. Life expectancy is the average number of years of life expected by a hypothetical cohort of individuals who would be subject during all their lives to the mortality rates of a given period. Median age is the age that divides the population in two parts of equal size. Tanzania includes Zanzibar. Data for China do not include Hong Kong and Macao, Special Administrative Regions (SAR) of China, and Taiwan Province of China. Malaysia includes Sabah and Sarawak
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4489001&req=5

Fig1: Epidemiologic transition in twelve countries, by 5-year period from 1950–2010. Data obtained from United Nations World Population Prospects: The 2012 Revision. Crude death rate reflects the number of deaths over a given period divided by the person-years lived by the population over that period. Life expectancy is the average number of years of life expected by a hypothetical cohort of individuals who would be subject during all their lives to the mortality rates of a given period. Median age is the age that divides the population in two parts of equal size. Tanzania includes Zanzibar. Data for China do not include Hong Kong and Macao, Special Administrative Regions (SAR) of China, and Taiwan Province of China. Malaysia includes Sabah and Sarawak
Mentions: We depict the epidemiologic transition by contrasting the shift in mortality and population demographics from 1950 to 2010 (Fig. 1) [18]. The general trend has been a steep increase in life expectancy, alongside even steeper declines in crude overall death rates. In most countries, median age has increased slightly, suggesting an older demographic composition. However, distinct characteristics are observed for countries across stages of economic development. For example, in LMIC such as Nigeria, Tanzania, and Kenya, life expectancy remains low despite a dramatic decrease in the crude death rate. These countries also have a younger population based on median age. We classify these countries as being in ‘early transition’. India and China also show dramatic decreases in overall mortality, but with stronger economic growth and improvements in health care, their life expectancies and median age are higher than in lower income countries. Thus, we categorize India and China as countries ‘ongoing transition’, along with Malaysia, Brazil, and Mexico, which have also experienced increases in life expectancy over the same timeframe. Finally, Costa Rica, Kuwait and the US, including the territory of Puerto Rico, are considered ‘transitioned countries’. These higher income countries have a less steep increase in life expectancy, and the decrease in death rate has stalled or even reversed in recent years.Fig. 1

Bottom Line: Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet.We depicted the epidemiologic transition using demographic and mortality data from the World Health Organization, and the nutrition transition using data from the Food and Agriculture Organization food balance sheets.These efforts may be valuable in shaping future research, community interventions, and public health and nutritional policies.

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. jmattei@hsph.harvard.edu.

ABSTRACT

Background: The prevalence of type 2 diabetes has been reaching epidemic proportions across the globe, affecting low/middle-income and developed countries. Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet. We aimed to depict the current state of type 2 diabetes worldwide in light of the undergoing epidemiologic and nutrition transition, and to posit that a key factor in the nutrition transition has been the shift in the type and processing of staple foods, from less processed traditional foods to highly refined and processed carbohydrate sources.

Discussion: We showed data from 11 countries participating in the Global Nutrition and Epidemiologic Transition Initiative, a collaborative effort across countries at various stages of the nutrition-epidemiologic transition whose mission is to reduce diabetes by improving the quality of staple foods through culturally-appropriate interventions. We depicted the epidemiologic transition using demographic and mortality data from the World Health Organization, and the nutrition transition using data from the Food and Agriculture Organization food balance sheets. Main staple foods (maize, rice, wheat, pulses, and roots) differed by country, with most countries undergoing a shift in principal contributors to energy consumption from grains in the past 50 years. Notably, rice and wheat products accounted for over half of the contribution to energy consumption from staple grains, while the trends for contribution from roots and pulses generally decreased in most countries. Global Nutrition and Epidemiologic Transition Initiative countries with pilot data have documented key barriers and motivators to increase intake of high-quality staple foods. Global research efforts to identify and promote intake of culturally-acceptable high-quality staple foods could be crucial in preventing diabetes. These efforts may be valuable in shaping future research, community interventions, and public health and nutritional policies.

Show MeSH
Related in: MedlinePlus