262 Diet and Health
point to note is that the effects of the economic hardship in Russia have not been
seen in the obesity trends. In 1996 the grade II obesity of females showed a decline.
A much higher rate of increase in prevalence of obesity was found among grade II
and above obesity for Russian females. Overall, the increase in total obesity is over
five percentage points per ten-year period for Russia but future directions of this
trend are less clear because the economy is in such flux.
The Health Implications: NIDDM and Related Conditions
A range of changes in health are accompanying the nutrition transition. As noted
above, foremost is the reduction of infant mortality – and related to that is under-
nutrition. Wasting is being rapidly reduced in many countries and rates of stunting
are also being lowered though recent information indicates that the rate of change
has slowed considerably in the last few years.^45 At the same time, many adverse
changes are taking place. The positive effects are not addressed here – effects that
must not be lost nor minimized. Rather the focus is on the other side of the coin –
the negative health effects which represent the most lasting and costly side effect of
the nutrition transition.
There is a growing literature that documents rapid increases in NIDDM in
many lower-income countries.33,46,47 Other work indicates that many of the cardio-
vascular conditions related to NIDDM such as hypertension, dyslipidaemia and
atherosclerosis are documented as increasing rapidly. The epidemiological preva-
lence data are spotty but indicate serious and high levels of these conditions, in
particular NIDDM. NIDDM comprises 85 per cent or more of all diabetes cases.
Recently, a most provocative cancer study has laid a strong basis for linking the
Figure 12.8 Obesity trends in Russia, 1992–1996