Trade liberalisation and the nutrition transition: mapping the pathways for public health nutritionists

OBJECTIVE: To describe pathways through which trade liberalisation affects the food environment, relevant to the nutrition transition, in order to enable public health nutritionists to understand trade policy as a macro-level influence on food consumption. DESIGN: The pathways mapped in the present paper are based on the agreements of the World Trade Organization, which shape national policy. Implications for nutrition are presented based on a comprehensive literature review, and case studies are used to illustrate the various pathways. SETTING: Developing countries are currently experiencing a nutrition transition, resulting in dietary patterns associated with chronic disease. Chronic diseases are amenable to prevention, and trade policy has been highlighted as a potential avenue for nutrition-related prevention. RESULTS: Trade liberalisation influences the food environment through facilitating trade in goods and services, enabling investment and decreasing support/protection for domestic industry. These policy outcomes facilitate the nutrition transition particularly through increasing the availability and affordability of processed foods and animal products. The framework highlights the complex relationship between trade policy and the nutrition transition, with both negative and positive outcomes arising from different aspects of trade liberalisation. CONCLUSIONS: Policy change associated with trade liberalisation has created incentives for consumption patterns associated with the nutrition transition, but has also had some positive nutritional outcomes. As a result, it is important for public health nutritionists to consider the implications of trade policy decisions in their efforts to prevent and control diet-related chronic diseases.