CLF 2006 Special Lecture - March 1, 2006 
Wolfe Street Bldg E1020 | 12:15 - 1:30PM

THE NUTRITION TRANSITION IN CHINA:
Risk Factors for Obesity and Diabetes in Urban and Rural Populations

Benjamin Caballero, MD, PhD
Professor, Departments of International Health and
Population and Family Health Sciences, JHSPH

Background
China is in the midst of an unprecedented socio-economic transition. The dramatic advance of a market economy has produced rapid changes in the human ecology of the country: lifestyle, types of employment, housing, and diet. The dietary part of the socio-economic transition results in what has been called the 'nutrition transition'. This term refers to nutrition-related changes affecting food availability, food choices and preferences, dietary energy intake, and energy expenditure. Besides food and diet, the other major factor in the nutrition transition is physical activity that impacts energy balance.

Two major factors fueling the dietary changes associated with the nutrition transition are: a) increase in income and b) promotion and availability of certain types of foods by international companies entering the food market. One effect of increase in income is an increase in the fat content of the diet.This increase is at the expense of vegetable fats, as they become more accessible to larger segments of the population, as well as to an increase in consumption of animal protein sources, perceived as better relative to plant sources in China. Although this issue has not yet been quantified, the number of fast-food restaurants is clearly increasing in major Chinese cities. The first McDonald’s opened in Beijing in 1994 and by 2006 there were 600 branches with 1400 outlets of Kentucky Fried Chicken - all serving the same meals as in the US. In addition, a good proportion of that fat is saturated fat, or contains an excessively high percentage of trans fatty acids, resulting from overheating of vegetable oils used for deep-frying. 

Research Project
The presentation will highlight the results of a multi-year pilot study funded by the Center for a Livable Future exploring the impact of dietary changes on risk for cardiovascular diseases in China. This project is, to our knowledge, the first that provides data comparing eating patterns, dietary energy and fat intake, animal and plant food sources, physical activity levels, and body composition in populations living in traditional rural areas, semi-urban areas and large-city urban areas. In addition, specific risk factors for cardiovascular diseases, diabetes, hypertension, and obesity were assessed. The information on diet quantity and quality was correlated with these indices of risk of disease, providing evidence of the link between dietary practices and development of major chronic diseases. With the large-scale household survey, done in coordination with the 4th Chinese national nutrition survey, additional information was obtained on health status of families in the three sites of our project, including disease patterns, and other lifestyle indicators that can also be correlated with disease risk.

We expect that this initial cross-sectional study will provide the basis to develop effective preventive interventions, and to offer health authorities the evidence of the impact of certain changes in lifestyle and dietary practices on risk for chronic diseases. The study was carried out in collaboration with the Chinese Academy of Preventive Medicine under the direction of Co-Principal Investigator, Dr. Gonghuan Yang.            (Adapted from other material by Dr. Ben Caballero)

Speaker Biography
Dr. Caballero received his medical degree from the University of Buenos Aires, Argentina, and his PhD in neuroendocrine regulation from the Massachusetts Institute of Technology in Cambridge, MA. He trained in Pediatrics at the Buenos Aires Children’s Hospital, and completed his training in clinical nutrition at the Harvard/MIT Clinical Nutrition Training Program in Boston.

He has served in a number of national and international advisory groups, including (past 5 years) the Food and Nutrition Board of the Institute of Medicine, National Academy of Sciences, the IOM Standing Committee for the Scientific Evaluation of the Dietary Reference Intakes, the Nutrition and Metabolism Study Section of the National Institutes of Health, and the 2005 Dietary Guidelines for Americans. He served on the Executive Council of the Society for International Nutrition Research (of which he was president in 1999-2001) and of the American Society of Clinical Nutrition. He is also a member of the American Society for Nutritional Sciences, the North American Society for the Study of Obesity, and the American Association for the Advancement of Science. He is the editor-in-chief of the Encyclopedia of Food Sciences and Nutrition, and co-editor of Modern Nutrition in Health and Disease.

His research focuses on child nutrition, particularly obesity risk factors and prevention interventions. His international work is centered on the emerging problem of diet-related chronic diseases in developing countries.