The effect of sugar and processed food imports on the prevalence of overweight and obesity in 172 countries

Abstract

BackgroundStudies find that economic, political, and social globalization – as well as trade liberalization specifically – influence the prevalence of overweight and obesity in countries through increasing the availability and affordability of unhealthful food. However, what are the mechanisms that connect globalization, trade liberalization, and rising average body mass index (BMI)? We suggest that the various sub-components of globalization interact, leading individuals in countries that experience higher levels of globalization to prefer, import, and consume more imported sugar and processed food products than individuals in countries that experience lower levels of globalization.MethodThis study codes the amount of sugar and processed food imports in 172 countries from 1995 to 2010 using the United Nations Comtrade dataset. We employ country-specific fixed effects (FE) models, with robust standard errors, to examine the relationship between sugar and processed foods imports, globalization, and average BMI. To highlight further the relationship between the sugar and processed food import and average BMI, we employ a synthetic control method to calculate a counterfactual average BMI in Fiji.ConclusionWe find that sugar and processed food imports are part of the explanation to increasing average BMI in countries; after controlling for globalization and general imports and exports, sugar and processed food imports have a statistically and substantively significant effect in increasing average BMI. In the case of Fiji, the increased prevalence of obesity is associated with trade agreements and increased imports of sugar and processed food. The counterfactual estimates suggest that sugar and processed food imports are associated with a 0.5 increase in average BMI in Fiji.Electronic supplementary materialThe online version of this article (10.1186/s12992-018-0344-y) contains supplementary material, which is available to authorized users.

A scoping review on economic globalization in relation to the obesity epidemic

“…The reasons for exclusion were that two articles were not directly related to economic globalization, two articles did not report any outcome pertaining to body weight status, four articles were narrative review, commentary, or study protocol instead of original study, and the other six articles were not data‐driven empirical research. In total, 16 articles met the eligibility criteria and were included in the review …”

“…Miljkovic et al reported a positive association between foreign direct investment and obesity among less‐developed countries. Lin et al documented sugar and processed food imports to be positively associated with mean BMI. Barlow et al found that the Canada‐US Free Trade Agreement was associated with a substantial rise in calorie availability in Canada.…”

“…Goryakin et al indicated that technological change accompanied with globalization might lead to a lower cost of energy intake and a higher opportunity cost of energy expenditure, causing an elevated obesity risk. Costa‐Font et al, Lin et al, and Nandi et al argued that new technologies have transformed the nature of workplace, transportation, and leisure activities, which demand less physical activity and encourage a sedentary lifestyle. Oberlander et al mentioned the role of communication technology in promoting social interaction and convergence in food cultures.…”

“…The first pathway shows market deregulation on fast food consumption, tariff reduction, and an increase in foreign investment are associated with increases in BMI and overweight/obesity prevalence in developing nations. Second, the adoption of the modern workplace, domestic technologies, and motorized transportation leads to a lower demand for active commuting, promoting a sedentary lifestyle, and thus, resulting in a higher obesity risk . Third, researchers have documented a positive relationship between social globalization and obesity .…”

Assessing the sustainability of public health in the era of globalization

“…In ecological globalization, which reflects that country is more depending on products from the outside world because of limited space left to produce food. Imported food which usually comes as processed food and not fresh causes health issues like obesity (Lin et al 2018).…”