Where is Nepal in the nutrition transition?

BACKGROUND AND OBJECTIVE
Nutrition transition is rapid in developing countries, but Nepalese transition is relatively unknown. This study aimed to describe nutrition transition in Nepal over the past 40 years by identifying the shifts in the Nepalese diets and nutritional status and the underlying shifts associated with this.

METHODS AND STUDY DESIGN
Popkin's framework was used to identify shifts in Nepalese diet and the inter-relationship of diet with epidemiological, demographic and economic shifts. The current study used quantitative methodology including secondary data analysis based on food balance sheets, economic surveys and the government databases.

RESULTS
The Nepalese diet is shifting away from agricultural staple based foods to modern processed foods with higher total energy, total fat, and sugar. The prevalence of overweight/obesity and diet related non-communicable diseases are increasing. Urbanisation is rapid and nutrition transition already advanced in urban area. The Nepalese economic structure has also changed shifting away from agricultural food supply system towards modern processing based food supply system. These changes in the Nepalese diet are triggered by income and urbanisation. The trade liberalisation has made processed foods, edible oil and sugar easily available at supermarkets and fast food outlets.

CONCLUSION
It is clear that Nepal has now entered into the fourth stage of nutrition transition according to Popkin's framework. As a result, overweight, obesity and the prevalence of many noncommunicable diseases are all rapidly growing. A further study is recommended to identify whether urban versus rural, rich versus poor and educated versus uneducated families are experiencing the transition in similar way.