Two years after Barack Obama took office, then-First Lady, Michelle Obama, announced the beginning of a nutritional program called ‘Let’s Move!’ which aimed to drive down levels of childhood obesity in the U.S. During the year that Michelle Obama founded the program, levels of childhood and adolescent obesity were at 16.9 percent; the program aimed to drive that number down to five percent by 2030. The program, however, never quite achieved its targets.

As necessary as governmental involvement is in eradicating obesity in American youths, obesity in children or adults is not simply the result of poor policy. The forces driving changes in the food industry around the world have allowed it to flourish and for food markets to be more diverse than ever. However, the growth of food industries also comes with what experts call the ‘nutrition transition,’ which basically means the changing of dominant eating habits.

The main reason for changes in the food industry is rapid urbanization, which has caused the the world’s urban population to swell to 54 percent, with expectations that it will grow to 66 percent by 2050. With the mass influx of people to cities, changing eating habits, and accessibility to food, the health of urban residents has been shifting.

By looking at how the nutrition transition affects cities, we examine urban food industries and look at how accessibility to food, the role of socio-economic standing, and the mechanicalization of food production can make communities more obese.

Obesity is not a coincidence

nutrition transition

(CC: National Cancer Institute)

The campaign that the First Lady started to eradicate obesity was strategic and helpful in its own right; however, obesity is never simply the result of poor food policy. The United States is notorious for its super-size meals and cheap pre-cooked meals, which are often blamed for the rise of obesity. But the shift in American eating habits is just one layer of the growth of America’s food industry.

As American cities industrialized in the post-World War II era and more people flocked to urban centers, more food also came to cities. With the rise of the fast food industry and supermarkets, purchasing food became a one-stop shop.

The industrialization of food facilitated this phenomenon, making frozen or pre-cooked meals not only more widespread, but also very cheap. And with the inclusion of women in the work force and the invention of the microwave during World War II, microwavable foods – otherwise known as ‘TV meals‘ – became commonplace in the American household. The ease with which food became readily available, however, came at the cost of the food’s nutritional value.

According to research conducted by Gopal K. Singh and Barry A. Miller on health among immigrants to the U.S., Hispanic-Americans born in the United States live three years less than their counterparts born in Latin America due to difference in dietary habits. In an article published in The New York Times, Hispanic immigrants reported that adjusting to life in America also meant adjusting to new eating habits.

Hispanic immigrants to the U.S. consume more meat and dairy and fewer fruits and vegetables than their Latin American counterparts. And as immigrant life in the U.S. goes, long working hours leave little to no time to fixate on eating healthy. Because junk food and processed foods are a quick fix (not to mention, easy to find and cheap), they end up constituting a large portion of immigrant families’ diets.

It isn’t just junk food, however, that plays a role in the changing eating habits of Americans. Accessibility to food and the income levels of individuals also determines what kind of food make up their diets.

The American Academy of Family Physicians (AAFP) says that nonmetropolitan residents in the United States are more likely to be obese than those living in metropolitan centers. In spite of the higher prevalence of obesity in nonmetropolitan areas, 28.7% of urban-dwellers were found to be obese.

When income levels and access to food are brought into the equation, which explains why nonmetropolitan Americans have high chances of being obese, chances of residents of metropolitan centers being obese also rise.

The AAFP’s reasoning points to a side of the food industry that experts call ‘nutrition transition.’ And while it impacts most echelons of American society, nutrition transition also affects communities in developed and developing societies.

Nutrition Transition

nutrition transition

There are two levels of nutrition transition that experts have defined: one on the demographic level and the other on the epidemiologic level. The former refers to shifts in mortality and fertility, while the latter refers to rise in disease due to ‘modern-industrial’ eating habits. In a more general sense, nutrition transition can be seen as a change in dietary habits as a result of larger, more implicating changes.

Changes in the food industry have resulted in more residents of developed societies consuming foods high in saturated fat, sugar, and processed foods that are low in fiber – sometimes called the ‘Western diet.’ This diet, however, arguably causes a number of chronic and degenerative diseases like obesity, affecting overall urban health.

Urban and rural residents experience nutrition transition very differently due to their geographical positioning and where supermarkets have spread in the United States. But in looking at how wage gaps and accessibility to food impacts the transition, how changes in the food industry impact urban health becomes slightly clearer.

In the Global Food Report 2017, which was published by the International Food Policy Research Institute (IFPRI), the differences between nutrition transition in urban and rural areas suggest that the phenomenon does not impact communities exactly the same.

The biggest driver of the nutrition transition is also the biggest change in the food industry: the modern supermarket. As cities became more populous, supermarkets and convenience stores became a staple of the urban food landscape, spreading even to smaller towns. The change has been most obvious in developing economies in recent years.

In Thailand, 85 percent of the population had access to a supermarket in 2014, which was double the number just one decade before, according to the IFPRI. Nearly 60 percent of the world’s processed foods are distributed in supermarkets. This distribution in developed economies happens through modern retail, whereas developing economies still rely on traditional retail outlets – the outcome, however, is the same.

Urban populations, for example, consume more calories than their rural counterparts, most of which come from carbohydrates and fat. The IFPRI believes that while urban dwellers consume more fruits and vegetables, the amount and quality of fruit and vegetables they consume differs vastly between low- and high-income households.

It’s not just America

Obesity in Africa has followed a similar pattern to that of the rest of the world. In recent years, obesity has been on the rise, pointing to how the growth of the food industry – in particular processed foods – has implicated African eating habits. The main drivers behind the rise of obesity in West Africa is urbanization, social and cultural dynamics, and, of course, globalization.

Since 1975, Sub-Saharan Africa has been experiencing a boom in urbanization, which has facilitated the growth of the urban food industry – in particular food manufacturing. And with the rise of urbanization, the nutrition transition in these parts of Africa meant that urban dwellers were consuming cheap processed foods or street food containing high concentrations of fat and cheap vegetable oils. Among lower income areas of cities, these foods are the most consumed, primarily because they are available on every street corner and are cheap.

For urban residents in Africa, there are also other elements that can contribute to how the food industry can affect obesity in communities. Research shows that things like gender, educational level, and employment can increase the prevalence of obesity in residents of African cities.

nutrition transition

Courtesy of the Cardiovascular Journal of Africa

The New York Academy of Sciences believes that one of the most direct consequences of nutrition transition – in particular a shift from foods rich in fiber and protein to those rich in saturated fats and sugars– is the rise of chronic diseases like obesity and diabetes.

Rising obesity does not directly point to the change or growth in the food industry, since it may well be attributed to poor eating habits or hereditary. Sedentary lifestyles, which include little to know physical activity, are also strongly affiliated with obesity as well as cardiovascular disease particularly in women, according to research conducted by the Texas Heart Institute.

But if we were to disregard obesity as a result of personal eating habits or lifestyle, obesity can be quantified. By using it as a measure, it can reflect how eating habits and the food industry are changing. In this case, it can also be used to measure nutrition transition.

Nutrition Transition and Obesity in the Developing World

nutrition transition

(CC: Global Justice Now)

In some parts of the world, being overweight might have been perceived as a sign of wealth – or the ability to feed oneself well. But as food has become more readily available thanks to the modern supermarket between the 1960s and 1990s, both lower and upper class urban residents have gained access to a variety of foods. With cheaper foods, most everyone has access to foods high in fat, often making healthier options a thing of the rich.

Accordingly, choosing healthier or less healthy food is largely impacted by income level. Poorer urban residents often find that the most abundant food options available to them consist of processed foods and fast-food, simply because they are cheaper and have longer shelf lives.

The encroachment of corporate food into the developing world is particularly felt in places in like Brazil. The presence of multinational companies like Nestlé have forged a new diet mostly for Brazil’s urban poor consisting of packaged foods. Unsurprisingly, the widespread availability of Nestlé’s packaged foods has placed many of Brazil’s urban poor between a rock and a hard place.

Nestlé is one of many companies that have been pushing a different food agenda in developing economies; one that encourages farmers to begin growing crops like corn, sugar cane, and soybeans that are used directly in modern food manufacturing processes. What this instigates is a move away from the traditional fruit/vegetable-based diet of the countryside to a modern, more ‘Western’ diet of the city, laying down the framework for the introduction of supermarkets and other big retail stores. To these communities’ dismay, the vicious cycle doesn’t stop.

Michelle Obama’s initiative “Let’s Move!” believed that American kids were becoming more obese due to the lack of or limited access to fruits and vegetables. These areas of the U.S. with limited access became to be known as ‘food deserts’ which are cities or towns where residents cannot easily purchase certain foods due to distance from stores or otherwise.

Recently, experts have been questioning the role of supermarkets and the creation of what are called ‘food swamps’ in the rise of obesity. Unlike food deserts, food swamps are cities or towns that have abundant access to junk or packaged foods.

With the sheer number of packaged foods around the world, experts are suggesting that food swamps have a direct role in the spread of obesity. According to New York Times, the number of packaged foods grew 25 percent from 2011 to 2016 around the world, while fast food grew 30 percent within the same time period.

Food conglomerates have also been marketing foods they claim are ‘light’ or ‘diet’ food options while benefiting off the backs of communities who already struggle with obesity. Clear examples of this are Diet Pepsi, for example, or McDonalds’ salads. And so when consumers see these food products that claim to be healthier, they buy them, often without considering whether foods are more harmful than their original counterparts.

Carlos A. Monteiro, a professor of nutrition and public health at the University of São Paulo thinks the days of ‘real’ food with positive nutritional value are long gone, as the nutrition transition takes the world by storm.

“What we have is a war between two food systems, a traditional diet of real food once produced by the farmers around you and the producers of ultra-processed food designed to be over-consumed and which in some cases are addictive,” he said to the New York Times.

“It’s a war,” he added, “but one food system has disproportionately more power than the other.”