The broad dimensions of rapid social, economic, and technological change and the related major shifts in diet, activity, obesity, and diabetes around the world are fairly well understood. This talk will briefly lay out what we know and then discuss a number of critical aspects yet to be understood as well as the empirically based program and policy options needed to address dietary transition problems. The major dimensions of rapid change—in particular, the rate of change and the ways these shifts are affecting adults and children, especially in poor households—need to be understood. Lessons will be drawn from data in other countries, including longitudinal and cross-sectional work from China.

In general, there is a broad-based shift across lower- and middle-income countries toward greater obesity among the poor in both urban and rural areas. In China, where we followed adults representing 56 percent of China's population for 13 years, we show that the worsening of the diet and body composition of the poor, even in rural areas, is far worse than it is for the rich in terms of both obesity and noncommunicable diseases.

Price policy and many other macroeconomic options need to be explored to learn more about the potential that macroeconomic policies have for mitigating the negative effects of the nutrition transition. A case study using longitudinal Chinese data is used to highlight some of these issues, including the effect of price changes on calorie consumption and diet quality.

Barry M. Popkin, Ph.D., The Carla Smith Chamblee Distinguished Professor of Global Nutrition, is an economist and directs the UNC-CH's Interdisciplinary Center for Obesity. His primary focus is on the nutrition transition around the world, particularly the demographic and economic determinants of dietary, activity, and body composition trends, particularly through the use of longitudinal analysis techniques. He has a long and active involvement in issues linked with population and nutrition concerns in the developing world. He has lived over six years in Asia, Africa and Latin America.

Popkin is working with researchers in a large number of other countries He has been an active consultant to an array of international agencies over his career (including the World Bank, WHO, UNICEF, and USAID). He heads the Nutrition Transition Task Force of the IUNS and belongs to several scientific advisory groups for international health, population, and nutrition. In 1998 he received the Kellogg Prize for Outstanding Research in International Nutrition from the Society for International Nutrition Research. His overall research program is laid out in more detail at www.nutrans.org