Rethinking the "diseases of affluence" paradigm: global patterns of nutritional risks in relation to economic development

This paper, published in the Public Library of Science Medicine, examines the global health effects of economic development, focusing on cardiovascular diseases and their nutritional risk factors, including overweight and obesity, elevated blood pressure, and cholesterol. The paper highlights findings from a study which used data from over 100 countries to examine the relationship between mean (average) blood pressure, cholesterol, and body mass index (BMI) and the following factors: national income, average share of household expenditure spent on food, and the proportion of the population living in urban areas. Results showed that BMI/cholesterol both increased in relation to national incomes, most rapidly up to an income of 5,000 US dollars (adjusted for inflation and for differences between countries in purchasing power). Higher BMI and cholesterol levels were also associated with lower household spending on food, and with urbanisation.

The authors argue that cardiovascular disease can no longer be classified as a disease of the rich. Cardiovascular disease risks can be expected to systematically shift to low- and middle-income countries and, together with the persistent burden of infectious diseases, further increase global health inequalities. The paper recommends that preventing obesity should be a priority from early stages of economic development, accompanied by population-level and personal interventions for blood pressure and cholesterol.