No abstract

The principal nutritional problems of developed economies are related to the excessive and unbalanced intake of energy and nutrients. During the 20th century, as economies improved and food production became more efficient, conditions related to undernutrition were replaced by epidemics of coronary heart disease, certain cancers and other chronic conditions related to food overconsumption. In developed countries such as the United States, obesity became the predominant public health nutrition problem. To prevent obesity, people must consume less energy and be more active, but the food supplies of developed economies offer their populations amounts of energy that greatly exceed physiological need. Food overproduction causes competition in the food industry, limits its expansion, and leads food producers to invest heavily in marketing. To increase sales, food companies must encourage people to consume more of their products, substitute their products for others or develop new markets. Such efforts create an environment in which food is readily available at all times and readily overconsumed. Marketing expenditures for any single food product greatly exceed the total amounts available to governments for national campaigns to prevent chronic diseases. Existing government policies often support this environment through price supports and other means. To reverse obesity and its health consequences, governments need to consider ways to address the food environment through policies in education, agriculture, school meals, pricing, taxation and other means, as well as to develop mechanisms to fund new programme initiatives.