"The dietary transition in the developing world is accelerating toward an increased burden of chronic disease. It is increasing human mortality and disease burdens, and it is lowering economic productivity. The dietary transition is driven by changing preferences fueled by growing incomes, changing relative prices, urbanization, and food technology and distribution systems. This paper identifies policy options from the food supply and demand sides that can influence the transition toward increasingly healthy outcomes. These options have had mixed success in industrialized countries, and the policy tradeoffs in the developing world will be even more complicated. Additional technical research is needed to assess competing risks and help develop policy options. There is also a need for research to engage different actors in the policymaking process. In a debate in which much is at stake, there is a potentially powerful role for researchers to bring these actors to the table. In the end, this may help improve the decisionmaking processes underlying food policies that aim to redirect the diet transition toward healthier outcomes. " Authors' Abstract

Haddad, Lawrence James

English

Research Papers in Economics

Discussion Paper 154 
Discussion Paper 165 
What Can Food Policy Do to Redirect the Diet Transition? 
Lawrence Haddad 
n the twenty-first century, developing countries will have to 
cope with the transition from acute disease to acute plus 
chronic disease. The two main contributors to this trend are 
diet and activity levels, both of which are changing at 
historically rapid rates. This paper focuses on dietary changes. 
Where good data on food consumption are available, they show 
that the availability and intake of foods that are risk factors for 
chronic diseases are increasing rapidly in urban and rural areas 
and across all income groups. Increases in overweight and 
obesity rates in the developing world show similar patterns. The 
coexistence of a double burden of undernutrition and “over-
nutrition” adds to human suffering and economic costs. It also 
complicates the design of food policy. 
This paper asks: “What can food policy do to redirect the 
transition in diets toward healthier outcomes?” The paper 
reviews the drivers of the changes in diet and the potential of 
both demand- and supply-side food policy options to influence 
the drivers. The paper ends by highlighting the challenges posed 
to food policy design by the coexistence of—and linkages and 
trade-offs between—under- and overnutrition. 
Drivers of Dietary and Nutrition Trends 
The commonly listed drivers of consumption trends include 
(1)  income growth, (2) changes in relative prices caused by 
technology, institutional, and policy changes, and (3) the socio-
economic and activity changes associated with urbanization. 
As income grows, consumers want to diversify out of 
cereals and other starchy staples. The consumption of the 
poorest households tends to be most responsive to increases in 
income. Preliminary simple regression analysis of producer 
prices in Nigeria, South Africa, and India did 
not demonstrate any significant systematic 
differences in relative price increases by food 
category. In China, however, oils low in 
saturated fats (soybean, sunflower, rapeseed, 
and sesame) posted significantly higher price 
increases over the 1976-95 period than palm 
oil (high in saturated fat), which showed one 
of the lowest price increases over the period. 
In the United States, the price of nonalco-
holic beverages (dominated by carbonated 
sweetened soft drinks) dropped dramatically 
over the 1982-97 period compared to an all-food average, as 
have the prices of dairy products, fats and oils, eggs, meat, 
poultry, and fish. Projections of the internationally traded prices 
for nonstaple, nonfruit, and nonvegetable goods indicate a con-
tinuation of these trends. 
More analyses of past trends in producer and retail food 
prices need to be undertaken from a health perspective. For 
example, we do not have consumer food price trends by fat 
content or, preferably, by type of fat content. Such trends would 
help identify the main sources of any decline or increase in the 
price of fat or added sugar. Such information, as we will see, is 
important for policy formulation. In addition, more studies are 
needed that seek linkages between price trends and health 
outcomes. Many studies link undernutrition to price changes but 
few link rates of chronic disease or obesity to relative price 
changes while controlling for a range of other factors. Two of 
the few such studies to do so using U.S. data suggest that 40 
percent of the growth in weight of the U.S. population between 
1976 and 1994 is due to technology-based reductions in food 
prices. 
Technology innovation and policy may be one important 
source of change in the relative prices of foods that pose a 
chronic health risk; institutional policy changes are another. For 
example, more research is needed from a health perspective on 
how trade liberalization (e.g., China’s membership of the WTO 
and its impact on edible oil prices faced by Chinese consumers) 
will affect the price of different foods that represent different 
health risks. 
Urbanization is proceeding rapidly in the developing world 
and is accompanied by a marked reduction in physical activity 
for the majority of the labor force. The higher population density 
of urban areas lowers the per person cost of mass-media 
advertising, where the spending power of food manufacturers 
and processors surely outweighs that of public health authorities. 
The urban environment is also marked by a greater physical 
disconnect between places of work and residence and smaller 
household sizes, especially for women. In this environment, free 
time is scarcer, at least for those gainfully employed, and where 
the fixed costs of food preparation are higher in smaller families, 
more food tends to be purchased outside the home even for poor 
households.  This food tends to be much more highly processed, 
and higher in salt and fat. 
What Can Food Policy Do? 
What is the rationale for 
public action to steer the diet 
transition toward greater 
healthiness? Perhaps the most 
obvious rationale is informa-
tion asymmetry between 
producers and consumers 
about what is and is not 
healthy. The paper reviews 
options from the supply and 
demand sides and discusses some of the trade-offs between 
addressing under- and overnutrition that are accentuated in 
developing countries. 
Possible supply-side interventions considered include 
(1)  more public investment in technology to deliver high-
productivity, low-cost vegetables and fruits and low-fat live-
stock products to poorer consumers, (2) eliminating incentives 
on growing high-fat foods and relaxing restrictions on growing 
healthier foods, and (3) evaluating food trade policy from a 
health perspective. 
Demand-side interventions considered include (1) increasing 
the relative cost of purchasing  unhealthy choices (either through  
I
Discussion Paper BRIEFS 
Food Consumption and Nutrition Division of the International Food Policy Research Institute 
What can food policy do to redirect the 
diet transition? We have identified a 
number of options on the supply and 
demand sides. These have had mixed 
success in industrialized countries. The 
policy trade-offs in the developing world 
are even more complicated. changing location of purchases or price), (2) providing clearer 
information about product contents, and (3) improving aware-
ness about consequences of poor diet. 
Policy formulation on dietary change in the developing 
world must build on the evidence base accumulated in the 
industrialized world. However, the developing country context 
is very different. First, policymakers in the developing world are 
faced with food consumption deficits. Second, certain groups 
need to consume even foods that are “empty” sources of the 
dietary component being discouraged, e.g., edible oils, to in-
crease the energy density of infant complementary foods. Third, 
the capacity to influence preferences via the public sector is 
likely to be lower than in the industrialized world. 
Finally, it is important to note that food represents a class of 
commodities that is difficult to influence in a predictable 
manner—for example, efforts to increase the price of high fat 
products will also increase the price of any micronutrients they 
contain. Moreover, food is not yet like tobacco, in that there are 
fewer “triggers” in place for strong public action to occur. 
Information and Analysis Gaps
Research in the area of diet transition in developing countries is 
in its infancy. Most of the work has been spent documenting the 
transition and, to a lesser extent, analyzing its causes. Much of 
this work has made do with crude food consumption data, and 
very little research has focused on policy analysis. 
The paper suggests that (among other things) there is a need 
to (1) use existing nationally representative household survey 
data to systematically chart trends in availability of “bad” diet 
components, (2) better connect the location of food purchase and 
the health content of that purchase, (3) generate food-price 
elasticities for large developing countries that are disaggregated 
enough to be policy relevant (e.g., “edible oil” is not useful, but 
“high-saturated fat edible oil” is), (4) evaluate nonprice inter-
ventions to change diets, both in terms of quality and quantity, 
(5) spell out the trade-offs in terms of the consumption changes 
of different dietary components of different population sub-
groups resulting from the change in the price of a single 
community and the implications for smallholder income genera-
tion, and (6) conduct more research on the investments and 
institutional innovations that smallholder farmers need to link up 
with growing domestic and international markets for healthy 
foods.
Conclusion 
The diet transition in the developing world seems to be 
accelerating. It seems to be a transition toward an increased 
burden of chronic disease. It is increasing human costs in terms 
of mortality and the disease burdens, and it is increasing 
economic costs in terms of lower productivity. It is driven by 
changing preferences fueled by growing incomes, changing 
relative prices, and urbanization; by changing food choice 
options fueled by changes in food technology and in food 
distribution systems; and by a legacy of low birth weights from 
the previous generation. Is there a case for public investment in 
efforts to influence the transition toward increasingly healthy 
outcomes? The existence of information asymmetries and 
negative externalities suggests that there is. 
What can food policy do? We have identified a number of 
options from the food supply and demand sides. These options 
have had mixed success in industrialized countries. The policy 
trade-offs in the developing world are even more complicated. 
For example, efforts to overcome overnutrition might undermine 
efforts to overcome undernutrition. The public health anti-
smoking policy model offers some insights, but it should not be 
leaned on too heavily—food is not tobacco. There are plenty of 
areas in which additional technical research is needed to assess 
competing risks and to help develop policy options. But there is 
also a great need for research to engage actors in the policy 
process underlying the diet transition. In a debate where so 
much is at stake—market shares, profits, livelihoods, and life 
itself—there is a potentially powerful role for researchers to 
bring different actors to the table. This may help to improve the 
decisionmaking processes underlying the attempts of food 
policy to redirect the diet transition toward healthier outcomes. 
Keywords: food policy, diet transition, health outcomes 
Copyright © 2003 International Food Policy Research Institute. The full text of this document and other FCND Discussion 
Papers are available on our Website (www.ifpri.org/divs/fcnd/dp.htm) or via M.Aspillera@cgiar.org
FCND BRIEFS 
International 
Food 
Policy 
Research
Institute
2033 K Street, N.W. 
Washington, D.C. 20006 U.S.A. 
What can food policy do to redirect the diet transition? 
We have identified a number of options on the supply 
and demand sides. These have had mixed success in 
industrialized countries. The policy trade-offs in the 
developing world are even more complicated.—DP165

What can food policy do to redirect the diet transition?

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What can food policy do to redirect the diet transition?

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