Trade and the Nutrition Transition: Strengthening Policy for Health in the Pacific

Abstract

This article describes pathways through which trade policy change in two Pacific Island countries has contributed to changes in the food supply, and thereby to the nutrition transition. The effect of various trade policies from 1960 to 2005 on trends in food imports and availability is described, and case studies are presented for four foods associated with the nutrition transition and chronic disease in the Pacific. Trade policies (including liberalization, export promotion, protection of the domestic meat industry and support for foreign direct investment) have contributed to a reduced availability of traditional staples, and increased availability of foods associated with the nutrition transition, including refined cereals (particularly polished rice and white flour), meat, fats and oils, and processed food products. This study suggests that promoting healthier imports and increasing production of healthier traditional foods, in both of which trade policy has an important effect, has the potential to improve diets and health, in conjunction with other public health intervention.

Systematic Review of Prevalence of Young Child Overweight and Obesity in the United States–Affiliated Pacific Region Compared With the 48 Contiguous States: The Children’s Healthy Living Program

“…47 Globalization 48 and trade policies placed pressures on food security. 48,49 The introduction of a cash economy 50 and other social, economic, and political changes contributed to a nutritional and epidemiological transition that resulted in an increase in chronic diseases.…”

A new generation of trade policy: potential risks to diet-related health from the trans pacific partnership agreement

“…These trends have been supported by further liberalisation under CAFTA, with an expected increased production of processed foods by US companies based in Central America, as well as by domestic companies (due to a more competitive market environment) [32]. Similarly, investment in Fiji by TNCs has increased availability and consumption of processed foods [37]. Stuckler etal have shown that FDI liberalisation through trade agreements with the USA significantly increased the consumption of soft drinks within the signatory country, consequently increasing the risk of some NCDs [45].…”

Trade as a structural driver of dietary risk factors for noncommunicable diseases in the Pacific: an analysis of household income and expenditure survey data

“…Diets in PICs have undergone a major transformation in recent history, with energy-dense, nutrient-poor processed foods having largely replaced traditional whole foods. A comprehensive review of dietary studies over time shows how food patterns have rapidly evolved from traditional low-fat diets–typically based on locally produced complex carbohydrates, fish, fresh meat and leafy greens – towards increased consumption of imported refined starch, oils, fatty processed meats and fish (tinned), sugar and confectionery [4,6]. Often referred to as the ‘nutrition transition’, this gradual process was significantly influenced by colonization and World War II, which opened up transportation and trade routes to the Pacific Islands and facilitated the increased availability of imported foods [4,6].…”

“…PICs’ trade policies since the 1960s are considered to have had a major precipitating effect on the nutrition transition by increasing the availability of imported and increasingly processed foods [4,6,7,11,12]. Consumption of these foods has followed in line with their increased availability and the monetization of island economies.…”

“…The review also noted that imported fat has been added to and not replaced existing traditional fat sources. The impact of trade on diets has particularly intensified since the mid-1990s when trade and investment liberalization accelerated the penetration of transnational food companies [6,11,12]. As a result of these changes, cereal products that are not produced locally (e.g., polished rice and bleached flour) have become the largest sources of energy, deepening both dietary transformations in and food dependency of PICs [4,6,7].…”