The Nutrition Transition

Modernization, urbanization, economic development, and increased wealth lead to predictable shifts in diet, referred to as “nutrition transitions.” (1, 2) Researchers divide the nutrition transition into five patterns:

  • Pattern 1 Hunter Gatherer: Individuals live highly active lifestyles, hunting and foraging for food. Diets typically are rich in fibrous plants and high in protein from lean wild animals.
  • Pattern 2 Early Agriculture: Famine is common, slowing individuals growth and decreasing their body fat.
  • Pattern 3 End of Famine: Famine recedes as income rises and nutrition improves.
  • Pattern 4 Overeating, Obesity-Related Diseases: As income continues to rise, individuals have access to an abundance of high-calorie foods, and they become less active, leading to increases in obesity and obesity-related chronic diseases, such as diabetes and heart disease.
  • Pattern 5 Behavior Change: In response to increasing rates of obesity and obesity-related chronic diseases, individuals change their behaviorand communities promote behavior changesto prevent these conditions.

Currently, most low- and middle-income countries are rapidly moving from pattern 3 (end of famine) to pattern 4 (consuming more energy-dense diets). This shift from traditional diets to Western-style diets has been a key contributor to the obesity epidemic in low- and middle-income countries.


1. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008; 93:S930.

2. Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006; 84:28998.