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Trade liberalization remains at the forefront of debates around globalization, particularly around the impact on agriculture and food. These debates, which often focus on how poorer countries can 'trade their way' out of poverty, pay limited attention to dietary health, especially in the light of the WHO's Global Strategy for Diet, Physical Activity and Health (2004), which warned that future health burdens will be increasingly determined by diet-related chronic diseases. This article examines the diet transition as the absent factor within debates on liberalizing trade and commerce. We describe the evolution of trade agreements, noting those relevant to food. We review the association between trade liberalization and changes in the global dietary and disease profile. We illustrate some of the complex linkages between trade liberalization and the 'diet transition', illustrated by factors such as foreign direct investment, supermarketization and cultural change. Finally, we offer three scenarios for change, suggesting the need for more effective 'food governance' and engagement by public health advocates in policy making in the food and agriculture arena.

In Europe, concerns about obesity have been stimulated by trends in several member states, raising challenges for multilevel governance. This paper gives a picture of obesity in Europe, pointing to variations between and within countries. It discusses the various explanations of generalized weight gain, and the policy levers that might tackle it, the paper also maps current policy responses. Policy considerations raised include financial burdens, health-care management, social inequalities, cultural issues, welfare support, and farm and food industry drivers. The paper proposes that obesity is unlikely to be reduced unless it receives both multi-level and multi-field analysis and intervention. In this context, action in Europe is hampered by a fragmented institutional architecture at all levels of governance. It also raises serious questions about the unequal relations between the state, the market and civil society within Europe. The paper concludes with a suggestion that obesity warrants improved European linkages across discrete areas of policy.

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