January 16, 2006
As the Times series has amply shown, our health suffers when we rely on fast foods and sugary drinks to sustain ourselves. But in places where malnourishment and poverty are rampant, the ramifications are even more profound.
In Western countries the transition from hardscrabble malnourishment to today’s drive-through, fast-food cornucopia occurred over centuries, with the happy result that our societies were able to control infectious diseases spread by hunger and poverty before facing the maladies of richly calorific diets, including diabetes, obesity and heart disease. As anyone who has seen the KFCs and Pizza Huts sprouting along the alleys of Mumbai and Cape Town knows, in developing countries, no such time lag exists. What experts call the “nutrition transition” is taking place within a single generation.
According to recent research, malnourished mothers tend to bear babies predisposed to storing excess energy as fat. This is a useful adaptive advantage in communities where calories are often scarce, enabling babies to survive nutritional deficits. But when such babies grow up to consume Western-style diets chock-full of fatty, sugary foods, that benefit turns into a deadly curse, leading them to gain disease-causing extra fat much more rapidly than they would have otherwise. And so, hot on the heels of the multinational soft drink and fast food companies in poor countries has been an epidemic of chronic disease.Today, four of out five people who die of chronic, noncommunicable diseases such as diabetes and heart disease perish not in New York or California but in developing countries, according to the World Health Organization. More Indians and Chinese suffer cardiovascular disease than Americans, Japanese, and Europeans put together.
Diabetes and coronary heart disease are epidemic in India, which is home to the greatest concentration of Type II diabetes sufferers in the world. In some areas of Africa, as many as one in five has diabetes. Nearly 20 million Africans suffer from hypertension. Worse, while diabetes in rich countries is primarily a condition of the elderly, in developing countries the disease strikes those in the prime of life, aged forty-five to sixty-five, slashing their average life expectancy by ten to fifteen years. For developing countries barely treading water amid the flood of malnutrition, HIV infection, malaria, and tuberculosis, “the public health implications of this phenomenon are staggering,” the WHO has noted, “and are already becoming apparent.”
The era of strings-attached IMF and World Bank loans, which forced the dismantling of many indebted countries’ public-health infrastructures, is partly to blame. Global trade agreements forged throughout the 1990s eased the entry of soda makers and fast-food companies into the emerging markets of the developing world. As we start to address the deadly legacy of hyper-marketed fast foods and sodas here at home, we should remember that the problem does not end at the corner Burger King. We’ve spread the problem beyond our borders, where its effect is likely to be much worse.
