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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.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.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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Age-standardized death rate by cause of death in twelve countries, 2008. Data obtained from WHO Global Burden of Disease Death Estimates, 2008. Cause-specific death rates were age-standardized to the WHO global standard population by applying age-specific death rates for the country to a global standard population. Mortality estimates are based on analysis of latest available national information on levels of mortality and cause distributions as at the end of 2010 together with latest available information from WHO programs, IARC and UNAIDS for specific causes of public health importance. Cause of death categories and their definitions were defined using the International Classification of Diseases, Tenth Revision (ICD-10). Cardiometabolic conditions and cancer includes malignant and other neoplasms, diabetes mellitus, endocrine disorders, and cardiovascular diseases. Total non-communicable diseases additionally include diseases in sense organ, respiratory (non-infectious), digestive, genitourinary, skin and musculoskeletal, as well as congenital anomalies, oral conditions and neuropsychiatric conditions Data for Puerto Rico is from 2007, obtained from the Centers for Disease Control and Prevention, National Vital Statistics Reports Final Data for 2007. Population used for computing death rates are postcensal estimates based on the 2000 census estimated as of July 1, 2007. Numbers after causes of death are categories of the International Classification of Diseases, Tenth Revision (ICD–10). Infectious diseases include influenza and pneumonia, and HIV. Total communicable diseases additionally include infant deaths (exclusive of fetal deaths). Cardiometabolic conditions and cancer include diseases of the heart, essential hypertensive disease, cerebrovascular diseases, diabetes, and malignant neoplasms. Total non-communicable diseases additionally include Alzheimer’s disease, chronic lower respiratory diseases, chronic liver disease and cirrhosis, nephritis, nephrotic syndrome and nephrosis, and Parkinson's disease. Causes of deaths included for Puerto Rico differ from those for the other counties, thus caution should be made when comparing death rates
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Fig2: Age-standardized death rate by cause of death in twelve countries, 2008. Data obtained from WHO Global Burden of Disease Death Estimates, 2008. Cause-specific death rates were age-standardized to the WHO global standard population by applying age-specific death rates for the country to a global standard population. Mortality estimates are based on analysis of latest available national information on levels of mortality and cause distributions as at the end of 2010 together with latest available information from WHO programs, IARC and UNAIDS for specific causes of public health importance. Cause of death categories and their definitions were defined using the International Classification of Diseases, Tenth Revision (ICD-10). Cardiometabolic conditions and cancer includes malignant and other neoplasms, diabetes mellitus, endocrine disorders, and cardiovascular diseases. Total non-communicable diseases additionally include diseases in sense organ, respiratory (non-infectious), digestive, genitourinary, skin and musculoskeletal, as well as congenital anomalies, oral conditions and neuropsychiatric conditions Data for Puerto Rico is from 2007, obtained from the Centers for Disease Control and Prevention, National Vital Statistics Reports Final Data for 2007. Population used for computing death rates are postcensal estimates based on the 2000 census estimated as of July 1, 2007. Numbers after causes of death are categories of the International Classification of Diseases, Tenth Revision (ICD–10). Infectious diseases include influenza and pneumonia, and HIV. Total communicable diseases additionally include infant deaths (exclusive of fetal deaths). Cardiometabolic conditions and cancer include diseases of the heart, essential hypertensive disease, cerebrovascular diseases, diabetes, and malignant neoplasms. Total non-communicable diseases additionally include Alzheimer’s disease, chronic lower respiratory diseases, chronic liver disease and cirrhosis, nephritis, nephrotic syndrome and nephrosis, and Parkinson's disease. Causes of deaths included for Puerto Rico differ from those for the other counties, thus caution should be made when comparing death rates

Mentions: The epidemiologic transition also involves shifts in the causes of morbidity and mortality [5], with a general trend for communicable, maternal and malnutrition conditions being gradually replaced by chronic, non-communicable diseases (NCD) as the main cause of death, which becomes more pronounced as the transition progresses. The shift in cause of death is partly driven by a transition in the types of risk factors, with physical inactivity and overconsumption of energy and energy-dense (nutrient-poor) foods as key contributors [19]. To illustrate this, we show the uneven distribution between 2008 age-standardized death rates of total communicable, maternal and malnutrition conditions (and specifically for infectious diseases and respiratory infections) and total NCD (and specifically for cardiometabolic conditions and cancer) in GNET countries, according to the stage of transition (Fig. 2) [14, 15].Fig. 2


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)

Age-standardized death rate by cause of death in twelve countries, 2008. Data obtained from WHO Global Burden of Disease Death Estimates, 2008. Cause-specific death rates were age-standardized to the WHO global standard population by applying age-specific death rates for the country to a global standard population. Mortality estimates are based on analysis of latest available national information on levels of mortality and cause distributions as at the end of 2010 together with latest available information from WHO programs, IARC and UNAIDS for specific causes of public health importance. Cause of death categories and their definitions were defined using the International Classification of Diseases, Tenth Revision (ICD-10). Cardiometabolic conditions and cancer includes malignant and other neoplasms, diabetes mellitus, endocrine disorders, and cardiovascular diseases. Total non-communicable diseases additionally include diseases in sense organ, respiratory (non-infectious), digestive, genitourinary, skin and musculoskeletal, as well as congenital anomalies, oral conditions and neuropsychiatric conditions Data for Puerto Rico is from 2007, obtained from the Centers for Disease Control and Prevention, National Vital Statistics Reports Final Data for 2007. Population used for computing death rates are postcensal estimates based on the 2000 census estimated as of July 1, 2007. Numbers after causes of death are categories of the International Classification of Diseases, Tenth Revision (ICD–10). Infectious diseases include influenza and pneumonia, and HIV. Total communicable diseases additionally include infant deaths (exclusive of fetal deaths). Cardiometabolic conditions and cancer include diseases of the heart, essential hypertensive disease, cerebrovascular diseases, diabetes, and malignant neoplasms. Total non-communicable diseases additionally include Alzheimer’s disease, chronic lower respiratory diseases, chronic liver disease and cirrhosis, nephritis, nephrotic syndrome and nephrosis, and Parkinson's disease. Causes of deaths included for Puerto Rico differ from those for the other counties, thus caution should be made when comparing death rates
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4489001&req=5

Fig2: Age-standardized death rate by cause of death in twelve countries, 2008. Data obtained from WHO Global Burden of Disease Death Estimates, 2008. Cause-specific death rates were age-standardized to the WHO global standard population by applying age-specific death rates for the country to a global standard population. Mortality estimates are based on analysis of latest available national information on levels of mortality and cause distributions as at the end of 2010 together with latest available information from WHO programs, IARC and UNAIDS for specific causes of public health importance. Cause of death categories and their definitions were defined using the International Classification of Diseases, Tenth Revision (ICD-10). Cardiometabolic conditions and cancer includes malignant and other neoplasms, diabetes mellitus, endocrine disorders, and cardiovascular diseases. Total non-communicable diseases additionally include diseases in sense organ, respiratory (non-infectious), digestive, genitourinary, skin and musculoskeletal, as well as congenital anomalies, oral conditions and neuropsychiatric conditions Data for Puerto Rico is from 2007, obtained from the Centers for Disease Control and Prevention, National Vital Statistics Reports Final Data for 2007. Population used for computing death rates are postcensal estimates based on the 2000 census estimated as of July 1, 2007. Numbers after causes of death are categories of the International Classification of Diseases, Tenth Revision (ICD–10). Infectious diseases include influenza and pneumonia, and HIV. Total communicable diseases additionally include infant deaths (exclusive of fetal deaths). Cardiometabolic conditions and cancer include diseases of the heart, essential hypertensive disease, cerebrovascular diseases, diabetes, and malignant neoplasms. Total non-communicable diseases additionally include Alzheimer’s disease, chronic lower respiratory diseases, chronic liver disease and cirrhosis, nephritis, nephrotic syndrome and nephrosis, and Parkinson's disease. Causes of deaths included for Puerto Rico differ from those for the other counties, thus caution should be made when comparing death rates
Mentions: The epidemiologic transition also involves shifts in the causes of morbidity and mortality [5], with a general trend for communicable, maternal and malnutrition conditions being gradually replaced by chronic, non-communicable diseases (NCD) as the main cause of death, which becomes more pronounced as the transition progresses. The shift in cause of death is partly driven by a transition in the types of risk factors, with physical inactivity and overconsumption of energy and energy-dense (nutrient-poor) foods as key contributors [19]. To illustrate this, we show the uneven distribution between 2008 age-standardized death rates of total communicable, maternal and malnutrition conditions (and specifically for infectious diseases and respiratory infections) and total NCD (and specifically for cardiometabolic conditions and cancer) in GNET countries, according to the stage of transition (Fig. 2) [14, 15].Fig. 2

Bottom Line: Two main contributors to this burden are the reduction in mortality from infectious conditions and concomitant negative changes in lifestyles, including diet.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.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