Epidemiological and nutrition transition in developing countries: impact on human health and development

Whereas common infectious and parasitic diseases such as malaria and the HIV/AIDS pandemic remain major unresolved health problems in many developing countries, emerging non-communicable diseases relating to diet and lifestyle have been increasing over the last two decades, thus creating a double burden of disease and impacting negatively on already over-stretched health services in these countries. Prevalence rates for type 2 diabetes mellitus and CVD in sub-Saharan Africa have seen a 10-fold increase in the last 20 years. In the Arab Gulf current prevalence rates are between 25 and 35% for the adult population, whilst evidence of the metabolic syndrome is emerging in children and adolescents. The present review focuses on the concept of the epidemiological and nutritional transition. It looks at historical trends in socio-economic status and lifestyle and trends in nutrition-related non-communicable diseases over the last two decades, particularly in developing countries with rising income levels, as well as the other extreme of poverty, chronic hunger and coping strategies and metabolic adaptations in fetal life that predispose to non-communicable disease risk in later life. The role of preventable environmental risk factors for obesity and the metabolic syndrome in developing countries is emphasized and also these challenges are related to meeting the millennium development goals. The possible implications of these changing trends for human and economic development in poorly-resourced healthcare settings and the implications for nutrition training are also discussed.

Peat, pine stumps and people: interactions behind climate, vegetation change and human activity in wetland archaeology at Loch Farlary, Northern Scotland

First paragraph: In 1993, a peat-cutter, Bruce Field, working on the blanket peat bank he rented from the Sutherland Estate by Loch Farlary, above Golspie in Sutherland (fig 1), reported to Scottish Natural Heritage and Historic Scotland several pieces of pine wood bearing axe marks. Their depth in the peat suggested the cut marks to be prehistoric. This paper summarizes the work undertaken to understand the age and archaeological significance of this find (see also Tipping et al 2001 in press). The pine trees were initially thought to be part of a population that flourished briefly across northern Scotland in the middle of the Holocene period from c 4800 cal BP (Huntley, Daniell & Allen 1997). The subsequent collapse across northernmost Scotland of this population, the pine decline, at around 4200-4000 cal BP is unexplained: climate change has been widely assumed (Dubois & Ferguson 1985; Bridge, Haggart & Lowe 1990; Gear & Huntley 1991) but anthropogenic activity has not been disproved (Birks 1975; Bennett 1995). It was hypothesized that the Farlary find would allow for the first time the direct link between human woodland clearance and the Early Bronze Age pine decline.