ENVIRONMENTAL-FACTORS AFFECTING NUTRITIONAL-STATUS IN URBAN AREAS OF DEVELOPING-COUNTRIES

The demographic and economic transition that many developing countries are undergoing is producing important changes in diet and lifestyle t hat greatly impact on disease risks. Among the risk behaviors associat ed with socioeconomic transition and urbanization are excessive dietar y fat intake, sedentary lifestyle, smoking, and environmental contamin ation. Combined with a reduced infant mortality and increased life exp ectancy, those risk factors lead to an increasing prevalence of chroni c diseases like non-insulin dependent diabetes and coronary heart dise ase. This disease profile is a relatively new phenomenon in developing countries, where health programs have traditionally focused on ''acut e'' interventions such as immunization or oral rehydration. A new appr oach will be needed to address chronic diseases, which frequently dema nd a life-long and technically complex medical management, and may hav e significant impact on the quality of life and productivity of the po pulation. Efforts to address this situation should focus on a) expandi ng tile information base on dirt, nutritional status and lifestyle cha nges in populations migrating to urban areas; b) developing and evalua ting approaches for improving diet quality in urban populations, inclu ding fortification and community-based supplementation programs; c) un derstanding better the social and behavioral determinants of nutrition al status in the urban poor; and d) defining the role of the food indu stry and of agricultural production for improving the quality of the f ood supply in urban areas.