Report on Activities of the Task Force on the Nutrition in Transition

FROM:     Barry M. Popkin, Chair
Carlos Monteiro, Vice Chair
DATE:     October 28, 2005

We feel the Task Force should continue.  The plans are noted below.

International Congress of Obesity

The Task Force met twice over the course of the meeting.  The decision was made by all involved to create a Bellagio + 7 meeting.  That would attempt to accomplish several things:

First it would systematically document dynamics and changes in a set of countries, including countries represented by those on the committee, but also 7-10 other developing countries.  A template is being developed for this initiative and then we will begin to work on which countries to invite, which individuals to involve, etc.

Second, it would critically lay out what is being done in each country to address the shifts of the pattern of the Nutrition Transition toward the stage linked with chronic degenerative diseases, including obesity.

Third, it would look at new emerging cross-cutting issues the committee will define over the next two years.

Fouth, all members wished to remain on the committee and we added two members—one, a young faculty from the Netherlands and the second, an older one from the US.  We are continuously searching for young professionals who fit our goals and criteria of excellence.  We have identified 5 potential young persons and will be watching them and considering them over the next year.

Fifth, the only two persons who could truly take over leadership are Carlos Monteiro and Gail Harrison and my sense is that for now, I remain the best option to keep this moving.

Committee activities June 2004-June 2005

The committee has been very active in a number of countries in pushing forward research and programmatic work in this area but has not undertaken any coordinated cross-national effort during this period. We try to highlight a few of the key initiatives underway linked with our key focal countries and committee members.

Brazil:  Carlos Monteiro lead the Brazilian task force that analyzed the most recent national food and nutrition survey conducted in Brazil in 2002/2003 on a random sample of 48 thousand families. This task force was integrated by researchers and representatives of the MoH and IBGE (the federal office for official statistics in Brazil). The publication of the main survey findings (available from the IBGE site under the title: Pesquisa de Orcamento Familiar 2002/2003) updated the nutrition transition showing increasing obesity rates in the country, particularly in the poorest regions and families, and a shifting of the diet towards increasing fat content, increasing saturated fat content and increasing sugary, salty, processed foods with no changes in the low consumption of fruits and vegetables. This publication had enormous repercussions in the nutrition community and also in the national media, particularly in light of the strong emphasis placed by the federal government on “anti-hunger” measures (Fome Zero program). Carlos also acted as a consultant for the WHO/FAO fruits and vegetables initiative participating in technical meetings in Geneva and Kobe that discussed and proposed ways to implement the initiative in developing countries. In Brazil, Carlos is assisting the federal government and selected municipalities in the implementation of the fruits and vegetable initiative. A recent community trial conducted by Carlos and his group at the University of São Paulo in a poor, underserved area of São Paulo city provided evidence that feasible actions combining education and improvements in the supply of fruits and vegetables can increase significantly the consumption of these foods by low income families. A large-scale replication of the intervention is being planned for the near future.

Mexico: Juan Rivera has led a major initiative to focus a great deal more work on noncommunicable diseases and related risk factors in Mexico.

  • They conducted an analysis of the 1999 Mexican Nutrition Survey which used cluster analysis to identify different dietary patterns. They further studied the association of the dietary patterns with NCD risk factors.
  • They are studying the prevalence of NCD risk factors such as blood lipids, glucose, and insulin in a probabilistic sample of adolescent and adult Mexicans studied in 2000. They are analyzing the nature of the association of the risk factors with BMI and other anthropometric indices.
  • They are participating in a project organized by the FAO Food and Nutrition Division entitled “Assessment of Dietary Changes and their Health Implications in Countries facing the ‘double burden’ of malnutrition”. They are in charge of preparing a document describing the situation and the trends in Mexico using data from several cross sectional surveys on food purchases, diet, anthropometry, chronic diseases and mortality.
  • They are conducting the evaluation of a poverty alleviation program which provides cash transfers as well as nutrition and health services to 5 million low income families in Mexico. Cash transfers are used as incentives for investment in nutrition, health, and education. They are studying the effects of the program on food intakes, body weight and composition, and chronic diseases.
  • They developed a proposal that was pre-selected for funding by ILSI/PAHO/CDC. The project will study the elements in the environment of public schools that promote overweight. With the use of formative research, interventions aimed at changing the environment to promote physical activity and a healthful diet for the prevention of obesity in children will be developed and their effects will be tested.
  • They have acquired funds to conduct this year the third national nutrition survey that will include a random sample of 40,000 households. They will use comparable methodology to the first (1988) and the second (1999) national nutrition surveys, which will allow the study of trends in diet and in under and overnutrition and chronic diseases in the Mexican population.
  • They have created, in collaboration with INTA (Chile) a network of research centers in nutrition in LA with support from UNU/IUNS. The two main Institutions are INTA Chile and INSP Mexico. Fernando Vio (INTA Director) and Juan Rivera are the regional coordinators of the UNU Nutrition Program in LA. The first activity involved a diagnosis of the main nutrition problems and an inventory of research institutions in nutrition, their capacity and their publications conducted in 8 LA countries. As a result of the diagnosis, research priorities were identified and working groups created. Each working group is developing multicenter proposals that will be sent to donors. One major group addresses obesity and chronic diseases. One of the projects is work with Industry in LA to reduce or eliminate trans fatty acids. We have another group dealing with childhood obesity. Each group involves investigators from INTA, INSP and other research institutions in the region.

Geoffrey Cannon:  He has led a worldwide group focused on creating a newer broader vision of nutrition. In addition, he is playing a major role with the World Cancer Research Federation in reviewing diet and cancer relationships within the context of the dynamic worldwide shift in stages of the Nutrition Transition. This Panel has Juan Rivera, a task force member, on it.

United States:  Barry Popkin is leading a group of scholars to develop a beverage guidance system for the US. Given the very high percentage of calories from beverages in the US (over 21%), this is viewed as a key way to continue to fight the obesity increases in that country. Barry Popkin has also presented aspects of the Nutrition Transition at a plenary talk as part of the Sixth International Conference on Preventive Cardiology Iguaçu, Brazil. He also created and received funding for an NIH Roadmap Center on Obesity that features a large component on the nutrition transition and involves 71 faculty members from over 35 departments and six schools on the UNC campus as well as other institutions in the region.

China-United States:  A national conference in China this summer will highlight the nutrition transition and Barry Popkin will be a key plenary speaker. The group is also working with the Chinese Ministry of Health to consider ways to prevent further increases in obesity in China.

South Africa:  With two very active committee members and nutrition viewed as a major concern by the government, Committee members have been most active there. South Africa is a country in transition, experiencing a quadruple burden of disease and the coexistence of both under-and overnutrition often within the same communities, and even within households.

The nutrition transition has been an integral focus of the Food-Based Dietary Guideline process in SA (initiated by Este Vorster in 1997). Since both the coexistence of under-and over-nutrition as well as changes/shifts in dietary intake with development and urbanization from local evidence has been incorporated. Primordial prevention of diseases of lifestyle (e.g., specific attention to intakes of types of fats, legumes and fruit and vegetables and physical activity are incorporated in the health messages). The South African Department of Health officially approved the FBDGs (comprising 11 Guidelines) in 2003, and the professional and national launches took place in 2004. Lesley Bourne was part of the core working group throughout this period and was tasked with/convened the Pediatric FBDGs (PFBDGs ages 0 – 7years). As with the core process all steps outlined in FAO/WHO have been followed and the database is extensive. Este and Lesley have convened over 25 meetings.

Another major issue is the South African leg of the PURE study, in which the health transition of Africans (urban and rural) is monitored over 12 years. Part of this study also monitors the nutrition transition. Este Vorster’s group is handling this.

The South African group has had a great deal to do with the ICN. Dr. Vorster has played a lead role as has Dr. Bourne. The latter has organized the Focus Asia symposium.

A third major issue relates to the linkage of HIV/AIDS and nutrition. It has become a major issue in South Africa.

Thailand:  One major effort was the organization and implementation of the Thai National Food Consumption Survey. A second has been the development in Thailand of a coordinated research agenda on the nutrition transition and cardiovascular disease. There are several agencies involved including national research council, Thailand research fund as well as the National Health

Foundation. Dr. Vongsvat was central to the organization of this as it relates nutrition to CVD and diabetes.

One initiative coming out of this is a large research effort she will lead on the Thai Muslim population related to the identification of the environmental contributing factors of noncommicable diseases.

Morocco:  They have also worked to develop a food based dietary guide. Further, they are working to understand how the Mediterranean diet, viewed as an excellent way to fight obesity in Morocco, is being followed there. There is also a joint Moroccan-Dutch study on  Moroccan women immigrants in the Netherlands.

Attachment A: Members of the International Union for Nutritional Sciences

Task Force on the Nutrition Transition as of September 24, 2005

Dr. Barry M. Popkin, Chair
Professor of Nutrition
Mailing Address
Carolina Population Carolina
University of North Carolina at Chapel Hill
CB # 8120 University Square
123 W. Franklin St.
Chapel Hill, NC  27516‑3997
Phone:  (919) 966‑1732
Fax:  (919) 966‑9159
E‑Mail: POPKIN@UNC.EDU
 Dr. Carlos A. Monteiro, Vice Chair
São Paulo University
Center for Epidemiological Studies in  Health and Nutrition (NUPENS/USP)
Av. Dr. Arnaldo, 715
01246‑904 ‑ Sao Paulo
SP‑Brazil
Phone:  (55‑11) 64‑6068
Fax: 55‑11‑852‑6748
E-Mail:  carlosam@usp.br
 Dr. Juan Rivera, Director
Center for Research in Population Health
Instituto Nacional de Salud Publica
Av. Universidad 655, Col. Sta. Ma. Ahuacatitlan,
Cuernavaca, Mor. CP 62508 Mexico
Tel/Fax: 011-52‑73‑11‑22‑19
E-mail:  jrivera@insp3.insp.mx
 Dr. Lesley Bourne
National Health & Development Research
Programme
Medical Research Council
19070 Tygerberg 7505
South Africa
Phone:  011‑27‑21‑938‑0313
Fax:   011‑27 21‑938‑0342
E-Mail:  lesley.bourne@mrc.ac.za
 Mr. Geoffrey Cannon
Director of Science
World Cancer Research Fund
105 Park St.
London W1Y 3FB
U.K.
Phone:  011‑44‑171‑343‑4200
Fax:  011‑44‑171‑343‑4201
E-Mail: g.cannon@wcrf.org.uk
 Professor  Dr. Vongsvat Kosulwat
Institute of Nutrition
Mahidol University
Salaya, Phutthamonthon
Nakhon Pathom, Thailand 73170
tel Off: 011-66-2-889-3820/800-238
fax Off: 011-66-2-441-9344
email: grvpt@mahidol.ac.th
Professor  Sabah Benjelloun
Département des Sciences Alimentaires et Nutritionnelles
Institut Agronomique et Vétérinaire Hassan II
BP 6202 Rabat‑Instituts
10101 Rabat, MAROC
Tél: Office: (212) 37 77 17 45
Home:   (212) 37 73 56 22
Fax:    (212) 37 77 81 35
Mobil:212 64 55 07 49
E-Mail: jelloun@iav.ac.ma
 Zhai Fengying, Professor and Head
Department of Public Nutrition
Institute of Nutrition and Food Safety
Chinese Center for Disease Control and Prevention
29 Nan Wei Road
Beijing, China
Phone:  86‑10‑6304‑1362 /631‑1875
Fax:  011‑86‑10‑63011875
E-Mail:  infh@public.bta.net.cn
 Professor H.H. Vorster
Dept. Home Economics and Dietetics
University of Potchefstroom
Potchefstroom  2520
South Africa
Phone: 011-27-0148 2992469
Fax: 011-27‑148 2992464 or (27‑148) 99 2799
E-Mail:  VGEHHV@puknet.puk.ac.za
 Dr. Gail HarrisonDept. of Community Health Sciences
UCLA School of Public Health
10833 LeConte Avenue
Los Angeles, CA 90095
Bus: (310) 825-3738, 206-8444 B Fax: (310) 794-1805
Home: (Phone) 805-496-5886 B (Fax) 805-496-2334
E-mail: gailh@ucla.edu
 Dr. Colleen Doak
Assistant Professor, Department of Nutrition and Health
Institute of Health Sciences, Vrije University Amsterdam
De Boelelaan 1085
1081 HV Amsterdam
The Netherlands
Work phone: +31 20 598 9282
Work fax: +31 20 598 6940
Email: colleen.doak@falw.vu.nl
Email for large attachments: colleen.doak@gmail.com
 Home address:
Kapelsteeg 3
1381 XK Weesp
The Netherlands
Home phone: +31 29 441 1290

Brief Report of IUNS Task Force on “Technologies and Nutrition”

(November 2003 – June 2005)

Prof. Mark. L. Wahlqvist, President, IUNS requested Dr. V. Prakash to Chair this Task Force in  November 2003 and  Dr. Prakash  accepted the same.

Address:  Dr. V. Prakash, Director, CFTRI, Mysore-570 020, India
(e-mail: prakash@cftri.com)

Members of the Task Force:
Prof. Ruth Oniango’o, Nairobi, Kenya ( Food, Education Publishing)
(e-mail: oniango@iconnect.co.ke)

Dr. Kalyana Sundaram, Malaysia ( Horticulture/Food/ health Technology)
(e-mail; kalyana@mpob.gov.my)

Dr. Hanifa  Bachou, Kampala, Uganda   (e-mail: sab@africaonline.co.ug)

Ms. Azizah Omar, Malaysia/ Australia (IT)
(e-mail: aoma1@student.monash.edu.au)

Following were interested and upon request by Chair made themselves  available to assist the Task Force as  and when required:

Dr. Venkatesh Iyengar ( Formerly in IAEA, Nuclear Technologist)  USA
(e-mail: gviyengar@biominerals.org)

Dr. Maureen McKay (Monsanto, Chicago/St. Louis) ( Biotechnology)
(e-mail: Maureen.a.mackey@monsanto.com)

Prof. Samuel Sefa-Dedeh, Ghana (ICSU & Ghana; Traditional African Technologies) (e-mail: crspugl@ghana.com)

Dr. Gayle Savige, (Asia Pacific Health & Nutrition Centre, Monash Asia Institute,   Australia (e-mail: gayle.savige@med.monash.edu.au)

A. The Objectives of the Task Force are principally :

  • To generate a Report which would bring together the current understanding of “Technologies with potential to accelerate human development through Food and Nutrition”
  • To develop a proposal, in conjunction with other science and technology partners, for prototype community-based projects which apply the Report Findings.

B. Agenda prioritized for this Task Force are :

1. Food Technology (in conjunction with IUFoST several activities and events are planned (or have taken place).  Some of them are :

  • On-line Education- Joint with IUFoST ( meeting, Nairobi 2002)
  • IUFoST-  12th World Congress of  Food Technology,Chicago, USA,  July 16-20, 2003
  • Post WCCN ( IUNS- World Congress of Clinical Nutrition)- Cairns, Queensland, August,2004

2. Biotechnology
Follow up from the ICSU report on GMF in which IUNS was involved.
3. Information Technology and Telecommunication

  • Industry Partnerships are being pursued
  • Focus on empowerment of  women (eg. Mobile phones through Grameen Bank in Bangladesh)

4.  Energy Conservation
(eg.  Use of solar cookers etc)

  • Environmental advantage and impact of de-afforestation
  • Reduced household pollution and respiratory illness (UNEP Report)
  • Convenience and reduced burden of work for women

C. Way Forward :

 (1)  First meeting, 7 February,2004, Mumbai, India
After taking over as Chair of this  Task Force by Dr. V. Prakash, The  First meeting  was held on 7th February, 2004 at Mumbai  with assistance from Prof. Marika Vicziany of Monash Asia  Institute (an Economist with a focus on poverty and on India) who organized the meeting at Mumbai.

Dr. Prakash invited all the Task Force members and  other resource persons for this meeting. Prof.  Mark L. Wahlqvist, President, IUNS attended this meeting.  Prof. Marika Vicziany and Ms. Azizah Omar were able to present and other members could not attend the meeting because of preoccupation.

The following agenda items were discussed in the meeting:

  • Fixing Priorities for the Year 2004 – 2005
  • Identification of  strategies with particular reference to Africa based on the  Cross-learning experience between Africa and Asia.
  • Bringing out Reports and Activities thereon
  • Matter concerning the  Durban IUNS Conference and Safaris.
  • Proposal on Joint meeting of Chairs of Task Force
  • About workshop on School Children Health and Nutrition
  • Holding Workshops and Symposia by IUNS Task Force on Technologies and Nutrition- selection of Topics, dates and venues during the next 3 Years (from 2004-2006)
  • Preparation of Report on Task Force meeting for  publication in “ Asia Pacific journal of Clinical nutrition” (ongoing)

The meeting deliberated a large number of issues as mentioned  above  and Prof. Mark L.  Wahlqvist briefed the committee on many areas and the following are the major points that were highlighted :

(a)    Review:

  • Brief of IUNS website
  • 1st meeting in Nairobi with Prof. Ruth  Oniango’o as the Chair
  • Interaction with Hanifa (Information Technology and Nutrition in Africa)
  • First 50 graduates – major work force in changing Africa in Technology leverage
  • Study center / reviewal linkage
  • “Developing a report to make the case for Technology and Development to show Technology is related to Nutrition”
  • Technology Impact and Nutrition –Food Technology, Information Technology and Biotechnology
  • Energy – renewable and sustainable/ economic factor
  • Technology for water / food – needs to be  addressed in tandem
  • Fortification and  Biofortification ( role of CFTRI)

(b)  Products / databases and  outreach

  • IUNS  Technical Reports
  • A policy statement can come out with an agreed statement
  • How technology can relate to nutrition  region wise
  • Multimedia super corridor (Malaysia  as an example)
  • Product profile

Ex: (i) Energy food

CFTRI
(ii) Protein biscuits

  • Food based approach and  Nutrition
  • Micronutrients –  Iron,  Folic, Vit A /  zinc,  Iodine
  • Coarse grains and cereals (availability)

(c )  Special issue of Journal  of  APJCN:
Title : “The Role of Nutrition-linked Technologies in Human Security”

As regards bringing a special volume of APJCN, the committee deliberated in length and  it was suggested to  bring out a special volume incorporating the entire concept of holistic nutrition with the mandate of not only reaching out through ICT but also through sustainability development sustainability nutritional outlook for health and economic development. It would contain about 14 articles of 6 to 8 pages per article perhaps not exceeding about 96 pages. Will contain preface and recommendations along with the articles. Leading Nutritionists have been invited for the articles and is in the press of receiving the articles and finalizing the volume.
(2) Meeting of Chair, Task Force with President, IUNS  November 3-4, 2004,  Mysore, India
The Second Meeting  of the Task Force was held at CFTRI, Mysore, India Under Chair of Dr. V. Prakash   during November 3-4, 2004. For this meeting Prof. Mark L. Wahlqvist was present who came  as a Chief Guest for Nutrition Society of India Symposium conducted by University of Mysore in collaboration with CFTRI from  November 5-6,2004. Dr. P. Ramesh Kumar, Scientist, CFTRI who assisted the meeting. Dr. Prakash  and  Prof. Mark L.  Wahlqvist  discussed  together the  whole perspective  with regard to articles  for  Asia  Pacific Journal of Clinical Nutrition (APJCN) in a second attempt during this Task Force meeting.  During this course  of the meeting   the Chair has got valuable inputs from Prof. Marika Vicziany through  online. Dr. Prakash and Dr. Mark L. Wahlqvist also  discussed various issues pertaining to   deliberations of CASNA meeting held at CFTRI in the month of August, 2004: Internet Access  and Capacity Building in Africa,  Community Projects with special reference to Rural women entrepreneurship  in Kuppam, Andrapradesh and  Food Proceesing Centre  at B.R.Hills, Karnataka in South India. These 2 places were visited by the IUNS President. Dr. Prakash  indicated that   CFTRI will integrate the community projects  as the  institute has vast experience  in this area. Invited  talks to be given at Durban  Nutrition Safari 2005 were also discussed in the meeting.

(a) Brief on Annual  Meet of Nutrition society of India at CFTRI, Mysore:
The  36th Annual Meet of Nutrition Society of India (NSI)  was held at CFTRI, Mysore from 5-6, November,2004  which was organized by Dept. of Studies in Food Science and Nutrition, University of Mysore, Mysore in collaboration with CFTRI. The Theme of the  Meet is “Bridging the Nutrition  Gap through Value addition”. The meeting had a  total of 1200 Registrants along with more than 1800 participants and the  Key Note Address was  given by Prof. Mark L.. Wahlqvist, President, IUNS.  Dr. V. Prakash has given Presidential address  and emphasized in his speech “If reach out of Nutrition to the Needy matters to us, we shall matter more to reach out”.  Dr. Mark Wahlqvist gave 28th  Gopalan Oration award Lecture entitled “ The Nutrition Science: Solutions  for Development”. Dr. Kamala Krishnaswamy ( President, NSI, India) gave  16th S.G. Srikantia Memorial Award Lecture entitled “Turmeric- “ The  Salt of the Orient is the  Spice of Life”. In addition to these  there are several  Scientific Sessions  with parallel symposia and poster sessions for youngsters. The symposia covered various areas in the fields of   Critical determinants of pregnancy outcome, Community  Nutrition, Experimental Nutrition and  Bridging the Nutrition gap through Value addition with reference to Food Processing, Capacity Building, Traditional knowledge base and Technology Intervention.  In Concluding Session, Dr. Mark Wahlqvist distributed Awards and Certificates to  budding Scientists in the  field of Nutrition.
(3) Next meeting of Task Force, September 2005 at Durban
The next meeting  of this Task Force  is expected  during  18th International Nutritional Congress  to be held at Durban, South Africa during 19-23 September, 2005.