bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new stage of the nutrition transition in China
Authors: Du Shufa , Lu Bing , Zhai Fengying , Popkin Barry M 
Published: February 2003

AbstractObjective:To fully explore the long-term shifts in the nutrition transition and the full implications of these changes in the Chinese diet.Design:A descriptive, population-based study.Setting:Data come from nationally representative surveys: the China Health and Nutrition Survey (1989–1997), the China National Nutrition Survey (1982 and 1992), the annual household consumption surveys of the State Statistical Bureau, and the Annual Death Report of China.Results:During the first part of the major economic transformation in China (before 1985), cereal intake increased but decreased thereafter. There was also a long-term reduction of vegetable consumption that has now stabilised. Intake of animal foods increased slowly before 1979 and more quickly after the economic reforms occurred. While the total energy intake of residents has decreased, as has energy expenditure, large changes in the composition of energy have occurred. The overall proportion of energy from fat increased quickly, reaching an overall average of 27.3% and 32.8% for urban residents in 1997. Over a third of all Chinese adults and 60.1% of those in urban areas consumed over 30% of their energy from fat in 1997. Large shifts towards increased inactivity at work and leisure occurred. These changes are linked with rapid increases of overweight, obesity and diet-related non-communicable diseases (DRNCDs) as well as total mortality for urban residents.Conclusions:The long-term trend is a shift towards a high-fat, high-energy-density and low-fibre diet. The Chinese have entered a new stage of the nutrition transition.
Nutrition transition in India
Authors: Shetty Prakash S 
Published: February 2003

AbstractObjective:The primary objective of this review is to examine the demographic and nutrition transition in India in relation to its contribution to the emerging epidemic of chronic non-communicable diseases in this country.Setting:India, the country as a whole and its different states with a population exceeding 1 billion in 2001.Subjects:The review examines demographic changes in the population with consequent effects on the population pyramid, the rapidity and rates of urbanisation with striking variations in chronic disease patterns and the trends in obesity between rural and urban communities, attempting to relate their prevalence with the diet and lifestyle changes accompanying them.Design:The review is based largely on representative large-scale surveys in the country and other reliable documented data on population characteristics. It also includes a review of the published literature.Results:The results indicate that the demographic changes, rates of urbanisation and changes in dietary patterns are contributing to the changing trends in chronic disease in India.Conclusions:There is clear evidence of a demographic, epidemiological and nutrition transition in India that is fuelling the epidemic of chronic diseases and obesity, particularly in the urban areas.
The nutrition and health transition in Malaysia
Authors: Noor Mohd Ismail 
Published: February 2003

AbstractThe accelerated phase of industrialisation and urbanisation in recent decades has inevitably brought about changes in the lifestyle of Malaysians. Changes in dietary habits and sedentary lifestyles are known to be associated with changes in health and increased prevalence of chronic diseases in the population. The objective of this paper is to provide a better understanding of the link between demographic variables and food consumption patterns related to the nutrition transition in Malaysia. This review uses various reports and publications from several ministries and selected local studies. The statistics compiled over the last two decades have shown that as the population achieves affluence, intakes of calories, fats and sugars increase, which may account for the substantial increase in food importation bills over the same period. Similarly, the rapid growth of the fast food industry during the last decade has added another dimension to the change in food consumption patterns of Malaysians. With the exception of a study on adolescents, the prevalences of overweight and obesity in children and adults are not strictly comparable due to the difference in body mass index (BMI) cut-off points in children and the study protocol in adults, and hence should not be misinterpreted as trends. The recent recommendation to lower the BMI cut-off points for Asians would only increase the magnitude of the existing prevalence among adults. The need to promote healthy nutrition for the population must be pursued vigorously, as the escalation of nutrition-related chronic degenerative diseases – once an urban phenomenon – has now spread to the rural population at an alarming rate. This paper indicates that the problem is real and needs urgent attention because it may be just the tip of the iceberg.
The unique aspects of the nutrition transition in South Korea: the retention of healthful elements in their traditional diet
Authors: Lee Min-June , Popkin Barry M , Kim Soowon 
Published: February 2003

AbstractObjective:The purposes of this paper are to describe the unique aspects of the nutrition transition in South Korea, including trends in food consumption and obesity, patterns of morbidity and mortality; to focus on efforts to maintain the traditional diet in the midst of rapid economic growth and the introduction of Western culture; and to provide insights for other countries.Design:We analysed secondary dietary intake, anthropometric, morbidity and mortality datafrom published reports and articles.Results:In South Korea, the level and rate of increase in fat intake have remained very low, whereas vegetable intake has been high and fruit intake has increased greatly. South Kore also has a relatively low prevalence of obesity compared with other Asian countries. The traditional Korean diet is a low-fat and high-vegetable diet. Therefore, the government and nutrition specialists have been initiating numerous efforts to advertise and teach the public that the traditional diet is a healthy diet. They are also working on revival of the traditional dietusing an approach that is acceptable to contemporary Koreans.Conclusions:The nutrition transition in South Korea is unique. A range of government, nutrition specialists and some private organisation efforts has worked to retain healthful elements of the traditional diet in South Korea. The continued low level of total fat in the overalldiet and the high intake of fruits and vegetables bode well for South Korea.
Cardiovascular diseases in the developing countries: dimensions, determinants, dynamics and directions for public health action
Authors: Reddy K Srinath 
Published: February 2003

AbstractThe global burden of disease due to cardiovascular diseases (CVDs) is escalating, principally due to a sharp rise in the developing countries which are experiencing rapid health transition. Contributory causes include: demographic shifts with altered population age profiles; lifestyle changes due to recent urbanisation, delayed industrialisation and overpowering globalisation; probable effects of foetal undernutrition on adult susceptibility to vascular disease and possible gene–environment interactions influencing ethnic diversity. Altered diets and diminished physical activity are critical factors contributing to the acceleration of CVD epidemics, along with tobacco use. The pace of health transition, however, varies across developing regions with consequent variations in the relative burdens of the dominant CVDs. A comprehensive public health response must integrate policies and programmes that effectively impact on the multiple determinants of these diseases and provide protection over the life span through primordial, primary and secondary prevention. Populations as well as individuals at risk must be protected through initiatives that espouse and enable nutrition-based preventive strategies to protect and promote cardiovascular health. An empowered community, an enlightened policy and and energetic coalition of health professionals must ensure that development is not accompanied by distored nutrition and disordered health.
The emergence of cardiovascular disease during urbanisation of Africans
Authors: Vorster HH 
Published: February 2003

AbstractObjective:To review the available data on risk factors for cardiovascular disease (CVD), the influence of urbanisation of Africans on these risk factors, and to examine why stroke emerges as a higher risk than ischaemic heart disease (IHD) in the health transition of black South Africans.Design:A review of published data on mortality from and risk factors of CVD in South Africans.Setting:South Africa.Subjects:South African population groups and communities.Methods:The available data on the contribution of stroke and IHD to CVD mortality in South Africa are briefly reviewed, followed by a comparison of published data on the prevalence and/or levels of CVD risk factors in the different South African population groups. The impact of urbanisation of black South Africans on these risk factors is assessed by comparing rural and urban Africans who participated in the Transition and Health during Urbanisation of South Africans (THUSA) study.Results and conclusions: The mortality rates from CVD confirmed that stroke is a major public health problem amongst black South Africans, possibly because of an increase in hypertension, obesity, smoking habit and hyperfibrinogenaemia during various stages of urbanisation. The available data further suggest that black South Africans may be protected against IHD because of favourable serum lipid profiles (low cholesterol and high ratios of high-density lipoprotein cholesterol) and low homocysteine values. However, increases in total fat and animal protein intake of affluent black South Africans, who can afford Western diets, are associated with increases in body mass indices of men and women and in total serum cholesterol. These exposures may increase IHD risk in the future.
Part III. Can we turn back the clock or modify the adverse dynamics? Programme and policy issues
Authors: Pekka Puska , Pirjo Pietinen , Ulla Uusitalo 
Published: February 2003

AbstractA global health transition is currently underway. The burden of non-communicable diseases (NCDs) is increasing rapidly in the developing world, very much as a result of changes in lifestyles. In addition to changes in tobacco use and physical activity, major changes are taking place in diets, contributing greatly to the growing epidemic of NCD. Thus, a huge global public health challenge is how to influence the trends in diet and nutrition for effective global NCD prevention.The health transition took place rapidly in Finland after World War II and mortality from cardiovascular disease (CVD) was exceptionally high. The North Karelia Project was launched in 1972 as a community-based, and later as a national, programme to influence diet and other lifestyles that are crucial in the prevention of CVD. The intervention had a strong theory base and it employed comprehensive strategies. Broad community organisation and the strong participation of people were the key elements. Evaluation has shown how the diet (particularly fat consumption) has changed and how these changes have led to a major reduction in population serum cholesterol and blood pressure levels. It has also shown how ischaemic heart disease mortality in a working-age population has declined by 73% in North Karelia and by 65% in the whole country from 1971 to 1995.Although Finland is an industrialised country, North Karelia was rural, of rather low socio-economic level and with many social problems in the 1970s and 1980s. The project was based on low-cost intervention activities, where people's participation and community organisations played a key role. Comprehensive interventions in the community were eventually supported by national activities – from expert guidelines and media activities to industry collaboration and policy. Similar principles for nutrition intervention programmes could be used in developing countries, obviously tailored to the local conditions. This paper discusses the experiences of the North Karelia Project in the light of needs from the less-industrialised countries and makes some general recommendations.
What Brazil is doing to promote healthy diets and active lifestyles
Authors: Coitinho Denise , Monteiro Carlos A , Popkin Barry M 
Published: February 2003

AbstractObjectives:To present the way the Brazilian government is addressing the prevention of nutrition-related non-communicable diseases (NR-NCDs).Results:Innovative legislative and regulatory actions, mass communications and capacity building have been combined to create a comprehensive approach for addressing poor dietary and activity patterns in Brazil that are leading to obesity and NR-NCDs. Included are new nutrition-related initiatives in the labelling area, shifts in the types of food purchased for the school food programme, use of mass media to communicate components of the food guidelines, establishment of a smart shopping initiative, and training of teachers and health workers.Conclusions:The entire effort has taken several years to get underway. This paper describes the process and some of the initial changes seen.
What is China doing in policy-making to push back the negative aspects of the nutrition transition?
Authors: Zhai Fengying , Fu Dawei , Du Shufa , Ge Keyou , Chen Chunming , Popkin Barry M 
Published: February 2003

AbstractObjective:To review the nutrition policies and efforts related to nutrition transition in China.Design and setting: This paper reviews the nutrition policy and activities of China to prevent and control diet-related non-communicable diseases (DR-NCDs). Data came from the Ministry of Health, the Ministry of Agriculture, the State Council and some cross-sectional surveys.Results:China is undergoing a remarkable, but undesirable, rapid transition towards a stage of the nutrition transition characterised by high rates of DR-NCDs in a very short time. Some public sector Chinese organisations have combined their efforts to create the initial stages of systematic attempts to reduce these problems. These efforts, which focus on both under- and overnutrition, include the new Dietary Guidelines for Chinese Residents and the Chinese Pagoda and The National Plan of Action for Nutrition in China, issued by the highest body of the government, the State Council. There are selected agricultural sector activities that are laudable and few other systematic efforts that are impacting behaviour yet. In the health sector, efforts related to reducing hypertension and diabetes are becoming more widespread, but there is limited work in the nutrition sector. This paper points to some unique strengths from past Chinese efforts and to an agenda for the next several decades.Conclusions:China is trying in its efforts to prevent and control the development of DR-NCDs but effects are limited. Systematic multi-sector co-operation is needed to effectively prevent and control DR-NCDs inside and outside the health sector.
Comparison of neonatal thyroid-stimulating hormone levels and indicators of iodine deficiency in school children
Authors: Copeland Daphne L , Sullivan Kevin M , Houston Robin , May Warwick , Mendoza Ivan , Salamatullah Quazi , Solomons Noel , Nordenberg Dale , Maberly Glen F 
Published: February 2003

AbstractObjectives:To compare thyroid-stimulating hormone (TSH) levels in neonatal cord blood between study sites in Bangladesh, Guatemala and the United States. Also, to compare neonatal TSH results with indicators of iodine deficiency in school children.Design:Consecutive births and, in school children, cross-sectional surveys.Setting:Savar, Bangladesh; San Pedro Sacatepequez, Guatemala; and Atlanta, United States.Subjects:In each study site, cord blood was spotted on to filter paper and TSH levels determined using a sensitive monoclonal assay. In the USA, heel stick blood specimens from newborns spotted on to filter paper were also obtained as well as exposure to iodine-containing antiseptics during the birthing process. Urine specimens were collected from mothers of newborns and tested for iodine concentration. School children in the same areas were surveyed for thyroid size by palpation and ultrasonography, and urine specimens collected for iodine concentration.Results:Between 141 and 243 cord blood specimens were collected from each study site. The prevalence of elevated cord blood TSH levels (>5 mU l−1) was high in all study sites, from 58% to 84%. All sites would be categorised as having ‘severe’ iodine deficiency based on WHO/UNICEF/ICCIDD criteria. Iodine-containing antiseptics were used during 98% of the births in the USA but not in Bangladesh or Guatemala. The neonatal TSH classification indicated more severe iodine deficiency levels than classifications based on urinary iodine and goitre in school children.Conclusions:In the USA, elevated TSH levels may be partially attributed to use of beta-iodine-containing antiseptics prior to birth. We recommend the cautious interpretation of TSH results in newborns for the assessment of iodine deficiency disorders when iodine-containing antiseptics are used during the birthing process.
Infant feeding indicators for use in emergencies: an analysis of current recommendations and practice
Authors: McGrath Marie , Seal Andrew , Taylor Anna 
Published: February 2003

AbstractObjective:To assess the applicability and use of infant nutrition and health indicators during emergencies.Design:Indicators recommended by international health and nutrition organisations for assessing infant feeding practice were compiled and analysed to evaluate their consistency and applicability for use in surveys of emergency-affected populations. These indicators included measures of breast-feeding status, use of artificial feeding, anthropometric status and morbidity. Health and nutrition surveys performed on the resident or refugee population of Kosovo during the years 1996–1999 were then reviewed and the use of infant feeding and morbidity indicators were compared.Results:A number of recommended indicators exist for assessing infant and child feeding practice which have been generated by different international organisations. A comparison of these indicators revealed a number of inconsistencies, both in target population and measurement method. Their use during the Kosovo crisis was likewise inconsistent and prevented conclusions being drawn about the effectiveness of the international response in protecting infant health and nutrition.Conclusions:Standard indicators need to be agreed and promoted for use during surveys of emergency-affected populations. Failure to do so will lead to a continued inability to monitor the health and nutrition of infants at a population level during international relief operations.
Motivations for fruit and vegetable consumption in the UK Women's Cohort Study
Authors: Pollard Jennie , Greenwood Darren , Kirk Sara , Cade Janet 
Published: February 2003

Abstract:Background: Despite recommendations to increase fruit and vegetable consumption within the UK population, intakes are still too low. In order to stimulate dietary behaviour change the determinants of food choice need to be explored.Objectives:To investigate how the priorities of high consumers of fruit and vegetables differ from those of low consumers, with respect to food choice motivations, and to identify what value high and low consumers place on different aspects of food choice behaviour.Design:A 4-day food diary and a questionnaire, including The Food Choice Questionnaire (FCQ) and a measure of Stage of Change (SOC) for fruit and vegetable consumption, were administered to subjects. Motivation scores from the FCQ were compared with fruit and vegetable intake and SOC data.Subjects:Nine hundred and ninety-eight females, aged 35–69 years, participating in the UK Women's Cohort Study.Results:In a multiple linear regression model, including age, education level and all FCQ motivations, the strongest motivations specifically affecting fruit and vegetable intake were health and natural content. It was found that, for a one point increase (measured on a scale of 0–4) in health and natural content scores, fruit and vegetable consumption increased by 1.11 portions (95% confidence interval (CI) 0.5–1.7) and 0.84 portions (95% CI 0.4–1.3), respectively (P>0.01). The SOC evaluation showed significant associations with portions of fruit and vegetables consumed (P>0.01). Women whose SOC was classed as maintenance phase were found to score higher on health, natural content, weight control and ethical concern factors (P>0.01). These women also scored lower on convenience questions (P>0.01).Conclusion:In this particular group of women the most important motivating factors for food choice, within the high fruit and vegetable consumers, were health and natural content of the food.
Food security and nutrition – the Ethiopian case for action
Authors: Kaluski Dorit Nitzan , Ophir Einat , Amede Tilahun 
Published: February 2003

AbstractObjective:To assess the 1999–2000 food security situation and the food relief programmes in Ethiopia, and evaluate the need for a national food and nutrition policy.Design:A systematic search of data sources from the Ethiopian Disaster Prevention and Preparedness Commission (DPPC), the Ethiopian Central Statistical Authority, the World Food Programme (WFP) and United Nations Children's Fund (UNICEF), the bibliographic database Medline and direct contacts with associations, institutions and people concerned with food security in Ethiopia.Setting:Consultations to WFP Ethiopia.Results:Food availability was severely restricted due to recurrent disasters such as drought, flood, war and a lack of diversity of food items. Food accessibility was limited due to a weak subsistence-agriculture-based economy, depletion of assets, absence of income diversity and a lack of alternative coping mechanisms. Food intake adequacy was rarely achieved due to food shortages, improper diet and poor sanitary conditions. There was a lack of early warning data to monitor food security indicators. Food aid programmes did not meet the requirements for food quantities and composition, and faced major obstacles in logistics and targeting of the vulnerable population.Conclusions:Improvements in food security and the eradication of famine will require investment in sustainable projects. There is an immediate need for better planning and targeting of food aid and a national food security monitoring system. A national food and nutrition policy is recommended, focusing both on relief efforts and on underlying factors contributing to the famine.