University of California, San Francisco, USA.
London School of Economics and Political Science, London, UK.
Global Health. 2018 Apr 14;14(1):35. doi: 10.1186/s12992-018-0344-y.
Studies find that economic, political, and social globalization - as well as trade liberalization specifically - influence the prevalence of overweight and obesity in countries through increasing the availability and affordability of unhealthful food. However, what are the mechanisms that connect globalization, trade liberalization, and rising average body mass index (BMI)? We suggest that the various sub-components of globalization interact, leading individuals in countries that experience higher levels of globalization to prefer, import, and consume more imported sugar and processed food products than individuals in countries that experience lower levels of globalization.
This study codes the amount of sugar and processed food imports in 172 countries from 1995 to 2010 using the United Nations Comtrade dataset. We employ country-specific fixed effects (FE) models, with robust standard errors, to examine the relationship between sugar and processed foods imports, globalization, and average BMI. To highlight further the relationship between the sugar and processed food import and average BMI, we employ a synthetic control method to calculate a counterfactual average BMI in Fiji.
We find that sugar and processed food imports are part of the explanation to increasing average BMI in countries; after controlling for globalization and general imports and exports, sugar and processed food imports have a statistically and substantively significant effect in increasing average BMI. In the case of Fiji, the increased prevalence of obesity is associated with trade agreements and increased imports of sugar and processed food. The counterfactual estimates suggest that sugar and processed food imports are associated with a 0.5 increase in average BMI in Fiji.
研究发现，经济、政治和社会全球化——特别是贸易自由化——通过增加不健康食品的可获得性和可负担性，影响各国超重和肥胖的流行率。然而，全球化、贸易自由化和平均体重指数（BMI）上升之间的联系机制是什么？我们认为，全球化的各个子成分相互作用，导致经历更高水平全球化的国家的个人比经历较低水平全球化的国家的个人更喜欢、进口和消费更多的进口糖和加工食品。
本研究使用联合国贸易数据库（Comtrade dataset）对 1995 年至 2010 年 172 个国家的糖和加工食品进口量进行编码。我们采用国家特定的固定效应（FE）模型，并使用稳健的标准误差，检验糖和加工食品进口、全球化和平均 BMI 之间的关系。为了进一步强调糖和加工食品进口与平均 BMI 之间的关系，我们采用合成控制方法计算斐济的反事实平均 BMI。
我们发现糖和加工食品进口是导致各国平均 BMI 上升的原因之一；在控制了全球化和一般进出口之后，糖和加工食品进口对平均 BMI 的上升具有统计学和实质性的显著影响。就斐济而言，肥胖症的流行率增加与贸易协定和糖及加工食品进口增加有关。反事实估计表明，糖和加工食品进口与斐济平均 BMI 增加 0.5 有关。
