N transitional economies: an ecosystem health dilemma Mark L. Wahlqvist (Zhejiang University) discussed the dilemma of obesity and other weight-management issues in transitional economies. According to Wahlqvist, virtually every economy is in transition and the most vulnerable individuals sacrifice ecosystems for survival–for example, to obtain firewood to cook. Others may be environmentally rapacious for profit. Most current health pattern change, of which body compositional disorders are indicative, is attributable to the loss of sustainable ecosystems. The achievement of optimal Pyrvinium pamoate supplier weight for the majority requires ecological approaches. Effective health care practitioners will be required to prevent, diagnose, and manage adiposity and its consequences using ecological methods. The ways and the circumstances in which we live are changing our energy acquisition and utilization requirements to the detriment of anatomy and physiology, not only intra- but also inter-generationally. The Food and Agricultural Organization (FAO) reports that, as agricultural productivity increases from the lowest to highest quartile, stunting and micronutrient deficiencies diminish while overweight and obesity increase, and its adverse consequences dominate.2 Prima facie, this looks like a problem of energy balance with more or less micronutrient intakes, especially iron, zinc, iodine, and vitamin A. But it is more than that, with problems of impaired energy regulation (IER), with its associated disorders of body composition and a limited diversity of sensory and nutritional inputs. Biodiversity and the use of biodiverse foods are essential for optimal health. That biodiversity extends to our heterogenomic prokaryotic microbiomes and to the extensive functions of molecules by which we sense our general and food environments. In other words, the overall problem is one of ecological disturbance which might be termed econutritional.3 A striking example of this is the United States, where the access to and consumption of fruit and vegetables by locality is inversely associated with obesity prevalence.4 The Organisation for Economic Co-operation and Development (OECD) has reported in 2014 that the global financial crisis of 2008?009 “caused a surge in unhealthy eating as people switched to cheaper, higher calorie food” and that “as a result, rising poverty likely contributed to rising obesity”. The most vulnerable were found to be women and the poor. Of particular note, “fruit and vegetable consumption decreased as unemployment increased” in the United States. In the UK, 8.5 less was spent on food, but 4.5 more energy was consumed.5 In Australia, a cohort study of 7,787 people during and after the global financial crisis in relation to financial stress BAY 11-7083 cost showed that, where present during 2008?009, there was a 20 increase in the prevalence of obesity to 2010.6 Adiposity to some extent reflects the financial environment. A complex biological dysfunction may be regarded as an ecosystem health disorder (EHD). The diagnosis and management of weight disorders requires an appreciation of their ecological context and as EHDs. Thus, while indices of body composition disorder may be represented by anthropometric or instrumental measures (e.g. impedance, DEXA), these belie primary causality and various pathogeneses, with a range of possible personal and societal interventions.Author Manuscript Author Manuscript Author Manuscript Author ManuscriptAnn N Y Acad Sci. Author manu.N transitional economies: an ecosystem health dilemma Mark L. Wahlqvist (Zhejiang University) discussed the dilemma of obesity and other weight-management issues in transitional economies. According to Wahlqvist, virtually every economy is in transition and the most vulnerable individuals sacrifice ecosystems for survival–for example, to obtain firewood to cook. Others may be environmentally rapacious for profit. Most current health pattern change, of which body compositional disorders are indicative, is attributable to the loss of sustainable ecosystems. The achievement of optimal weight for the majority requires ecological approaches. Effective health care practitioners will be required to prevent, diagnose, and manage adiposity and its consequences using ecological methods. The ways and the circumstances in which we live are changing our energy acquisition and utilization requirements to the detriment of anatomy and physiology, not only intra- but also inter-generationally. The Food and Agricultural Organization (FAO) reports that, as agricultural productivity increases from the lowest to highest quartile, stunting and micronutrient deficiencies diminish while overweight and obesity increase, and its adverse consequences dominate.2 Prima facie, this looks like a problem of energy balance with more or less micronutrient intakes, especially iron, zinc, iodine, and vitamin A. But it is more than that, with problems of impaired energy regulation (IER), with its associated disorders of body composition and a limited diversity of sensory and nutritional inputs. Biodiversity and the use of biodiverse foods are essential for optimal health. That biodiversity extends to our heterogenomic prokaryotic microbiomes and to the extensive functions of molecules by which we sense our general and food environments. In other words, the overall problem is one of ecological disturbance which might be termed econutritional.3 A striking example of this is the United States, where the access to and consumption of fruit and vegetables by locality is inversely associated with obesity prevalence.4 The Organisation for Economic Co-operation and Development (OECD) has reported in 2014 that the global financial crisis of 2008?009 “caused a surge in unhealthy eating as people switched to cheaper, higher calorie food” and that “as a result, rising poverty likely contributed to rising obesity”. The most vulnerable were found to be women and the poor. Of particular note, “fruit and vegetable consumption decreased as unemployment increased” in the United States. In the UK, 8.5 less was spent on food, but 4.5 more energy was consumed.5 In Australia, a cohort study of 7,787 people during and after the global financial crisis in relation to financial stress showed that, where present during 2008?009, there was a 20 increase in the prevalence of obesity to 2010.6 Adiposity to some extent reflects the financial environment. A complex biological dysfunction may be regarded as an ecosystem health disorder (EHD). The diagnosis and management of weight disorders requires an appreciation of their ecological context and as EHDs. Thus, while indices of body composition disorder may be represented by anthropometric or instrumental measures (e.g. impedance, DEXA), these belie primary causality and various pathogeneses, with a range of possible personal and societal interventions.Author Manuscript Author Manuscript Author Manuscript Author ManuscriptAnn N Y Acad Sci. Author manu.