Redirecting The Diet Transition: What Can Food Policy Do?: Lawrence Haddad
Redirecting The Diet Transition: What Can Food Policy Do?: Lawrence Haddad
Where good data on food consumption are available they show that the availability and
intake of foods that are risk factors for chronic diseases – such as cardiovascular
disease, diabetes, and some forms of cancer – are increasing rapidly in both urban and
rural areas and across all income groups in developing countries. Increases in
overweight and obesity rates in the developing world show similar patterns (see Popkin
1998, 2001; Guo et al., 2000a). The co-existence of a double burden1 of under-nutrition
and ‘over-nutrition’2 adds to human suffering and economic costs (see Popkin et al.,
2001 for estimates of these costs for some Asian countries). It also complicates the
design of food policy.
What can food policy do to redirect the transition in diets towards healthier
outcomes? This article reviews the drivers of changes in diet and then reviews the
potential of both demand- and supply-side food policy options to influence the drivers.
∗
Director, Food Consumption and Nutrition Division, International Food Policy Research Institute,
Washington, DC ([email protected]). He wishes to thank Mary Arimond, Marie Ruel, Amalia Waxman,
Rajul Pandya-Lorch and seminar participants at IFPRI, WHO, OECD, Cornell University and USDA/ERS
for their many helpful comments and suggestions on this article. All errors are the author’s.
1. See WHO website (www.who.int/nut/db_bmi.htm) for data on the population co-existence of underweight
and overweight and see Garrett and Ruel (2003) for the co-existence in the same household.
2. In a scientific sense the term ‘over-nutrition’ lacks consensus. In this article we use the term as useful
shorthand for excess consumption of added sugar, processed meats, red meats, starch from refined grains
and potatoes, dairy products, trans isomers of fatty acids (found in partially hydrogenated vegetable oils
found in some margarines and shortening), saturated fat, cholesterol, and overall calories – no matter the
source – which leads to overweight and obesity. The term over-nutrition is problematic in that it focuses
on excess consumption of some diet components, but what is displaced from the diet by these unhealthy
foods matters as well. In particular, the consumption of fruits and vegetables, nuts and pulses, poultry and
fish, healthy oils and fats, and whole grains are thought to be health-promoting and increased intakes
should be encouraged (see WHO/FAO, 2002; Willett and Stampfer 2002; McCullough, 2002).
Overseas Development Institute, 2003.
Published by Blackwell Publishing, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA.
600 Lawrence Haddad
The article ends by highlighting the difficult challenges posed to food policy design by
the co-existence, linkages and trade-offs between under- and over-nutrition.
The drivers of consumption trends include (a) income growth, (b) changes in relative
prices caused by technological, institutional and policy change and (c) the socio-
economic and activity changes associated with urbanisation.
Income growth
We know that as income grows, consumers want to diversify out of cereals and other
starchy staples. Data from USDA (Regmi, 2001) on how food expenditure responds to
increases in income (food expenditure-income elasticities) across a number of
developing countries show that the poorest countries have the highest elasticities. Fish,
then dairy and then meats have the highest values followed by fruit and vegetables, oils
and fats and lastly cereals. Elasticities may increase in the short term; for example, data
from China (Guo et al., 2000b) show that the income elasticities for pork and oil
increased between 1989 and 1993, more so at the lowest income levels, especially for
edible oil.
Relative prices
Basic economics tells us that if the relative price of a foodstuff increases, demand for it
will decrease. How have the relative prices of different foodstuffs changed over time?3
In the United States, the relative prices of dairy products, fats and oils, eggs, meat,
poultry and fish, and sugar and sweets have dropped dramatically over the period 1982-
97, as has the price of non-alcoholic beverages (dominated by carbonated sweetened
soft drinks) (Putnam and Allshouse, 1999). Future projections of the internationally
traded prices for non-staple non-fruit and non-vegetable goods, whenever available,
indicate a further decline in their prices relative to cereals (Delgado et al., 1999).4
More analyses need to be undertaken from a health perspective of past trends in
producer and retail food prices. For example, we do not have consumer food price
trends by fat content or, even better, by type of fat content. Such trends would help
identify the main sources of any decline or increase in the price of fat or added sugar –
obviously important for policy formulation. In addition, there need to be more studies
linking price trends to health outcomes. There are many linking under-nutrition
outcomes to price changes (for example Pitt and Rosenzweig, 1986), but few linking
3. One price that we do not examine here is the wage rate, which has risen for occupations that tend to be less
physically demanding. This, of course, is the other side of the coin, but one which, for now, we ignore
with respect to what food policy can do.
4. Preliminary simple regression analysis of FAOSTAT’s producer price series (no retail prices were
available) for Nigeria, South Africa, India and China did not demonstrate any significant systematic
differences in relative price increases by food category, with the exception of China where oils low in
saturated fats (soybean, sunflower, rapeseed, and sesame seed) posted significantly higher price increases
over the 1976-95 period compared to palm oil which showed one of the lowest price increases over that
period.
Redirecting the Diet Transition: What Can Food Policy Do? 601
rates of chronic disease or levels of obesity to relative price changes, controlling for a
range of other factors. One of the few such studies to do so, using US data, suggests that
40% of the growth in weight of the US population between 1976 and 1994 was due to
technology-based reductions in food prices (see Lakdawalla and Philipson, 2002;
Philipson and Posner, 1999).
Technology may be one important source of change in the relative prices of foods
that pose a chronic health risk; institutional change is another. Examples of the latter
include (a) trade policy governance and (b) changing food distribution mechanisms. An
illustration of the first is the entry of China into the World Trade Organization, expected
by many (for example, Fang and Beghin, 2000) to lead to a 20% decline in the prices
paid by consumers in China for soybean oil and related products. More research is
needed from a health perspective on how trade liberalisation will affect the prices of
different foods that represent different health risks.
An illustration of institutional policy changes, fuelled in part by technology
changes, is the rapid transformation of food retailing in Latin America. Reardon and
Berdegué (2002) report that the percentage of food distributed by supermarkets in retail
outlets in the region grew from 10-20% in 1990 to 50-60% in 2000, driven by
liberalisation of financial flows and developments in inventory management
technology. These changes are also happening in Asia and Africa (Reardon et al., 2003).
Do these supermarkets provide poorer consumers with increased access to more
unhealthy processed foods (for example, those with high levels of trans fatty acids)? Do
they also provide increased access to fresh fruit and vegetable products and other
healthy diet components? What happens to the choice sets of those who do not use
supermarkets? These issues have not been investigated yet. More research is needed to
identify the trade-offs between healthy foods and healthy profits.5
Urbanisation
5. Reardon and Berdegué (2002) note that profit margins are highest on fresh fruit and vegetables, but are
also high on dairy and processed foods.
602 Lawrence Haddad
particularly true for poorer urban dwellers compared to the more wealthy group. A
recent Accra-wide study (Maxwell et al., 2000) finds that households in the poorest
expenditure quintile obtain on average 31% of their total calories away from home,
compared to 22% for the top quintile (see Figure 1).
6 1.6
3 1.4 30
27 .5 28.8
2 4.3 22 .5
20 .2
1 5.1
10
MSource: Maxwell
axw ell et. et al.
al., 2000 (2000).
Tinker, in her study of street foods in seven countries of Asia and Africa, shows
expenditures on street foods ranging from 16% in Manikgani (Bangladesh) to 50% in
Ile-Ife (Nigeria), and higher street foods expenditures among the poorest quartiles in
both Bangladesh and the Philippines (Iloilo) (Tinker, 1997). Very little information is
available on the contribution of street foods to the daily nutrient intake of consumers. In
the Philippines, commercially prepared foods were found to contribute 25% of the
energy intake of urban working women and 45% of their fat intake (Bisgrove and
Popkin. 1996). In the US, data from the Department of Agriculture (Lin et al., 2000)
show that the saturated fat content of foods consumed at home has dropped steadily
over the 1980s and 1990s, whereas the fat content in fast food restaurants and in schools
has remained high (see Figure 2).
Location clearly matters, but does it matter when price and income are controlled
for? That it does is clearly shown by a modelling exercise for China, where food
consumption shifts due to rural-to-urban migration were modelled, controlling for prices
and income levels (Huang and Bouis, 1996). The results are presented in Figure 3.
Interestingly, in this case, urbanisation seems to have led to a large increase, all things
being equal, in the consumption of fruit, a moderate increase in the consumption of
meat, fish, milk and eggs, and a moderate decline in the consumption of all other foods.
Clearly, one cannot generalise too much about the urban experience before more studies
of this type are undertaken.
125
26
Table 1 summarises the rationale for public action to influence the diet transition
towards a healthier outcome. Perhaps the most obvious rationale is information
asymmetry between producers and consumers about what is healthy and what is not.
There may also be negative externality effects if health care resources are directed away
from infants to middle-aged individuals, and in terms of the intergenerational
transmission of obesity from mother to baby (see Parsons et al, 2002). There will also
be a case for public intervention if private sector incentives result in poorer consumers
being priced out of access to healthier food options, especially basic processed foods.
604 Lawrence Haddad
Rationale for public action Example of broad areas in which public intervention
may be justified
Underprovision of ‘public If generation of affordable healthy food is not available to
goods’ poorer consumers
Externalities not captured Negative externality if obesity of mothers is risk factor for
child obesity. Health care costs diverted from prevention
Information asymmetries Case for providing healthy alternatives. Case for labelling;
nutrition education
Capital market failure Investing in anti-low birth weight interventions
Universal access and equity Obesity is linked to more marginal groups in US, UK
concerns
Health insurance market failure Prevention and treatment of chronic diseases
Options emanate from the supply side and the demand side, although success will
obviously be enhanced via the effective interaction of both. Table 2 summarises the
food policy options available to moderate dietary fat intake, based on US experience
(see Sims, 1998; Ralston, 2000). Although focused only on dietary fat and only on US
policy instruments, the table highlights several points. First, there are many stages in the
food system where policy can act – both on the supply side and on the demand side.
Second, many of the instruments may have small effects – either because behaviour is
hard to change in the desired direction or because there are off-setting effects (for
example, moving to lower-calorie foods, but consuming additional portions: Sims,
1998). This is a rather sobering conclusion and one that should be kept in mind during
the process of policy formulation throughout the developing world. Third, several
instruments have ambiguous effects on fat intake – either because they have not been
evaluated (for example, harmonisation of fat descriptors between regulatory agencies)
or because their direct effects may be overwhelmed by their indirect effects (for
example, restrictions on beef imports may result in a reaction from domestic beef
producers and a search for new outlets for beef products). The table represents a menu
of options that need to be evaluated if their impacts are to be maximised in the desired
direction.
Redirecting the Diet Transition: What Can Food Policy Do? 605
Stage of the Types of policy Examples used in the dietary fat issue Effectiveness
food system instrument in controlling
fat intake
Food Commodity Feed grain subsidies for feedlot animals Negative
production price subsidies/ Dairy price supports Negative
supports
Import/export Export incentives for US vegetable oil Uncertain
quotas Restrictions on beef imports Uncertain
Food Meat grading Beef grading (changes from choice to Positive
processing standards select)
‘Standards of ‘Standards of identity’ changed for low- Positive
identity’ fat milk and yoghurt
Food labelling Food label descriptors (e.g. ‘low fat’, etc.) Quite positive
changed for fluid milk, ice cream
Food Marketing Changes in milk marketing orders Negative
distribution orders for dairy
and Food labelling Use of ‘% lean’ claims on ground beef Slightly
marketing negative
Restaurant labelling of menu items with Slightly
‘low fat’ claims positive
Food Harmonisation between the FTC and Uncertain
advertising FDA on ads using fat ‘discriptors’
Food Food labelling Fat descriptor information on food label Positive
consumption Dietary Dietary guidelines Positive
information Food Guide Pyramid Quite positive
Commodity Promotion of cheese, ice cream, milk, Negative
promotion beef, pork
boards
Source: Adapted from Sims (1998).
Supply-side interventions
and quantity instruments reflects the economic, social and political importance of
the various crops and growers’ associations and the small and large industries that
rely on them. Whenever the welfare of small sub-groups is weighed against the
broader interest, the politics of hurting a small but powerful group will usually
outweigh the smaller negative impacts on a much vaster set of individuals (Nestle,
2002). When small welfare losses result, over time, in a large cumulative disease
burden, the economics of such trade-offs needs to be revisited.
(ii) Evaluate food trade policy from a health perspective. GATT and the World Trade
Organization use a number of agreements to navigate health issues, including the
Sanitary and Phytosanitary (SPS) Agreement and the Trade Related Intellectual
Property Rights (TRIPs) Agreement. Can these Agreements be used to regulate the
health content of food imports? Past experience suggests ‘yes’, if scientific risk
assessments show the danger (Millstone and van Zwanenberg in this volume).
Beyond obvious health-related trade instruments, can the health community
influence the trade community in much the same way as the labour and
environment communities have done? Do we know whether the commodity-
protection profiles of different countries are pro- or anti-health? If we did, would
the health community be able to influence trade policy? If it could (which must, at
this point in time, be considered improbable), are there non-health downsides for
poor farmers and consumers from an altered pattern of trade? These issues have not
been explored to date, and this is surely an area for future research as the
percentage of food consumed from trade increases.
(iv) Impose tougher standards on the fat content of food away from home and in
schools. In the US, for example, the menus in many public schools fail to meet US
Department of Agriculture dietary guidelines (Brownell, 2002a, b).
(v) Reduce malnutrition in utero. The so-called ‘Barker Hypothesis’ posits that
maternal dietary imbalances at critical periods of development in the womb can
trigger an adaptive redistribution of foetal resources (including growth retardation).
Such adaptations affect foetal structure and metabolism in ways that predispose the
individual to later cardiovascular and endocrine diseases (Barker, 1998). The
correlation between low birth weight or early childhood stunting and later
cardiovascular disease and diabetes may arise from the fact that nutritional
deprivation in utero, or in early childhood, ‘programmes’ a newborn for a life of
scarcity. The problems arise when the child’s system is later confronted by a
higher-fat, higher-sugar diet, in combination with lowered activity patterns. If this
hypothesis is borne out (and evidence is accumulating both for and against) it will
serve to remind us that one food policy option for attenuating the impacts of the
diet transition is to reduce intra-uterine growth retardation. For example, based on a
balanced review of the evidence as of 2000, Popkin et al. (2001) conclude that in
China approximately one-third of diabetes can be traced back to low birth weight
and stunting in infancy, with this percentage declining in 2020, on the assumption
that low birth weight and stunting will decline. There are a number of interventions
to address low birth weight at term, ranging from the immediate (for example,
improving the food intake quantity and quality of adolescent girls and expectant
mothers and improving the quality of pre-natal care) to the underlying (for
example, improving women’s status relative to men’s in terms of resource
allocation decisions).
Redirecting the Diet Transition: What Can Food Policy Do? 607
Demand-side interventions
(i) Increase the relative price of unhealthy choices. This is an option that those
familiar with anti-smoking campaigns might find appealing. It often underlies
discussions of what food policy can do to increase the healthiness of the diet
transition (for example, Guo et al., 1999). However, it is difficult in practice to
identify a food for which an increase in price will not reduce access to healthy
components of a diet – components that in a developing country context may be in
short supply. Examples in Figures 4 and 5 illustrate this for US data on meat and
edible oil consumption. As Figure 4 shows, an increase in the price of meat does
have a negative impact on fat and cholesterol intake, but it also has a negative
impact on a wide range of diet components that are crucial to diets, especially those
of infants and women, such as iron and calcium, which are not found in high
densities in non-animal source foods (Huang, 1996). For the same demand system
estimates, Figure 5 shows that an increase in edible oil prices does decrease fat
consumption and increase the consumption of nearly every other diet component
because of a substitution towards other foods. This is more in line with the kind of
results we might be seeking. However, in a developing country context, edible oil is
often used to increase the energy density of infant diets.
0.064
0.05
0
energy
protein
fat
carbohydrate
cholesterol
calcium
phosphorous
iron
potassium
sodium
vitamin A
thiamin
riboflavin
niacin
vitamin C
-0.025
-0.05 -0.041
-0.027
-0.025
-0.009 -0.078-0.08 -0.076 -0.074-0.072
-0.1 -0.091 -0.096
0.067
0.054
0.05
0.045
0.036
0.027 0.028 0.027
0.021
0.017
0.009
0 -0.001
energy
protein
fat
carbohydrate
cholesterol
calcium
phosphorous
iron
potassium
sodium
vitamin A
thiamin
riboflavin
niacin
vitamin C
-0.021
-0.056
H uang, 1996
Source: ibid.
(ii) Clearer information about product contents. Food labelling can help in reducing
information asymmetries, but it can often be confusing, it is obviously of limited
value in areas where literacy is weak, and it may be better at discouraging certain
types of behaviours perceived as risky than encouraging healthy behaviour (for
example, Verbeke and Ward, 2001 on BSE in Belgian beef).
(iii) Better awareness about consequences of poor diet. A number of initiatives have
been employed in developing countries to raise awareness of the causes and
consequences of poor diet. These include a mass media campaign to reduce
overweight in Brazil; dietary guidelines for nutritional well-being in China; and
school-based training for improving diet and activity levels in Singapore (Doak,
2002). Evaluations of the effectiveness and cost-effectiveness of these attempts to
change behaviour are badly needed.
Policy formulation on diet change in the developing world must build on the evidence
accumulated in the industrialised world. However, the developing country context is
very different and policy-makers must remember that:
• Food consumption deficits are still widespread. When looking for foods to
discourage the consumption of, remember that many groups require the other
nutrients contained in the food (for example, the micronutrients in livestock).
• Certain groups of individuals, for example infants, will need to consume even
foods that might otherwise be discouraged, for example, edible oils.
• The capacity to influence preferences via the public sector is likely to be lower
than in the industrialised world. Whether the imbalance between public and
Redirecting the Diet Transition: What Can Food Policy Do? 609
Research in the area of the diet and nutrition transition in developing countries is in its
infancy. Most of the work has been spent documenting it and analysing its causes, and
much of it has had to make do with crude food data (national supply, not household-
level availability or individual intake). Very little research has focused on policy
analysis. The following areas deserve much more attention from the research
community.
Conclusion
References
Alderman, H. (1986) The Effect of Food Price and Income Changes on the Acquisition
of Food by Low-income Households. Washington, DC: International Food Policy
Research Institute.
Barker, D. J. (1998) ‘In Utero Programming of Chronic Disease’, Clinical Science 95
(2): 115-28.
Bisgrove, E. Z. and Popkin, B. M. (1996) ‘Does Women’s Work Improve their
Nutrition? Evidence from the Urban Philippines’, Social Sciences and Medicine 43
(10): 1475-88.
Brownell, K. D. (2002a) ‘Public Policy and the Prevention of Obesity’, in C. Fairburn
and K. D. Brownell (eds), Eating Disorders and Obesity: A Comprehensive
Handbook, 2nd edn. New York: Guilford.
Brownell, K. D. (2002b) ‘The Environment and Obesity’, in C. Fairburn and K. D.
Brownell (eds), Eating Disorders and Obesity: A Comprehensive Handbook, 2nd
edn. New York: Guilford.
Buse, K. and Walt, G. (2000a) ‘Global Public-private Partnerships: Part 1 – A New
Development in Health?’, Bulletin of the World Health Organization 78 (4): 549-
61.
Cogneau, D. and Robilliard, A. (2000) Growth, Distribution and Poverty in
Madagascar: Learning from a Microsimulation Model in a General Equilibrium
Framework. Trade and Macroeconomics Division Discussion Paper No. 61.
Washington, DC: International Food Policy Research Institute.
Delgado, C., Rosegrant, M., Steinfeld, H., Ehui, S. and Courbois, C. (1999) Livestock to
2020. The Next Food Revolution. Food, Agriculture, and the Environment
Discussion Paper No. 28. Washington, DC: International Food Policy Research
Institute.
Doak, C. M. (2002) ‘Large-scale Interventions and Programmes Addressing Nutrition-
related Chronic Diseases and Obesity: Examples from 14 Countries’, Public Health
Nutrition 5 (1A): 275-7.
Fang, C. and Beghin, J. C. (2000) Urban Demand for Edible Oils and Fats in China:
Evidence from Household Survey Data. Working Paper 00-WP-245. Ames, IA:
Iowa State University.
FAOSTAT. www.fao.org.
Garrett, J. and Ruel, M. (2003) Stunted Child-overweight Mother Pairs: An Emerging
Policy Concern? Food Consumption and Nutrition Division Discussion Paper No.
148. Washington, DC: International Food Policy Research Institute.
Guo, X., Popkin, B. M., Mroz, T. A, and Zhai, F. (1999) ‘Food Price Policy Can
Favorably Alter Macronutrient Intake in China’, Journal of Nutrition 129: 994-
1001.
Guo, X., Popkin, B. M. and Zhai, F. (2000a) ‘Patterns of Change in Food Consumption
and Dietary Fat Intake in Chinese Adults, 1989-93’, Food and Nutrition Bulletin 20
(3): 344-53.
Guo, X., Mroz, T. A., Popkin, B. M. and Zhai, F. (2000b) ‘Structural Change in the
Impact of Income on Food Consumption in China, 1989-1993’, Economic
Development and Cultural Change 48 (4): 737-60.
Redirecting the Diet Transition: What Can Food Policy Do? 613
Hawkes, C. (2002) ‘Marketing Activities of Global Soft Drink and Fast Food
Companies in Emerging Markets: A Review’, in Globalization, Diets and
Noncommunicable Diseases. Geneva: World Health Organization.
Huang, K. S. (1996) ‘Nutrient Elasticities in a Complete Food Demand System’,
American Journal of Agricultural Economics 78 (February): 21-9.
Huang, J. and Bouis, H. (1996) Structural Changes in the Demand for Food in Asia.
Food, Agriculture, and the Environment Discussion Paper No. 11. Washington,
DC: International Food Policy Research Institute.
Kersch, R. and Morone, J. (2002) ‘When the Personal Becomes Political: The Case of
Obesity’, Syracuse, NY: Syracuse University (mimeo).
Lakdawalla, D. and Philipson, T. J. (2002) The Growth of Obesity and Technological
Change: A Theoretical and Empirical Examination. Working Paper No. 8946.
Cambridge, MA: National Bureau of Economic Research.
Lin, B.-H., Guthrie, J. and Frazão, E. (2000) ‘Nutrient Contribution of Food Away
From Home’, in Nutrients Away From Home. Washington, DC: Economic
Research Service, US Department of Agriculture.
McCullough, M. L., Feskanich, D., Stampfer, M. J., Giovannucci, E. L., Rimm, E. B.,
Hu, F. B, Spiegelman, D., Hunter, D. J., Colditz, G. A. and Willett, W. C. (2002)
‘Diet Quality and Major Chronic Disease Risk in Men and Women: Moving
Toward Improved Dietary Guidance’, American Journal of Clinical Nutrition 76:
1261-71.
Maxwell, D., Levin, C., Armar-Klemesu, M., Ruel, M., Morris, S. and Ahiadeke, C.
(2000) Urban Livelihoods and Food and Nutrition Security in Greater Accra,
Ghana. Research Report No. 112. Washington, DC: International Food Policy
Research Institute in collaboration with the Noguchi Memorial Institute for Medical
Research, Ghana, and the World Health Organization.
Nestle, M. (2002) Food Politics. Berkeley, CA: University of California Press.
Parsons, T. J., Power, C. and Manor, O. (2002) ‘Fetal and Early Life Growth and Body
Mass Index from Birth to Early Adulthood in 1958 British Cohort: Longitudinal
Study’, British Medical Journal 18 (1), March.
Philipson, T. J. and Posner, R. A. (1999) The Long-run Growth in Obesity as a Function
of Technological Change. Working Paper No. 7423. Cambridge, MA: National
Bureau of Economic Research.
Pitt, M. and Rosenzweig, M. (1986) ‘Agricultural Prices, Food Consumption and the
Health and Productivity of Indonesian Farmers’, in I. Singh, L. Squire and J.
Strauss, Agricultural Household Models: Extensions, Applications and Policy.
Baltimore, MD: Johns Hopkins University Press for the World Bank.
Popkin, B. M. (1998) ‘The Nutrition Transition and its Health Implications in Lower-
income Countries’, Public Health Nutrition 1 (1): 5-21.
Popkin, B. M. (2001) ‘Nutrition in Transition: The Changing Global Nutrition
Challenge’, Asia Pacific Journal of Clinical Nutrition 10 (Supplement1): S13-S18.
Popkin, B. M., Horton, S. and Kim, S. (2001) ‘The Nutrition Transition and Prevention
of Diet-Related Chronic Diseases in Asia and the Pacific’, Nutrition and
Development Series 6: 58. Manila: Asian Development Bank.
Putnam, J. J. and Allshouse, J. E. (1999) ‘Food Consumption, Prices, and Expenditures,
1970-97’, Statistical Bulletin 965, Food and Rural Economics Division, Economic
Research Services, US Department of Agriculture.
614 Lawrence Haddad
Ralston, K. (2000) ‘How Government Policies and Regulations Can Affect Dietary
Choices’, in Government Regulation and Food Choices. Washington, DC:
Economic Research Services, US Department of Agriculture.
Reardon, T. and Berdegué, J. A. (2002) ‘The Rapid Rise of Supermarkets in Latin
America: Challenges and Opportunities for Development’, Development Policy
Review 20 (4): 371-88.
Reardon, T. C., Timmer, P. Barrett, C. and Berdegué, J. (2003) ‘The Rise of
Supermarkets in Africa, Asia and Latin America’, American Journal of
Agricultural Economics 85 (5).
Regmi, A. (ed.) (2001) Changing Structure of Global Food Consumption and Trade.
Agriculture and Trade Reports, WRS-01-1. Washington, DC: Market and Trade
Economics Division, Economic Research Service, US Department of Agriculture.
Sims, L. S. (1998) The Politics of Fat. Armonk, NY: M. E. Sharpe Inc.
Tinker, I. (1997) Street Foods: Urban Food and Employment in Developing Countries.
New York: Oxford University Press.
Verbeke, W. and Ward, R. (2001) ‘A Fresh Meat Almost Ideal System Incorporating
Negative TV Press and Advertising Impact’, Agricultural Economics 25: 359-74.
Willett, W. and Stampfer, M. (2002) ‘Rebuilding the Food Pyramid’. Scientific
American, 17 December.
World Bank (1999) Curbing the Epidemic: Governments and the Economics of Tobacco
Control. Washington, DC: World Bank.
WHO/FAO (2002) Expert Consultation on Diet, Nutrition and the Prevention of
Chronic Diseases, 28 January-1 February, Geneva.