It is clear from the nutritional literature that there is no magic bullet to reverse the epidemic of diet-related diseases that have started to affect so many. Lifestyle conditions such as cardiovascular disease, cancer, diabetes and obesity have multi-factorial aetiologies, often relating to detrimental changes in the quality of the diet that results in serious nutritional imbalances. Western nations have moved well into the phase where these disease are established due to complete abandonment of the traditional diets for highly processed, nutrient poor, energy dense foods. It is therefore difficult to investigate the effects of nutritional changes except using retrospective epidemiological data or clinical trials, that suffer from poor reliability and questionably application to the real world, respectively. For this reason studies collecting data from developing nations can shed important light on the transition phases of lifestyle from traditional to modern diets.
For example, researchers1 used descriptive cross-sectional epidemiology to analyse the micronutrient and macronutrient intakes of urban Asian Indians (13 to 25 years) and compared it to the same data collected from fellow countrymen living in rural locations. The results showed that urban subjects ate a significantly higher amount of total fat when compared to rural dwellers. In fact rural fat intake was nearly one third lower than urban counterparts. Comparison of the urban fat intakes with those of young American adults showed that intakes were similar. The authors concluded that the high total and saturated fat was offset by reductions in monounsaturated and n-3 polyunsaturated fats causing an imbalance in nutritional intakes. This is a similar pattern that is seen in Western nations. In the urban subjects, the prevalence of hypercholesterolaemia (>169 mg/dl males, >181mg/dl females) and overweight (body mass index >23.1kg/m2) was 14.4 and 16%, respectively.
These results are interesting in that they suggests that as countries develop, they display distinct patterns of nutritional changes that are similar between distinct geographical regions. The Westernisation of third World countries is likely a contributory factor in the loss of the traditional nutritional practices of these regions. An increase in saturated, total and n-6 polyunsaturated fat to a detriment of the n-3 polyunsaturated fats has been hypothesised to be a major cause of the increasing rates of obesity, cardiovascular disease, metabolic syndrome, diabetes and cancer seen in Western nations. Although data for refined and whole grains were not made in this study, it would be interesting to see if the pattern of change for urban dwelling was away from high fibre whole grains to more energy dense refined carbohydrates that are also associated with the development of lifestyle disease.
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