15
Food and Nutrition-Related Diseases:
The Global Challenge
Hester H Vorster and Michael J Gibney
Key messages- This chapter deals with the current situation, trends and types
of nutrition-related diseases in developed and developing
countries. - It shows that in developed countries excessive intakes of macro-
nutrients (overnutrition) and suboptimal intakes of micronutrients
(hidden hunger), mainly because of low fruit and vegetable con-
sumption, lead to obesity and related noncommunicable diseases
(NCDs). - The chapter also shows that developing countries are suffering
from a double burden of disease because of the persistence of
© 2009 HH Vorster and MJ Gibney.
undernutrition and related defi ciency and infectious diseases
(including human immunodefi ciency virus/acquired immunodefi -
ciency syndrome HIV/AIDS), and the emergence of NCDs as
a result of the nutrition transition. It explains the vicious cycle
of poverty and undernutrition and how this is related to under-
development and increased risk of NCDs in the developing
world.- Current global challenges for food and nutrition interventions on
different levels are highlighted.
15.1 Introduction
The relationship between nutrition and health was
summarized in Figure 1.2, illustrating that the nutri-
tional quality and quantity of foods eaten, and there-
fore nutritional status, are major modifi able factors
in promoting health and well-being, in preventing
disease, and in treating some diseases. It is now
accepted that our nutritional status infl uences
our health and risk of both infectious and non-
communicable diseases.
But it is also accepted that billions of people in both
developed and developing countries suffer from one
or more forms of malnutrition, contributing to the
global burden of disease. Mankind has an inherent
preference for palatable, sugary, salty, fatty and smooth
(fi nely textured, refi ned) foods. These foods are
mostly energy-dense and low in micronutrients. Food
production, processing, manufacturing, marketing
and promotion have responded to this preference by
making high energy-dense foods available at increas-
ingly affordable prices. This has led to changes in food
consumption patterns which unfortunately coincided
with more sedentary, less active lifestyles. The resul-
tant overnutrition of especially macronutrients is the
major cause of obesity and also, together with obesity,
a risk factor for many of the noncommunicable
disease (NCDs) such as type 2 diabetes, coronary
heart disease, stroke, hypertension, dental disease,
osteoporosis, and some forms of cancer.
These changes from traditional low-energy dense,
high-fi ber diets to the dietary pattern described above
are collectively known as the nutrition transition (NT).
The NT has proceeded gradually over centuries in the
developed world and accelerated during the industrial
revolution with a resultant gradual and then acceler-
ated emergence of the NCDs. However, globalization
characterized by urbanization, acculturation, global