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Over the past 20 years, low- and middle-income countries have experienced progressive urbanisation and a shift from predominantly plant-based low-energy-density diets and high levels of physical activity to increased consumption of energy-dense processed food (high in fat and sugars) and animal-food products, with increased levels of inactivity during work and leisure.1 The not-unexpected yet remarkable consequence of this process has been the unprecedented rise in the prevalence of obesity, which is now reaching epidemic proportions globally. Among countries undergoing such a transition, the epidemic first affected urban middle-aged women, later extending to adolescents and children of low socioeconomic income groups.2–4 Using International Obesity Taskforce (IOTF) criteria, it is estimated that by 2010 almost 50% of school-aged children in the Americas, 40% of children in the Eastern Mediterranean region (including Pakistan), 33% of children in the Western Pacific region and 20% of children in South East Asia will be overweight.5
The obesity epidemic in the developing world will probably have a direct bearing on the prevalence of related conditions such as diabetes, cardiovascular disease and some forms of cancer.6 Indeed, the most recent WHO estimate of distribution of deaths from non-communicable chronic diseases (NCDs) indicates that 80% of all deaths from …
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