Rethinking the “Diseases of Affluence” Paradigm: Global Patterns of Nutritional Risks in Relation to Economic Development

Ezzati, Majid; Hoorn, Stephen Vander; Lawes, Carlene M.M.; Leach, Rachel; James, W. P. T.; Lopez, Alan D; Rodgers, Anthony; Murray, Christopher J L

doi:10.1371/journal.pmed.0020133

Cited by 466 publications

(322 citation statements)

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“…A recent study has also demonstrated the potential of remote sensed and meteorological data products as being reliable representation of global observations of PM2.5 for epidemiological studies (Lary et al, 2014). Our bivariate results also indicated a positive association between GDP and lung cancer incidence illustrating the fact that rising affluence in developing countries may possibly be associated with an increase in smoking (Ezzati et al, 2005). Developing countries, moreover, now account for 80% of all smokers and lung cancer is projected to increase markedly in these countries (Mathers and Loncar, 2011;Murray, 1997;Tesfaye et al, 2007).…”

Section: Discussionsupporting

confidence: 70%

How much incident lung cancer was missed globally in 2012? An ecological country-level study

Sartorius

2016

Geospat Health

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Lung cancer incidence is increasing in many low-to-middle-income countries and is significantly under-reported in Africa, which could potentially mislead policy makers when prioritising disease burden. We employed an ecological correlation study design using countrylevel lung cancer incidence data and associated determinant data. Lagged prevalence of smoking and other exposure data were used to account for exposure-disease latency. A multivariable Poisson model was employed to estimate missed lung cancer in countries lacking incidence data. Projections were further refined to remove potential deaths from infectious/external competing causes. Global lung cancer incidence was much lower among females vs males (13.6 vs 34.2 per 100,000). Distinct spatial heterogeneity was observed for incident lung cancer and appeared concentrated in contiguous regions. Our model predicted a revised global lung cancer incidence in 2012 of 23.6 compared to the Globocan 2012 estimate of 23.1, amounting to ~38,101 missed cases (95% confidence interval: 28,489-47,713). The largest relative under-estimation was predicted for Africa, Central America and the Indian Ocean regions (Comoros, Madagascar, Mauritius, Mayotte, Reunion, Seychelles). Our results suggest substantial underreporting of lung cancer incidence, specifically in developing countries (e.g. Africa). The missed cost of treating these cases could amount to >US$ 130 million based on recent developing setting costs for treating earlier stage lung cancer. The full cost is not only under-estimated, but also requires substantial additional social/family inputs as evidenced in more developed settings like the European Union. This represents a major public health problem in developing settings (e.g. Africa) with limited healthcare resources.

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Section: Discussionsupporting

confidence: 70%

How much incident lung cancer was missed globally in 2012? An ecological country-level study

Sartorius

2016

Geospat Health

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“…Given the overall low-SER of Arab towns, these findings can be explained by the fact that in poor communities where funds limit caloric intake, the more financial resources available, the more food and prepared industrial food they can obtain, and therefore the individual will have a higher chance of being overweight or obese [32] . It should be remembered that obesity has been called a disease of affluence, also because of this reason [40] . In this study wealth inequality was found to be negatively associated with adolescent overweight/obesity in Jewish towns, but not in the Arab towns.…”

Section: Discussionmentioning

confidence: 99%

The Socioeconomic and Spatial Dimensions of Adolescent Overweight and Obesity: The Case of Arab and Jewish Towns in Israel

Moran¹,

Moran²,

Goldblatt³

et al. 2015

JEHS

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Childhood and adolescent overweight/obesity is a major burden on public health worldwide. A growing body of empirical evidence highlights the impact of community characteristics of childhood obesity. This study explored socioeconomic and spatial variations of adolescent overweight/obesity in Israel by using an ecological approach. Towns' socioeconomic and spatial characteristics were found associated with adolescent overweight/obesity in opposite directions in Jewish and Arab towns. Adolescent overweight/obesity was found to be more prevalent in Jewish towns characterized by lower socioeconomic rank (SER) and higher peripherality levels and in Arab towns characterized by higher SER and lower peripheraliy levels. Additionally, inequalities were found to be positively related to adolescent overweight/obesity in Jewish towns. After adjusting for SER, the associations between peripherality and adolescent overweight/obesity were attuned in Jewish towns, but not in Arab towns. These findings correspond with the literature, as the results obtained for the Jewish and Arab towns are consistent with studies conducted in developed and in developing countries, respectively. Therefore, the findings highlight the importance of macro level factors enhancing obesity, and suggest that national policy may benefit from town-level interventions addressing adolescent overweight/ obesity. Several explanations to the study's findings are discussed, involving social, environmental and individual factors.

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“…On the basis of data from economically developing countries (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) , we hypothesized that children from a…”

Section: Snacks Traditional Diet Food Patterns Nutrition Transitionmentioning

confidence: 99%

Socio-economic status and urbanization are linked to snacks and obesity in adolescents in Botswana

Maruapula

Jackson

Holsten

et al. 2011

Public Health Nutr.

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Objective: To describe patterns of food consumption associated with overweight/ obesity (OW/OB) and their links to socio-economic status (SES) and urbanization. Design: A nationwide cross-sectional survey. Setting: Secondary schools in cities, towns and villages in Botswana, Africa. Subjects: A total of 746 adolescent schoolchildren. Results: OW/OB is associated with greater SES, city residence and a snack-food diet pattern. Students belonging to higher SES compared with those from a lower SES background reported significantly (P , 0?01) more daily servings of snack foods (1?55 v. 0?76) and fewer servings of traditional diet foods (0?99 v. 1?68) and also reported that they ate meals outside the home more often (90 % v. 72 %). Students in cities ate significantly (P , 0?01) more servings of snacks (1?69 v. 1?05 v. 0?51) and fewer servings of traditional foods (0?67 v. 1?52 v. 1?61) compared with those in urban and rural villages. The odds of OW/OB were increased 1?16-fold with a snack-food diet, a result that was diminished when controlled for SES. Conclusions: These data suggest that nutritional transition occurs at different rates across urbanization and SES levels in Botswana. In cities, increasing the availability of fruit while reducing access to or portion sizes of snack items is important. Emphasis on continued intake of traditional foods may also be helpful as rural areas undergo economic and infrastructural development. Keywords Snacks Traditional diet Food patterns Nutrition transitionThe worldwide obesity epidemic is evident in children belonging to economically developed countries, as well as in children belonging to countries undergoing such development. According to the International Obesity Taskforce, approximately 10 % of youth aged 5-17 years worldwide were overweight (OW) and 2-3 % were obese (OB) in the year 2000 (1) . In a nationwide sample of adolescent secondary-school students in Botswana, 16 % of adolescents were OW/OB, with three OW/OB adolescents for every underweight one (2) . In this sample, OW/OB prevalence was higher among adolescents having a higher socio-economic status (SES) and among those from cities than among those from rural villages. These data suggest that initial efforts to prevent further increase in the prevalence of OW/OB must consider environmental and behavioural factors associated with increasing SES and urbanization as economic development continues.The typical food intake patterns of adolescents in Botswana and whether these patterns have any relationship with OW/OB have not been published. In addition, the role that SES or urbanization plays in patterns of food consumption has not been examined in adolescents. It is critical to understand these behaviours as a first step towards designing interventions to prevent the expected further increases in OW/OB. Therefore, the purposes of the present study were:1. to characterize the patterns of food intake of adolescent schoolchildren and the relationship of these patterns with OW/OB; 2. to evaluate the associatio...

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Rethinking the “Diseases of Affluence” Paradigm: Global Patterns of Nutritional Risks in Relation to Economic Development

Cited by 466 publications

References 50 publications

How much incident lung cancer was missed globally in 2012? An ecological country-level study

How much incident lung cancer was missed globally in 2012? An ecological country-level study

The Socioeconomic and Spatial Dimensions of Adolescent Overweight and Obesity: The Case of Arab and Jewish Towns in Israel

Socio-economic status and urbanization are linked to snacks and obesity in adolescents in Botswana

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