Rethinking the "diseases of affluence" paradigm: Global patterns of nutritional risks in relation to economic development

Background Cardiovascular diseases and their nutritional risk factors-including overweight and obesity, elevated blood pressure, and cholesterol-are among the leading causes of global mortality and morbidity, and have been predicted to rise with economic development. Methods and Findings We examined age-standardized mean population levels of body mass index (BMI), systolic blood pressure, and total cholesterol in relation to national income, food share of household expenditure, and urbanization in a cross-country analysis. Data were from a total of over 100 countries and were obtained from systematic reviews of published literature, and from national and international health agencies. BMI and cholesterol increased rapidly in relation to national income, then flattened, and eventually declined. BMI increased most rapidly until an income of about I$5,000 (international dollars) and peaked at about I$12,500 for females and I$17,000 for males. Cholesterol's point of inflection and peak were at higher income levels than those of BMI (about I$8,000 and I$18,000, respectively). There was an inverse relationship between BMI/cholesterol and the food share of household expenditure, and a positive relationship with proportion of population in urban areas. Mean population blood pressure was not correlated or only weakly correlated with the economic factors considered, or with cholesterol and BMI. Conclusions When considered together with evidence on shifts in income-risk relationships within developed countries, the results indicate that cardiovascular disease risks are expected to systematically shift to low-income and middle-income countries and, together with the persistent burden of infectious diseases, further increase global health inequalities. Preventing obesity should be a priority from early stages of economic development, accompanied by population-level and personal interventions for blood pressure and cholesterol.

Is the potential of Coccidoxenoides perminutus, a mealybug parasitoid, limited by climatic or nutritional factors?

The encyrtid Coccidoxenoides perminutus is a widely distributed parasitoid of citrus mealybug (Planococcus citri). Worldwide, it has been implicated in successful biocontrol in only a few widely separated localities. C perminutus contributes little to control P. citri in field situations in south-east Queensland, Australia, but invades insectary cultures and reduces mealybug populations considerably under these controlled conditions. This discrepancy between poor field performance and good performance under controlled conditions was investigated to establish whether climatic factors inhibit the field performance of this species in the biological control of P. citri. Subsequent laboratory examination of the influence of varied humidities and temperatures on the activity levels and survival of C perminutus revealed a low tolerance for high saturation deficits (i.e., low % RH at high T degreesC) with reduced reproductive output. The influence of different food sources on adult survival and reproduction was also quantified, to establish if the adverse effects of climate could be overcome by supplementing adult diet. Neither honeydew from their mealybug hosts nor nectar from Alphitonia flowers significantly enhanced parasitoid survival. A subsequent test of five nectar species revealed a significant difference in their influence on C. perminutus survival and reproduction, with only Alpinia zerumbet proving to be as suitable as honey. The floral species that proved suitable in the laboratory need to be checked for their attractiveness to C perminutus in the field and for their ability to enhance the survival and reproductive output of parasitoids. This information suggests that the prevailing dry conditions in south-east Queensland citrus-growing areas apparently impede successful biological control of P. citri by C perminutus, but possibilities are available for habitat manipulation (by providing suitable nectar sources for adult parasitoids) to conserve and enhance C perminutus activity in the field. (C) 2004 Elsevier Inc. All rights reserved.