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How many books can claim the winner of a World Food Prize as the author of the foreword and a Nobel laureate in economics as the coauthor of the lead chapter? The Nutrition Transition: Diet and Disease in the Developing World, edited by Benjamin Caballero and Barry M Popkin, and the latest book in Academic Press’s prestigious Food Science and Technology International Series, comes with these calling cards. The parent series contains pioneering textbooks on food technology covering topics such as sensory analysis, animal proteins, food engineering, food texture manipulation, food acceptance, and consumer research, dating back to 1965. Ironically, this latest contribution (only the second on human health issues in the series) places all of these technological advances—aimed at making food more abundant, more appealing, and more secure—in light of their potential downside for the health of individuals and populations. That is, the initiatives for making processed food sweeter, more tender, and more appetizing and appealing may be inciting (or at least enabling) the epidemic of diet-related maladies overtaking the world’s population.
This is a difficult book to read; one may have to pick it up and set it down several times before getting into the broad, dense, and diverse subject matter. Legibility is one issue: the text print is fine, small, and tightly crammed over a highly glossy surface. The illustrations accompanying the text have even more minute lettering over backgrounds of various shades of blue. By contrast, the bold and beautiful color maps of the percentage of the national population living in urban areas in 1950 (inner back cover) and 2000 (inner back cover) enliven the book.
The term nutrition transition, introduced in 1994 by one of the book’s coeditors (1), initially came to be defined by the realization that "problems of under- and overnutrition often coexist, reflecting the trend in which an increasing proportion of people consume the types of diets associated with a number of chronic diseases." The most salutary consequence of this formulation by Popkin was to legitimize over the past decade an intellectual and policy concern for linkages other than just undernutrition and development. The treatments of the nutrition transition are assorted and somewhat uneven. One can distill a basic "truism" that civilization with urbanization and globalization are factors in the paradoxical dilemma that confronts public health in developing countries.
The organizational scheme does not adequately align the contributions. The book contains an introductory chapter followed by 2 major sections: "The Global Context" (containing 4 chapters on economics of body size, food production, globalization, and demographic trends) and "Biological Factors Affecting the Nutrition Transition" (with 8 chapters on dietary transition, health consequence of early nutrition, obesity, diabetes, cardiovascular disease, a case study from China, a case study from Brazil, and policy implications). The most novel and interesting biological concepts are found in the first chapter of part I, whereas the final chapter of part II presents the most cogent discussion of the global context for interventions. Part II encompasses topics that go well beyond the biological factors affecting the nutrition transition. The thinking and writing is generally good throughout. The case studies are not written as review articles but rather as original research papers.
Truly superb and formidable crafting of the text is shown in the first chapter of part I on economics and technological development and their relations to body size and productivity and in the second chapter of part II on early nutrition and later risk of disease. Notably, the last 3 text pages of the book present the Bellagio Declaration: Nutrition and Health Transition in the Developing World: The Time to Act, a "manifesto" produced at a retreat of international intellectuals and academics held at Lake Como, Italy, in August, 2001.
Nutrition Transition does not bring us to a comprehensive consensus on the title topic but serves up a panoply of questions that provide a vibrant and challenging intellectual quality to the reading experience. For those, on the one hand, who like their blueprints neat and pat, this book is not for you. On the other hand, for those who seek to wrestle with paradoxes and dilemmas of food choice and eating behavior in the technological age of an urbanizing world with a globalizing food market where profound social inequalities continue to exist, then cover-to-cover reading of this compendium will put you into the center of the fray.
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