A Tanzanian perspective on the nutrition transition and its implications for health

OBJECTIVE: The purpose of this paper is to describe social and economic changes related to shifts in diet and activity and to present prevalences for chronic diseases associated with the nutrition transition. DESIGN: Observations about social changes are descriptive, based on published reports and personal observations. Prevalence and trends data are based on a Ministry of Health published report and, for infants and toddlers, on primary data. SETTING: Disease prevalences for diabetes mellitus and hypertension are taken from four sites, representing underdeveloped, semi-developed and well-developed rural communities and Dar es Salaam, the largest city in Tanzania. The prevalences of underweight and overweight for infants and toddlers are taken from a small periurban clinic in Tanzania. SUBJECTS: Adults over 15 years of age are included in the prevalence data for chronic disease. The urban sample is stratified by occupation and ethnicity. The data for infants and toddlers include newborns to those aged 23 months. RESULTS: An increase in the prevalence of diabetes and hypertension was observed. Simultaneously, there have been rapid changes in diet and physical activity related to urbanisation and modernisation. The highest prevalences for diabetes and hypertension were among high-ranking executives. CONCLUSION: The increase in chronic disease could be related to the rise in the number of high-ranking executives. Simultaneously, per capita income has gone down, and malnutrition prevalence has risen. Programmes are being developed to simultaneously monitor trends in overweight while preventing protein-energy malnutrition and micronutrient deficiency.