Large-scale interventions and programmes addressing nutrition-related chronic diseases and obesity: examples from 14 countries.

Developing countries are clearly facing a double burden of disease. The prevalences of overweight and obesity are rising among adults simultaneously with high rates of undernutrition among children. Consequently, nutrition-related chronic diseases, such as cardiovascular disease and diabetes, are emerging as concerns in developing countries. These concerns are combined with the continued need to address undernutrition and infectious disease. Overweight and obesity are increasing in Chile among low-income groups and poor communities. There is a triple burden of disease in South Africa, described by Vorster. These are poverty-related infectious diseases, including HIV/AIDS, violence-related injuries and an increase in lifestyle-related non-communicable diseases. The burden of obesity and cardiovascular disease in the more developed regions of Brazil is also emerging among the poor. As nutrition-related chronic diseases become more prevalent, limited resources will be further strained by the simultaneous cost of addressing infectious disease and undernutrition, while treating nutrition-related chronic diseases. Early prevention is essential in order to prevent the epidemic. As Reddy states in this supplement, prevention is a necessary, cost-effective means of avoiding the high social, biological and economic costs of a treatment-based approach to nutrition-related chronic diseases. Thus, as a part of this meeting, we considered programmes in developing countries that have sought to intervene early to prevent obesity and nutrition-related chronic diseases.