Demand for animal protein for human consumption is rising globally at an unprecedented rate. Modern animal production practices are associated with regular use of antimicrobials, potentially increasing selection pressure on bacteria to become resistant. Despite the significant potential consequences for antimicrobial resistance, there has been no quantitative measurement of global antimicrobial consumption by livestock. We address this gap by using Bayesian statistical models combining maps of livestock densities, economic projections of demand for meat products, and current estimates of antimicrobial consumption in high-income countries to map antimicrobial use in food animals for 2010 and 2030. We estimate that the global average annual consumption of antimicrobials per kilogram of animal produced was 45 mg⋅kg(-1), 148 mg⋅kg(-1), and 172 mg⋅kg(-1) for cattle, chicken, and pigs, respectively. Starting from this baseline, we estimate that between 2010 and 2030, the global consumption of antimicrobials will increase by 67%, from 63,151 ± 1,560 tons to 105,596 ± 3,605 tons. Up to a third of the increase in consumption in livestock between 2010 and 2030 is imputable to shifting production practices in middle-income countries where extensive farming systems will be replaced by large-scale intensive farming operations that routinely use antimicrobials in subtherapeutic doses. For Brazil, Russia, India, China, and South Africa, the increase in antimicrobial consumption will be 99%, up to seven times the projected population growth in this group of countries. Better understanding of the consequences of the uninhibited growth in veterinary antimicrobial consumption is needed to assess its potential effects on animal and human health.

https://www.pnas.org/content/pnas/112/18/5649.full.pdf

Global trends in antimicrobial use in food animals

OBJECTIVE: This paper explores the major changes in diet and physical activity patterns around the world and focuses on shifts in obesity DESIGN: Review of results focusing on large-scale surveys and nationally representative studies of diet, activity, and obesity among adults and children SUBJECTS: Youth and adults from a range of countries around the world MEASUREMENTS: The International Obesity Task Force guidelines for defining overweight and obesity are used for youth and the body mass index Z25 kg/m 2 and 30 cutoffs are used, respectively, for adults RESULTS: The nutrition transition patterns are examined from the time period termed the receding famine pattern to one dominated by nutrition-related noncommunicable diseases (NR-NCDs) The speed of dietary and activity pattern shifts is great, particularly in the developing world, resulting in major shifts in obesity on a worldwide basis Data limitations force us to examine data on obesity trends in adults to provide a broader sense of changes in obesity over time, and then to examine the relatively fewer studies on youth Specifically, this work provides a sense of change both in the United States, Europe, and the lower- and middle-income countries of Asia, Africa, the Middle East, and Latin America CONCLUSION: The paper shows that changes are occurring at great speed and at earlier stages of the economic and social development of each country The burden of obesity is shifting towards the poor International Journal of Obesity (2004) 28, S2–S9 doi:101038/sjijo0802804

https://cdr.lib.unc.edu/downloads/sb397b319

The nutrition transition: worldwide obesity dynamics and their determinants

Changes in diet and activity patterns are fueling the obesity epidemic. These rapid changes in the levels and composition of dietary and activity/inactivity patterns in transitional societies are related to a number of socioeconomic and demographic changes. Using data mainly from large nationally representative and nationwide surveys, such as the 1989, 1991, 1993 and 1997 China Health and Nutrition Surveys, in combination with comparative analysis across the regions of the world, we examine these factors. First, we show the shifts in diet and activity are consistent with the rapid changes in child and adult obesity and in some cases have been causally linked. We then provide a few examples of the rapid changes in the structure of diet and activity, in particular associated with increased income. Cross-country and in-depth analysis of the China study are used to explore these relationships. People living in urban areas consume diets distinctly different from those of their rural counterparts. One of the more profound effects is the accelerated change in the structure of diet, only partially explained by economic factors. A second is the emergence of a large proportion of families with both currently malnourished and overweight members as is shown by comparative analysis of a number of Asian and Latin American countries.

The Nutrition Transition and Obesity in the Developing World

As with other fields, medical sciences are subject to different sources of bias. While understanding sources of bias is a key element for drawing valid conclusions, bias in health research continues to be a very sensitive issue that can affect the focus and outcome of investigations. Information bias, otherwise known as misclassification, is one of the most common sources of bias that affects the validity of health research. It originates from the approach that is utilized to obtain or confirm study measurements. This paper seeks to raise awareness of information bias in observational and experimental research study designs as well as to enrich discussions concerning bias problems. Specifying the types of bias can be essential to limit its effects and, the use of adjustment methods might serve to improve clinical evaluation and health care practice.

/pdf/information-bias-in-health-research-definition-pitfalls-and-1as13hgk9p.pdf

Information bias in health research: definition, pitfalls, and adjustment methods.

OBJECTIVE
To identify factors in childhood which might influence the development of obesity in adulthood.


BACKGROUND
The prevalence of obesity is increasing in the UK and other developed countries, in adults and children. The adverse health consequences of adult obesity are well documented, but are less certain for childhood obesity. An association between fatness in adolescence and undesirable socio-economic consequences, such as lower educational attainment and income, has been observed, particularly for women. Childhood factors implicated in the development of adult obesity therefore have far-reaching implications for costs to the health-services and economy.


SEARCH STRATEGY
In order to identify relevant studies, electronic databases--Medline, Embase, CAB abstracts, Psyclit and Sport Discus-were searched from the start date of the database to Spring 1998. The general search structure for electronic databases was (childhood or synonyms) AND (fatness or synonyms) AND (longitudinal or synonyms). Further studies were identified by citations in retrieved papers and by consultation with experts.


INCLUSION CRITERIA
Longitudinal observational studies of healthy children which included measurement of a risk factor in childhood (<18 y), and outcome measure at least 1 y later. Any measure of fatness, leanness or change in fatness or leanness was accepted. Measures of fat distribution were not included. Only studies with participants from an industrialized country were considered, and those concerning minority or special groups, e.g. Pima Indians or children born preterm, were excluded.


FINDINGS
Risk factors for obesity included parental fatness, social factors, birth weight, timing or rate of maturation, physical activity, dietary factors and other behavioural or psychological factors. Offspring of obese parent(s) were consistently seen to be at increased risk of fatness, although few studies have looked at this relationship over longer periods of childhood and into adulthood. The relative contributions of genes and inherited lifestyle factors to the parent-child fatness association remain largely unknown. No clear relationship is reported between socio-economic status (SES) in early life and childhood fatness. However, a strong consistent relationship is observed between low SES in early life and increased fatness in adulthood. Studies investigating SES were generally large but very few considered confounding by parental fatness. Women who change social class (social mobility) show the prevalence of obesity of the class they join, an association which is not present in men. The influence of other social factors such as family size, number of parents at home and childcare have been little researched. There is good evidence from large and reasonably long-term studies for an apparently clear relationship for increased fatness with higher birth weight, but in studies which attempted to address potential confounding by gestational age, parental fatness, or social group, the relationship was less consistent. The relationship between earlier maturation and greater subsequent fatness was investigated in predominantly smaller, but also a few large studies. Again, this relationship appeared to be consistent, but in general, the studies had not investigated whether there was confounding by other factors, including parental fatness, SES, earlier fatness in childhood, or dietary or activity behaviours. Studies investigating the role of diet or activity were generally small, and included diverse methods of risk factor measurement. There was almost no evidence for an influence of activity in infancy on later fatness, and inconsistent but suggestive evidence for a protective effect of activity in childhood on later fatness. No clear evidence for an effect of infant feeding on later fatness emerged, but follow-up to adulthood was rare, with only one study measuring fatness after 7y. Studies investigating diet in childhood were limited and inconc

Childhood predictors of adult obesity: a systematic review.

China is undergoing a marked transition in its diet and nutritional status patterns. This study determines the structural change in the impact of income on food consumption in China during 1989-93. Utilizing data from a longitudinal study of 3800 households in China evidence points to a shift in the relationship between income dietary structure and total nutrient intake at the macrolevel. Overall it is noted that the increase in income over time in the country coincided with a shift in the demand for inferior and normal food groups. In addition there was a pronounced increase in the income elasticity for more luxury foods during the specified period while less superior goods became more inferior over this 4-year span. Such an increase in income elasticities for total energy and for energy from fat suggest a worsening of the composition of the diet in ways that are linked to obesity and obesity-related diseases as incomes continue to rise. In view of this several implications for the formulation of future nutrition policies in China are cited.

/pdf/structural-change-in-the-impact-of-income-on-food-18lqkscryb.pdf

Structural change in the impact of income on food consumption in China, 1989-1993

The rapid change in diets, physical activity and body composition in low income countries has led to the coexistence of large pockets of undernutrition and overnutrition. Public health strategies for addressing this situation may be necessary, and price policy options are examined for China. Longitudinal dietary data collected in China in 1989-1993 on a sample of 5625 adults aged 20-45 y were examined. Three-day averages of food group consumption and nutrient intake were used in longitudinal statistical models to examine separately the effects of food prices on the decision to consume each food group and then the amount consumed. The effects of changes in six food prices on the consumption of each of six food groups, not just the food group whose price had changed, and on three macronutrients were estimated. The effects show large and significant price effects. If the joint effects of the nutrition transition are to be considered, then there are clear tradeoffs among which foods to tax and which to subsidize. Most important is the effect of prices in reducing fat intake of the rich but not adversely affecting protein intake for the poor. Increases in the prices of pork, eggs and edible oils are predicted to lower fat intake. Only increases in pork prices led to reduced protein intakes. This raises questions about earlier policy changes being implemented in China and provides insight into an important and controversial area for public health policy.

Food Price Policy Can Favorably Alter Macronutrient Intake in China

Objectives: To examine the effect of measurement error in dietary data on the relationship between diet and body mass index (BMI). To correct for the effect of measurement error on diet–BMI association by using replicate measurements of diet. The effect of measurement error on diet–BMI relationship was simulated, and its implications are discussed. Design: Prospective study design. Setting: The first and second China Health and Nutrition Survey conducted in 1989 and 1991, respectively. Subjects: Three thousand, four hundred and seventy-nine adults age 20–45 y at the 1989 survey. Methods: Statistical methods were used to demonstrate the effect of measurement error in dietary data on the diet-BMI association. Results: By using the average of three replicate 24 h dietary recalls, the attenuation of diet-BMI association was reduced substantially. The regression coefficients of fat and energy intakes differed markedly from those computed by using only single measurement of diet. Conclusions: Measurement error in dietary data may significantly attenuate the diet-disease association. Where appropriate, specific emphasis may be needed to address the problem of measurement error in the study of diet-disease relationship. Spnosorship: This research was supported by the National Institute of Health, the Carolina Population Center and the Nutrition Institute, University of North Carolina at Chapel Hill.

Measurement error in dietary data: implications for the epidemiologic study of the diet-disease relationship.

We compared two dietary survey methods using the 1991 nationwide China Health and Nutrition Survey. Data were collected over three consecutive days by 24-hour dietary recall and a household invento...

https://journals.sagepub.com/doi/pdf/10.1177/156482659601700209

Evaluation of the 24-hour individual recall method in China

Dietary and socio-economic data were collected from over 5,600 Chinese adults aged 20 to 45 in 1989, 1991, and 1993. Adults were categorized by income and other socio-economic variables, and dietary changes between 1989 and the subsequent two periods were studied. the quantities and proportions of animal foods and edible oils consumed increased dramatically, while daily consumption of grains and potatoes decreased by about 41 to 77 g. This decrease was greatest among coarse grains (corn, millet, and sorghum). the largest contributors to increased fat intake were edible oils, high-fat red meat, and lard and butter. Those eating more grain consumed less fat. Among high-income persons in 1993, 58% had a higher fat intake than recommended (> 30% of calories from fat), 31% had a high intake of saturated fat (> 10% of calories from saturated fat), and 40% had a cholesterol intake exceeding 300 mg/day. the corresponding figures were 27%, 15%, and 21% among low-income persons. This study raises important concerns about some long-term adverse consequences of economic change in China.

https://journals.sagepub.com/doi/pdf/10.1177/156482659902000312

Xuguang Guo

Papers

Structural change in the impact of income on food consumption in China, 1989-1993

Food Price Policy Can Favorably Alter Macronutrient Intake in China

Measurement error in dietary data: implications for the epidemiologic study of the diet-disease relationship.

Evaluation of the 24-hour individual recall method in China

Patterns of change in food consumption and dietary fat intake in Chinese adults, 1989-1993.