Does food import contribute to rising obesity in low- and middle-income countries?

Abstract

Several studies show a positive association between the rise of obesity in developing countries and globalization, trade, and food trade, but most do not account for reverse causality between the prevalence of obesity and trade flows. Moreover, most studies adopt broad definitions of trade and food trade, notwithstanding the main effects of trade on obesity may pass through import of specific foods. We address these concerns by empirically investigating the impact of food import on obesity in a sample of 116 developing countries (2000–2016) and by focusing, particularly, on processed and sugar-rich food. This is done by controlling for other globalization-related factors and by correcting the bias stemming from potential reverse causality through a two-step approach instrumenting obesity with the average height of adult population. One main robust conclusion emerges: it is neither economic and cultural globalization nor general food import, but rather the import of processed and sugar-rich food, which contributes to increase obesity.