Dietary Transitions and Health Outcomes in Four Populations – Systematic Review

• Published in: Frontiers in Nutrition
• Main Authors: Mariel Pressler, Julie Devinsky, Miranda Duster, Joyce H. Lee, Courtney S. Glick, Samson Wiener, Juliana Laze, Daniel Friedman, Timothy Roberts, Orrin Devinsky
• Format: Article in Journal/Newspaper
• Language: English
• Published: Frontiers Media S.A. 2022
• Subjects: obesity; diabetes; western diseases; refined carbohydrates; nutrition transition; Nutrition. Foods and food supply; TX341-641; inuit
• Online Access: https://doi.org/10.3389/fnut.2022.748305; https://doaj.org/article/f34d40439ff54acda06de9e17e1d0fcb

ImportanceNon-communicable chronic diseases (NCDs) such as obesity, type 2 diabetes, heart disease, and cancer were rare among non-western populations with traditional diets and lifestyles. As populations transitioned toward industrialized diets and lifestyles, NCDs developed.ObjectiveWe performed a systematic literature review to examine the effects of diet and lifestyle transitions on NCDs.Evidence ReviewWe identified 22 populations that underwent a nutrition transition, eleven of which had sufficient data. Of these, we chose four populations with diverse geographies, diets and lifestyles who underwent a dietary and lifestyle transition and explored the relationship between dietary changes and health outcomes. We excluded populations with features overlapping with selected populations or with complicating factors such as inadequate data, subgroups, and different study methodologies over different periods. The selected populations were Yemenite Jews, Tokelauans, Tanushimaru Japanese, and Maasai. We also review transition data from seven excluded populations (Pima, Navajo, Aboriginal Australians, South African Natal Indians and Zulu speakers, Inuit, and Hadza) to assess for bias.FindingsThe three groups that replaced saturated fats (SFA) from animal (Yemenite Jews, Maasai) or plants (Tokelau) with refined carbohydrates had negative health outcomes (e.g., increased obesity, diabetes, heart disease). Yemenites reduced SFA consumption by >40% post-transition but men's BMI increased 19% and diabetes increased ~40-fold. Tokelauans reduced fat, dramatically reduced SFA, and increased sugar intake: obesity and diabetes rose. The Tanushimaruans transitioned to more fats and less carbohydrates and used more anti-hypertensive medications; stroke and breast cancer declined while heart disease was stable. The Maasai transitioned to lower fat, SFA and higher carbohydrates and had increased BMI and diabetes. Similar patterns were observed in the seven other populations.ConclusionThe nutrient category most strongly ...