Diet and Health: Diseases and Food 277others’ rising wealth;^18 low income countries are experiencing the effects of the
transition but cannot afford to deal with them.^19 Popkin argues that, while the
nutrition transition brings greater variety of foods to people who previously had
narrow diets, the resulting health problems from the shift in diet should not be
traded off against the culinary and experiential gains. Consumers might enjoy the
new variety of foods that greater wealth offers but they are often unaware of the
risk of disease that can follow. The implications of the nutrition transition now
ought to exercise the minds of global as well national policy makers: certainly
health policy specialists are concerned at the rise of degenerative diseases in low-
and middle-income countries.20,21
Nutrition may have recently become a key notion in modern dietary thinking
but it only echoes the insights of an earlier generation of researchers which included
nutrition and public health pioneers such as Professors Trowell and Burkitt, whose
observations from the 1950s to the 1980s led them to question ‘whether Western
influence in Africa, Asia, Central and South America and the Far East is unneces-
sarily imposing our diseases on other populations who are presently relatively free
of them’.^22 Trowell and Burkitt, both with long medical experience in Africa, could
easily explain the variation in infectious diseases, but not the variation in rates of
non-infectious diseases such as heart disease between countries at different eco-
nomic levels of wealth and development. In Africa in the post-World War II period,
they witnessed the rise of key indicators for diseases such as heart disease and high
blood pressure in peoples who had previously had little experience of them.^23 The
dietary transition is swift. An FAC study of very undernourished Chinese people
(living on 1480kcal per day) shows that they derive three-quarters of their energy
intake from starchy staples such as rice, while better-fed Chinese (living on
2500kcal per day) are able to reduce their energy intake from such staples and to
diversify their food sources (see Figures 13.3 and 13.4 which compare the diets of
undernourished and well-nourished people in China).
Popkin has shown how this same process occurs in both urban and rural pop-
ulations in developing countries with rising incomes. Figures 13.5 and 13.6 show
Source: National Survey of Income and Expenditure of Urban Households. Government of
China, 1990; FAO, State of Food Insecurity, 2000; http://www.fao.org
Figure 13.3 Diet of a well-nourished Chinese adult (2500kcal/person/day)