From undernutrition to obesity and dietrelated disease Will Masters Friedman School of Nutrition Science amp Policy Tufts University wwwnutritiontuftsedu httpsitestuftseduwillmasters ID: 919454
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Slide1
The global pattern of malnutrition
: From undernutrition to obesityand diet-related disease
Will MastersFriedman School of Nutrition Science & Policy, Tufts Universitywww.nutrition.tufts.edu | http://sites.tufts.edu/willmasters
Building Human Capital: Nutrition is Fundamental
BIFAD side event at the World Food Prize 2015 Borlaug Dialogue
October 14
th
, 2015
Slide2Source
:
Author’s calculations from FAO Food Balance Sheets, http://faostat3.fao.org/download/FB/FBS/E (June 2015).
In fifty years, from more food to better
food
More
Better
The global pattern of malnutrition
stunting |
wasting | obesity | disease
Slide3Progress on stunting and wasting …but still far to goSharp rise in obesity
…and more to comeRapid shift in diet-related diseases …even in developing countriesFifteen years into the 21st
c., we have:The global pattern of malnutritionstunting | wasting | obesity | disease
Slide4Are countries just richer, or different in other ways?Richer = more of everything, both public and private
Different = new things, both technologies and institutionsStrategytest for shifts in the global average at each level of national income
this generalizes the Preston curve (Preston 1975, Bloom & Canning 2007), first applied to life expectancyData national income: purchasing power per capitaheight and weight: stunting, wasting and obesity
disease burden: diabetes and diarrhea (% of DALYs lost)Methodall data are nationally representative; results are weighted
by
population
calculate local mean and confidence interval at each income level
this represents the average person in countries at that level of income, in each period of time
How has the food system changed?
The global pattern of malnutrition
stunting |
wasting | obesity | disease
Slide5The main development goal:
child stunting
Slide6Clear progress against child stunting,
at each level of income
O = 1985-99
□
= 2000-11
The global pattern of malnutrition
stunting
|
wasting | obesity | disease
Slide7O = 2000-05
□
= 2006-11
Less stunting
Less stunting and higher income
Focusing on the poorest in recent years,
we can zoom in to see FTF countries’ gains
The global pattern of malnutrition
stunting
|
wasting | obesity | disease
Slide8Less prevalent, but still serious:
child wasting
Slide9Child wasting rates have also fallen
O = 1985-99
□
= 2000-11
The global pattern of malnutrition
stunting |
wasting
| obesity | disease
Slide10The most visible kind of change:
adult obesity
Slide11Adult obesity had a clear income gradient in 1990
The global pattern of malnutrition
stunting |
wasting | obesity | disease
Slide12From 1990 to 2010, did the income gradient shift?
But China and India may be influential
∆
= 2005
O = 1990
□
= 2010
The global pattern of malnutrition
stunting |
wasting |
obesity
| disease
Slide13Adult obesity has shifted up in richer countries
Outside of
China & India the gradient is now steeper
∆
= 2005
O = 1990
□
= 2010
The global pattern of malnutrition
stunting |
wasting |
obesity
| disease
Slide14The worst diet-related disease:
diabetes
Slide15A clear income gradient
…but also
more variance at
higher incomes
Diabetes burdens in 1990
The global pattern of malnutrition
stunting |
wasting | obesity |
disease
Slide16Diabetes burdens in 1990, with local means
Note the wider confidence interval at higher incomes
Note India and China are near their local means
The global pattern of malnutrition
stunting |
wasting | obesity |
disease
Slide17Changes in diabetes from 1990 to 2005
From 1990 to 2005, relative burden rose in lower and middle income countries
and
China shifted up and along the same curves as other countries
India
The global pattern of malnutrition
stunting |
wasting | obesity |
disease
Slide18Diabetes burdens have risen in poor countries
∆
= 2005
O = 1990
□
= 2010
China and India remain near their local means
The change was from 1990 to 2005; no significant further rise to 2010
The global pattern of malnutrition
stunting |
wasting | obesity |
disease
Slide19Now contrast with the signature
illness of undernourishment:
d
iarrheal disease
Slide20Diarrhea burdens have fallen but are still large
∆
= 2005
O = 1990
□
= 2010
India
r
emains an outlier
What happened at
each income level
o
ther than
India & China?
China
The global pattern of malnutrition
stunting |
wasting | obesity |
disease
Slide21∆
= 2005
O = 1990
□
= 2010
Relative burdens fell most in the poorest countries
The global pattern of malnutrition
stunting |
wasting | obesity |
disease
Diarrhea burdens have fallen but are still large
Slide22Progress on stunting and wasting …large gains from higher income, and also big improvement in poor countries
Sharp rise in obesity…so far, almost entirely due to higher income and also worsening in the richest countriesRapid shift in diet-related diseases…worsening of diabetes at low and middle incomes while diarrhea is improving in poor countries
In conclusion:Fifteen years into the 21st c., we have…
The global pattern of malnutritionstunting | wasting | obesity | disease
Slide23Complete eradication of stunting and wasting …and reap large gains in later health & cognition
Bend the curve of obesity…and reverse its rise at higher incomesTreat and prevent diet-related diseases…such as diabetes and diarrhea
Looking forward:In the coming decades, we can…The global pattern of malnutrition
stunting | wasting | obesity | disease
Slide24Acknowledgements
Global Dietary Database
(BMGF)Feed the Future Innovation Lab for Nutrition(USAID)
Feed the Future Policy Impact Study Consortium(USDA)
Slide25t
hank you!