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Pillars of the Nutrition Transition: the Global Impacts of Ultra-Processed Foods and Beverages on Overweight and Obesity and National Nutrient Supplies" (2020)

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Pillars of the Nutrition Transition: the Global Impacts of Ultra-Processed Foods and Beverages on Overweight and Obesity and National Nutrient Supplies Washington University in St. Louis Washington University Open Scholarship Arts & Sciences Electronic Theses and Dissertations Arts & Sciences Spring 5-15-2020 Pillars of the Nutrition Transition: The Global Impacts of Ultra- Processed Foods and Beverages on Overweight and Obesity and National Nutrient Supplies Jacob Eaton Washington University in St. Louis Follow this and additional works at: https://openscholarship.wustl.edu/art_sci_etds Part of the Agricultural and Resource Economics Commons, Agricultural Economics Commons, Human and Clinical Nutrition Commons, and the Public Health Education and Promotion Commons Recommended Citation Eaton, Jacob, "Pillars of the Nutrition Transition: The Global Impacts of Ultra-Processed Foods and Beverages on Overweight and Obesity and National Nutrient Supplies" (2020). Arts & Sciences Electronic Theses and Dissertations. 2180. https://openscholarship.wustl.edu/art_sci_etds/2180 This Dissertation is brought to you for free and open access by the Arts & Sciences at Washington University Open Scholarship. It has been accepted for inclusion in Arts & Sciences Electronic Theses and Dissertations by an authorized administrator of Washington University Open Scholarship. For more information, please contact [email protected]. WASHINGTON UNIVERSITY IN ST. LOUIS Brown School Department of Public Health Dissertation Examination Committee: Lora Iannotti, Chair Amy Eyler Douglas Luke Rachel Tabak Corinna Treitel Pillars of the Nutrition Transition: The Global Impacts of Ultra-Processed Foods and Beverages on Overweight and Obesity and National Nutrient Supplies by Jacob Eaton, MPH A dissertation presented to The Graduate School of Washington University in partial fulfillment of the requirements for the degree of Doctor of Philosophy May 2020 St. Louis, Missouri © 2020, Jacob Eaton Table of Contents List of Tables ................................................................................................................................. iv List of Figures ................................................................................................................................. v Acknowledgments.......................................................................................................................... vi Abstract ........................................................................................................................................ viii Chapter 1: Introduction ................................................................................................................... 1 Background and Significance...................................................................................................... 2 Specific Aims and Research Questions ..................................................................................... 12 Methods ..................................................................................................................................... 13 Conclusion ................................................................................................................................. 15 Chapter 2: Refining Frameworks for Fats: Evolutionary, Industrial, and Ecological Perspectives on the Global Supply of Fatty Acids............................................................................................. 17 Abstract ..................................................................................................................................... 18 Introduction ............................................................................................................................... 20 Methods ..................................................................................................................................... 23 Results: Trends in Global Vegetable Oil Production ............................................................... 24 Conclusion ................................................................................................................................. 48 Chapter 3: Measuring the Associations Between Ultra-Processed Food and Sugar-Sweetened Beverage Sales and National Nutrient Supplies ........................................................................... 51 Abstract ..................................................................................................................................... 52 Introduction ............................................................................................................................... 54 Methods and Data Sources ........................................................................................................ 56 Results ....................................................................................................................................... 66 Discussion ................................................................................................................................. 71 Chapter 4: Country-Level Sales of Ultra-Processed Foods and Sugar-Sweetened Beverages and Their Associations with Adult and Child and Adolescent BMI, Overweight, and Obesity Prevalence ..................................................................................................................................... 92 Abstract ..................................................................................................................................... 93 Introduction ............................................................................................................................... 95 Methods ..................................................................................................................................... 97 Results: Descriptive Statistics ................................................................................................. 101 ii Results: Modeling ................................................................................................................... 109 Discussion ............................................................................................................................... 121 Chapter 5: Conclusion................................................................................................................. 125 Policy Options ......................................................................................................................... 130 Academia ................................................................................................................................. 138 Limitations and Future Research............................................................................................. 139 Conclusion ............................................................................................................................... 143 Bibliography ............................................................................................................................... 145 Appendix A: EuroMonitor Country Coverage ........................................................................... 169 Appendix B: Aim 3 Full Models ................................................................................................ 174 iii List of Tables Table 2.1: Trends in Omega-FA Availability, 1961-2013 ............................................................ 31 Table 3.1: Association Between UPF and SSB Sales and National Supply of Calories .............. 78 Table 3.2: Association Between UPF and SSB Sales and National Supply of Carbohydrates .... 80 Table 3.3: Association Between UPF and SSB Sales and National Supply of Sugar .................. 82 Table 3.4: Association Between UPF Sales and National Supply of Total Fat ............................ 83 Table 3.5: Association Between UPF Sales and National Supply of Omega-6 Fatty Acids ........ 84 Table 3.6: Association Between UPF Sales and National Supply of Omega-3 Fatty Acids ........ 86 Table 3.7: Association Between UPF Sales and National Omega-6:Omega-3 Ratio ................... 87 Table 3.8: Association Between UPF Sales and National Supply of Monounsaturated Fat ........ 88 Table 3.9: Association Between UPF Sales and National Supply of Saturated Fat ..................... 89 Table 3.10: Association Between UPF Sales and Food Supply from Non-Staple Crops ............. 91 Table 4.1: Trends in UPF and SSB Sales, 2005-2018 ................................................................ 104 Table 4.2: Trends in Adult BMI, Obesity, and Overweight, 2005-2016 .................................... 108 Table 4.3: Associations Between UPF and SSB Sales and Adult BMI ...................................... 113 Table 4.4: Associations Between SSB Sales and Child and Adolescdent BMI ......................... 114 Table 4.5: Associations Between UPF and SSB Sales and Adult Overweight Prevalence ........ 115 Table 4.6: Associations Between UPF and SSB Sales and Youth Overweight Prevalence ....... 116 Table 4.7: Associations Between UPF and SSB Sales and Adult Obesity Prevalence .............. 118 Table 4.8: Associations Between UPF and SSB Sales and Child and Adolescent Obesity Prevalence ................................................................................................................................... 119 iv List of Figures Figure 1: Growth in Vegetable Oil Availability By Region, 1961-2013 ...................................... 26 Figure 2: Global Availability of Omega-6 Fatty Acids, 1961-2013, By Source .......................... 27 Figure 3: Global Availability of
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