Chapter Ten
Fat and Sugar in the Global
Diet: Dietary Diversity in
the Nutrition Transition

Adam Drewnowski

Chronic undernutrition is mostly a consequence of widespread poverty (World Development Report 1993). World economic development has been associated with both an improvement in and a progressive globalization of the human diet. As countries develop and populations become more urban, societies enter different stages of what has been called the nutrition and demographic transitions. As incomes grow, grain-based diets rich in complex carbohydrates and fiber are being gradually abandoned in favor of diets that contain more animal products, sugars, and vegetable fats. The nutrition gap between rich and poor countries grows narrower, as all nations converge on a global diet higher in meat, milk and sweeteners and deriving 30 to 35 percent of its energy from fat.

Such diets are often superior to what had gone on before. Yet changing dietary habits are regarded by many nutritionists as a deplorable by-product of global economic growth (Gopalan 1992). Nutritionists have warned that the nutrition transition in developing nations has been associated with a shift in disease patterns away from malnutrition and nutrient deficiency diseases and toward increased risk of cardiovascular disease, non-insulin dependent diabetes, and cancer (World Development Report 1993). A world-wide epidemic of childhood obesity is another potential consequence of changing lifestyles and changing diets. Childhood obesity is an intermediate health marker that can serve as a predictor of more diet-related chronic diseases to come (Popkin 1992). However, it must be noted that diet-related chronic

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